Host: Hi there everyone. I'm your host, Heather Lee, and welcome to this latest episode of Medically Speaking. Joining me today is Dr. Roberto Peeley, who is the VP of Oncology Services for Kaleida Health. Thank you for being here. Guest 1: It is a pleasure to be here, Heather. Thank you. Host: So let's dive into your background. How long have you been practicing medicine for And what drew you into oncology services? Guest 1: Well, I've been, uh, many years, uh, as a very, as a matter of fact, I grew up in Rome, in Italy, And then I came to the state to do research. Um, And then, uh, I did all my training and, uh, eventually, uh, end up to, uh, be an oncologist. But, uh, taking care of cancer patient has always been my, uh, dream. And I, I, and actually I, I, I leave this, uh, professional, like a mission. So, uh, it's really. Uh, I have a lot of proud but and humbling profession, so very Host: humbling. Guest 1: Very humbling. So, And we learn every day, so Host: Yeah. Guest 1: From our patient's. Host: Exactly. And we're gonna talk a little bit more about some of your research in a little bit. But first, um, when folks think of cancer care, sometimes they don't always think of Kaleida health. Why should somebody come to Kaleida for their care? Guest 1: Well, you know, Kalida of course has a, a, a big presence in the medical field here in Western New York, not just in Buffalo. And cancer care is part of, uh, Kaleida, um, a Host: growing part of Kaleida, Guest 1: growing part of Kaleida. And I think, uh, I came here, um, five years ago, um, to really, to build them. And, and, and grow this program. And This is really a partnership, um, and a, a strong partnership of course with the, the University of Buffalo And the UBMD. So And so with Kaleida Willi, we've been able to consolidate and, and grow this program, um, both on the medical oncology And the surgical oncology. And so, And we believe that we are in the position now really due to. To take a great care of our patient's that deserve the highest possible care. Yeah. And compassionate care. So Host: I think that's one of the key points there, right? Is the compassion. Also, what does a partnership, you know, with UBMD, for example, what does that mean for patient's in what we can offer them in terms of the services, the depth of knowledge, the number of providers, and, and those specialties? Guest 1: A very, very good point. I think it is. It's been really a strategic partnership that Carolina has, not just in oncologists, you know, but also in other fields. But for oncology in particularly because, uh, it does bring that depth and expertise. Many of us are involving. Uh, lab research or clinical research, And so have access to clinical trials. I think that's very important and, and it is partly really of outstanding cancer care. So again, the, I think this partnership has, uh, been critical And we are very excited to continue this in the future. Host: And I feel like over the past several years, there have been more clinical trial. Trials that we've been able to offer to patient's, again, because of that collaboration. Are there any that come to mind, um, or, you know, any advancements that come to mind that you're particularly proud of and, and want people to know about? Guest 1: Well, what I'm. Uh, our strong interest is actually in nutrition and, uh, diet. So we do actually have, uh, uh, three and hopefully in the next few months, four clinical trials that we offer to our patient where we offer, um, dietary restriction. We believe, uh, like many other's, the car restriction and some type of fasting and plant-based diet can help our cancer patient not only to have less side effect. From chemotherapy, for example, but increase also the efficacy of our treatment in particularly immunotherapy or monotherapy for prostate cancer. So we're very excited about that. And Host: if I understand correctly, you have some folks that are in that right now, right in Yes. Guest 1: These studies are open and accruing. Um, we're almost completed, the first studies about 30 patient, uh, where we offer, um. A calorie restriction and plant-based diet. Again, these are open to any type of cancer, um, and to any type of chemotherapy. And, and I, me, let me tell you, our preliminary observation are pretty astonished. This, this patient, some of these patient really have a much less side effect from chemotherapy, but just, uh, fasting. Before each cycle of chemotherapy. Host: So it's basically how the diet can make the, the medicine more effective. Absolutely. But also reduce, I mean, it Guest 1: is this, uh, saying food is medicine. I, I truly believe. And, uh, and, and, and, and I think it is really having healthy lifestyle, uh, not smoking, not drinking, but having a, a healthy diet. And sometimes they do, some cardio restriction might actually help these patient's. So, Host: uh, that sort of taps into the, the. The screening, the prevention, the early detection. What is your message to folks out there, no matter what, the type of cancer, what can we all be doing to take our health into our hands and hopefully either prevent things the best we can or, uh. If you get a diagnosis to put us on the right course to course to making us the healthiest. Absolutely. Guest 1: I mean, of course the prevention is, should be our goal And we don't do enough. Uh, unfortunately, the resources are limited. Um, you know, work with your primary care physician That is in the frontline, uh, to really, um, offer that type of, uh, um, screening opportunity. But as a. As a cancer care, we are really implementing with, uh, screening opportunities in breast cancer, colon cancer. We do early detection in high-risk patient pro prostate cancer, opening a, a lung screening program, uh, screening improvement for lung cancer. So I think these all initiatives are very important, especially for our. Inner city patient population Absolutely. Who have, who has less access to, uh, care. And we do see this difference since we are serving, for example, but for general suburban, the different patient population that, uh, are there. So the needs are different. So screening is a top priority for our program. Host: Absolutely. And in marginalized communities we often see higher rates, uh, of disease, but there's also. On some levels, some mistrust with healthcare providers, what can you do to sort of help break down those barriers so that people feel comfortable, uh, and they're not scared or they're not apprehensive about getting a screening or coming for healthcare? Guest 1: Um, you touch a very important, um, issue. We, we have, uh. Again, we, through Ghislaine, but also through our division at ub, we, we, um, established in an outreach program, you know, working with the churches And the communities, um, and to sense, um, make it this, uh, opportunity about screening an important, um, aspect of. Daily life for this, uh, um, patient population here in inner inner city. So we're trying to bridge that gap. Um, it's not easy. It's gonna take time. Uh, it's gonna take time, but I think Kaleida is really, um, in the best position to address these needs. And, um, we all working. For the same goals. Yeah. Host: There is a patient that I work with who was diagnosed with prostate cancer and after his diagnosis took it upon himself to go out into the community and basically scream it from the rooftops, you need to get screened. This affects us. Right? This is important. When you hear stories like that, I would imagine as a provider. That, that makes you smile and makes you feel like you're starting to crack the surface of that. Guest 1: Absolutely. And, uh, we all have a, a story like that, that we're, You know, uh, we're making difference, um, there in the community. It is a long way to go, but, um, um, that's really a priority. Host: Yeah. One of our priorities at Kaleida is sort of having that one stop shop, if you will, when it comes. To cancer care and perhaps some of the treatments that might be around it. Um. If patient's need blood work, infusion services, perhaps emergency services, we're able to provide that, which not everybody is. Guest 1: Absolutely. And I think we're very excited about, uh, the new infusion clinic And we open, um, early this year. We have a multidisciplinary clinic above for general, uh, um, across the infusion clinic and, and, and, And we are really. Position, like you said, to have a really one stop, um, uh, where patient can, um, get all the cares that need, uh, in, in one location. So, um, we're very excited about that. Um, and there is a great opportunity to grow. So, um, but uh, we we're definitely in a better position now than a few years ago. With Host: having the infusion center, the new infusion center at Buffalo General Medical Center, that also removes one of those barriers because Absolutely. Say somebody lives in the city of Buffalo, Guest 1: absolutely. They can just walk. I mean, have some patient I do, I have in my clinic, uh, at the D one here at Buffalo General, and I have a patient that just walk And so That's amazing. Yeah. Host: They don't have to travel to the suburbs, they don't have to travel. Yeah. Yeah. Which makes it very, very convenient. Um, we talked about your, your research involving nutrition. Any other research or clinical trials that might be on the horizon that you're excited about? Guest 1: Well, we are, uh, thanks to colitis support. Uh, we have, uh, a research, clinical research infrastructure. And so we are, our goal is really to try to bring clinical trial trials for the, the lot biggest disease like. Prostate cancer, uh, lung cancer, breast cancer, colon cancer. And in the future, we're gonna be able to bring also cellular therapies. This new, um, um, treatment there are on the RI horizon for many solid tumors. So again, we're very excited to be, uh, able, we we're about to open, uh, um, um, here above for general opportunity to, for patient. For prostate cancer to get a, a, a, a new compound that delivered radiation directed to the cancer cell. So again, there are more treatment coming up, more clinical trials opportunities. We're very excited. Host: And with that, more directed radiation, what does that mean for a patient, for their, their outlook, for their recovery time? Um. You know, And in their healing process. Yeah. I mean Guest 1: the, the, the future for cancer therapeutics is in this we call a drug conjugate. These are antibody warheads. They recognize retic cancer cells, And so they can deliver chemotherapy, for example, or radiation. And so the side effect. Of radiation chemotherapy, uh, much less because it's a much more targeted therapy. So again, we're very excited to be able to provide this type of treatment to our patient's. Host: And in recently talking with one of your colleagues, he was explaining that with prostate cancer, uh, these days it's not automatically going, doing very aggressive surgeries. Sometimes there's a, a watch and wait approach, watch. Guest 1: Uh, especially yes, in prostate cancer. One-third of the patient with early diagnosis of prostate cancer are candidate, what we call it for. This is not, uh, just, uh, forget about it. It is called active surveillance. So this patient monitor, um, routinely, but Those are the patient that, that actually we can offer. And over the next few weeks actually opportunity for diet and intervention. And I truly believe the change in the diet, uh, changing the exercise can actually have impact in early disease, especially disease like prostate cancer. Host: And that goes back to the prevention that Yes. That we were talking about a little bit earlier. Um, you also, one of your specialties is, is bladder cancer. Mm-hmm. What should we know about bladder cancer? The risks, um. That, that lead to it. And again, what we can do to, to take our health into our own hands. Yeah, Guest 1: absolutely. There are unfortunate, there's still too many people who are smoking. So I think a smoking cessation program, uh, is something that, uh, I know Kaleida is very involved in that, uh, working with the primary care physician, a general physician, uh, is very important. So I think, uh, um. Uh, I would love to go to the school for, to, to the kids in the schools and talk about how bad is vaping is as bad as smoking. Um, if you wanna live a healthy life. So for bladder cancer on the other side, there has been a great advancement with immunotherapy. Nowadays, we can really treat very effectively, even more advanced stage of bladder cancer. But as you said, prevention is the key. So, uh, we need to have less people smoking here. In western New York, Host: I think of mammograms for breast cancer, colonoscopies for colon cancer and prostate exams. But for some of the other cancers, are there necessarily screenings that, that we can do or, you know, what are the real preventative, proactive measures I should say, that we can take to, to try to detect it early? Guest 1: Yeah, you, again, family history is important. If you have many cases of cancer in your family, That is a sign you need to get attention as you need to get screened. Better for, even for some roughly rare disease. And so there are opportunities there, but as you mentioned, the for big, for colon cancer, prostate cancer, lung cancer, and breast cancer, There are, uh, screening tools available. Just ask your primary care physician. Um, don't be shy. Host: I used to be one of those people that, you know, was afraid to go to the doctor because I was anxious about what I was going to find out, what they were going to tell me. Right? But then I think about it, if you don't go and you learn something down the line, right, and it's. You know, a not so great diagnosis, you don't wanna be told, well, you should have been here 10 years ago. Of course. What is your message to people who maybe are a little bit apprehensive about the screenings, you know, going through the actual process, or just think that they don't have to worry about it. What would your message be and Guest 1: take ownership of, of your body and, You know, on your. Health, uh, That is, that's the message. And then part of be, again, seeing your primary care physician on a regular basis. And if there is a cancer in the family. If you're risk for cancer because you've been smoking for a long time, ask for screening opportunities. Don't be afraid because. The screening might be negative and, but you need to continue to, to check regularly, so, yeah. Um, it's, it's important. So, and, uh, and hopefully we can try to educate our kids to, to be more aware about this. Host: Yeah. And I understand you're growing your GI team soon. Guest 1: There is a opportunity for, um, um, the, um, uh, the GI teams, uh, with Dr. Gado as a surgical oncologist. They come in full-time at Kaleida. Um, as you know, he's a will national expert in, uh, epi bil tumors. They do high-risk, uh, surgery here, buffer general for this type disease. And so, And that we are bringing, actually. Uh, more medical oncology with expertise in GI cancer. So we're very excited that we can offer even more opportunity to our patient's Host: and, and it's right here in Buffalo. It's right in our backyard. In what does that mean for a patient's, not only their, their physical wellbeing, but mentally not having to travel anywhere to get cancer care, being perhaps able to still work, being close to family. That seems like it's all part of the prescription as well. Guest 1: Absolutely. And again, I, I am, our, our, um, uh, team have the expertise to treat, um, any type of cancer. And of course, uh, we are part of a larger network, so we have access to, um, other, um, uh, medical centers or any cancer centers So, It. It is not just an. Silos. We follow all this, we call it NCCA guidelines And the National Comprehensive Cancer Network Guidelines. So again, patient's do not need to travel. If the, for some reason there needs to be travel, we are gonna be the first, um, people to advocate for that. Then we're gonna take care of that. Host: Yeah, we got some of the, the best of the best right here at Kaleida Health. Guest 1: Absolutely. Host: All right. Dr. Roberto Peele, VP of Oncology Services for Kaleida Health. I really enjoyed our conversation. A lot of really great information, a lot of important information, Guest 1: a lot important. We talked about a lot of important things, so, but it was a pleasure and, and very thank you for giving me the opportunity to. Host: Yeah. And as you have more and exciting things happening, we'll come back. Yeah, we will be back. For sure. We'll be back. All right. Thanks for watching. Thanks for listening, And we will see you next time right here on medically Speaking.