JAAPA Podcast – Meet Joe + Discuss the JAAPA Article on Esophageal Cancers

Date: June 4, 2024
Host: JAAPA Podcast Team
Main Sections:

• Introduction of New Team Member Joe Harrison
• Team Discussion on Career Paths & Professional Involvement
• Deep Dive: JAAPA Article Review on Esophageal Cancers

Episode Overview

This episode welcomes Joe Harrison, the newest member of the JAAPA Podcast team, and features a detailed group discussion of the April JAAPA article “Esophageal Treatment Advances and Need for Screening” by PA Daniel Eisner. Alongside professional introductions and stories about entering the PA field, the team unpacks the latest guidance on esophageal cancer screening, risk stratification, and emerging treatments.

Meet Joe Harrison: Background & Interests

[00:57] Joe Harrison’s Introduction

• PA since 2004, graduate of ATSU in Mesa, AZ
• Primary/urgent care and 15+ years emergency medicine (now in telemedicine and part-time ED work)
• Assistant Clinical Professor & Clinical Coordinator at Northern Arizona University, Phoenix
• Co-chairs the Wellbeing Committee for PA students, serves on Community Outreach, Admissions, and Curriculum Committees
• Active with Arizona State PA Association (ASAPA), involved in CME and Diversity, Equity, and Inclusion (DEI/JEDI) Committees

What’s the “JEDI Committee”?

“That’s our like our DEI. So that’s that Diversity, Equity Inclusion for ASAPA. So… whenever they have some kind of question regarding diversity, equity inclusion, they come to us to make sure that they’ve… covered all their bases.”
— Joe Harrison [02:08]

Personal Interests & Goals for the Podcast

• Student wellbeing, equity in education, and supporting increased clinical preceptorship opportunities
• Excitement to bring professional conversations and mentorship to listeners

Career Journeys, Special Interests, and the Importance of PA Leadership

Evolving Career Paths

[03:52] Kim:

• Transitioned from clinical to partial leadership role
• Most enjoys talking with researchers, learning about workforce trends, especially challenges like the preceptor shortage

“We have a couple of wonderful conversations about postgraduate clinical training, peer review, all sorts of things that I think PAs need to be prepared for…”

[04:39] Martine:

• Emphasizes PA leadership and exploring non-clinical spaces PAs can thrive in
• Desire to highlight PAs in government, leadership, or less traditional roles

“…every time I find something unusual, a PA in an unusual position, I like to highlight it. Because we need more PAs in the leadership space, even in government, in every area…”

[06:07] Joe:

• Academia proved completely different from clinical work, opening his eyes to a wider breadth of PA roles and leadership opportunities

“…not realizing how important it was for my own profession to be a part of the conversation. And fortunately, I’ve had this job change to be able to become more of [a contributor].”

Fun Facts & Personal Touches

[07:48] Joe:

• Currently brings a wrist splint to work due to a snowboarding injury, sharing a love of trying to keep up with his 10-year-old daughter on the slopes

“Why Medicine? Why PA?”: Team Origin Stories

[08:41] Kim:

• Inspired by her mother (a nurse) and an influential PA shadowing experience

“My mom is a nurse…my inspiration. I was very fortunate to shadow a fantastic PA…she completely changed my life.”

[09:36] Martine:

• Grew up in a medical family, initially attended medical school abroad, eventually found PA role as a perfect fit after moving to the US:

“I could do any specialty. I still could do pediatrics and started out like that… but it’s been all my life. I’ve always liked [medicine]…”

[10:36] Joe:

• Grew up in rural Mississippi, was a frequent patient as a sick child; inspired by a community doctor’s impact and a mentor’s journey into PA profession as soon as Mississippi licensed PAs

“It seemed like, you know, basically just fate. Everything kind of worked out and it was kind of at a crossroads in my own life… [the PA path] just clicked for me…”

Pursuing Doctorate While Balancing Other Roles

[12:22] Joe:

• Doctor of Medical Science student at NAU; motivation came from wanting to further his focus on equity in healthcare and leadership

“…it’s really been eye opening for me and… helped me to foster… a focus on creating more equity in healthcare for the population. It’s been challenging, but I can see that it’s gonna be so worth it in the long run…”

Team Involvement: Committee, State & National Roles

[13:48] Martine:

• Board member for PAs in Obesity Medicine, PAs for Women Empowerment, director roles, DEI committees, and HOD delegate for Florida
• Frequent involvement in organizational meetings and taskforces

[16:06] Kim:

• Volunteered for NCCPA exam writing, works closely with state organizations and shared governance (a leadership structure empowering frontline providers, originally from nursing)

Article Discussion: “Esophageal Treatment Advances and Need for Screening”

(JAAPA, April edition, by PA Daniel Eisner)

[17:32] Transition to Article Review

Key Points and Insights

• Rising Prevalence & Epidemiology
  • Esophageal cancer is increasingly common in the US, though it still accounts for only 1% of all US cancers
  • 95% of cases are either squamous cell carcinoma (SCC) or adenocarcinoma; 90% globally are SCC [18:07]

“Men over the age of 50 are three to four times more likely to develop esophageal cancer, and in the US White, Native American and Blacks are at higher risk. White patients being more likely to develop adenocarcinoma and Black patients being more likely to develop squamous cell carcinoma.”
— Kim [18:36]

• Socioeconomic & Geographic Disparities

  • 80% of cases occur in populations with lower Human Development Index (HDI)—a composite of life expectancy, education, and income
  • Adenocarcinoma is more prevalent in high-HDI Western countries [19:07]

• Risk Factors

  • Squamous cell carcinoma: smoking and alcohol use are main risks
  • Adenocarcinoma: obesity, Barrett’s esophagus, and GERD
    — Martine [19:33]

• Clinical Presentation

  • Most present with dysphagia; other symptoms include weight loss, night sweats, odynophagia, chest pain, heartburn, hemoptysis, persistent cough, hoarseness
  • Initial evaluation: bedside swallow test (95% sensitivity); gold standard: upper endoscopy with biopsy [20:01]

“One of the initial evaluations recommended is a bedside swallow evaluation where the patient sips on water and they are monitored… the screening test has 95% sensitivity for dysphagia. … [But] ultimately this patient will need an upper endoscopy since this is considered the gold standard…”
— Joe [20:01]

• Diagnosis & Advances in Imaging

  • Imaging options: CT (most common), PET, MRI
  • Use of precision medicine/precision oncology to tailor treatment plans is now standard of care for many cancers [20:51]

• Prognosis & Importance of Early Detection

  • Poor prognosis and low five-year survival rates are still the norm for esophageal cancer, emphasizing the importance of screening in at-risk individuals [21:17]

“Ultimately, early diagnosis and screening for esophageal cancer in these patients with risk factors or symptoms…is very important in improving outcomes.”
— Kim [21:17]

Notable Quotes & Memorable Moments

• “I think what is lacking in the PA profession is… all the space where PAs can work and the leadership… we can create, we can be in leadership positions.” — Martine [04:39]
• “I’ve had this job change to be able to become more of [a contributor]. And I appreciate that so much.” — Joe [06:07]
• “My mom…made me start thinking about healthcare. … I was very fortunate to shadow a fantastic PA… she completely changed my life.” — Kim [08:41]
• “It seemed like, you know, basically just fate. Everything kind of worked out… at a crossroads in my own life… [PA] just clicked for me.” — Joe [10:36]

Timestamps for Major Segments

• Joe Harrison Introduction & Background: [00:57–02:45]
• Team Snapshots: Interests & Podcast Goals: [02:45–07:05]
• Fun Facts from the Team: [07:48]
• “What’s your why?” Career Stories: [08:41–12:22]
• Committee/Leadership Involvement: [13:48–17:31]
• Esophageal Cancer Article Discussion: [17:31–21:49]
• Closing Comments & Welcome to Joe: [21:49–22:31]

Takeaway Messages

• PA roles are expanding rapidly—including clinical, educational, leadership, advocacy, and research arenas
• Mentorship and visibility are crucial for recruiting new PAs and encouraging professional growth
• Esophageal cancer screening remains underutilized—awareness of risk factors and early detection is vital to improving outcomes
• Precision medicine is now standard of care in many cancers, and palliative strategies are essential given poor survival rates
• Active involvement in professional organizations and committees empowers PAs to lead and innovate in healthcare

For CME credit, visit cme.aapa.org, and remember to follow JAAPA on social media: @jaaonline.