In this episode of The Cancering Show, host Dr. Jennifer Young Pierce talks with Dr. Rebecca Perkins, a nationally recognized expert in cervical cancer prevention, about the latest updates in HPV testing and cervical cancer screening. They emphasize that HPV (human papillomavirus) is linked to virtually all cervical cancers (and several other cancers in men and women), and that testing for high-risk HPV is better at catching problems early compared with the traditional Pap test. The episode highlights new self-collection kits, in which patients can collect their own sample, usually at a doctor’s office, to make screening easier without a pelvic exam. However, if the test result is positive, the patient will need to follow up with a doctor for further tests. Home testing kits are also being introduced, but they’re not widely available yet. The main takeaway is that knowing your HPV status is crucial for preventing cervical cancer, and self-collection options will make screening more accessible for many people in the future. Listeners are encouraged to talk to their doctor about the best screening option for them and to always follow up after a positive test. Resources such as the American Cancer Society’s “Screening Tests for Cervical Cancer” and cervicalrisk.com are recommended for more information.

3 Key Takeaways


1. HPV testing is more effective than the Pap test alone.
The conversation emphasizes that HPV causes the vast majority of cervical cancers (99.7%), making HPV testing a critical component of early detection. Dr. Perkins explains that HPV testing can detect about 90% of pre-cancers and cancers, compared to roughly 70% with Pap tests. Because of its higher sensitivity, HPV testing can be done less frequently while still providing strong protection.


2. Self-collection for HPV testing expands access to screening.
Self-collection kits for HPV testing, which allow patients to collect their own samples in a clinic setting without a pelvic exam, are becoming more available.This approach encourages cervical cancer screening for individuals who may avoid or delay pelvic exams and helps integrate screening into primary care, family medicine, and even mobile clinics. While at-home kits are still not widely available, in-clinic self-collection is currently a promising step toward improving screening rates.


3. Follow-up after a positive HPV test is essential.
If a patient tests positive for high-risk HPV, especially types 16 or 18, it is important to follow up with additional testing or procedures, such as colposcopy, to check for pre-cancerous changes.The episode stresses that no one who tests positive for high-risk HPV should wait longer than one year for further evaluation, underlining the importance of timely follow-up to prevent cervical cancer.


Show Overview


02:17 Meet Rebecca Perkins, MD, MSc

03:11 HPV test vs. Pap test

04:55 Know your status

05:19 What to know if your HPV test is positive

08:39 HPV self-collection

10:48 Who should see a doctor for an exam?

14:00 Types of self-collection

18:50 HPV vaccine has reduced cervical cancer rates

20:28 Importance of follow-up after positive test results

21:15 When will home self-collection be available?

24:12 Where to find out more

In this episode of The Cancering Show, Dr. JYP welcomes certified oncology yoga instructor Michelle Ryan-Day to discuss the transformative impact of yoga for cancer patients and survivors. Michelle shares her journey into oncology yoga, emphasizing its evidence-based benefits, including reducing recurrence risk, managing treatment side effects such as fatigue and neuropathy, and supporting emotional health. The conversation highlights the accessibility of chair-based yoga tailored for all fitness levels, the power of the breath, and the importance of self-compassion in healing. Listeners also get a bonus: a 60-second guided breath exercise to try out yoga’s self-care benefits.

Check out yoga4cancer.com for more yoga info!

3 Key Listener Takeaways



1. Yoga is accessible and beneficial for cancer patients and survivors

Michelle Ryan-Day emphasizes that yoga — especially oncology-specific, chair-based yoga — is accessible for everyone, regardless of physical limitations or where they are in their cancer journey. Oncology yoga classes are designed to be safe and effective, taking into account common cancer treatment side effects such as fatigue, lymphedema, neuropathy, and low bone density. The focus is not on advanced poses, but on gentle movement, community, and adapting practices to individual needs so that anyone can participate and experience the benefits.

2. Evidence supports yoga's role in recovery and survivorship

Dr. JYP notes that yoga is a well-studied intervention, supported by hundreds of studies and recommended by reputable organizations such as the American Cancer Society. Practicing yoga regularly can help treat symptoms including fatigue, emotional distress, and physical limitations. It may also reduce the risk of cancer recurrence and enhance long-term health and survivorship, making it a valuable, low-cost addition to cancer care.

3. Mindfulness and breathwork play a vital role in healing

They discuss the transformative power of awareness, especially through breathwork and mindfulness. Learning to control and be mindful of one's breath can regulate the nervous system, reduce anxiety, and promote feelings of well-being and self-compassion. Michelle walks listeners through a simple breathing exercise, demonstrating how breath can be an immediate tool for physical and emotional balance. This focus on mindfulness promotes not only physical recovery but also the emotional healing and self-acceptance crucial to cancer survivorship.

Show Overview


02:05 Meet Michelle Ryan-Day

03:28 “When the student is ready, the teacher will appear.”

05:30 A different kind of yoga

09:30 Who can benefit from oncology yoga?

13:30 Special considerations for cancer patients and survivors

15:08 Learn to love yourself and your body

19:50 60-second breath exercise for listeners

23:00 What cancer patients say about oncology yoga

In this episode, Dr. JYP talks with Dr. Natalie Bath, M.D., a USA Health surgical oncologist, about a new groundbreaking cancer treatment for liver tumors called histotripsy. Histotripsy is a non-invasive technology that uses high-intensity sound waves to break up liver tumors without surgery, incisions or long recovery times. Patients go under general anesthesia, and the machine delivers sound waves to the cancer cells while the physician uses imaging to monitor the treatment. Most people go home the same day and recover quickly, needing only over-the-counter pain medication. This treatment works for different types of liver tumors, including those that have spread from other cancers, and it doesn’t require people to stop blood thinners. Histotripsy is FDA-approved for liver tumors and offers hope for patients who might not have other options. This episode encourages patients to ask their doctors about all possible treatments and to keep learning more about their choices.

3 Key Listener Takeaways

Groundbreaking, Non-Invasive Liver Cancer Treatment

The episode introduces histotripsy, an exciting new technology that uses focused ultrasound waves from outside the body to destroy liver tumors in a non-invasive manner. This innovative approach preserves surrounding liver tissue and offers an option for patients who might not be candidates for surgery.

Eligibility and Patient Benefits

Histotripsy can be used to treat both primary liver cancer and metastatic cancers from other sites. It's especially promising for patients who are not surgical candidates or who are on medications like blood thinners that would otherwise complicate surgery. With minimal recovery — often just a same-day or next-day discharge — patients experience less downtime and can continue other therapies, such as chemotherapy or immunotherapy, without interruption.

Expansion of Treatment Options and Ongoing Research

The episode highlights how histotripsy adds to the arsenal of cancer care, offering hope and additional options, especially for those who previously had few. It is FDA-approved for liver tumors, with ongoing research exploring its use for kidney, prostate, and pancreatic cancers. Patients are encouraged to advocate for themselves, ask about new technologies, and seek out multimodal therapies that combine traditional and emerging treatments for the best possible outcomes.

Show Overview

00:45 Introduction to histotripsy, a groundbreaking, non-invasive treatment for liver tumors

01:26 Meet Dr. Natalie Bath

02:20 First adopter in Alabama

03:15 What patients can expect

04:55 Who is a candidate?

07:49 Benefits of non-invasive treatment

10:45 FDA approved for liver tumors

15:05 Potential uses for histotripsy

16:45 Where to learn more

In this episode, Dr. JYP welcomes back Dr. Thomas Butler, a seasoned oncologist who specializes in supportive oncology. Dr. Butler shares his journey from humble beginnings and a fascination with science to a career in cancer care, emphasizing the importance of addressing both the physical and emotional needs of patients. He discusses the distinction between palliative and supportive care, advocating for an approach that supports patients throughout their cancer journey — not just at the end of life. Dr. Butler also offers personal insights from his own cancer diagnosis, reflecting on what he has learned regarding trust, honesty, spirituality, and quality of life. Listeners will hear practical advice for navigating cancer care and the value of a compassionate, team-based approach.

3 Key Listener Takeaways


1. Supportive care in oncology is essential and distinct from palliative care


Dr. Butler emphasizes the importance of supportive care, which focuses on alleviating the complications and side effects of cancer and its treatments. Unlike palliative care, which is often associated with end-of-life scenarios, supportive care is meant for patients at any stage of their cancer journey. Its goal is to address not just physical symptoms like pain and fatigue, but also emotional needs, ensuring patients don't have to suffer unnecessarily while undergoing treatment.

2. The value of listening and building trust between doctor and patient


A recurring theme throughout the conversation is the critical role trust and honest communication play in cancer care. Dr. Butler encourages patients to be open about their symptoms and concerns, highlighting that withholding information for fear of losing treatment options can hinder proper care. The relationship between oncologists and patients should be built on mutual respect and understanding, with doctors aiming to know the person and not just the disease.


3. Personal experience deepens provider empathy and influences care


Dr. Butler shares his journey from being an oncologist to becoming a cancer patient, which has profoundly impacted his outlook and practice. Experiencing cancer firsthand gave him a new perspective on the reality of side effects, the emotional burden of a diagnosis, and the importance of quality of life. This dual perspective has made him even more empathetic toward his patients and has reinforced his commitment to providing compassionate, holistic care where comfort and patient wishes are the top priorities.

In this episode, Dr. JYP talks with Dr. J. Harrison Howard, a surgical oncologist who specializes in melanoma. Dr. Howard explains that not all skin cancers are the same, emphasizing that melanoma is more dangerous compared with basal cell and squamous cell carcinomas. He highlights the importance of detecting melanoma early, as it is the most dangerous form of skin cancer.

They discuss surgical and systemic treatment advancements, including the practice of sentinel lymph node biopsy and the game-changing benefits of immunotherapy. Dr. Howard says clinical trials are essential in improving treatment methods and increasing survival rates. He stresses the necessity of regular follow-ups for melanoma patients to catch any recurrence early. Lastly, Dr. Howard and Dr. JYP discuss skin cancer prevention, recommending sunscreen, protective clothing, and annual dermatologist visits to reduce the risk.

3 Key Takeaways


1. Diversity in skin cancer types: Not all skin cancers are created equal. Dr. Howard emphasizes the differences among various types of skin cancer, with a specific focus on melanoma. While basal cell carcinoma and squamous cell carcinoma are often treatable with surgery and have high cure rates, melanoma can quickly become life-threatening if not caught early. The depth of melanoma in the skin is critical, and it can spread and become fatal.

2. Advancements in melanoma treatment: There are exciting developments in both surgical and systemic treatments for melanoma. Dr. Howard talks about the trend toward less invasive surgery and the success of sentinel lymph node biopsy – developed by his late mentor, Dr. Donald Morton – as a significant advancement in minimizing side effects. Furthermore, systemic treatments such as immunotherapy are proving to be game-changing as they drastically improve survival rates for stage 4 melanoma.

3. Prevention and follow-up: The importance of prevention and regular monitoring is heavily emphasized. Sunscreen, protective clothing, and regular skin check-ups are crucial in reducing the risk of skin cancer. Dr. Howard also underscores that once someone has had melanoma, the risk of another melanoma greatly increases, necessitating lifelong vigilance and regular dermatologist visits to detect any cancers or pre-cancers early.

Show Overview

00:00 Basal cell and squamous cell carcinomas

05:08 Melanoma increases future risk tenfold

07:43 Development of sentinel lymph node biopsy

12:17 Redefining melanoma surgery

15:49 Clinical trials explained

17:43 To clinical trial participants: “You’re a hero.”

22:34 SPF-infused clothing for sun protection, and more

In this episode, Dr. JYP welcomes Margaret Wielbut, a trained art therapist who works with patients at the USA Health Mitchell Cancer Institute. Margaret delves into her personal journey, from discovering art therapy to implementing it in cancer care in Mobile, Alabama. She describes art therapy as a marriage between art and psychology, emphasizing its benefits for cancer patients in creating hope, reducing anxiety, and bringing purpose to the cancer journey.

She shares stories about how art can turn clinical spaces into environments of light and creativity. Sponsored by the Zoe Foundation, the MCI’s art therapy program is free to patients. Margaret highlights the therapeutic power of creativity and her aspirations for expanding art therapy, including group projects and involving families. For those without access to art therapy, she recommends engaging in personal creative activities to enrich the healing journey.

3 Key Takeaways

1. Healing power of art therapy: Art therapy is described as a fusion between art and psychology, offering emotional healing and a creative outlet, which can be particularly beneficial for those on a cancer journey. Margaret highlights how art therapy has brought joy, reduced anxiety, and helped patients create meaning and enjoyment during their treatment.

2. Impact on cancer patients: The episode emphasizes the positive impact of art therapy on cancer patients, even those who may initially seem closed off or disinterested in the projects. Through creative sessions, patients can experience emotional breakthroughs, improve their mood and find a sense of community, as witnessed in the interactions facilitated by Margaret at the MCI.

3. Expanding art therapy in cancer care: Margaret discusses the value of expanding art therapy programs, including initiatives for children, and ideas to enhance patient engagement with group projects and art displays. The art created by patients not only serves as a personal therapeutic process but also contributes to a positive atmosphere within the clinical cancer space for all to enjoy.

In this episode, Dr. JYP welcomes medical oncologist and hematologist Dr. Daisy Escobar to discuss her background and her expertise in cancer diagnosis and treatment. Dr. Escobar shares her journey to the Mitchell Cancer Institute and talks about her family. The conversation focuses on cell-free DNA technology, also known as liquid biopsy, which is used primarily for cancer surveillance and monitoring. Dr. Escobar explains the benefits and limitations of this technology, including how it compares with traditional biopsies and its potential in early cancer detection. The conversation also covers the emotional aspects of cancer surveillance and the importance of patient autonomy in treatment decisions. Dr. Escobar emphasizes the importance of continual research and advancements in cancer diagnostics to improve patient outcomes.

3 Key Listener Takeaways

1. Introduction and implementation of liquid biopsy: Dr. Daisy Escobar explains that liquid biopsy, or cell-free DNA (cfDNA) technology, involves a simple blood draw used primarily to monitor treatment response and detect relapse or recurrence in cancer patients. Unlike traditional biopsies that require tissue samples, liquid biopsy offers a less invasive alternative for surveillance. The ease of monitoring is particularly beneficial for cancer patients who are frequently undergoing lab tests for other reasons. Dr. Escobar details the conditional nature of liquid biopsy’s current use, emphasizing its role in patient monitoring rather than initial cancer diagnosis.

2. Challenges and limitations: Despite its advantages, liquid biopsy is not without its challenges. Dr. Escobar mentions the necessity of comparing ctDNA with DNA from a previous biopsy. Additionally, certain conditions, such as a previous bone marrow transplant, may limit ctDNA effectiveness. Another significant challenge is the potential for emotional impact on patients due to "watchful worrying," knowing that while their markers may be rising, visible signs of cancer may not immediately appear on scans.

3. Potential and future of liquid biopsy: Dr. Escobar discusses the hopeful future of cfDNA technology, particularly for the early detection of ovarian and pancreatic cancers, which currently lack effective screening methods. Advancements in identifying specific ctDNA signatures for various cancers could revolutionize early detection and management, reducing the necessity for more invasive procedures. However, she underscores that while promising, the science has yet to fully catch up to the technology, and ongoing research is crucial.

In this episode, Dr. JYP and State Health Officer Dr. Scott Harris discuss the intersection of infectious disease and cancer in Alabama. Dr. Harris shares insights into the state's cancer trends, including the impact of delayed screenings during the pandemic, and disparities in cancer outcomes based on geography and race. They discuss the collaborative efforts among state agencies, nonprofits, and medical communities to combat cancer. They also delve into Alabama's strategic initiative, Operation Wipe Out, aimed at eliminating cervical cancer through vaccination, screening, and treatment. Additionally, they emphasize the importance of lifestyle changes, regular screenings, and knowing one’s family medical history in preventing cancer. Dr. Harris encourages community involvement and awareness to improve cancer outcomes across Alabama.


3 Key Listener Takeaways


1. Impact of COVID-19 on cancer screenings: Dr. Scott Harris expresses concern over the interruptions in routine cancer screenings due to COVID-19. During the pandemic, many people postponed elective medical procedures, including crucial cancer screenings such as colonoscopies, mammograms, and pap tests. This delay has led to more advanced cancer diagnoses and poorer outcomes.

2. Disparities in cancer outcomes: Dr. Harris highlights significant disparities in cancer outcomes based on geographic location, race, and socioeconomic status. Black residents and those who live in rural areas face a higher risk of developing cancer and dying from the disease. This suggests that social determinants such as access to healthcare, economic opportunity, and education play a significant role in cancer outcomes.

3. Operation Wipe Out and cancer prevention: Operation Wipe Out is a strategic plan to eliminate cervical cancer through vaccination, screening, and timely treatment. The initiative underscores the importance of the HPV vaccine, which can drastically reduce the risk of cervical cancer in women and several other cancers in both men and women. Public health efforts also focus on educating healthcare providers and the public about cancer prevention and available screening programs, particularly in underserved rural areas.