Symptoms Spotlight: Neutropenia with Abigail Johnston and Melanie Sisk

Symptoms Spotlight: Vaginal Dryness with Abigail Johnston and Melanie Sisk

In this episode of Symptoms Spotlight, hosts Abigail Johnston and Melanie Sisk take an honest and personal look at one of the most common yet least talked about side effects of metastatic breast cancer treatment: vaginal dryness. Both living with MBC, Abigail and Melanie share what has worked for them, from water-based lubricants and coconut oil to topical lidocaine cream and low-dose estradiol. They talk openly about the emotional toll of painful intimacy, the importance of a supportive partner, and the challenge of finding the right provider to have these conversations with. The episode also explores a question many MBC patients wrestle with: is vaginal estrogen safe when your cancer is estrogen receptor positive? Podcast team member and retired OB-GYN Dr. Ellen Landsberger weighs in with the latest clinical evidence, including findings from a 2025 systematic review published in the American Journal of Obstetrics and Gynecology, offering cautious reassurance along with practical guidance on recommended formulations. Whether you are newly navigating these symptoms or have been managing them for years, this episode reminds you that you are not alone, that options exist, and that talking about it is the first step. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org [http://www.livefromstage4.org/] for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Developing Story: The Trial That Dares to Say Cure with Dr. Lior Braunstein

We've always been told that metastatic breast cancer can't be cured, only managed. But what if that's no longer the whole story? In this episode of Live from Stage 4, hosts Victoria Goldberg and Dr. Ellen Landsberger sit down with Dr. Lior Braunstein, a radiation oncologist at Memorial Sloan Kettering Cancer Center, to talk about the ARCHER trial, a first-of-its-kind clinical study asking a bold question: can surgery and radiation, added on top of standard HER2-targeted therapy, eradicate every last cancer cell in patients with oligometastatic HER2-positive breast cancer? Dr. Braunstein breaks down what "oligometastatic" really means, why HER2-positive disease is uniquely positioned for this kind of approach, what ablative radiation to the liver or lungs actually involves, and why the word "cure" makes oncologists nervous, even when it might be warranted. We also cover: * What the ARCHER trial is looking for in eligible patients * Why previous trials failed to answer this question * How cancer develops resistance and why treating visible disease early may be the key * The role of AI in matching patients to clinical trials * What comes next if the trial succeeds Who should listen: Anyone living with HER2-positive metastatic breast cancer, their caregivers, oncology professionals, and anyone who believes patients deserve to hear the hard questions asked out loud. 🔗 Find the ARCHER trial: search "ARCHER trial breast cancer" at clinicaltrials.gov 📝 Show notes and resources at https://www.livefromstage4.org/ Nothing in this episode constitutes medical advice. Please consult your own medical team before making any decisions about Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org [http://www.livefromstage4.org/] for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Developing Story: CureWise Goes Live - The AI Platform Built by Cancer Patients, for Cancer Patients

Last time, we had a front row seat to a vision. This time, that vision has a launch date. On June 20th, CureWise officially launched, and for every cancer patient who walks into an oncologist's office with ten minutes and no idea what to ask, it couldn't come at a better time. In this episode of Live From Stage 4, Victoria Goldberg sits down with Steve Brown (founder & CEO of CureWise) and Lisa Booth (metastatic breast cancer advocate and CureWise's patient #2) to talk about what it actually means to have an AI platform that knows your full medical history, speaks your language, and helps you show up to your appointments prepared and empowered. Also joining us: Beta users Lynda Weatherby (MBC patient and Live From Stage 4  team memberr) and her husband Todd Weatherby (CEO of Siemens Advanta, former VP at AWS), bringing the real-world patient and caregiver perspective to the conversation. In this episode: * How CureWise pulls your medical records from multiple institutions automatically * The Cross-Check feature: asking ChatGPT, Claude, and Gemini the same question simultaneously * Why 60% of cancer patients have an actionable mutation, but only 15% are being treated for it * How to prepare for your oncology appointment using AI * The caregiver experience and what's coming next on the roadmap * Pricing, the 7-day free trial, and how to get started Important note: CureWise is not a doctor. It is a powerful tool to help you understand your medical records and have better conversations with your care team. All medical decisions should be made with your physician. 🔗 Sign up at www.curewise.com [http://www.curewise.com/] Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org [http://www.livefromstage4.org/] for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Developing Story: Beyond Camizestrant — The Evolving Landscape of ER+/HER2- MBC with Dr. Sarah Premji

The field of hormone receptor-positive, HER2-negative metastatic breast cancer is moving faster than ever, and in this episode, we go beyond SERENA-6 to map the full picture of what's changing. Joining hosts Victoria Goldberg and Abigail Johnston is Dr. Sarah Premji, Assistant Director of Breast Cancer Research at Sarah Cannon in Nashville, for a comprehensive deep dive into the new wave of endocrine therapies reshaping treatment for the most common subtype of breast cancer. Together, they cover the evolution from CDK4/6 inhibitors to the era of oral SERDs, FDA approvals of elacestrant, imlunestrant, and vepdegestrant and what makes each unique, the emerging mechanisms of PROTACs and CERANs, and how ESR1 mutations drive treatment decisions at progression. Dr. Premji also shares her real-world approach to sequencing therapy, weighing tumor profiling, prior treatment history, sites of disease, and each patient's individual lifestyle and priorities. The conversation closes with a look at the growing role of AI in oncology, from clinical trial matching to pathology and imaging. Whether you are a community oncologist navigating an increasingly complex algorithm or a patient advocate trying to stay current, this episode is your guide to where ER+ breast cancer treatment stands today and where it is headed. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org [http://www.livefromstage4.org/] for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Symptoms Spotlight: Neutropenia with Abigail Johnston and Melanie Sisk

In this episode of the Symptom Spotlight Series, hosts Abigail Johnston and Melanie Sisk are joined by Dr. Jill Tirabassi, this podcast's team member, to break down neutropenia. It is one of the most common and important side effects of cancer treatment. Dr. Tirabassi explains what neutropenia actually means, why neutrophils matter, and how chemotherapy and CDK 4/6 inhibitors can deprive your body of these critical infection-fighting white blood cells. The conversation covers what happens when your absolute neutrophil count (ANC) drops too low, when your oncology team might delay or reduce your dose, and what medications like bone marrow stimulators (and the auto-injectors that deliver them) can do to help. The hosts also share their own personal experiences: from managing bone pain with loratadine (Claritin), to navigating a hospital admission with a dangerously low ANC, to learning what questions to ask your doctor before a fever or infection hits on a weekend. Topics covered: * What neutropenia is and why it's a concern during cancer treatment * The ANC number your care team watches and what happens when it's too low * Bone marrow-stimulating drugs: how they work, timing, and side effects * Lifestyle tips (diet, masking, sleep) when your counts are low * CDK 4/6 inhibitors and dose reductions * When to call your doctor vs. go to the ER, and why that conversation matters Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org [http://www.livefromstage4.org/] for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.