Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Have cancer, you want a second opinion, or you recently
diagnosed with cancer, you need to search for a great
cancer doctor. Look no further than OHC the Cancer Specialist
eight eight eight six four ninety eight hundred online ohcare
dot com. Welcome back. It's been about a year to
the fifty five Carse Morning Show instudio or doctor Akash
mccerjee who is a blood cancer specialist. It is Blood
(00:20):
cancer Awareness month. We've got one of those. Doctor, good
to have you back in.
Speaker 2 (00:23):
Thank you so much Brian for having me over and.
Speaker 1 (00:25):
Of course near and dear to my heart. Lymphoma one
of the blood cancers. You're a specialist. And by way
of background, doctor mccerjee is a hematologist, medical oncologist, bone
marrow transplant specialist and cellular therapy expert. Interest areas of
interest CARTI cell therapy. We've talked about that before. Leukemia, lymphoma,
a plastic andemia. Clinical research. They've always got clinical trials
(00:47):
going on at OHC. Let's start with what's the difference
between lymphoma, which is what I've got, and leukemia, both
blood cancers.
Speaker 2 (00:55):
That's a great question, Brian, I mean lymphoma. Start off
by talking about that, I mean, it's the eighth most
common cancer in United States and every year roughly there
are eighty thousand to ninety thousand new cases. And lymphoma
is essentially a cancer of your lymphatic system, the immune system.
(01:16):
And you have lymphocytes which are a type of white
blood cell and their function is to get rid of
any type of foreign pathogens bacteria, virus, fungus. But because
of certain genomic mutation, abnormal chromosomal translocation, those lymphocytes they
start to divide in an abnormal, uncontrolled, excessive fashion, and
(01:37):
they start to cause lymphnot soiling, painless lymphnot soiling. It
can involve your liver spleen, can cause enlargement of the
liver spleen, and then it can even infiltrate the bone marrow,
causing low counts. So the most common type of lymphoma
which we see here in US is your non Hotchkin lymphoma,
(02:00):
about eighty ninety percent of the total lymphoma cases. And
then you have hot skin lymphoma, which is about ten
percent of those. And in non hatch Kin lymphoma, you
have the diffuse large piece cell lymphoma polycylolymphoma. Then you
have leukemia on the other hand, which is an entirely
distinct entity, and that's the cancer of your involving the
(02:23):
blood and the bone marrow. And you have white blood cells.
It could be mature, or it could be the precursor
of white blood cells, such as the blast cells or
the stem cells, and they start to divide, you know,
out of control, and they encroach your entire bone marrow,
leaving no room for healthier cells to grow. Sotastasizing right, correct, Yeah,
(02:46):
And essentially what happened is since your normal hematopoietic stem
cells or blood stem cells, since they are not dividing
and maturing the way they should be, and your marrow
is getting in filter with all these bad cells, the
lucamic cells, your counter start to drop low. So if
your white count, if it gets too high or too low,
(03:08):
you'll keep in mind those are just dysfunctional white blood cells.
Then your patient is more susceptible to recurrent infections of fever.
If your red blood cell count or the hemoglobin drops
too low, you are just out of breath and exhausted,
feeling fatigue all the time. And then the other cells
which get affected is the platelet and if they drop
(03:30):
too low then you are at increased RISCO bleeding. So
a lot of time your leukemia patient will present like that.
Now in US, in the adult population we primarily see
AML acute mallard leukemia, which is an aggressive blood cancer.
In pediatric population we primarily see ALL then, and that's
(03:53):
more of an immature white blood cell cancer. And on
the mature white blood cell group CLL chronic lymphosotic leukemia
as the one which is more common. But over the
last i will say two decades, the treatment landscape has
evolved dramatically and your cure rate and survival rates have
(04:15):
pretty much doubled. Wonderful, But you know, back in the
old days we used to rely on chemotherapy, and chemotherapy
still has a pretty important role. But with the advent
of immunotherapy, you have the BYTE therapy, the by specific
T cell engager, the targeted therapy, and the cart and
cellular therapy, and in certain group of patients the use
(04:38):
of a stem cell transplant or a bone marrow transplant.
Your and better supportive care. Your survivorship has gone up,
and you know, the field is only looking more and
more promising with all these new drugs coming up.
Speaker 1 (04:53):
I love that now. Is is like, for example, CARTI,
I always like to think of them as sort of
bespoke tree. You know, you're tailoring them to the specific patient.
It's not an off the shelf fill a prescription kind
of thing. Yet I am I still accurate on my
general understanding of that.
Speaker 2 (05:09):
Oh yeah, right. So essentially with CARTI, you are trying
to harness the patient don't immune cell and a lot
of time, you know, disease like leukemia lymphoma happen because
a patient is immune compromised or for whatever reason, they're
immune cells, primarily the T cells. They are not able
(05:30):
to identify and recognize the cancer cell and they cannot
kill those cells, so they are able to grow unchecked.
But if you can harness the patient lymphocyte or the
immune cell, genetically engineer them, target them with their receptor
which identifies the protein expressed on the cancer cell, you
(05:53):
can you know, infuse those cells back and kill the leukemia.
Speaker 1 (05:59):
Or training them to go after the cancer.
Speaker 2 (06:01):
Correct. Yeah, you are basically arming them with a better
gun so that they can kill the leukemia them. Pullman
put vision back into romas.
Speaker 1 (06:09):
Fair enough, uh, doctor mccrijee. I stumbled upon my cancer inadvertently.
It was some other completely unrelated medical condition I had,
which resulted in me getting a CT scan which confirmed
that no, there was nothing wrong with me. However, the
CT scan revealed that my lymph nodes had grown, and
that's when I started seeing you are the cancer doctors
(06:30):
at OHC. So that's my little path there. I didn't
know that. For example, I was experiencing night sweats at
the time. I never connected that with anything medically, never
even thought about it. It says, this is weird, I
started getting night sweats. But what are the symptoms people
should be looking for when it comes to blood cancers?
Are there parallel symptoms with lymphoma and leukemia? So what
(06:51):
are they? What should we be looking for?
Speaker 2 (06:53):
Excellent question, Brian. I think what people don't recognize is
with lukemi ye lymphoma. I mean, it's very common to
have painless sowling of the lymph node and along with
it you can also have b symptoms and what that
entail is you can start to have recurrent fever, you
(07:15):
can start to have drenching night sweats, and you know
a lot of time patients they dismiss them, or the
weather might be too hot, or I just have way
too many covers, or my hormones are off, or sometimes
you start to have unintentional weight loss. That means without
modifying your diet or without working out, you just start
(07:37):
losing weight.
Speaker 1 (07:38):
Yeah, I never got lucky that way. Always joke about that.
How come I never got the weight loss as a symptom.
I got cancer, damn it. I would like to have
the weight loss with it.
Speaker 2 (07:47):
A lot of patients sure tell about the same thing,
but hey, you don't want to lose weight by having
can but you know, so those are some of the
common symptoms. Besides that can have progressive fatigue. They feel
like they're just drained out at the end of the day.
They can have unusual bone pin shortness of breath with exertion.
(08:12):
They can have abnormal excessive bleeding, like when they're brushing
their teeth. They can be bleeding from their gums, itchy skin.
So yeah, I mean, if at any point you are
concerned that something just doesn't feel right, they should approach
their primary care and just a quest for a general
blood count. Just take complete blood count, and a lot
(08:33):
of time that's able to capture bulk off your blood cancers,
and just a simple lymph nor examination which only takes
like two minutes to do and checking for enlargest blean
and liver can assure the physician that you know you
are either okay or be into some kind of trouble.
Speaker 1 (08:52):
I suggest I suppose this suggests that's a good reason
for everyone to have at least have an annual physical
because they'll do blood work. Oh yeah, absolutely, okay, wonderful
advice on that one. Now, risk factors, let me guess
smoking is on the list. It's always on the list
for every cancer, right.
Speaker 2 (09:08):
Yeah, it's alcohol. You can always put them at the
risk for pretty much bulk of the cancer. Just being overweight,
you know, when you are obese, that has been shown
to be associated with you know, excessive sugar calorie intake
that can mess with your gut microbiome. When you eat
(09:29):
a low fiber diet a lot of processed food, it
can alter your gut microbiome. And these days we are
having a ton of data that how gut is biosis.
That means you have essentially gotten rid of the good
bacteria the gut and it's just overpopulated with bad bacteria
and that can somehow affect your immune functionality which entire
(09:53):
increase your risk of developing lymphoma or leukemia, or if
someone has autoimmune disease or they are on immune suppressive medication.
And sometimes you know, there are certain leukemia lymphoma which
we see more commonly in older age, and obviously you
know that's something which no one can avoid. But just
in general, having a more plant rich or plant based
(10:19):
died with a lot of fiber, making sure including a
lot of like your healthy gut microbiome based tie and
staying hydrated, working out for at least thirty to sixty
minutes every day. Just those are some of the things
which we can do on our end and.
Speaker 1 (10:38):
Get the sugar out of here.
Speaker 2 (10:40):
Oh yeah, absolutely, you want to get rid of the
sugar or have a avoid simple crops or processed crops
out of your diet.
Speaker 1 (10:49):
Doctor, I know you guys always have clinical trials going on.
It's one of the things OHG is known for. How
about clinical trials with regard to the blood cancers we're
talking about this morning?
Speaker 2 (10:57):
Oh yeah, so at OC we have more than ten
different clinical trial just for these two types of cancers. Leukemia, lymphoma,
and then we have a whole bunch of clinical trials
for other blood cancer like multiple maloma MDS and where
we essentially try new medication along with the standard of
(11:19):
care treatment, and there are some clinical trials which are
first in human trial. OC was the first place in
Greater Cincinnati area to offer CARTI, the chrimeric cantigen receptor
de cell therapy for relapse or fractory lymphoma, so we
are always at the forefront with a clinical trial as
(11:40):
well as celuver therapy or immunotherapy, and our clinical trials
are crucial to our fighting these blood cancers and providing
our patient with better outcomes and longer romation.
Speaker 1 (11:53):
Doctor Coosh mccargye one of the outstanding doctors at OHC.
To reach OHC, either initially because you've just found out
about it, or to get a second opinion, the number
is eight eight eight sixty four ninety eight hundred eighty
eight six four ninety eight hundred again online at ohcare
dot com. Very positive information as always from the folks
at OHC. Doctor, It's been a pleasure talking with you.
(12:14):
I'm excited about the developments in the specifically the lymphoma
area selfish me, but at least I know I'm in
fantastic hands with the care I'm getting at OHC, and
I know my listeners will be as well. Keep up
the great work, doctor,
Have cancer, you want a second opinion, or you recently
diagnosed with cancer, you need to search for a great
cancer doctor. Look no further than OHC the Cancer Specialist
eight eight eight six four ninety eight hundred online ohcare
dot com. Welcome back. It's been about a year to
the fifty five Carse Morning Show instudio or doctor Akash
mccerjee who is a blood cancer specialist. It is Blood
(00:20):
cancer Awareness month. We've got one of those. Doctor, good
to have you back in.
Speaker 2 (00:23):
Thank you so much Brian for having me over and.
Speaker 1 (00:25):
Of course near and dear to my heart. Lymphoma one
of the blood cancers. You're a specialist. And by way
of background, doctor mccerjee is a hematologist, medical oncologist, bone
marrow transplant specialist and cellular therapy expert. Interest areas of
interest CARTI cell therapy. We've talked about that before. Leukemia, lymphoma,
a plastic andemia. Clinical research. They've always got clinical trials
(00:47):
going on at OHC. Let's start with what's the difference
between lymphoma, which is what I've got, and leukemia, both
blood cancers.
Speaker 2 (00:55):
That's a great question, Brian, I mean lymphoma. Start off
by talking about that, I mean, it's the eighth most
common cancer in United States and every year roughly there
are eighty thousand to ninety thousand new cases. And lymphoma
is essentially a cancer of your lymphatic system, the immune system.
(01:16):
And you have lymphocytes which are a type of white
blood cell and their function is to get rid of
any type of foreign pathogens bacteria, virus, fungus. But because
of certain genomic mutation, abnormal chromosomal translocation, those lymphocytes they
start to divide in an abnormal, uncontrolled, excessive fashion, and
(01:37):
they start to cause lymphnot soiling, painless lymphnot soiling. It
can involve your liver spleen, can cause enlargement of the
liver spleen, and then it can even infiltrate the bone marrow,
causing low counts. So the most common type of lymphoma
which we see here in US is your non Hotchkin lymphoma,
(02:00):
about eighty ninety percent of the total lymphoma cases. And
then you have hot skin lymphoma, which is about ten
percent of those. And in non hatch Kin lymphoma, you
have the diffuse large piece cell lymphoma polycylolymphoma. Then you
have leukemia on the other hand, which is an entirely
distinct entity, and that's the cancer of your involving the
(02:23):
blood and the bone marrow. And you have white blood cells.
It could be mature, or it could be the precursor
of white blood cells, such as the blast cells or
the stem cells, and they start to divide, you know,
out of control, and they encroach your entire bone marrow,
leaving no room for healthier cells to grow. Sotastasizing right, correct, Yeah,
(02:46):
And essentially what happened is since your normal hematopoietic stem
cells or blood stem cells, since they are not dividing
and maturing the way they should be, and your marrow
is getting in filter with all these bad cells, the
lucamic cells, your counter start to drop low. So if
your white count, if it gets too high or too low,
(03:08):
you'll keep in mind those are just dysfunctional white blood cells.
Then your patient is more susceptible to recurrent infections of fever.
If your red blood cell count or the hemoglobin drops
too low, you are just out of breath and exhausted,
feeling fatigue all the time. And then the other cells
which get affected is the platelet and if they drop
(03:30):
too low then you are at increased RISCO bleeding. So
a lot of time your leukemia patient will present like that.
Now in US, in the adult population we primarily see
AML acute mallard leukemia, which is an aggressive blood cancer.
In pediatric population we primarily see ALL then, and that's
(03:53):
more of an immature white blood cell cancer. And on
the mature white blood cell group CLL chronic lymphosotic leukemia
as the one which is more common. But over the
last i will say two decades, the treatment landscape has
evolved dramatically and your cure rate and survival rates have
(04:15):
pretty much doubled. Wonderful, But you know, back in the
old days we used to rely on chemotherapy, and chemotherapy
still has a pretty important role. But with the advent
of immunotherapy, you have the BYTE therapy, the by specific
T cell engager, the targeted therapy, and the cart and
cellular therapy, and in certain group of patients the use
(04:38):
of a stem cell transplant or a bone marrow transplant.
Your and better supportive care. Your survivorship has gone up,
and you know, the field is only looking more and
more promising with all these new drugs coming up.
Speaker 1 (04:53):
I love that now. Is is like, for example, CARTI,
I always like to think of them as sort of
bespoke tree. You know, you're tailoring them to the specific patient.
It's not an off the shelf fill a prescription kind
of thing. Yet I am I still accurate on my
general understanding of that.
Speaker 2 (05:09):
Oh yeah, right. So essentially with CARTI, you are trying
to harness the patient don't immune cell and a lot
of time, you know, disease like leukemia lymphoma happen because
a patient is immune compromised or for whatever reason, they're
immune cells, primarily the T cells. They are not able
(05:30):
to identify and recognize the cancer cell and they cannot
kill those cells, so they are able to grow unchecked.
But if you can harness the patient lymphocyte or the
immune cell, genetically engineer them, target them with their receptor
which identifies the protein expressed on the cancer cell, you
(05:53):
can you know, infuse those cells back and kill the leukemia.
Speaker 1 (05:59):
Or training them to go after the cancer.
Speaker 2 (06:01):
Correct. Yeah, you are basically arming them with a better
gun so that they can kill the leukemia them. Pullman
put vision back into romas.
Speaker 1 (06:09):
Fair enough, uh, doctor mccrijee. I stumbled upon my cancer inadvertently.
It was some other completely unrelated medical condition I had,
which resulted in me getting a CT scan which confirmed
that no, there was nothing wrong with me. However, the
CT scan revealed that my lymph nodes had grown, and
that's when I started seeing you are the cancer doctors
(06:30):
at OHC. So that's my little path there. I didn't
know that. For example, I was experiencing night sweats at
the time. I never connected that with anything medically, never
even thought about it. It says, this is weird, I
started getting night sweats. But what are the symptoms people
should be looking for when it comes to blood cancers?
Are there parallel symptoms with lymphoma and leukemia? So what
(06:51):
are they? What should we be looking for?
Speaker 2 (06:53):
Excellent question, Brian. I think what people don't recognize is
with lukemi ye lymphoma. I mean, it's very common to
have painless sowling of the lymph node and along with
it you can also have b symptoms and what that
entail is you can start to have recurrent fever, you
(07:15):
can start to have drenching night sweats, and you know
a lot of time patients they dismiss them, or the
weather might be too hot, or I just have way
too many covers, or my hormones are off, or sometimes
you start to have unintentional weight loss. That means without
modifying your diet or without working out, you just start
(07:37):
losing weight.
Speaker 1 (07:38):
Yeah, I never got lucky that way. Always joke about that.
How come I never got the weight loss as a symptom.
I got cancer, damn it. I would like to have
the weight loss with it.
Speaker 2 (07:47):
A lot of patients sure tell about the same thing,
but hey, you don't want to lose weight by having
can but you know, so those are some of the
common symptoms. Besides that can have progressive fatigue. They feel
like they're just drained out at the end of the day.
They can have unusual bone pin shortness of breath with exertion.
(08:12):
They can have abnormal excessive bleeding, like when they're brushing
their teeth. They can be bleeding from their gums, itchy skin.
So yeah, I mean, if at any point you are
concerned that something just doesn't feel right, they should approach
their primary care and just a quest for a general
blood count. Just take complete blood count, and a lot
(08:33):
of time that's able to capture bulk off your blood cancers,
and just a simple lymph nor examination which only takes
like two minutes to do and checking for enlargest blean
and liver can assure the physician that you know you
are either okay or be into some kind of trouble.
Speaker 1 (08:52):
I suggest I suppose this suggests that's a good reason
for everyone to have at least have an annual physical
because they'll do blood work. Oh yeah, absolutely, okay, wonderful
advice on that one. Now, risk factors, let me guess
smoking is on the list. It's always on the list
for every cancer, right.
Speaker 2 (09:08):
Yeah, it's alcohol. You can always put them at the
risk for pretty much bulk of the cancer. Just being overweight,
you know, when you are obese, that has been shown
to be associated with you know, excessive sugar calorie intake
that can mess with your gut microbiome. When you eat
(09:29):
a low fiber diet a lot of processed food, it
can alter your gut microbiome. And these days we are
having a ton of data that how gut is biosis.
That means you have essentially gotten rid of the good
bacteria the gut and it's just overpopulated with bad bacteria
and that can somehow affect your immune functionality which entire
(09:53):
increase your risk of developing lymphoma or leukemia, or if
someone has autoimmune disease or they are on immune suppressive medication.
And sometimes you know, there are certain leukemia lymphoma which
we see more commonly in older age, and obviously you
know that's something which no one can avoid. But just
in general, having a more plant rich or plant based
(10:19):
died with a lot of fiber, making sure including a
lot of like your healthy gut microbiome based tie and
staying hydrated, working out for at least thirty to sixty
minutes every day. Just those are some of the things
which we can do on our end and.
Speaker 1 (10:38):
Get the sugar out of here.
Speaker 2 (10:40):
Oh yeah, absolutely, you want to get rid of the
sugar or have a avoid simple crops or processed crops
out of your diet.
Speaker 1 (10:49):
Doctor, I know you guys always have clinical trials going on.
It's one of the things OHG is known for. How
about clinical trials with regard to the blood cancers we're
talking about this morning?
Speaker 2 (10:57):
Oh yeah, so at OC we have more than ten
different clinical trial just for these two types of cancers. Leukemia, lymphoma,
and then we have a whole bunch of clinical trials
for other blood cancer like multiple maloma MDS and where
we essentially try new medication along with the standard of
(11:19):
care treatment, and there are some clinical trials which are
first in human trial. OC was the first place in
Greater Cincinnati area to offer CARTI, the chrimeric cantigen receptor
de cell therapy for relapse or fractory lymphoma, so we
are always at the forefront with a clinical trial as
(11:40):
well as celuver therapy or immunotherapy, and our clinical trials
are crucial to our fighting these blood cancers and providing
our patient with better outcomes and longer romation.
Speaker 1 (11:53):
Doctor Coosh mccargye one of the outstanding doctors at OHC.
To reach OHC, either initially because you've just found out
about it, or to get a second opinion, the number
is eight eight eight sixty four ninety eight hundred eighty
eight six four ninety eight hundred again online at ohcare
dot com. Very positive information as always from the folks
at OHC. Doctor, It's been a pleasure talking with you.
(12:14):
I'm excited about the developments in the specifically the lymphoma
area selfish me, but at least I know I'm in
fantastic hands with the care I'm getting at OHC, and
I know my listeners will be as well. Keep up
the great work, doctor,
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