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“This study comes from a very honest place. Because I want all patients out there with lung cancer to feel empowered to ask their doctor because they don't have to suffer in silence,” said Dr. Narjust Duma.

International Survey to Assess How Lung Cancer Treatment Affects Women’s Sexual Health

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Hope for Stomach Cancer helps provide awareness for patients with stomach cancer and their caregivers.


Stomach Cancer Awareness

Patient navigators are the vaunted “healthcare emissaries” for patients with breast cancer and can help navigate their journey a great deal. In this conversation from the Susan G. Komen Greater New York City “Empowering and Mobilizing Our Patient Navigation Workforce” virtual conference experts highlight the results of a survey of patient navigators.
 

Knowing Your Community of Patient Navigators

On the Today Show, Scott Hamilton share's his cancer story and also gives a look at his book "Frtizy Finda A Hat",  a children's book to help parents talk about cancer with their kids. 

Scott Hamilton Shares His Story

Every cancer journey is unique, and everyone's personal story is different.

We have all dealt with the current COVID-19 pandemic in our own way. But we all have some shared experiences. It is difficult to ignore the similarities between being placed into an immediate and indefinite quarantine, with those of a cancer diagnosis. At least for me, anyway.

Think WAY back to before "COVID" was a term you constantly heard and thought about. Check off everything you have personally experienced, giving yourself one point for each that applies to you.

You have come to terms with your own mortality.

You have come to terms with the mortality of your loved ones.

You have made decisions based first around your health, instead of what would be “easy” or “fun”.

You were nervous that you might encounter someone who could spread something to you that you would not be able to fight off. 

Or, you might bring that infection home to a vulnerable loved one.

You became a sanitization expert and now always pack hand sanitizer and constantly wash your hands.

You've witnessed the "good" in people when they have come out to help those less able to care for themselves.

You have worn a mask. Regardless of it was to protect yourself or others, you wore a mask when it was recommended.

You have wondered when and if life would ever return to the normal you knew before this started. And you also have wondered if it SHOULD return without changes.

You have wondered if and when you'd get back to work or school.

You have appreciated the little things in life: Such as dinner with family, talking to a friend, or watching the sunset.

You have wondered when the government would make rational decisions with your health as a priority.

You wonder about the long-term effects of your situation and condition.

You panicked at each new symptom you've experienced, that this is the beginning of the end.

You have anxiously watched or read the news, hoping a scientific breakthrough would come sooner rather than later, so people could stop suffering.

You were forced to put your plans on hold and rearrange your priorities.

How did you do? Did you check of more than 10? What if you reviewed the list again, but specific to your cancer encounter? Not everyone is the same.

But personally, if I read through this list as it related to my cancer journey, I'd end up checking off the same points as it relates to thinking about COVID. In fact, I’d check all of them. The experiences are strikingly similar, and the lessons are the same. Appreciate the now. Be safe. Be smart. Make the best decisions for you and your loved ones. And, don't ever allow yourself to regret today.

Every cancer journey is unique, and everyone's personal story is different. But COVID-19 has given many people the chance to see the world from the shoes of a cancer survivor.

How COVID-19 Has Allowed Everyone to Walk in The Shoes of A Cancer Survivor

After the devastating explosion in Beirut, dozens of children with cancer are now left without access to treatment as the region tries to find a way forward.

"It's hard to know that we have a deadly but treatable disease, and we cannot do anything for these kids because everything is destroyed," Peter Noun, the head of St. George's pediatric hematology and oncology department in Beirut, Lebanon, said in an 

. St. George’s Hospital, one of the city’s biggest hospitals, was one of two hospitals damaged in the explosion.

For the children being sent away from cancer centers, operating hospitals in the area are currently overwhelmed from treating the more than 5,000 people injured from the blast, but also have the threat of the novel coronavirus that is rising in Lebanon. Critical cancer patients have been sent to hospitals outside of the country, but Noun is worried more won’t have treatment if field hospitals aren’t ready soon enough.

At the age of 13, Caitlyn Mortus was diagnosed with cancer and had to receive treatment at MD Anderson’s Children’s Cancer Hospital. Ten years later, Mortus is working at the same hospital as a pediatric oncology nurse.

During her time at MD Anderson as a patient undergoing chemotherapy, Mortus found inspiration and encouragement from the nurses that helped her through her treatment to pursue her dreams of joining their ranks, and now Mortus is working with some of the practitioners from her original care team.

Along with her efforts as a pediatric oncology nurse, Mortus is also using her experience to help address everyday problems kids with cancer face, like isolation from their friends and family. Through her non-profit, Keep Kids Connected, Mortus looks to provide every kid going through cancer treatment with a tablet or computer to help stay in touch with friends and family while isolated from treatment, an issue that Mortus went through herself and addressed by getting a working laptop and sharing it with other patients.

“I barely knew anything about cancer when I first came here,” she said in an 

, “but now it has shaped my life and made me into the person I am today.”

A 5-time cancer survivor rode 80 miles on a handcycle to help raise money and awareness for Chai Lifeline and the summer sleep away camp it sponsors for children with cancer, Camp Simcha.

JJ Eizik has been faced with cancer five times before his 30th birthday and has underwent 20 surgeries that included the loss of his left leg, where a cancerous tumor on his femur originated. While cancer has taken a major toll on his life, Eizik hasn’t lost his love for athletics, making the bike ride not just a charity event, but a way to keep pushing himself despite past hardships.

"My message always is and has been: When you think you're done, keep pushing," said Eizik, in an 

. "It's a mental attitude that you have to develop, that I had to develop. It carried me through a lot of hard times."

Eizik was among 40 other riders that helped raise over $6 million for the sleepaway camp.

Utilizing intestinal bacteria in cancer treatment could boost its effects four-fold, according to research from the University of Calgary.

According to the lead researchers, these intestinal microbiomes can help to “supercharge” the potency of targeted immunotherapies for patients with cancer when the bacteria essentially turns on a switch in the immune cell, activating T-cells to stop cancer by generating a tiny molecule called inosine.

“With cancers (normally) susceptible to immunotherapy 20% of the time, and it responds at 80%, that’s a major increase in efficacy,” explained Dr. Kathy McCoy of the Snyder Institute for Chronic Diseases at the U of C’s Cumming School of Medicine, in an 

. In this study, three types of bacteria were found to create the desired effect of making new specific T-cells to fight cancer.

“We actually found there was an increase in bacterium in the patients responding, but the studies were too small,” said McCoy. The researchers are seeking to expand their study to focus on lung cancer and melanoma over the next several years.

From the recent Beirut explosion compromising pediatric oncology hospitals, to researchers looking at how intestinal bacteria can supercharge targeted immunotherapies, here’s what’s happening in the cancer landscape this week. 

Friday Frontline: Beirut Explosion Costs Children’s Access to Cancer Treatment, Researchers Find Intestinal Bacteria ‘Supercharges’ Immunotherapy and More

Follicular Lymphoma Risk Factors, Diagnosis, Prognosis

Progression in R/R Follicular B-Cell Non-Hodgkin Lymphoma

Understanding Relapsed/Refractory Follicular Lymphoma

Emesis, the medical term for vomiting, is one of the most common side effects associated with cancer treatment, especially chemotherapy. But now the field has a host of antiemetic drugs to help prevent vomiting, a reality that wasn’t the case in the early days of medical oncology.

Dr. Richard J. Gralla was one of the leaders in the early medical oncology field looking at making supportive care an integral part of cancer care. Part of his work involved having patients with lung cancer take antiemetics to help prevent vomiting and avoid treatment discontinuation due to side effect fears.

® Gralla, director of oncology research for the North Bronx Healthcare Network, spoke about what the early days of research into cancer treatment-related emesis looked like and where supportive care stands now in the lung cancer space.

In those early days, when we were thinking what we should do, we needed to look at something a little different. Basically, over two or three days, or even less, I read the world's literature on clinical studies in emesis. It didn't take very long. However, these two pioneers, Boris and McCarthy, and several others had really worked out the physiology of emesis. And most of us really have not been well educated in reading their views and understanding the clinical problem.

We were able to look at some different areas, and then, because we've done work in phase one, said, hey, are we giving the right doses of these drugs? And then when we found ways that were working, the question came up: how are these working? And then it was through collaboration with some neuro pharmacologists, who were so bright and said, we think that these must be working in this pathway, not the original pathway, and the drugs that work in that pathway might be safer and more effective. And so that was kind of a fun way of putting that together. But then seeing the clinical aspect of it, as that nurse expressed to me, yeah, that’s true.

Then, one of my other interests has been in day hospitals, and doing (treatment) without overnight admissions in many, many aspects, and having proper antiemetics is kind of important for that. And then measuring, from a quality of life standpoint, do patients agree with us, and well let's hear the patient's voice. So, hearing those things together, has been very interesting and rewarding at the same time.

Dr. Ricahrd J Gralla discusses the history of the early medical oncology space and how things have changed when it comes to treating side effects related to chemotherapy. 

Pioneer in Supportive Care Research Discusses History of Emesis Management

In patients with diffuse large B-cell lymphoma (DLBCL), the most common form of non-Hodgkin lymphoma, low muscle mass (LMM) and low muscle density (LMD) could play a role when deciding what kind of treatment option to pursue, and could also impact a patient’s odds of survival, according to a recent study published in the journal 

In recent years, researchers have spent more time examining patients’ muscle mass and density in relation to how well they can tolerate treatment, the authors noted. However, many studies reporting on LMM and LMD often use different definitions for each term, and various factors relating to age or unfavorable disease characteristics also make it difficult to come to any concrete conclusions.

That’s why a team of researchers from the Netherlands set out to investigate how LMD, LMM and the combination of both relate to survival in patients with DLBCL, while also evaluating the prevalence of LMM and LMD in this patient population compared to a database of healthy kidney donors, which they used to create a standardized way to measure muscle.

In the single-center retrospective study, researchers used the Netherlands Cancer Registry to identify 164 patients with DLBCL that were diagnosed at a large regional hospital in the Netherlands between January 2006 and December 2015. Patients were excluded if they had a second active malignancy or a history of malignant lymphoma in the past. Information about the patient characteristics, height, weight, chemotherapeutic dosage and tumor response were all collected.

The primary endpoint of the study was overall survival (OS), defined as the date of diagnosis to the end of follow-up or death whichever came first. Secondary endpoints were progression-free survival (PFS), the complete remission (CR) rate and completion of planned treatment.

The median age of all patients was 64.5 years, with two-thirds of patients above age 60. One hundred and twenty-nine patients (79%) saw complete response after therapy, and the median duration of follow-up was 57 months. CT-based measurements of muscle mass were made on all 164 patients prior to chemo-immunotherapy, who were then given scores that were also adjusted for gender, age and body mass index derived from the healthy reference group.

Overall, the authors noted that the combination of LMM and LMD, which was found in 13% of patients, was an independent risk factor for shorter overall survival and progression-free survival.

When looking at what patients went on to complete treatment, they also found that patients with LMM and LMD frequently discontinued the standard treatment of chemotherapy combined with the monoclonal antibody Venclexta (rituximab). These patients were also less likely to achieve a complete response.

While the authors note that the lower CR-rate could be a result of treatment termination, they cited another study to offer further explanation. “In a study involving 187 DLBCL patients, CR-rate did not differ between patients with LMM and patients with normal muscle mass if it was possible to administer all planned treatment cycles,” they explained. “Therefore, it is possible that premature termination of treatment is the cause of the diminished CR-rate, highlighting the possibility that targeting LMM/LMD might result in a higher CR-rate, thereby improving survival.”

The authors also explained that OS and PFS in their study were highly comparable, leading them to believe that the cause of death in the patients they evaluated was mainly due to disease progression.

“Muscle measurement may help to guide optimization of chemotherapy dosage in order to reduce toxicity, while still maintaining oncological efficacy,” the authors concluded. However, in order to best benefit patients, standardization of muscle measurement is needed, and more study is needed to investigate the prognostic impact of LMM and LMD, and to determine if optimization of these factors during treatment could result in a higher CR-rate and prolonged survival.

In patients with diffuse large B-cell lymphoma, low muscle mass (LMM) and low muscle density (LMD) could play a role when deciding what kind of treatment option to pursue, and could also impact a patient’s odds of survival, according to a recent study. 

Muscle Mass and Density Could Factor Into Treatment Decisions and Survival for Some Patients with Lymphoma

While prostate cancer treatment can cause cardiovascular-related side effects, patients can take certain steps to mitigate those risks, according to Dr. Neal D. Shore, medical director of the Carolina Urologic Research Center.

’s sister publication, Shore recently discussed the role that general health-related interventions such as regular exercise and bloodwork play in keeping the risk of treatment-related cardiovascular toxicity low. Shore also touched on the idea that the choice of therapy could impact these risks in a positive way, based on the results of the recent HERO trial, which examined the use of the hormone-suppressing drug relugolix in this patient population.

Yeah, that's a very important question. The whole field of cardio oncology, across all the different oncology or cancer disease states, has gotten so much more traction. As we know, where we give testosterone suppression, we basically create what's described as this quasi-metabolic syndrome, where we see central adiposity (excessive body weight). We see, potentially, with LHR agonists — and it's in their label — a warning as it relates to arrythmia and potential QT prolongation (heart rhythm irregularities). We didn't see that with relugolix.

But what are the things that we can do? We can make sure that patients are following a better, heart-healthy diet, that they're regularly exercising (and) having their lipid panels and their cholesterol checked. If they have diabetes, they're under really tight glucose management, monitoring their hemoglobin A1C. And so, these are some factors, (including) avoidance of smoking (and) avoidance of a sedentary lifestyle; there are these classic, sort of ABCDE outlines that people can be thinking about.

I'm really happy and proud of our HERO trial, because this adds to a strategy to avoid cardiovascular toxicity, and yet at the same time achieve what we're trying to achieve, which is rapid T (testosterone) suppression and rapid PSA (prostate-specific antigen) corollary declines. We had really excellent results in our T levels that went below 20, even though less than 50 nanograms per deciliter is the pharmacologic endpoint for approval.

So, yes, we can be a lot more proactive in our cardio-oncology strategies, as well as in our prostate cancer therapeutic selections.

Prostate cancer treatments can cause side effects in a part of the body that might be unexpected— the heart. Here's how one expert believes patients can mitigate them. 

How Patients Can Mitigate the Heart-Related Side Effects of Prostate Cancer Treatment

In the winter of 2019, life was pretty perfect for me. I was 36 years old and happily practicing as a lawyer. But that’s when I suddenly started experiencing flu-like symptoms, back pain and night sweats. I went to the doctor not knowing exactly what was wrong. After a few tests, I was diagnosed with stage 4 non-Hodgkin lymphoma. My entire life stopped in an instant.

I started receiving chemotherapy and R-CHOP immediately, and with the support of my oncologist,

I started chemotherapy and R-CHOP immediately, and with the support of my oncologist Dr. Asghar H. Asghar from Memon Medical Institute Hospital and some other amazing supporters, I began my journey to beat cancer. I spent the next 60 days in and out of the hospital. In those 60 days, I learned what it really means to fight for your life. I experienced what it was like to receive chemotherapy. I lost more than $180,000 and all my dreams. I was on a feeding tube. And, I suffered many life-threatening infections. I remember there were days when I looked in the mirror and I did not recognize the frail, bald man looking back at me. In just over three months, I had gone from being carefree to being someone who required a caregiver.

Now thanks to Almighty Allah, I am so blessed to be able to say that I am in remission, and that life gets better and better every single day.

I know I was fortunate enough to have access to all the incredible medical treatments and support of my family members and Dr. Asghar, which all played a gigantic part in me beating cancer. Equally important was the support of my family and friends.

I also knew that I had to keep myself moving. Even though I was fighting for my life, I had to push just a little bit harder. My commitment to physical activity never stopped. Once I was in remission, I started going on walks to slowly rebuild my inner and outer strength. That was one of the best gifts I gave myself. It helped me reconnect with myself in a whole new way.

Beating cancer takes an unbelievable toll on you both mentally and physically. My body and mind were in constant survival mode. I experienced some depression, which is very normal for someone fighting cancer. Prayers to Allah really helped me reconnect with my body and spirit. It helped me process what had just happened and allowed me to work through all my feelings.

I understood early on in my cancer journey that it was going to be a physical and mental fight. How I thought about my fight with cancer was going to be just as important as my physical fight. I had a vision board that I kept in my room during my treatment to remind me of all the things I loved, and what I was fighting for. My vision represented hope and a beautiful future. It kept me motivated and focused on all the wonderful things that life still had to offer. I also learned in these troubled moments of life that laughter is the best medicine. Comedy became such an amazing outlet and relief for me while I was going through treatment. Prayers to Almighty Allah are so therapeutic and healing to my spirit, and it really helped me take my mind off all the heaviness around me.

I never gave up, even when I was scared. I believe anything is possible once you set your mind on it and we are willing to work hard to achieve it.

The cancer journey can show you what it really means to fight for your life. 

Cancer Taught Me What It Really Means to Fight for Your Life

Patients with newly diagnosed ovarian cancer who received weekly chemotherapy reported a lower mean quality of life (QOL) compared to patients who received the standard treatment every three weeks, according to results of a recent study published in 

The primary endpoint of the iCON8 study also found that patients who received weekly chemotherapy saw no increase in progression-free survival (PFS) compared to patients who received the standard treatment, making it a poor choice for the management of newly diagnosed ovarian cancer.

Prior to this study, the phase 3 JGOG-3016 trial in Japan found that weekly paclitaxel combined with three-weekly carboplatin improved PFS and overall survival (OS) when compared to standard treatment in Japanese patients with advanced disease. But given the increasing evidence of the difference in response to treatment between Asian and white populations, the creators of the ICON8 trial set out to build on these results and determine if the same survival advantage could be found in a mostly European population.

While PFS was the primary endpoint of the ICON8 trial, the secondary endpoints examining QOL in these patients are what the 

The open-label, randomized, controlled phase 3 study included patients from 117 hospital sites in the UK, Australia, New Zealand, Mexico, South Korea and the Republic of Ireland, between June 6, 2011 and November 28, 2014. All patients were then randomly assigned to one of three groups:

three-weekly carboplatin and Taxol (paclitaxel),

three-weekly carboplatin and weekly dose-dense Taxol, or

weekly carboplatin and weekly dose-dense Taxol.

All patients had either epithelial ovarian, primary peritoneal or fallopian tube carcinoma (collectively termed ovarian cancer in the study) and had not received previous systemic therapy for their ovarian cancer.

Out of the 1,566 patients in the study, 1,540 completed the European Organisation for Research and Treatment of Cancer QLQ-C30 and QLQ-OV28 questionnaires. The QLQ-C30 includes questions that measure a global health status score, function scales to determine physical, role, emotional, cognitive, and social QOL, and symptom scales to measure fatigue, nausea or vomiting, pain, insomnia, appetite loss, constipation, diarrhea, and financial difficulties. The QLQ-OV28 measures experiences more specific to ovarian cancer, including abdominal or gastrointestinal symptoms, peripheral neuropathy, chemotherapy side effects, hormonal or menopausal symptoms, and other factors. 

These questionnaires were completed by patients during outpatient attendances at day one of each chemotherapy cycle, and during follow-up visits every six weeks until nine months from randomization, then every three months for the next 2 years, and finally, every six months for up to five years from randomization. Researchers also had patients complete these surveys at six-month intervals after disease progression.

Baseline questionnaires were completed by 1,438 (92%) of patients, and of the 1,280 patients available for 9-month follow-up questionnaires 882 patients (69%) contributed data to that set. When accounting for patients who dropped out of the study due to disease progression, withdrawal or death, a total of 828 patients contributed QOL data both at 9 months and baseline.

Upon examination, the researchers found no significant difference in the global health score at 9 months between the study groups, but upon a longitudinal analysis, found lower global health scores for those receiving weekly paclitaxel compared to patients who received the standard chemotherapy every three weeks.

“We found no evidence of a difference in global quality of life between treatment groups at 9 months; however, patients receiving weekly treatment reported lower mean quality of life across the 9-month period after randomization,” the authors concluded.

“Taken together with the lack of progression-free survival benefit, these findings do not support routine use of weekly paclitaxel-containing regimens in the management of newly diagnosed ovarian cancer.”

For newly diagnosed patients with ovarian cancer, a recent study shows how too much chemotherapy can lead to less favorable results. 

Increased Chemotherapy Leads to Lower Quality of Life in Newly Diagnosed Ovarian Cancer

Use of a novel anti-CD30 CAR T-cell therapy following treatment with fludarabine-based lymphodepletion induced a high rate of durable responses in patients with heavily pretreated relapsed or refractory Hodgkin lymphoma, according to data published in 

Results from the parallel phase 1 and phase 2 studies also demonstrated that the CAR T-cell therapy was safe and did not produce any serious or severe side effects.

Researchers from the UNC Lineberger Comprehensive Cancer Center and Baylor College of Medicine administered anti-CD30 CAR T cells to 41 patients with relapsed or refractory Hodgkin lymphoma. All patients underwent lymphodepletion with bendamustine alone, bendamustine and fludarabine, or cyclophosphamide and fludarabine prior to the anti-CD30 CAR T-cell therapy.

Measuring safety was the primary goal of the two parallel studies.

The overall response rate, or the percentage of partial or complete responses to therapy, among 37 evaluable patients was 62%. Thirty-four of the patients received fludarabine-based lymphodepletion – 17 of which received it with bendamustine, and the other half received it with cyclophosphamide. Two of these patients were considered to be complete response at infusion and maintained the response, so they were not included in final analysis.

The overall response rate among the remaining patients was 72%, with 59% of patients achieving a complete response. After a median follow-up of 533 days, researchers identified the one-year progression free survival rate to be 36% and the one-year overall survival rate to be 94%.

“This is particularly exciting because the majority of these patients had lymphomas that had not responded well to other powerful new therapies,” said senior study author Dr. Barbara Savoldo, professor in the Department of Microbiology and Immunology at the UNC School of Medicine, in a press release.

Patients within the study had received a median of seven previous lines of therapy that included checkpoint inhibitors and autologous or allogeneic stem cell therapies, therapies known to be powerful but also tend to come with a host of side effects.

However, treatment with the anti-CD30 CART cells demonstrated a favorable safety profile. Although 10 patients developed cytokine release syndrome, all cases were considered minor.

Patients who received fludarabine-containing lymphodepletion were the only participants in the study to have a response to the anti-CD30 CAR T-cell therapy.

“Although CD30 CAR T (cells) showed modest activity in (Hodgkin lymphoma) when infused without lymphodepletion, robust clinical responses were achieved when these cells were infused in hosts lymphodepleted with fludarabine-containing regimens,” the authors wrote.

“The activity of this new therapy is quite remarkable and while we need to confirm these findings in a larger study, this treatment potentially offers a new approach for patients who currently have very limited options to treat their cancer,” said Dr. Jonathan Serody, director of the bone marrow transplant and cellular therapy program at UNC Lineberger Comprehensive Cancer Center, in the release. “Additionally, unlike other CAR T-cell therapies, clinical success was not associated with significant complications from therapy. This means this treatment should be available to patients in a clinic setting and would not require patients to be hospitalized, which is critical in our current environment.”

“Unlike other CAR T-cell therapies, clinical success was not associated with significant complications from therapy,” said Dr. Jonathan Serody. “This means this treatment should be available to patients in a clinic setting and would not require patients to be hospitalized, which is critical in our current environment.” 

Novel CAR T-Cell Therapy Shows Promise in Advanced Hodgkin Lymphoma

After taking office as the Governor of Maryland, Larry Hogan began to experience some aches and pains that he chalked up to a whirlwind year of campaigning and travel. But when a handful of doctor’s visits led him to a series of CAT scans, he was devastated to hear the diagnosis: advanced, aggressive cancer.

, Hogan recently opened up about how he relied on the help of his family, both his personal and professional one, to take on treatment and eventually overcome the disease not once, but twice.

I had just been elected governor of Maryland and just was sworn in. I'd only been governor for five months and I was on our first trade mission to Korea, China and Japan. We had been really busy going through a year-long campaign, our first legislative session, had been working day and night. I had no idea I was really sick, but I started to have some aches and pains, and on this trip, I started to feel a little run down, but I thought it was I was okay. But I noticed a lump in my throat, and I said I better check this out.

And so I went to the doctor as soon as we got back, and the first primary care physician sent me to another doctor, who sent me to another doctor, and I ended up having three doctors after doing a bunch of CAT scans walk into the room together, which I said, this can't be a good sign when three doctors that you don't know walk into the room. And they said we have some bad news to share with you, governor: you have very advanced and aggressive cancer. We found about 50-some tumors from your neck to your groin, and we're going to have to set you up with a specialist oncologist right away.

I was, frankly, stunned that my first doctor said I didn't think it was anything to worry about. You know, it's probably just a benign cyst of some kind, fluid and my lymph node and my neck. And but then I heard this shocking news and it set off a whole series of things.

This was Father's Day weekend, the Friday of Father's Day weekend, and my very first thought was not really about being afraid of what was going to happen to me. But I think it's probably what so many other cancer patients go through, and my first thought was about my family, you know. How am I going to tell my wife? My three daughters were coming to visit for Father's Day weekend, I was going to break that news to them. And then my dad who was coming over for Father's Day weekend, and it doesn't matter how old you get, I was still his little boy. And he took it almost tougher than anybody, but it was a group hug, a little tears, and I thought everybody was going to be okay.

And then, I had to then break the news to my staff who worked so hard and just was getting started on our administration, and break it to the six million people of Maryland, who had just put their faith and trust in me to help run the state. I was trying to be as open and honest and transparent as I could possibly be with all the people of the state, and they kind of went through and shared the whole cancer battle with me.

After a cancer diagnosis, Maryland Governor Larry Hogan had to lean on family from both his personal and professional life to helping take on treatment and beat cancer twice. 

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