Precision Medicine Made Simple

Surviving Cancer in a System That Wasn’t Built for You

What happens when a highly motivated patient meets a healthcare system that’s… not built for patients? In this episode, Kathy Giusti joins Taylor Cu and Dr. William Stanford to break down why cancer care can feel impossible to navigate—and what patients can do to take control of decisions, timelines, and outcomes. Kathy shares how her diagnosis pushed her into “research mode,” how she identified the right myeloma centers before Google existed, and why personalization in cancer care is moving from “tumor type” to the underlying biology. She also gets real about trust: when patients can’t access their doctors or get answers beyond a 15-minute visit, trust erodes fast. Key mindset shift: being informed isn’t “being difficult”—it’s survival. As Kathy puts it, the goal is to learn how to get the best medical advice, not replace your doctor. Key Takeaways: 1. How patients can build the right care team and choose specialists in a complex cancer system 2. Why trust breaks down in healthcare and how limited access impacts patient outcomes 3. The difference between personalized medicine and precision medicine in real-world care 4. How genomics and epigenetics are reshaping cancer classification and treatment decisions 5. How to use AI and digital tools to prepare for doctor visits and support shared decision-making 6. The core ideas behind Kathy Giusti’s 12-step framework for patients and caregivers navigating cancer In This Episode: 1. [00:00:00] Why patients lose trust in cancer care 2. [00:02:12] Kathy Giusti’s diagnosis + why she turned to advocacy 3. [00:05:54] The hardest early step: choosing the right team/center 4. [00:07:48] Identical twin insight + transplant-era decision-making 5. [00:09:48] Finding true specialists (and why it changes everything) 6. [00:12:51] Epigenetics, family patterns, and future cancer classification 7. [00:16:32] “Cure cancer” optimism vs the access reality 8. [00:18:10] Prevention, screening, and why people still avoid action 9. [00:21:15] Finding a great primary care doctor (and why it’s hard) 10. [00:25:46] One system vs fragmented care: coordination wins 11. [00:29:20] What precision medicine still gets wrong: clarity + language 12. [00:31:20] Trust, influencers, and using your time with doctors wisely 13. [00:36:00] Kathy’s book: Fatal to Fearless + the 12-step framework 14. [00:41:16] Using AI carefully: “prompt wisely” + trusted sources 15. [00:48:36] How to reach Kathy + closing thoughts Notable Quotes 1. “The first step in cancer is often the hardest—deciding where to go, who’s your team.” [00:07:09] 2. “Patients end up wasting their 15 minutes doing administrative work.” [00:33:12] 3. “I think the trust issue overflows because the system is so broken.” [00:31:29] Our Guest Kathy Giusti was diagnosed with multiple myeloma at 37 and given three years to live—nearly 30 years ago. She co-founded the Multiple Myeloma Research Foundation (MMRF), helping accelerate drug development and improve outcomes for patients. She’s advised U.S. Presidents on cancer research and shares practical guidance for patients and caregivers navigating complex care. Resource and Links Kathy Giusti 1. https://www.kathygiusti.com/ [https://www.kathygiusti.com/] Taylor Cu 1. https://precision-medicine-made.captivate.fm/ [https://precision-medicine-made.captivate.fm/] 2. https://www.linkedin.com/in/taylorcu [https://precision-medicine-made.captivate.fm/] 3. https://www.instagram.com/taylor_cu [https://precision-medicine-made.captivate.fm/] Dr. William Stanford 1. https://www.linkedin.com/in/william-stanford-md-phd-facp [https://www.linkedin.com/in/william-stanford-md-phd-facp] Sponsored by: Biography Health This episode is sponsored by Biography Health — where DNA-powered healthcare is designed just for you. Biography Health is a HIPAA-compliant precision medicine platform that equips providers with AI-driven recommendations powered by your genetics, health history, and clinical insights — all while keeping data private, secure, and independent from large EHR systems. If you're a provider ready to bring precision medicine into your practice, visit BiographyHealth.com to learn more. Or, if you're a patient who wants your doctor to explore this, point them our way — we’ll help them bring personalized healthcare to life.

Sleep, HRV & Longevity: What Your Data Really Means with Dr. Mohammad Jarbou

In this episode of Precision Medicine Made Simple, we continue our discussion with Dr. Mohammad Jarbou from Episode 33, where we first explored the significance of VO₂ Max testing and its role in personal health optimization. Now, we dive deeper into the importance of sleep health, heart rate variability (HRV), and the insights provided by sleep studies. Dr. Jarbou breaks down how HRV can be a valuable indicator of overall health and recovery, highlighting its connection to sleep quality and longevity. He also provides a closer look at mild sleep apnea, its effects on well-being, and how lifestyle interventions can help prevent the condition from progressing. With actionable advice on improving sleep hygiene and the science behind REM sleep rebound, this episode offers valuable insights for those looking to optimize their sleep and overall health through a precision medicine approach. Key Takeaways: * HRV reflects the balance between “fight or flight” and “rest and digest”—high HRV = good recovery. * High REM percentage can signal sleep deprivation, not “better sleep.” * Mild sleep apnea (AHI 5.6) is common and often doesn’t require CPAP in young, healthy patients. * Consistent sleep and wake times matter more than “making up sleep” with naps. * Sleep, fitness, and recovery exist in a cycle—fix one, improve the others. In This Episode: * [00:00:00] HRV explained: stress, recovery, and sleep’s role * [00:02:19] Taylor sets the stage: VO₂ max test and sleep study follow-up * [00:05:33] Home sleep study setup, devices, and first-night discomfort * [00:07:59] In-lab sleep studies vs home sleep tests * [00:10:35] 4–3–2–1 sleep hygiene rule and real-life challenges * [00:13:18] HRV, alcohol, and what readiness metrics can and can’t tell you * [00:16:44] Total sleep time: why 5–6 hours is Taylor’s “first problem” * [00:18:30] High REM percentage and REM rebound from sleep deprivation * [00:20:00] Deep sleep vs REM: what truly restores your body * [00:24:33] AHI, 3% vs 4% oxygen drop, and Taylor’s mild sleep apnea * [00:29:32] Snoring, sleeping on your back, and positional therapy * [00:35:42] Naps, “social jet lag,” and protecting your sleep drive * [00:40:28] When to repeat sleep studies and add body composition (DEXA) * [00:43:05] Taylor’s takeaways and next step: VO₂ max deep dive in a future episode Notable Quotes: * “REM sleep isn’t the restorative stage—deep non-REM sleep is where your body really recovers.” – Dr. Jarbou * “If your HRV is low in the morning, it’s often your body telling you it didn’t get the recovery it needed.” – Dr. Jarbou * “Most people don’t need fancy tests—they need better sleep structure and consistency.” – Dr. Jarbou * “Mild sleep apnea doesn’t mean treatment right away. Fix the basics first.” – Dr. Jarbou Our Guest Dr. Mohammad Jarbou is a physician with over 20 years of experience in pulmonary medicine, critical care, sleep medicine, and clinical informatics. He is the co-founder of the Longevity Clinic, a practice dedicated to proactive, personalized care aimed at optimizing health and preventing chronic diseases. Dr. Jarbou combines genetic testing, fitness assessments, and sleep optimization to create individualized wellness plans that promote health span and longevity. Resource and Links Dr. Mohammad Jarbou * https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/mohammad-jarbou-md [https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/mohammad-jarbou-md] * https://www.linkedin.com/in/mohammad-jarbou-42300a2b/ [https://www.linkedin.com/in/mohammad-jarbou-42300a2b/] Taylor Cu * https://precision-medicine-made.captivate.fm/ [https://precision-medicine-made.captivate.fm/] * https://www.linkedin.com/in/taylorcu [https://precision-medicine-made.captivate.fm/] * https://www.instagram.com/taylor_cu [https://precision-medicine-made.captivate.fm/] Dr. William Stanford * https://www.linkedin.com/in/william-stanford-md-phd-facp [https://www.linkedin.com/in/william-stanford-md-phd-facp] Sponsored by: Biography Health This episode is sponsored by Biography Health — where DNA-powered healthcare is designed just for you. Biography Health is a HIPAA-compliant precision medicine platform that equips providers with AI-driven recommendations powered by your genetics, health history, and clinical insights — all while keeping data private, secure, and independent from large EHR systems. If you're a provider ready to bring precision medicine into your practice, visit BiographyHealth.com to learn more. Or, if you're a patient who wants your doctor to explore this, point them our way — we’ll help them bring personalized healthcare to life.

Inside the Membership Model That’s Making Healthcare Personal Again

The traditional healthcare system is breaking under the weight of burnout, short appointments, and profit-driven incentives, and Dr. Adam Wheeler has lived it from the inside. After losing a patient and realizing that all his creative energy was going into improving metrics instead of improving lives, he decided to build something radically different. In this episode of Precision Medicine Made Simple, recorded live at Bigtree Medical in Columbia, Missouri, Dr. Wheeler joins host Taylor Cu and co-host Dr. William Stanford to share how he reimagined primary care from the ground up. His direct primary care network now serves more than 13,000 patients with a model built on unlimited time, transparent pricing, and authentic, patient-centered relationships. You’ll hear how Dr. Wheeler’s model leverages nurse practitioners to expand access, integrates genetic and metabolic testing to personalize care, and embraces patient-requested treatments such as testosterone therapy, compounded GLP-1s, IV infusions, and preventive protocols. He also discusses how AI and shared decision-making empower patients to take control of their health, creating a system that rewards outcomes instead of volume. This conversation explores what it truly takes to make healthcare personal again and why the future of medicine belongs to those willing to rebuild it from trust, data, and compassion. Key Takeaways * Why Dr. Wheeler walked away from the traditional insurance model * How the direct primary care (DPC) membership system works and why patients love it * The role of nurse practitioners in solving the physician shortage * How Bigtree trains new NPs to lead with empathy and precision * Why shared decision-making is critical to modern medicine * What peptides, testosterone therapy, and GLP-1 medications mean for personalized care * How AI tools are empowering, not replacing, doctors * Why genetic and metabolic testing helps patients “know the fight they’re fighting” * The real difference between health span and lifespan and how to extend both * What the future looks like when healthcare becomes proactive instead of reactive In This Episode * [00:00] Turning points in medicine * [01:17] Intro to Precision Medicine Made Simple * [02:39] Meet Dr. Adam Wheeler * [05:49] Membership model explained * [07:23] Bigtree care models * [08:19] Scaling intimacy in care * [08:48] Direct vs. concierge care * [09:51] Innovative patient care * [31:34] Genetics and cancer risk * [33:11] Personalized medicine * [34:06] Motivational interviewing * [35:11] Prostate cancer and genetics * [49:50] AI in healthcare * [53:01] AI’s role in medicine * [56:39] Bigtree Medical vision * [57:48] Final thoughts Notable Quotes * [05:43] “It’s really sad that all this creative energy is going to juicing the numbers, as opposed to taking care of people.” — Dr. Adam Wheeler  * [05:24] “We allow our patients to leave our practice at any time. If we do a bad job, they’re supposed to leave, and if we do a good job, they stay.” — Dr. Adam Wheeler  * [14:27] “The direct pay model absolutely changes your incentives as a doctor… it forces you to care about the things patients actually care about.” — Dr. Adam Wheeler * [38:21] “There’s nothing you can do about the Lp(a), but you need to really optimize all of your other numbers.”— Dr. Adam Wheeler * [55:19] "I think before we have AI replacing me, we're gonna have me enabled with AI." — Dr. Adam Wheeler Our Guest Dr. Adam Wheeler is a board-certified pediatrician and the founder of Bigtree Medical, a membership-based direct primary care practice based in Columbia, Missouri. Under his leadership, Bigtree serves over 13,000 patients and continues to expand access to affordable, compassionate, and high-quality healthcare. He has been recognized as Missouri’s Best Young Physician (2019) and Entrepreneur of the Year (2021) for his innovation in healthcare delivery. Resources and Links Dr. Adam Wheeler * https://www.linkedin.com/in/adam-wheeler-a972a039/ [https://www.linkedin.com/in/adam-wheeler-a972a039/] * https://bigtreemedical.com/ [https://bigtreemedical.com/] Taylor Cu * https://precision-medicine-made.captivate.fm/ [https://precision-medicine-made.captivate.fm/] * https://www.linkedin.com/in/taylorcu [https://precision-medicine-made.captivate.fm/] * https://www.instagram.com/taylor_cu [https://precision-medicine-made.captivate.fm/] * LinkedIn [https://precision-medicine-made.captivate.fm/] * Instagram [https://www.instagram.com/taylor_cu] Dr. William Stanford * https://www.linkedin.com/in/william-stanford-md-phd-facp [https://www.linkedin.com/in/william-stanford-md-phd-facp] Sponsored by: Biography Health This episode is sponsored by Biography Health — where DNA-powered healthcare is designed just for you. Biography Health is a HIPAA-compliant precision medicine platform that equips providers with AI-driven recommendations powered by your genetics, health history, and clinical insights — all while keeping data private, secure, and independent from large EHR systems. If you're a provider ready to bring precision medicine into your practice, visit BiographyHealth.com to learn more. Or, if you're a patient who wants your doctor to explore this, point them our way — we’ll help them bring personalized healthcare to life.

Optimizing Health Span: How Fitness, Sleep, and Genetics Shape Longevity

In this episode of Precision Medicine Made Simple, we’re joined by Dr. Mohammad Jarbou, co-founder of the Longevity Clinic. Dr. Jarbou, a board-certified physician in pulmonary medicine, critical care, sleep medicine, and clinical informatics, discusses how his clinic uses a holistic approach to aging and health span. The clinic focuses on prevention and early detection, utilizing personalized medicine, genetic testing, fitness plans, and sleep optimization. Dr. Jarbou explains how cutting-edge practices, such as VO2 max testing, personalized nutrition, and genetic evaluations, help optimize long-term health. He also highlights the importance of muscle mass and good sleep hygiene for aging well, and how these factors are integral to preventing chronic diseases. Key Takeaways: * VO2 max testing is an excellent predictor of longevity and health span. * Muscle mass is critical for long-term health and quality of life. * Genetic testing helps guide personalized wellness plans and prevent chronic illness. * Sleep hygiene plays a significant role in overall health, affecting everything from energy to metabolism. * Personalized health strategies should incorporate fitness, nutrition, and genetics to achieve optimal wellness. * Prevention of chronic conditions like diabetes, Alzheimer’s, and sleep apnea can be achieved with early detection and lifestyle modifications. In This Episode: * [00:00] – Introduction to Dr. Mohammad Jarbou and the Longevity Clinic * [05:00] – How the clinic’s focus on prevention and early diagnosis led to personalized care * [10:00] – The significance of VO2 max testing and wearable technology for tracking fitness * [15:00] – The importance of muscle mass and weightlifting for longevity * [20:00] – The role of genetic testing in guiding personalized health strategies * [25:00] – How sleep quality affects overall health and Dr. Jarbou’s tips for better sleep * [30:00] – The benefits of personalized nutrition and building sustainable habits * [35:00] – Addressing chronic conditions with early intervention and prevention * [40:00] – Hormone replacement therapy and its role in health optimization for longevity * [45:00] – How genetic testing can help identify risks for chronic diseases like Alzheimer’s Notable Quotes * "Longevity is not just how long you live, but the quality of life you have along the way." – Dr. Mohammad Jarbou * "Muscle mass is critical for both physical function and longevity." – Dr. Mohammad Jarbou * "Prevention should be the foundation, not an afterthought, when it comes to aging and health." – Dr. Mohammad Jarbou * "You can't just focus on one area of health. Fitness, nutrition, sleep, and genetics all play an essential role in how you age." – Dr. Mohammad Jarbou * "Small changes in habits can have a huge impact on your longevity." – Dr. Mohammad Jarbou Our Guest Dr. Mohammad Jarbou is a physician with over 20 years of experience in pulmonary medicine, critical care, sleep medicine, and clinical informatics. He is the co-founder of the Longevity Clinic, a practice dedicated to proactive, personalized care aimed at optimizing health and preventing chronic diseases. Dr. Jarbou combines genetic testing, fitness assessments, and sleep optimization to create individualized wellness plans that promote health span and longevity. Resource and Links Dr. Mohammad Jarbou * https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/mohammad-jarbou-md [https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/mohammad-jarbou-md] * https://www.linkedin.com/in/mohammad-jarbou-42300a2b/ [https://www.linkedin.com/in/mohammad-jarbou-42300a2b/] Taylor Cu * https://precision-medicine-made.captivate.fm/ [https://precision-medicine-made.captivate.fm/] * https://www.linkedin.com/in/taylorcu [https://precision-medicine-made.captivate.fm/] * https://www.instagram.com/taylor_cu [https://precision-medicine-made.captivate.fm/] Dr. William Stanford * https://www.linkedin.com/in/william-stanford-md-phd-facp [https://www.linkedin.com/in/william-stanford-md-phd-facp] Sponsored by: Biography Health This episode is sponsored by Biography Health — where DNA-powered healthcare is designed just for you. Biography Health is a HIPAA-compliant precision medicine platform that equips providers with AI-driven recommendations powered by your genetics, health history, and clinical insights — all while keeping data private, secure, and independent from large EHR systems. If you're a provider ready to bring precision medicine into your practice, visit BiographyHealth.com to learn more. Or, if you're a patient who wants your doctor to explore this, point them our way — we’ll help them bring personalized healthcare to life.

Understanding Polygenic Risk Scores: A Deep Dive into Genetics and Predictive Healthcare

In this episode of Precision Medicine Made Simple, we’re joined by Dr. Jeff Gulcher, co-founder of Decode Genetics and current leader at Galateo Bio. Dr. Gulcher shares his vast experience in the field of genomics and precision medicine, covering everything from polygenic risk scores (PRS) to the challenges of integrating diverse genetic data into predictive healthcare. Dr. Gulcher takes us back to the early days of genetic research with Decode Genetics, where his team pioneered genome-wide association studies (GWAS) in Iceland. He dives into the development of PRS and the challenges of improving disease prediction models, especially by ensuring they are accurate across diverse populations. In addition, Dr. Gulcher discusses his personal journey with prostate cancer and how polygenic risk scores helped predict his elevated risk at an early age. The episode also covers how genomics, when combined with other clinical data, can revolutionize preventative healthcare. Key Takeaways: * Polygenic risk scores (PRS) are essential in predicting the risk for diseases like cancer and cardiovascular conditions. * The development of PRS is revolutionizing preventative healthcare, especially when there's no family history. * Ancestry-aware PRS models are crucial, as current models are mainly based on European populations. * Dr. Gulcher’s personal experience with prostate cancer demonstrates the power of early genetic screening. * Combining genetic data with clinical risk factors can provide a more accurate disease risk prediction. * The future of PRS lies in the integration of AI and better data representation across diverse populations. In This Episode:  * [00:00] – Introduction to Dr. Jeff Gulcher and the significance of polygenic risk scores * [05:00] – Dr. Gulcher’s background and the founding of Decode Genetics * [10:00] – How polygenic risk scores work and their application in predicting diseases * [15:00] – The challenge of making PRS models work for non-European populations * [20:00] – Dr. Gulcher's personal story: how early genetic testing saved his life * [25:00] – The role of genetic data in determining the risk for common diseases like prostate cancer * [30:00] – The importance of combining genetic risk with lifestyle factors in disease prevention * [35:00] – The potential of AI in refining polygenic risk score models * [40:00] – The challenges of integrating genetic data into real-world clinical practice * [45:00] – How diverse genetic data will help improve precision medicine globally Notable Quotes: * “Polygenic risk scores help us understand how much our genes contribute to disease, but they are just one piece of the puzzle.” – Dr. Jeff Gulcher * “Genetics isn’t destiny, but it’s an important part of the story, especially when combined with other risk factors.” – Dr. Jeff Gulcher * “We need to build more inclusive data sets so that precision medicine works for everyone, not just for those of European ancestry.” – Dr. Jeff Gulcher * “Personalized healthcare is about understanding each individual’s unique genetic makeup and how that impacts their risk for disease.” – Dr. Jeff Gulcher * “Polygenic risk scores are not diagnostic, but they can offer a more accurate prediction for individuals at risk.” – Dr. Jeff Gulcher Our Guest Dr. Jeff Gulcher is a co-founder of Decode Genetics and the Chief Scientific Officer at Galateo Bio. With over 200 publications and years of pioneering work in genetics, he has been instrumental in shaping the field of genomic medicine. Dr. Gulcher’s current work at Galateo Bio focuses on building a global biobank with diverse genetic data to advance precision medicine, particularly for underserved populations. Resource and Links Dr. Jeff Gulcher * https://www.linkedin.com/in/jeff-gulcher-274912a [https://www.linkedin.com/in/jeff-gulcher-274912a] * https://galatea.bio/ [https://galatea.bio/] Taylor Cu * https://precision-medicine-made.captivate.fm/ [https://precision-medicine-made.captivate.fm/] * https://www.linkedin.com/in/taylorcu [https://precision-medicine-made.captivate.fm/] * https://www.instagram.com/taylor_cu [https://precision-medicine-made.captivate.fm/] Dr. William Stanford * https://www.linkedin.com/in/william-stanford-md-phd-facp [https://www.linkedin.com/in/william-stanford-md-phd-facp] Sponsored by: Biography Health This episode is sponsored by Biography Health — where DNA-powered healthcare is designed just for you. Biography Health is a HIPAA-compliant precision medicine platform that equips providers with AI-driven recommendations powered by your genetics, health history, and clinical insights — all while keeping data private, secure, and independent from large EHR systems. If you're a provider ready to bring precision medicine into your practice, visit BiographyHealth.com to learn more. Or, if you're a patient who wants your doctor to explore this, point them our way — we’ll help them bring personalized healthcare to life.