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Becker’s Healthcare Podcast
Dr. Chandler Wilfong & Dr. Edward Cho of the Gastrointestinal Cancer Program at OSF Healthcare
00:17:32
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- [00:02]
A
Welcome to the Becker's Healthcare Podcast. I'm Elizabeth Gregerson, a reporter here at Becker's, and I'm thrilled to interview HPV surgeons Dr. Chandler Wilfong and Dr. Edward Cho from OSF Healthcare on the podcast today. Thank you so much for joining me. I'm so grateful to share your insights with our podcast audience. Before I dive into my questions, could each of you introduce yourselves and just tell us a bit about your background and the HPB program at OSF? If we could start with you, Dr. Wilfong, that'd be great.
- [00:38]
B
Oh, sure. Thanks for having us, Elizabeth, and it's a pleasure. My name is Chandler Wilfong, and I'm an HPV surgeon at OSF in Peoria, Illinois. And I've been here for a little over seven years, and we've been gradually building our complex oncology and HPV program for about that long here in Peoria, and we take care of patients from a large area of Illinois who have these problems.
- [01:11]
A
Thank you and Dr. Cho.
- [01:15]
C
And thank you again, Elizabeth, for the opportunity. My name is Edward Cho. I'm one of the HPV surgeons, also like Dr. Wolfong. My practice started in Dallas, Texas, and then I was in practice in Tulsa, Oklahoma, before joining Dr. Wolfong here about two, two and a half years ago. And yeah, I reiterate exactly what Dr. Wolfong said. We're building up our program pretty quickly here and excited for the opportunity.
- [01:44]
A
Perfect. Thank you both for those introductions. So, as you may know, the podcast audience may have a specialty in oncology, but they might come from different fields of medicine or the administrative side of things. Could you tell us a little bit more about these surgeries and the program and what role it's playing in the. In the region?
- [02:11]
B
Sure, I'd be happy to thank. Dr. Cho can chime in as well, but we do surgeries for both benign and cancerous conditions of the liver, gallbladder, pancreas, stomach, bile duct. The National Cancer Institute started a focus on rural cancer care around 2019 especially. They started really promoting a focus on rural cancer outcomes because of the. There's a big disparity in cancer outcomes in rural areas versus urban settings, and there's a lot of reasons why that is. But one of the things we've really focused on here in Peorias, you know, even though Peoria itself is not considered rural. You know, we COVID patients for, give or take, 100 miles in any direction, and about 80% of our population comes from rural areas. So we've had a big focus on facilitating cancer Care for these folks, especially when they need surgeries like whipple operations or liver resections that are a little more complicated. And we see these at big centers. Primarily, we've been able to build a high volume program taking care of these patients that have more challenging cancers to deal with.
- [03:42]
C
Just to supplement a little to what Dr. Wolfong said. The goal here is to provide easier access to the patients rather than going to a complex urban center, while providing a world class care to these patients. And I believe that we're working towards and have done that for our patients and hopefully many more patients to come. The need for this is the other big thing. Pancreatic cancer, for example, used to be pretty low on the incidence and whatnot, but it's been steadily rising. And so now it's the third leading cause of cancer death in the country, in the world, and the incidence is rising. And so Dr. Wolfong and I are trying to provide some expertise in these kind of areas for patients that may not get inadequate care because of their location or their setting.
- [04:46]
A
Perfect. Yes, thank you for kind of setting the stage for some of our listeners who may not know, you know, the mortality rates and of pancreatic cancer and you know, what it means to have access to this type of care wherever you're located. I think that's such an important point to make. I also love to touch on the OSF Cancer Institute and what role the institute has played so far in the success of your HPV program. Dr. Wilfong, can I start with you again?
- [05:22]
B
Yeah, absolutely. I think, you know, there's a number of things that we see from, you know, building and opening the cancer institute over the last couple of years and its direct impact on our program. You know, we've always had a, you know, high volume program that we developed here, but having access to, you know, really cutting edge technology and a big focus on cancer care within our organization really does make a difference. We've been able to open and recruit patients into two national cancer institute trials. And we have really an organization wide focus on advancing access and treatment for our patients, but also exposure to things we generally would think of as big academic center type programs like major cancer research programs. And the cancer institute has been really integral in developing or rounding out our program, not just for clinical care for the patients, but research and clinical trial access, which I think is a big part of a world class program.
- [06:47]
C
I completely agree with Dr. Wolfong and I think that kind of opportunity opens up greatly with the OSF Cancer Institute. The other highlight is that it Takes a village to take care of these cancer patients. If we're looking at some of the programs that have been instituted within the cancer institute, such as our nursing navigation program, where we schedule our patients and stock our patients so they can get all of their testing done within the same time frame, within the same day, so they don't have to come multiple days to do this. Our nutritional program, where with our dietitians, our physical therapy, the support system that we offer to not just the patient and the family, all of this organizational model is much easier done under the umbrella of the cancer center. And I think that kind of multidisciplinary, a multimodal approach to patient care is what's successful, and that's what we provide at OSF.
- [07:56]
A
Perfect. And you touched Dr. Cho on some of the highlights. Dr. Wolfong, are there any other highlights that you've seen since launching the program that you could share with our listeners?
- [08:08]
B
I think, you know, you can't, you know, congratulate our program enough, not for myself and Dr. Cho's work, but the multidisciplinary care really is the highlight, I think, of the program. We do complex surgery, and we do have a big focus on minimally invasive surgery. But the things that really help our patients outside of that is the nutritional program, the teaching kitchen, the massage therapy program, all the things that go into taking care of cancer patients that we don't think about. We think about chemotherapy and surgery, radiation treatments, but all the supportive care that these patients really thrive with, I think is the highlight of our institutions program.
- [09:10]
A
Yeah, those supportive services, like you said, can make such a difference. So it's very interesting to, you know, hear another health system that's leaning into providing those services for cancer patients. You know, we've kind of looked back at, you know, how impactful the program's been for the region, the role the cancer institute has played in the success of the program. I'd love to kind of shift gears now and look towards the future. Dr. Cho, if I could start with you, what are some of the goals with the HPV program for the years to come?
- [09:48]
C
I think that Dr. Wolfong and I, along with the leadership at the cancer institute, have many goals in mind. And one of the things that we're grateful for is that the plans and the hopes for the kids for alignment, you know, strategically and in all ways with the leadership. And so, you know, that's extremely. We're extremely thankful for working under that kind of leadership. So the volume dictates outcomes in many of the papers, and so you when we ask for, when we counsel patients on their cancer care or non cancer care, because we also tackle, you know, very complex benign diseases in the HPV world as well. We always kind of counsel patients that they need to look at the experience of the surgeon and the volume and whatnot in order for. To determine whether they're going to have a good outcome. And that's one of the things that we boast at osf. And so hopefully as we go into the future, we'll be serving a greater region and area and greater number of patients. And as we do that, hopefully our program in terms of our surgical expertise and numbers will also kind of expand over the course of time. Dr. Wolfong mentioned research. And so, you know, even though we have national, national research projects, you know, coupled with National Cancer Institute and whatnot, and so, you know, but there's always room for growth in terms of expansion so that we can take a huge part in not just treating our patients now, but figuring out stuff to help our patients in the future. And then the educational model as well. We want to be an institute that serves our population, but we also want to invest in the future with future clinicians and surgeons going forward. And so there's plans hopefully to expand in the educational model and training model within the cancer institute to kind of invest for the future. So I usually see future plans as tried into three part model. One is clinical in terms of serving our patients, one's research and one's educational. And Dr. Wolfong and I have great plans for kind of expanding that and accomplish that hopefully in the near future.
- [12:24]
A
Great. And I'm going to spring a question on you both, but I don't think it'll be too difficult for you to answer. Whenever I interview leaders in oncology, I always love to ask them what makes them hopeful about the cancer care or the oncology field as a whole and where it's going and the innovation that's happening. So, Dr. Wilfong, if I could start with you. What comes to mind when someone asks you what excites you about the future of cancer care or what gives you hope for the field of oncology? What would you say?
- [12:57]
B
I think that's a great question. And we've seen really huge advancements in immunology and biologic treatments for many different cancers, which has not translated particularly well to what we do in our fields. That we have seen improvements in survival and pancreatic and liver and bile duct cancers, but not on the same level as many other cancers. We have seen some recent approvals for gastric cancer with immunotherapies. I think those are the things that I see in cancer treatment that I think are really exciting for the future. I'm hopeful that as we work to find better treatments for these diseases, earlier detection strategies, that with a combination of better ways to detect these cancers early, hopefully new treatment modalities outside of just surgery. I mean, surgery is helpful and certainly, you know, one of the pillars of treating these diseases. But I want to see better long term outcomes. And I think the, you know, immunotherapies are the biggest breakthroughs we've seen in the last decade or so.
- [14:24]
A
Perfect, thank you. And Dr. Cho.
- [14:28]
C
Yeah, I mean, I agree with Dr. Wolf on and everything. And some of the systemic therapies like immunotherapy has gone, has improved markedly. And so that's helped us fight this combat against cancer. Another disease process that we can use in this example is metastatic colorectal cancer. And so anything metastatic is stage four. And so when patients hear that, especially in these rural populations, they think of it as a death sentence. And we've shown, and with improvements in technology and the treatment modalities, we've actually improved that to the point that metastatic colon cancer, that's metastatic to the liver because that's one of the first organs that it likes to go to the cancer. The five year survival has now improved to over 50%. And it used to be dismal, it used to be less than 10%. That's an improvement that we've had. And not just the systemic therapy like Dr. Duofeng said, with the chemotherapy immunotherapy. That's also with the improvements that we have in local regional therapies that we use as surgeons to treat the liver. And liver is regenerative and so we can be pretty aggressive with it in certain sets of patients and give a extended quality of life and quantity of life to our patients. The problem is our patients don't know this. And so they hear stage four. And a lot of the patients don't have the ability to seek an HPV surgeon for consultation to get these information and to get all these kind of treatment modalities kind of lined up for them. And so I really think that that's where a big part of where Dr. Wolfong and I come in is to give some treatment options and hope to the subset of patients and to tell them, yes, they may be stage four, but that doesn't mean that sense anymore because of the advancements that we've made and hopefully we'll make continue to make much more advancements in the field, in our field. It's an exciting time for us in the HPV world.
- [16:41]
A
Amazing. Thank you both. It's always so inspiring to speak to people in the field of oncology. Like you said, just giving those examples of what a diagnosis means and all the different innovative technologies and therapies out there. So I appreciate both of you sharing your expertise and for joining me on the podcast today. It's been a really amazing and informative discussion.
- [17:05]
C
Just wanted to thank you again.
- [17:06]
A
You're fine. Thank you. And I invite our listeners too, to turn into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com. i hope you all have a wonderful rest of your day. Thank you.