Steve Brown is a genuine digital health OG. Starting with video games for kids with diabetes he eventually turned Health Hero into one of the first disease management companies. It was used in the VA to manage patients at home with CHF, diabetes and more and eventually sold to Bosch. Steve left health care for 15 years, but then at the start of this year had his own health issue. Which turned out to be cancer. He turned to AI and has built an amazing early stage patient facing AI doctor, called CureWise. It essentially has turned LLMs into multiple doctors. He gave me a full and fascinating demo. This is clearly the future but it’s also the present for Steve who is patient zero and the first user as well as the CEO. Amazing stuff. — Matthew Holt
Dr Kimmie Ng discusses young onset colorectal cancer
Dr Kimmie Ng discusses cancer with Dr. George Beauregard. Dr Ng heads the Young-Onset Colorectal Cancer Center, at the legendary Dana Farber Cancer Institute, and she treated George’s son who died age 32. Why are these cancers in younger people increasing so quickly? What can we do about it? What is connecting the environment, the immune system, mental health and cancer? What kind of early intervention can we advocate for? A fascinating conversation between two real leaders in this field.
Between Hope and Grief: A Medical Memoir of Father, Son, and Family
By GEORGE BEAUREGARD
This piece is different from the typical “health-care industry” topics covered in this forum.
My Sunday morning routine usually involves getting a cup of coffee and downloading the most recent editions of magazines on my iPad.
The cover of the February 13 edition of Time magazine immediately caught my attention because the title read “OUR CANCER MYSTERY. WHY IT’S NOW STRIKING US SO YOUNG’’. Four people are on the cover: their names, cancer types, and age at diagnosis displayed. 18 to 40. I imagine that the majority of readers might describe their expressions as neutral and composed, their posture calm.
But I see what exists below the restrained surfaces. Something I am all too familiar with. Disbelief. Worry, Bewilderment. Uncertainty. Sadness.
Although overdue, a major news magazine had finally put it out there, front and center. A call to action.
On September 14, 2017, I was standing in a hospital room in Boston, when my previously healthy son, Patrick, then 29, received the shocking news that he probably had stage 4 colorectal cancer, which further tests confirmed. That grave diagnosis came with a bleak 14 percent relative 5-year survival rate. Like the cognitive simulation of Schrödinger’s cat, my beloved son’s life now lay in a sealed box, with a hammer hovering over a flask of toxin. Would it fall, smash the vial, and kill my son? I could only be an observer. I desperately wanted to be the one in the box instead of him.
Fatherhood and medicine are integral to my identity. Throughout the three years during which he received superb care at Dana Farber Cancer Institute, in Boston, I had to be his father first, offering emotional support with love and hope. The physician adviser part was a secondary role.
Despite his indomitable spirit, positivity and best efforts, Patrick took his last breath on September 6, 2020, in his childhood home, Although relieved that his suffering was over, I was caught in immense sorrow, not yet realizing that eventually acceptance would slowly weave itself through the grief, and I would gain a nuanced understanding of “before and after.’’
As I mentioned in my 12/6/2024 piece in this forum, I hadn’t thought very much about early-onset cancer during many of the years that I was in clinical practice and as a physician executive.( I had categorized my experience with bladder cancer at 49 as an anomaly.) But that has changed in the past few years, during which the rising incidence of cancer in younger adults has been, first, in the scientific and medical literature and then sporadically in the broad national news, especially since the summer of 2023. But millions of people still have no idea that this is happening.
Writing is how I express myself best, so in early 2020, I started writing to help myself navigate what was happening to Patrick. As the global phenomenon of early-onset cancers expanded, I felt compelled to tell my son’s inspirational story and raise awareness of early-onset cancer and the need to dramatically expand screening for it. Over three years, I wrote a book titled RESERVATIONS for NINE: A DOCTOR’S FAMILY CONFRONTS CANCER, published earlier this month and timed to CRC Awareness Month. A labor of love and grief, it’s a book about family, love, loss, science and spirituality. Craig Melvin, NBC’s TODAY Show co-anchor, graciously wrote the foreword. Three months after my son passed away, Craig lost his 43-year-old brother to the same disease.
Many books have been written about cancer. From a patient undergoing treatment, to a family member or other caregiver, to a doctor treating a patient, to a researcher looking to change the trajectory of those being diagnosed and treated. But this one is unique. Part memoir and tribute, interspersed with journal entries by my son and others in my family. Part medical saga, the book aims to educate the public about the dangerous global rise in early-onset cancers, and to help provide a roadmap by example of loved ones going through cancer battles, and a call to action to the medical community to get ahead of this crisis.
My son’s life shouldn’t be defined by cancer, but, rather, how he responded to it. Most inspirational was how he became a strong public advocate of screening and funding for cancer research.
I hope that readers of THCB can find the time to share the messages of this book with family, friends and colleagues.
Thank you, Matthew and THCB for providing this forum to present my story.
My website is https://www.georgebeauregard.com and you can buy the book there or on Amazon. My appearance on the Today show is here.
George Beauregard, DO is an Internal Medicine physician whose experience includes 20+ years of clinical practice as well as leading organizations strategic and clinical initiatives
Patients are Not “Consumers”: My Cancer Story
By JEFF GOLDSMITH
On Christmas Eve 2014, I received a present of some profoundly unwelcome news: a 64 slice CT scan confirming not only the presence of a malignant tumor in my neck, but also a fluid filled mass the size of a man’s finger in my chest cavity outside the lungs. Two days earlier, my ENT surgeon in Charlottesville, Paige Powers, had performed a fine needle aspiration of a suspicious almond-shaped enlarged lymph node, and the lab returned a verdict of “metastatic squamous cell carcinoma of the head and neck with an occult primary tumor”.
I had worked in healthcare for nearly forty years when cancer struck, and considered myself an “expert” in how the health system worked. My experience fundamentally changed my view of how health care is delivered, from the patient’s point of view. Many have compared their fight against cancer as a “battle”. Mine didn’t feel like a battle so much as a chess match where the deadly opponent had begun playing many months before I was aware that he was my adversary. The remarkable image from Ingmar Bergman’s Seventh Seal sums up how this felt to me.
The CT scan was the second step in determining how many moves he had made, and in narrowing the uncertainty about my possible counter moves. The scan’s results were the darkest moment: if the mysterious fluid filled mass was the primary tumor, my options had already dangerously narrowed. Owing to holiday imaging schedules, it was not until New Years’ Eve, seven interminable days later, that a PET/CT scan dismissed the chest mass as a benign fluid-filled cyst. I would require an endoscopy to locate the still hidden primary tumor somewhere in my throat.
I decided to seek a second opinion at my alma mater, the University of Chicago, where I did my doctoral work and subsequently worked in medical center administration.
The University of Chicago had a superb head and neck cancer team headed by Dr. Everett Vokes, Chair of Medicine, whose aggressive chemotherapy saved the life and career of Chicago’s brilliant young chef, Grant Achatz of Alinea, in 2007.
If surgery was not possible, Chicago’s cancer team had a rich and powerful repertoire of non-surgical therapies. I was very impressed both with their young team, and how collaborative their approach was to my problem. Vokes’ initial instinct that mine was a surgical case proved accurate.
The young ENT surgeon I saw there in an initial consultation, Dr. Alex Langerman performed a quick endoscopy and thought he spotted a potential primary tumor nestled up against my larynx. Alex asked me to come back for a full-blown exploration under general anaesthesia, which I did a week later. The possible threat to my voice, which could have ended my career, convinced me to return to Chicago for therapy. Alex’s endoscopy found a tumor the size of a chickpea at the base of my tongue. Surgery was scheduled a week later in the U of Chicago’s beautiful new hospital, the Center for Care and Discovery.
This surgery was performed on Feb 2, 2015, by a team of clinicians none of whom was over the age of forty. It was not minor surgery, requiring nearly six hours: resections of both sides of my neck, including the dark almond and a host of neighboring lymph nodes. And then, there was robotic surgery that removed a nearly golf ball-sized piece of the base of my tongue and throat. The closure of this wound remodeled my throat.
I arrived in my hospital room late that day with the remarkable ability to converse in my normal voice.
Continue reading…Interview: Sarah MacDonald, Author, The Cancer Channel
by MATTHEW HOLT
I met Sarah MacDonald in the early 2000s. She is the ultimate extrovert who sings, cooks, maintains a huge circle of friends, and lives life to the fullest–all at a pace & level most of us can’t imagine. In the early 2010s Sarah was flying high. Newly married, trying to get pregnant, all while being a Silicon valley business exec who had increasingly senior roles at eBay. Then in 2012 she was diagnosed with two completely separate types of cancer. And in her head “The Cancer Channel” started playing nonstop.
That became the title of her book. I just read it and I literally couldn’t stop. It’s practical, it’s heart-wrenching, it’s warm, it’s funny (yes, funny!). And it’s an amazing look at the exact experience of someone going through cancer. Or in this case cancer x 2. I was lucky enough to interview Sarah (so there is a very happy ending). So please watch this and buy & read the book
About That Cancer Moonshot
BY KIM BELLARD
Joe Biden hates cancer. He led the Cancer Moonshot in the Obama Administration, and, as President, he reignited it, vowing to cut death rates in half over the next 25 years. Last month, on the 60th anniversary of President Kennedy’s historic call for an actual moonshot, he vowed “to end cancer as we know it. And even cure cancers once and for all.”
But, as several recent studies show, cancer is still surprising us.
Continue reading…THCB Gang Episode 90, Thursday May 5 – Cancer Special
#THCBGang on May 5 was an extraordinary special on cancer & navigation. Everyone on this gang has been touched by cancer as a patient or caregiver.
Joining Matthew Holt (@boltyboy) will be fierce patient activist Casey Quinlan (@MightyCasey); Jennifer Benz (@Jenbenz); Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune); patient advocate Grace Cordovano (@GraceCordovano); policy consultant/author Rosemarie Day (@Rosemarie_Day1); Jeff Goldsmith; Jennifer Benz (@Jenbenz); PLUS Adam Pellegini (@adampellegrini) from cancer navigation company Jasper Health. It really was a great conversation about what to do (and what is being done) to make the experience better for people with cancer and those that love them.
You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.
New Cancer Care Navigator Thyme Care Starts Out with $22M Series A & Big Name Backing
By JESSICA DaMASSA, WTF HEALTH
Thyme Care is a cancer navigation platform that is looking to use technology to make the kind of high-touch care coordination usually only found at Centers of Excellence available to oncology practices across the country. The navigation we’re talking about is typically quarterbacked by experienced oncology nurse navigators, and is known to have a direct impact on a patient’s experience and their health outcomes. Thyme Care’s platform not only scale-ups this expertise, but also augments it with analysis of claims data and EMR data to help those navigators quickly detect which patients might be at higher risk for poor outcomes and which interventions might help mitigate those risks – whether that be addressing social determinants of health issues like transportation to appointments, or just more quickly spotting gaps in care.
Thyme Care’s President & Chief Medical Officer Bobby Green (an oncologist himself) introduces us to the tech platform and explains how, among a competitive field of tech-enabled care navigators, it’s managed to stand apart enough to win Medicare Advantage plan Clover Health as an early client and to gain a $22 million dollar Series A investment from platform-savvy investors like Andreessen Horowitz and AlleyCorp. (Frist Cressey Ventures, Casdin Capital and Bessemer also participated in the round, which was announced in October 2021.)
As the business looks to scale, what’s to make of all its connections to Flatiron Health, arguably health tech’s best-known cancer care platform? Lots of alumni on the cap table and in the biz, including Bobby himself! Find out more about expansion plans and points of differentiation in this quick get-to-know-you chat.
Our Cancer Support Group On Facebook Is Trapped
Our Experience on Facebook Offers Important Insight Into Mark Zuckerberg’s Future Vision For Meaningful Groups
By ANDREA DOWNING
Seven years ago, I was utterly alone and seeking support as I navigated a scary health experience. I had a secret: I was struggling with the prospect of making life-changing decisions after testing positive for a BRCA mutation. I am a Previvor. This was an isolating and difficult experience, but it turned out that I wasn’t alone. I searched online for others like me, and was incredibly thankful that I found a caring community of women who could help me through the painful decisions that I faced.
As I found these women through a Closed Facebook Group, I began to understand that we had a shared identity. I began to find a voice, and understand how my own story fit into a bigger picture in health care and research. Over time, this incredible support group became an important part of my own healing process.
This group was founded by my friends Karen and Teri, and has a truly incredible story. With support from my friends in this group of other cancer previvors and survivors I have found ways to face the decisions and fear that I needed to work through.
Financial Toxicity is Hurting my Cancer Patients
By LEILA ALI-AKBARIAN MD, MPH
As news of Tom Brokaw’s cancer diagnosis spreads, so does his revelation that his cancer treatments cost nearly $10,000 per day. In spite of this devastating diagnosis, Mr. Brokaw is not taking his financial privilege for granted. He is using his voice to bring attention to the millions of Americans who are unable to afford their cancer treatments.
My patient Phil is among them. At a recent appointment, Phil mentioned that his wife has asked for divorce. When I inquired, he revealed a situation so common in oncology, we have a name for it: Financial Toxicity. This occurs when the burden of medical costs becomes so high, it worsens health and increases distress.
Phil, at the age of 53, suffers with the same type of bone cancer as Mr. Brokaw. Phil had to stop working because of treatments and increasing pain. His wife’s full time job was barely enough to support them. Even with health insurance, the medical bills were mounting. Many plans require co-pays of 20 percent or more of total costs, leading to insurmountable patient debt. Phil’s wife began to panic about their future and her debt inheritance. In spite of loving her husband, divorce has felt like the only solution to avoiding financial devastation.
