Ep. 62 | Paul Adedoyin, MD, Radiation Oncology

Transcript

When people hear the word radiation, they often have a lot of questions and sometimes a few misconceptions. Welcome to what brings You in today at podcast by SMC health. I'm Kara Hope and I'm Erica Bennett. And today we're here with Paul at an MD, a radiation oncologist here at our Perlman Cancer Center. So, doctor, what brings you in today?

Thank you for having me. I'm here to talk about radiation oncology and everything that's involved in it. Very good. Well, let's just start it off by just giving us a little background, maybe about your education, how you got here. What inspired you to take this career journey? Absolutely, absolutely. So I started my undergrad education at Florida Atlantic University in Boca Raton in Florida.

I majored in chemistry. After I graduated, I took a two year gap before going to medical school at University of Central Florida in Orlando. I stayed there for additional year after graduating from my intern year before then relocating to Brooklyn, New York City for the Radiation College Residency program. I finished that program in 2021, right in the middle of Covid, and then took my first job at West Virginia with Marshall University, where I was on faculty for three years before relocating to South Georgia.

Yeah, you moved around a lot. Yes, yes, yes. That's been, you know, the élite of my career in education. Just growing up, we've always moved from one place to another. I can't I can't count many times I've moved. So what do you think about Valdosta since you've been here for a few years now? It's a very warm community.

You know, I I've enjoyed my time here. The people are very nice, just very collegiate in terms of working together to provide the best care for our patients. What made you decide to go into radiation oncology? Yeah, I get that question quite a lot because and it's such a unique field, it's not something that we are exposed to in medical, medical, medical school.

But for me, I was lucky to go to University of Central Florida, where you are. You're exposed to research program such as like between your your first and second year. And we were given at least of research topics that we could participate in as a medical student. And one of the research topic was about using immunotherapy for brain metastases that are spread from melanoma.

It was a topic that I found quite interesting in at the time I was. This is this is very interesting. So I reach out to the to the to the physician that was, you know, that was in charge of that research. And he happened to be a relation. So when I met with him, I, you know, we talked about my interest in the research.

And then he asked me, say, what do you know about radiation oncology? I said, you know, flat out nothing. Yeah. You're the first edition I've ever met. And that's how the interest started, because I had to shadow him and work with him closely in the clinic. And also on that, on that research. So for those that don't know, as you said, you didn't really know anything about radiation therapy when you spoke with him.

I'm sure many of our listeners don't know what it is either. So what's the simplest way of explaining what radiation oncology is or radiation therapy? I'm sure it may be used in things other than oncology, but yes. No, that's a good question. You know, first and foremost, radiation oncology is an oncologist that specializes in using our energy x ray targeting cancers, you know, working in collaboration with our medical oncologist and surgical oncologists to provide an optimized cancer care for our patients.

What is radiation, though, like how do you explain radiation in general? Radiation. Therapeutic radiation is is a targeted high energy x ray. That's basically what it is. You know, it's a targeted x ray that we use, you know, in the form of proton, you know, having ions or just, you know, regular old x rays. Yeah. Okay. Yeah. I mean I don't know how it works.

I just know I was seeing x rays and you get radiation exposure to radiation when you're having an x ray. But it's kind of baffling how all of that even came about. And it's evolved and is used to treat patients. I mean, it's fascinating. Correct. And, you know, the only one it's a very common question that we get from from the patient.

I guess one of the most misconception is just focus things that the whole body are going to be exposed to radiation. It's just only the part of of the cancer because it's it's highly targeted. It's hard. It's, you know, because we get questions like when my hair fall off, if we're if we're treating your breast, for instance, or if we train your prostate, will my hair fall off?

And the answer is no. It's not going to follow because it's very targeted. And we're only trading where where the cancer is. So it won't affect part of your body that are not being exposed to radiation. Yeah. So I've seen I've been able to see some of the when we do tours throughout the cancer center and they'll show like how you can actually how they build like cast and things to keep your body exactly still.

00:05:55:02 - 00:06:23:11
Unknown
And so that you are only treating that very, very specific part and that you don't move. And I mean, that's amazing. Like the technology that you can use to make sure that you're in that way. Yes, we use quite a bit of technology in the field, and technologists come a long way. One example that I use with my patient is just looking at your your regular appliances at home.

00:06:23:14 - 00:06:56:22
Unknown
Your, your your TV 30 years ago. It's not the same TV that we have now days. That's right. So you can imagine with the same technology we have in radiation and delivering it just change quite a bit. So even just speaking to what you were talking about the cast and that's just one part of the treatment is the what we call the immobilization to make sure that we can immobilize that part of the body that we're trying to target, and so that we can rely on the consistent positioning for the daily treatment of radiation with radiation.

00:06:57:00 - 00:07:26:23
Unknown
What types of cancers are most commonly treated with radiation here at the Roman Cancer Center? That's a good question. So we treat variety of cancers. I would say the two most common would be prostate and breast. We also treated head in that cancers. We know we treat GI cancers as well. But yeah prostate is a very common cancer that we treat with with radiation.

00:07:27:01 - 00:07:58:16
Unknown
You know some some patients are eligible for surgery. And in those cases they go right to surgery. And if there are any indication for additional treatment, radiation might be part of that equation. And for patients that are a little bit older, that are not candidate for for surgery for different reasons, including their age or medical comorbidities. Radiation definitely is the mainstay for those for those folks.

00:07:58:18 - 00:08:35:08
Unknown
Does it have less side effects than like chemotherapy? I mean, well, obviously I'm sure it does. But what are the side effects, I guess, of radiation therapy? That's a good question. So side effects the way we think of radiation side effects are mainly dictated by the parts of the body that we're treating. Yeah. But to your questions, I do say for the most part, radiation side effects are less severe than chemo side effect, because chemo is typically systemic, you know, when it's given its intravenously.

00:08:35:09 - 00:09:05:21
Unknown
So wherever you have low supplies it's going on. It's going all over. Whereas radiation is only going to target where we pointed machine. So for for radiation side effect if you're treating prostate you know the organs around the prostate such as the bladder and the rectum. Those are the two organs that would typically counsel patients on on what to expect, such as increased urinary frequency or increased bowel movement with the rectum.

00:09:05:21 - 00:09:30:16
Unknown
So it just kind of depends on what part of the body that that we're targeting with radiation and for radiation therapy. How long does that. I'm sure I'm sure it's patient a patient. But like how many times would someone might have to go through radiation therapy and then how like long of a period could it be, you know, you know, minimum to maximum.

00:09:30:17 - 00:10:00:20
Unknown
Right. In terms of the the length, it depends on the dose. And this is where the radiation oncology expertise comes in. We decide we calculate the dose that we need to to cure the patient to to get rid of the cancer. And those can be given in a very small increment. It's the same amount every day. It could be a bigger dose per fraction.

00:10:01:02 - 00:10:31:06
Unknown
Fraction is just the it's just the treatment. So we say you know let's say you know two gripper fraction. That would be the conventional amount of radiation that they're getting in a per day. Versus if we give like seven grade per fraction that's a little bigger, bigger dose. And in those cases where we're given a bigger dose of radiation, patient only require anywhere from 3 to 5 treatments, you know, for, for their, for their course of treatment.

00:10:31:07 - 00:10:52:13
Unknown
Yeah. So they finish in a shorter period of time versus if they're getting smaller those per fraction, they may require anywhere from five 5 to 7 weeks, of course, of radiation or even longer in the case of prostate cancer. So that's what you'll do. You'll look at the cancer, and then you determine what the dose in treatment would be based on that and based on the patient.

00:10:52:14 - 00:11:23:12
Unknown
Correct? It's quite individualized in the sense of depending on the type of cancer, the or the treatment the patient have had before. What are the organs around the target that goes into, you know, the amount of radiation that the patient can receive as well? I know it is really smart. We recently introduced new treatment options for patients with prostate cancer.

00:11:23:13 - 00:12:01:05
Unknown
Can you talk a little bit about that? Sure. Absolutely. This is a this is a new type of radiation in the class of its own radiopharmaceuticals. These are radioisotope, you know, some form of treatment that we offer patients that are castrate resistant in the sense that their, their prostate cancer have stopped responding to the hormone therapy. And it's no longer basically showing signs that, you know, the cancers are regressing.

00:12:01:05 - 00:12:12:03
Unknown
So instead of just sort of giving up, you know, we have this other option of using.

00:12:12:05 - 00:12:51:23
Unknown
Is one of the newest radiopharmaceuticals in the market, has been FDA approved for for this group of patients. And what this trimmer does is it targets all prostate cancers, you know, in the body that has this protein. You know, this SMA protein and delivered radiation to those cells is a very unique and interesting way of delivering radiation than the conventional way of of how we do it, you know, delivering radiation from externally from the machine.

00:12:52:00 - 00:13:19:04
Unknown
This one is actually intravenous given and, and the, the, you know, radioisotopes just kind of go specifically to where the cancer is, you know, which is quite unique. That is that's fascinating. Yeah. I mean, so cancer has obviously evolved tremendously, just like with any technology and medical advancements. What do you say to patients that are diagnosed with cancer now?

00:13:19:05 - 00:13:50:19
Unknown
I mean, I know it's it used to be like this big word that everyone was, you know, like a dead sentence, right? You felt like cancer is big, but I feel like I'm around it much more working in your next door. But I hear so many positive things, so many good outcomes now that we have such, you know, a comprehensive team here in our cancer center, maybe just speak to, you know, if someone is diagnosed with cancer and they do decide to have treatment or consult with the cancer center, what can they expect?

00:13:51:01 - 00:14:17:23
Unknown
Of course. Well, the first thing I tell patient is there's nothing you did or you didn't do that caused the cancer. Cancer happens in, you know, almost, you know, does not discriminate. Cancer is not discriminate. We've seen cancer in people and you know, less than, you know, less than ideal situation as well. So that's the first thing I tell patient, you know, don't build yourself up regarding this new diagnosis.

00:14:18:01 - 00:14:40:06
Unknown
You know, I mean, sometimes it could be, you know, a form of a blessing in the sense that it means that you've lived long enough. Yeah. You know, if, you know, sometimes because if you live long enough, if you don't die of some sort of cardiovascular or stroke, it might be like these days I feel like cats are on the rise.

00:14:40:07 - 00:15:16:23
Unknown
I mean, just from the well, of course, you know, we are seeing cancer in younger, younger folks as well. And, you know, the same thing goes with them as well. There's nothing, you know, you've done or you didn't do that cause it's just just a random event that is bound to happen. So, you know, when patient comes in for a consultation, you know, there are a lot of time, they're very anxious and understandably so correct because they're walking into the department knowing that they will be talking to a radiation oncology.

00:15:17:01 - 00:15:40:16
Unknown
A lot of times they think they will be receiving their first round of radiation that day. But, you know, we quickly reassure them, this is just a consultation. We're just talking today. It takes a lot to get everything ready. But it's a team. It's a team effort. Starting from the front desk staff to our nursing staff to the therapist.

00:15:40:18 - 00:16:07:02
Unknown
You know, we all do unique job of trying to reassure the patient that everyone is working as a group, as a team, but it involves, you know, talking to them about the diagnosis or the stage. The stage of the cancer is which dictates the chairman's that we offer and what to expect, you know, when they come for their daily treatment day to day and week by week as well.

00:16:07:02 - 00:16:37:09
Unknown
And subsequently we follow them and we manage. And what is considered success in terms of their their cancer treatment. Well, now that you've been in your career, in your field for several years now, what what do you love most about your job? I would say, without a shadow of doubt, it's the patient. The patient's definitely makes the the day to day grind worth it.

00:16:37:11 - 00:17:04:00
Unknown
You know, being given the opportunity to treat patients with cancer, it's a you know, it's nothing short of a calling. So I think the patient definitely, you know, just as much as the patient comes to learn about radiation, I learn a lot from my patients, you know, lessons of resilience, you know, courage, being brave in the face of cancer diagnosis.

00:17:04:04 - 00:17:26:09
Unknown
So I would say patients, you know, it's definitely something that I love the most. We do patient testimonials a lot in our department where we'll interview those patients. And I mean, you're right. And you see it every day. We get to see it when we just get the opportunity to talk to some of those. But those are the strongest people alive, you know, and they're they're so inspiring.

00:17:26:09 - 00:17:49:16
Unknown
And then that goes to like impact so many of them around them in communities even, it's just an interesting dynamic because it is a challenging and hard time. But through that you grow and get stronger. And so it's interesting field, you know, that, you know, it makes me cry. Usually it is it's sad, but it's also very, very inspiring.

00:17:49:20 - 00:18:21:07
Unknown
Yes. Very inspiring, very inspiring. Especially, you know, the the success story, just it gives you the strength to wake up the next day to keep going because if, if the patient can face there, you know, the diagnosis show up for the treatment, you know, the staff, us included the physician. We have no excuse. Yeah, absolutely. Early detection plays a major role in the outcome of your cancer.

00:18:21:07 - 00:18:44:13
Unknown
So what are some screenings or warning signs that people can look out for when it comes to cancer prevention and early diagnosis? Absolutely. Early detection. It's a big it's a big, you know, big component of cancer care. And that's what I tell a patient all the time. The difference between stage one and stage four is just time.

00:18:44:15 - 00:19:25:16
Unknown
It's time. That's all it is. And time, you know, is what healthy patients to be diagnosed early on, you know, and check in with your primary care doctor going for your routine screenings with mammograms with, say, those goes a long way. Absolutely. Absolutely. I think about are their sons. I mean, I know that there are signs and symptoms, but I feel like people probably put off, like going because they fear that they're going to find something and then have to, like, undergo this big treatment and stuff.

00:19:25:16 - 00:19:47:13
Unknown
But how would you encourage people to not let that fear keep them from, you know, getting the help that they need? No, I think that it's very common. And you said it's the fear, the fear of the unknown, the fear of that word cancer. But a lot of the time it's just something, you know, something else. Yeah, it's just something else.

00:19:47:13 - 00:20:18:12
Unknown
But, knowing that the care professionals are there for you to to get to the bottom of whatever symptoms you may be having, I think does help. And also to knowing that their treatment for their cure for some of these cancers, you know, a lot of cancers are not are not that sentence, right? I think it's it's a lot easier to, to seek out care if you know that this can be this can be resolved.

00:20:18:15 - 00:20:49:13
Unknown
Yeah. It's when you think, oh, you know, if I get cancer, oh my God, there's nothing they can do. Yeah. I'm just going to slowly die. I, I think that plays a huge role in people avoiding seeking care when you know that we've come a long way in care, in research, in, in caring for cancer patients. I think that helps reassure patients that, okay, even if this is cancer, hopefully stage one and we can we can take care of it.

00:20:49:13 - 00:21:11:16
Unknown
And maybe all you need is your surgery, right. And that's the that's the other aspect of cancer care is that when it's diagnosed early, you may only need one form of treatment in that, say, versus if it's diagnosed at a later stage like stage three, that may require three different modality, you know, surgery, chemo and radiation, things like that.

00:21:11:16 - 00:21:37:21
Unknown
Yeah, it's very dynamic. Cancer care. Well, maybe there's so many different ways that you can approach things. And y'all, all you work together with the medical oncologist, the surgeons and the health care providers in the cancer center. Y'all collaborate to yes on when when we have cases there are not conventional or straightforward. We definitely have a meeting every week called Tumor Board.

00:21:37:22 - 00:22:08:15
Unknown
This is where we present cases that we need, the opinion of our colleagues. And it's reassuring for the patient also to know that, you know, the case of being discussed in a collaborative manner. And everyone is kind of putting, you know, having an input or, you know, make a recommendation on the best course of action on how to approach it as opposed to unilaterally making those decisions, because cancer cases can be very complex.

00:22:08:16 - 00:22:32:01
Unknown
So knowing having our medical oncology colleagues and surgical oncology colleagues in providing us the with with their expertise and caring for these patients in a goes a long way. Yeah, that would make me feel better to know that I had 3 or 4 doctors discussing my case rather than just one like, yeah, absolutely. It's a team effort. Absolutely.

00:22:32:02 - 00:23:00:00
Unknown
Absolutely. Yeah. Are there any lifestyle habits or risk reduction strategies that people can adopt to lower their chances of developing cancer? Yeah, there are some with the caveat that even even doing all those things doesn't guarantee that, you know, cancer may not may not still develop because we see patients that have the utmost healthier lifestyle, that have never smoked, they've never drank and still developed cancers.

00:23:00:06 - 00:23:28:09
Unknown
So sometimes it's just, you know, genetics as well. But some of the lifestyle changes I think most people are aware of is the biggest, I would say is, you know, smoking and drinking, you know, those are I would say the two biggest ones. The other ones that, you know, I may add, would be avoided. You process mate as well, just the way those those food and process and also goes a long way.

00:23:28:11 - 00:23:48:00
Unknown
You may or may not know the answer to this. So I'm just throwing this out here randomly. But you know, you mentioned smoking and drinking and smoking. You know, it has the surgeon general's warning or whatever on it. It's well known that it can result in cancer. Alcohol, on the other hand, is much more promoted, you know, as a lifestyle.

00:23:48:01 - 00:24:07:13
Unknown
You know, people have a glass of wine and relax or whatever. It's less connected to the cancer. I mean, you're not seeing those warnings on there. I don't feel like it's frequently I have seen a lot more messages about it now. But why is that with the alcohol? I think the, the, you know, the shortest answer is just cultural.

00:24:07:14 - 00:24:27:16
Unknown
You know, it's just our cultural, you know, disposition to alcohol. And, you know, I think that's what it is. It's promoted. It's like fun, you know, same way cigarettes were back when they first came out. You know, I mean, it's just interesting that, you know, that hasn't like, turned completely yet. I think as a society we're kind of getting there.

00:24:27:17 - 00:24:56:11
Unknown
I see more messages about like limiting or avoiding. I think they even did change it recently to where because for a while it was like a glass a day was okay. And now they're like, right, there's no amount. Correct? Right? Correct. And alcohol has always been listed on W.H.O. carcinogen. You know, it's always been listed there. It's just we're just catching up to their standard actually it's been there on their list as you know level one carcinogen.

00:24:56:13 - 00:25:22:11
Unknown
But I think it's because, you know, it's promoted. It's something that, you know, it's part of our culture. You know, when we watch sports, it's their celebration everywhere. So it's interesting that it's such a difference between the alcohol and the cigarettes as far as the societal like right. Marketing. Right. And there's this idea of the, the amount, the, you know, the threshold.

00:25:22:12 - 00:25:46:22
Unknown
Okay. Maybe one glass is enough. You know, it's it's fine, you know, or, you know, drinking too much might be where you cross the threshold, but we really don't know. And you know, the less the better. I think that's the message. Yeah. And it's like one of those things where it seemed like growing up that maybe we were going to be the generation to end smoking.

00:25:46:22 - 00:26:09:02
Unknown
And then vape started rising in popularity. You know, I feel like they just adapt to make it appealing again so that young people will start doing it. Yes. No. Unfortunately, that's. Yeah. Like you said, it seems like that was going to be gone for good. But, you know, they find a way, you know, technology. I know Maine is interesting.

00:26:09:03 - 00:26:26:22
Unknown
Well, I know we're about to wrap up in here in a second, but I did want to ask, how are your kids? Because you have two kids. Yes. And how old are they now? They're one and four year old. Okay. Yes, boys. One girl, the one year old. She's a girl. And the four year olds are bored. Okay, I think last time I talked to you, maybe you just.

00:26:26:23 - 00:26:57:17
Unknown
I know you're expecting her. Yes. Yes, yes. How are they? They're good. Yes. Okay. Usual stuff in kids, right? That's fine, that's fine. Looking toward the future, are there any exciting developments in radiation oncology or cancer care that that you're excited about? Yeah. One of which is we've discussed the radiopharmaceuticals. There's a lot in the pipeline for different cancers, because the one we talked about was for prostate cancers in the metastatic cancer resistant settings.

But there are other isotopes in the pipeline. There have been developed for other types of cancers. You know, I'm very excited about yeah. Who knows what will be. Yeah. Five, five, ten years. Absolutely. The way it's going. Yeah. That's crazy, but that's such good news. I mean, it's great for South Georgia and North Florida. Absolutely. Have the Perlman Cancer Center to count on.

00:27:24:01 - 00:27:47:08
Unknown
Definitely. Definitely. Yeah. Well, we thank you for joining us today. Getting an update on everything you've been doing here, the cancer center, and appreciate your service. Thank you for having me. That's been it's been fun. And don't forget to like and subscribe. And you can submit any questions that you might have for future podcasts at.

00:27:47:10 - 00:27:48:17
Unknown
See you next time.