Forget the old narrative that lung cancer belongs only to smokers. We open the door to a different reality: a rising number of women, many in their 30s to 50s, who never smoked, face late-stage diagnoses and limited options. With Dr. John Xie from Virginia Oncology Associates, we break down the biology that sets non-smoker lung cancers apart and the practical steps that can save lives through earlier detection and smarter treatment.

Dr. Xie explains how genetics, hormones, and environment intersect, with a particular focus on East Asian women who show a higher prevalence of EGFR-driven disease. A vivid case study of a 40-year-old non-smoker misdirected toward melanoma reveals how easily lung cancer hides behind atypical symptoms like vision loss, fatigue, or bone pain, and why biopsy and staging matter before assumptions take over.

From there, we dive into solutions. Precision oncology has changed the map: EGFR inhibitors now extend median survival in stage four disease, and combinations with chemotherapy are pushing gains further. Early-stage detection is where cure lives, and new evidence from a study of 1,000 East Asian non-smoking women shows low-dose CT can find lung cancers at stages one to three with detection rates similar to smokers. We talk through access hurdles, how to push for imaging when symptoms persist, and the promise of pairing low-dose CT with routine mammograms to simplify screening for select women.

If you or someone you love has risk factors like East Asian ancestry, a family history of lung cancer, or unexplained symptoms that won’t resolve: ask for evaluation and consider low-dose CT.

Dr. John Xie is board-certified in medical oncology, hematology, and internal medicine. He grew up in Connecticut and studied at Columbia University, and graduated with a Bachelor of Science in Biomedical Engineering. After that, he obtained his Doctorate in Medicine from the Geisel School of Medicine at Dartmouth and finished his internal medicine residency at Tulane Medical Center.

Dr. Xie treats patients with all types of cancer and blood disorders. He remains actively engaged in advancing the field of hematology and oncology, particularly through clinical trials. He has published peer-reviewed research in several publications, including Leukemia & Lymphoma. He has also presented at numerous conferences, including the American Society of Hematology (ASH) Annual Meeting.

Resources:

• American Cancer Society: https://www.cancer.org/
• https://clinicaltrials.gov/
• Female Asian Nonsmoker Screening Study: https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.8510
• Stanford Study: https://med.stanford.edu/news/insights/2025/05/lung-cancer-women-mammogram-screening.html

Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.

Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.

Most thyroid cancers are not just treatable; they’re highly curable, and the newest guidelines make the path to cure gentler than ever. We welcome Dr. Michael Miller, radiation oncologist at Virginia Oncology Associates, to break down who thyroid cancer affects, how it’s found, and why the 2025 American Thyroid Association (ATA) guidelines lean into less invasive care without sacrificing outcomes.

We start with the basics: the demographics of thyroid cancer, why young women face a higher risk, and the simple steps that lead from a neck lump to diagnosis. From there, we compare the old “one-size-fits-all” approach to today’s options, including active surveillance for select low-risk patients and hemithyroidectomy that preserves half the gland and often avoids lifelong hormone replacement. Dr. Miller demystifies radioactive iodine therapy by explaining how thyroid cells’ appetite for iodine turns a small capsule into targeted internal radiation, and why modern doses are a fraction of what was used two decades ago, cutting side effects and shortening isolation.

Not all cancers listen to the rules, so we also cover advanced and metastatic scenarios, where radioactive iodine may lose its punch. Here, targeted therapies like lenvatinib and sorafenib bring new options and new hope, guided by molecular insights. Finally, we map the aftercare that keeps people safe: thyroglobulin as a reliable tumor marker, neck ultrasound as a simple, precise surveillance tool, and the indispensable role of a skilled endocrinologist in long-term follow-up. If you or someone you love has questions about a thyroid nodule, family history, or the path from diagnosis to recovery, this conversation offers clarity, practical steps, and trusted resources.

If this helped you feel more informed and less anxious, subscribe, share with a friend who needs it, and leave a review to help others find the show.

Resources:

American Thyroid Association (ATA): https://www.thyroid.org/

ATA Low Iodine Diet: https://www.thyroid.org/low-iodine-diet/

Previous episode with Dr. Michael Miller: https://cancercareconnections.buzzsprout.com/2167428/episodes/15842196-revolutionizing-cancer-care-advances-in-radiation-oncology

Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.

Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.

When cancer enters the room, clarity can vanish. We dive straight into that moment—what gets heard, what gets lost, and how mental health care can restore focus when everything tilts. With medical oncologist Dr. Nina Balanchivadze, palliative care psychiatrist Dr. Kyle Lavin, and patient Melissa, we map the real terrain: shock at diagnosis, sleepless nights, caregiver overload, survivor guilt, and the quiet dread behind “staying strong.”

Dr. B explains how she balances tumor biology with human reality, using both formal screening (PHQ-9, GAD-7) and subtle cues to catch distress early. She names the burdens some patients undergo: identity shifts from hair loss, financial strain, and the emotional cost of being “the fighter.”

Dr. Lavin opens the door to a different standard: a collaborative care model that brings a care manager and consulting psychiatrist onto the oncology team. The result is faster access, tailored brief therapies, careful medication choices that avoid cancer drug interactions, and measurable improvements in depression, anxiety, and quality of life.

Melissa’s story shows the stakes. A rare diagnosis, rapid referrals, and leading-edge immunotherapy didn’t spare her from fear or uncertainty. What changed everything was timely, plainspoken support from professionals outside her family who could navigate the system, push for results, and teach practical tools. Together, they make the case for a culture shift: treat mental health as the fourth pillar of oncology, offer it from day one, and remove the stigma so help arrives when it’s needed most.

If this conversation resonates, share it with someone facing cancer, subscribe for more human-centered oncology, and leave a review to help others find these tools and stories.

To learn more about Cerula Care visit: https://cerulacare.com/

Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.

Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.