Cancer Screening And Recurrence: Why 'Wait And Watch' Is the Worst Decision You Can Make

Part 2 of 3 Series - Why “wait and watch” misses early recurrence—and how blood tests can catch it sooner or stop recurrence 

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Episode Description:

🔬 What You’ll Learn In This Video:

• Why cancer treatment often starts in the wrong order 
•  The role of genomics and biomarker testing in treatment decisions 
•  Why targeted therapy and immunotherapy may be more effective early 
•  How chemotherapy is often overused upfront 
•  Why some treatments have no chance of working for certain patients 
•  The problem with matching drugs to cancer type instead of mutations 
•  How better sequencing can improve outcomes and reduce side effects 
•  Why early decisions in cancer care matter most 

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Inquiries: 

info@elevatingcancertreatment.com

https://elevatingcancertreatment.com

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Disclaimer:
The information provided in this podcast is for educational and informational purposes only, and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard or read in this podcast or on this channel.
Reliance on any information provided by Dr. Jay Chaplin or Elevating Cancer Treatment is solely at your own risk. Dr. Jay Chaplin is a scientist and drug developer, not a medical doctor providing patient care. The content presented here reflects general scientific understanding and research, and may not be applicable to your individual health circumstances. Individual medical conditions and treatments vary, and no two situations are exactly alike.
Always consult with your personal healthcare provider before making any decisions about your health or treatment plan.

Transcript

SPEAKER_01 0:00

Don't do the dumb thing. No! Pharmaceutical companies, here's an option to not do the dumb thing. And early detection. That's the other piece. We are getting better at early detection, and fortunately, more and more options are coming up that do not require invasive procedures. So, blood biomarkers, they're great. We use those for monitoring for cancer now. We could be using those more often for screening for cancer. We have them for breast cancer, we have them for multiple other cancers. We don't really use them that way. Really, the only one that we use is a blood-based biomarker for screening for cancer is PSA. There's no reason why we can't use other blood-based diagnostic markers. If you're gonna go in and get a blood sample taken when you go into the doctor for your physical, we may as well use that to screen for cancer at the same time.

SPEAKER_00 0:45

That's really cool. I didn't know that. What about after treatment? Because I know that a lot of folks can't get any help until they have another recurrence. Instead of helping them along the way, helping you along the way to make sure that it doesn't come back. So if you could change it however you wanted, how would you change it for those folks who have completed treatment? What would be different?

SPEAKER_01 1:06

You're really making me struggle to stay positive here.

SPEAKER_00 1:09

I like to challenge you. Always.

SPEAKER_01 1:13

Hello, and welcome to Elevating Cancer Treatment, where we explain the science and debunk myths to help you navigate your health journey. My background is a little different. Beyond educating about cancer, I'm actually designing new drugs that are defining the future of oncology. This direct hands-on experience offers me a very different perspective of how these cancer treatments work on the body, interact with the cancer cells, and cause side effects. And these are insights that I'm excited to share with you. If that sounds interesting, make sure to like this video, subscribe to the channel, and hit that notification bell so you never miss an update. And please share it if you find it useful. I'm Dr. Jay Chaplin. An important reminder, I'm a PhD, not an MD. The information in this video is education and it's not medical advice. Every cancer is unique and no general information applies to everyone. Please remember that. Always consult with your healthcare provider for guidance on your specific situation. And two quick things. First, as a thank you for being here, I've created a free resource, 10 things to elevate your chemo journey, which you can download from the link below. And second, by signing up, you'll also get updates on that innovative cancer treatment I'm working on. I'm confident it represents a significant advancement in immunotherapy. So please take a moment, download your free guide, and join us in shaping the future of cancer treatment. So one of the things that I hear pretty frequently from folks who have finished treatment is that once they are stable disease or no evidence of disease, that their oncologist will say, Okay, we're in wait and watch. We will do a CT scan every nine months. Good luck. And that is You're being very generous. He's using his words carefully. That is not the best way to do it. For many cancers, not all, but for many cancers, again, there are these blood-based biomarkers, where with a small blood sample, you can send it off. Even if your hospital doesn't run them themselves, many of the common ones are done through Lab Core. Your blood sample can be sent off to Lab Core, it can be processed for that. And you can watch for those cancer biomarkers. And in most cases, it doesn't matter what the number is, it matters what the trend is. And you can plot over time, if you are post-treatment, you can plot over time what the trend in those numbers are. If it's flat over time, or if it goes down over time, these are good, excellent. If it starts to come up, that's what we call a biochemical recurrence. You may not be able to see a tumor yet. There may not be a detectable tumor yet. Tumors have to be of a decent size to show up on CT scans and MRIs. You need a contrast difference. The tumor has to be a different density and big enough to see in order for it to show up on those scans. You really want to catch and treat cancer before it gets to that state. And the biochemical tests, the blood tests, allow you to detect that very early, even before a CT scan or MRI can pick them up, or even a PET scan. So if that were integrated as a part of post-treatment cancer care for everyone, and this is available, at least in the US, for everyone, then you can follow this, catch cancer recurrences very early, and treat very early. That would be great. Wait and watch until you have symptoms and something big enough to show up on a CT scan. No, that's waiting too late. That's waiting until after the accident to put your seatbelt on. Not smart. Does that answer the question?

SPEAKER_00 4:38

Yeah, yeah. And this is something that you can actually get? You can but does your doctor have to approve it?

SPEAKER_01 4:45

Your doctor has to approve it, but most insurances will if you're post-treatment, almost all insurances will cover it, but your doctor has to ask for it. So you have to know that it exists to ask your doctor for it in order to get it approved by insurance and have it be part of your standard panel. But again, you know, even if it's once a year, once a year is better than waiting for a tumor to show up.

unknown 5:05

Yeah.

SPEAKER_00 5:05

I had one other thing I was thinking about.

SPEAKER_01 5:08

Yes. I make everybody on.

SPEAKER_00 5:10

So you have changes for early detection, more early detection, better early detection.

SPEAKER_01 5:16

Well, and honestly, the biggest problem with early detection, primary detection, is that people don't get it. If your choices are a colonoscopy, then most people defer those. If your choices are running a blood panel with the sample that you already give every year for your physical, then that's easier. There are obviously other things of value for a colonoscopy. If they detect something, they can get rid of it right then. But if we can push detection earlier and earlier, we can get early stage treatment of more of these cancers. And honestly, today, one of the biggest issues that we have in cancer treatment isn't the treatment, it's the early detection. Our cure rates for early detection are pretty darn good. But if it's not found until it's stage four, it's much harder to treat. If it is an early stage localized cancer, if it's detected early, we can do great things. If we detect it late, it's a lot harder. So it's to everyone's benefit to do cheap blood work tests earlier and on a regular basis and get that baseline and see if it shifts. And if it shifts, then go to more invasive screening methods to try and figure out what the heck is going on and from where. But it should be easier to get patient adoption of these things. If screening becomes easier and integrated with what we already do, makes the barrier to doing it smaller.

SPEAKER_00 6:40

Yeah. So my last question for you, since you I'm inherently suspicious. So you got early stage I'm I keep trying to summarize, but it's like so early stage early detection, biomarker and genomics.

SPEAKER_01 6:54

Biomarker and genomics. Move targeted therapies and immunotherapies up first. Yep. End with chemotherapy and irradiation. Once you're at no evidence of disease or stable, continue to do blood-based biomarkers and look for the trend to do early detection of recurrence and treat recurrences as early as possible. Instead of waiting until they've developed and show up on scans.

SPEAKER_00 7:16

Okay.

SPEAKER_01 7:16

Because that's the same thing. And then is there anything late? Don't do that. That's late.

SPEAKER_00 7:20

Don't do that. So with all of this new vision, right, of what snap, it's in place, that's very cool. And the cool thing is, is that you still have been able to work with clients and sometimes have been able to switch around timing of things and have people get their biomarker tests earlier and be able to advocate on their behalf, or I should say, helping them to advocate.

SPEAKER_01 7:48

By giving them the right questions to ask and helping them educate their oncologists. Unfortunately, a lot of it really does come down to the oncologist. If they're open to that, then it works better and it works easier. If they're not, it can be a long road.

SPEAKER_00 8:02

But you have actually, I mean, we just don't want to feel left with little it's sad that we don't we have to wait for all of these things to come into place and we have had success there.

SPEAKER_01 8:11

I wish it was more, and we have had success there.

SPEAKER_00 8:13

Yeah. However, it is nice to at least know that there are folks within the system that have been willing to work with you and get help with the process to make it possible. That's pretty cool. It actually does give some hope that it's possible. But hold this vision with us. Or else. Because it's a cool, it's a cool vision to have. That things would go in a more natural order and be more focused earlier on and more tailored to the individual's specific, unique cancer treatment journey. That's really what it comes down to.

SPEAKER_01 8:50

Right. Well, and in order of efficacy. Start with the things that work the best and have the fewest side effects, the best chance of creating a cure, and if necessary, keep moving down to the less specific, more general, harsher ones. Start with the best, move to the worst if you have to. Don't start with the worst and then gradually work your way up to the best. That makes no sense.

SPEAKER_00 9:15

How did these things get changed? That was my final, final, funnel, funnel, final, final, final question. How would we even get involved to be able to? Does anybody know?

SPEAKER_01 9:25

How do we go about changing for those of you who have investments or connections to pharmaceutical companies, to regulators, keep posing the question and keep applying pressure to shift the way that drug trials are done. Drug trials are currently done in a way that minimizes risks and minimizes costs for pharmaceutical companies and makes it as easy as possible to interpret the data for the FDA. But that's not what's good for patients. That's not what's good for cancer treatment. And in the long run, that's not even what's good for the pharmaceutical companies. So keep applying pressure through whatever avenues you have, and maybe just start making comments about this on social media so awareness starts coming up that clinical trials can and should be done for the way the drug works, not the particular kind of cancer that you're testing in. Open that up, do a broader clinical trial. It's a little more risky on the front end, but if they make it, it's massively better for patients and it's massively better for the pharmaceutical companies. Because then instead of selling to only people with glioma with this mutation, they get to sell to anybody with that mutation. Their market is way bigger, and your options as a patient are way bigger. It's a win-win for everybody. It's just they're hedging their bets at the early phase, and that clamps everything down for everyone later. Just remind the world that it can be different. And this is the way to make it different. Do the trials right in the first place. I am an opinionated person. Person. Good catch. I never used this because certain people did not like this as a tagline, but I had initially wanted to have a tagline for these of don't do the dumb thing. No. Pharmaceutical companies, here's an option to not do the dumb thing. I can understand why your oncologist does not want to do a genomics test. Because if they have to do chemotherapy first and they don't understand that a genomics test can guide chemotherapy too, then they don't see any value in it. If they have to do chemotherapy first and can only do targeted therapy later, then why do a genomics test early? But as more targeted therapies move into first line treatment, the value of that genomics test becomes easier and easier to see. Somebody has to make the first move. And the group that has the biggest benefit is the pharmaceutical companies because if you move those targeted therapies to first line and you make them based on the biomarker, not on the tissue the cancer arose from, your market gets bigger, you sell more drug, and you make more money. Just do it.

SPEAKER_00 12:06

Well, and the other thing I think is education. Educating, there needs to be a better system for educating the oncologists on what is the latest information because I just don't think that they have the time or the bandwidth to be able to keep up on all of the latest developments. And also understanding how they guide that person's individual treatment. I'm just the I2 person.

SPEAKER_01 12:30

So there's more to it than that because I don't want to make it sound like oncologists are lazy or don't care about keeping up. And there is a world of difference between them going to a conference like ASCO or going to continuing education classes to find out about new cancer drugs, versus actually having the time to think about the systems that are used for the testing and recommendation and prescription of these drugs. If you don't update your mindset, a new piece of information slots into the same framework that you've always had. And the way that oncologists have been trained is you do chemotherapy first because that's first line, and later on you do targeted therapies, even though that's backwards for what's actually of most value. It's not a matter of having more information, it's a matter of changing the mind frame about where the value is. Because the value proposition for cancer treatment has changed drastically in the last 20 years. It has flip-flopped. And if the textbooks are old and the instructors are coming from the old model, what people are being educated on and what they're carrying forward is the old model. And that old model is you start with chemo because that works for everything, but it works poorly for everything. The targeted therapies work better. Start with those first. Wait, is this a final, final, final, final question?

SPEAKER_00 13:50

That was a comment. That wasn't a comment. Sounded like a question. It wasn't a question. It was only a comment.

SPEAKER_01 13:55

You're too cute. You're cute.

SPEAKER_00 13:58

I have no idea how I'm gonna edit this.

SPEAKER_01 14:00

Beyond these videos, if you need more personalized guidance or a deeper dive into specific treatments to have your treatment be as effective as possible, I offer one-on-one sessions and medical advocacy. You can find information on our website, which is linked down below. Again, if you found this video informative, please give it a thumbs up, click the notification bell, and subscribe to our channel for more science-based cancer insights.