A tiny change on your skin can be the loudest early warning you’ll ever get, and it doesn’t always show up where you expect. We sit down with Dr. Celeste Bremer, a board-certified medical oncologist and hematologist at Virginia Oncology Associates, for a clear, practical conversation about what skin cancer can look like and what to do when something on your skin just feels off. If you live near the beach, spent your childhood getting burned, or simply haven’t checked your skin in a while, this one is for you.

We walk through the ABCDE rule for melanoma, then talk about the other half of cases that don’t follow it. Dr. Bremmer explains what “fast-growing but symmetric” nodular melanoma can look like, plus the high-miss areas people rarely check: nail beds, palms, and soles. You’ll hear why acral lentiginous melanoma and subungual melanoma are often mistaken for a callus, fungus, or a simple injury, and why delayed healing matters. We also dig into risk factors, including family history, lots of moles, and being immunocompromised.

From there, we zoom out to what a dermatologist actually does during a head-to-toe skin exam, why biopsy timing is so important, and what happens if melanoma spreads. Dr. Bremer also shares how melanoma treatment has evolved, especially with immunotherapy, maintenance approaches, and clinical trials including vaccine strategies that are pushing survival and quality of life forward in a way we didn’t have 10 to 20 years ago.

If this sparked a little concern, use it as momentum: do a quick self-check, book a dermatologist visit if something is new or changing, and share this conversation with someone who keeps putting off their skin exam. Subscribe, leave a review, and tell us what skin-check habit you’re starting this week.

Dr. Celeste A. Bremer is board-certified in Medical Oncology and Hematology. She has conducted Hematology/Oncology research, with a special focus on breast tumors. She is also involved in clinical research as a primary investigator on several hematologic disorders.

Dr. Bremer is a diplomate of the American Board of Internal Medicine, with subspecialties in Hematology and Oncology. She is a fellow of the American College of Physicians (FACP) and an active member of the American Society of Clinical Oncology (ASCO) and American Society of Hematology (ASH). She received the Governor's Recognition Award from ACP's Navy Chapter in 2006 and the Navy Commendation Medal from the Expeditionary Medical Facility in 2007 for superior patient care at Camp Lemonier, Djibouti, Africa.

Dr. Bremer served on the Board of Directors for Susan G. Komen for four years and currently serves on the Board of Directors for Wings Over Leukemia and Lymphoma and Hampton Roads Cancer Care Foundation, and she is part of the Breast and Colon Cancers Committee with Sentara.

Resources:

NCCN Guidelines: https://www.nccn.org/patients/guidelines/content/PDF/melanoma-patient.pdf

ACS: https://www.cancer.org/cancer/types/melanoma-skin-cancer.html

Melanoma Research Foundation: https://melanoma.org/

NCI: https://www.cancer.gov/types/skin

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.

People hear “social worker” and think crisis, child removal, or something you only need if you are struggling financially. That misconception can quietly keep patients and families from getting support that would make cancer treatment easier, earlier, and more sustainable.

We sit down with KeAuna and Elisabeth to explain what oncology social work actually looks like inside the clinic and across the full cancer journey. We talk about preventative, whole-person support: coping with distress, navigating psychosocial stress, and problem-solving the practical barriers that can derail care. That includes help with transportation, financial concerns, and even applications like disability or Medicaid when life changes fast during treatment. We also share how social work fits into the larger healthcare team, working alongside medical providers to support both the person in treatment and the people who love them.

We also focus on the family system around cancer. Caregivers can burn out, kids need age-appropriate language and emotional support, and households often need community resources to stay steady. We discuss partnerships and outreach that bring tangible help to patients, from local organizations to seasonal assistance, because life does not pause for a diagnosis.

If you have ever thought, “Someone else needs this more than me,” this conversation is for you. Subscribe, share this episode with someone who could use support, and leave a review to help more patients and families find Cancer Care Connections.

https://www.virginiacancer.com/cancer-resources/

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.

Nobody wants to imagine a crisis, but most medical emergencies don’t arrive with a warning or a neat checklist. We sit down with Dr. Galicia-Castillo, a leader in geriatrics and palliative medicine, to talk about advance care planning in plain terms and why it should start far earlier than most people think. The goal is not to predict every possible outcome. The goal is to protect your voice and lighten the load on the people you love.

We walk through what an advance care plan actually includes and why naming the right health care proxy matters more than trying to script every medical scenario. Dr. Galicia-Castillo shares a powerful story about how a completed plan can bring peace after an unexpected tragedy, and she explains what can happen when you do not choose a decision maker and state law takes over. We also talk about complicated family realities, including separation and blended families, where the “default” decision maker may not be the person you would want.

From there, we dig into quality of life, how to clarify your values, and how those values guide real medical decisions when technology, such as ventilators, dialysis, and other life-sustaining treatments, enters the picture. We also explain the difference between advance directives (guidance) and medical orders, such as DNR and POLST forms. Finally, we cover practical next steps: where to find conversation tools, how to share copies with your surrogate decision-maker and your doctor, and how to make sure your documents are accessible while traveling.

If you’ve been putting this off, use this conversation as the nudge to start. Subscribe, share this with someone you care about, and leave a review. Who would you trust to speak for you if you couldn’t?

Resources Mentioned in this Podcast:

The Conversation Project: https://theconversationproject.org/wp-content/uploads/2020/12/ConversationStarterGuide.pdf

US ACP Registry: https://www.usacpr.com/

Advance Care Planning Guide and Forms for VA & NC (Spanish Available): https://www.sentara.com/patientguide/advance-care-planning

Virginia Advance Directives Page: https://virginiaadvancedirectives.org/
Link to Forms (scroll down the page under the map): https://virginiaadvancedirectives.org/completing-an-advance-directive/

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.

Cancer changes more than your body. It can shake your sense of control, rewrite your identity, and make everyday life feel like it’s happening in a different language than everyone else is speaking.

We sit down with the Virginia Oncology Associates oncology social work team to talk plainly about mental health during the cancer journey for both patients and caregivers. We walk through the emotional reality of diagnosis, treatment, survivorship, and end-of-life care, including fear, shock, sadness, anger, anxiety, and the fear of recurrence that can linger long after treatment ends. We also name something we hear all the time: the pressure to “stay strong.” When people feel like they can’t share what they’re really feeling, they may withdraw, miss appointments, or struggle in silence while juggling financial stress, transportation, work, and family roles.

Caregivers are a huge part of cancer care, and their mental health often gets overlooked. We talk about guilt, isolation, and the heavy burden of trying to hold everything together, plus the subtle signs of caregiver burnout like brain fog, mood changes, emotional numbness, and getting sick more often.

We share practical ways to ask for help in small steps, use community resources, and reframe support as strength, not weakness, especially when stigma and access barriers are shaped by culture, age, race, and socioeconomic stress.

Make sure to visit our show notes for mental health resources mentioned in this podcast.

Resources:

988: https://988lifeline.org/
NAMI: https://www.nami.org/
VOA: https://www.virginiacancer.com/cancer-resources/#support-groups-at-voa

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.

We sit down with Dr. Gary Simmons and Fred Varewyck to explain CAR T cell therapy for multiple myeloma and what it can mean for deeper remission and real time away from treatment. Dr. Gary Simmons unpacks how CAR T works, why it’s a major advancement in blood cancer care, and what “treatment-free time” can look like when it succeeds.

We also get specific about the lived experience. Fred walks through diagnosis, stem cell transplant, relapse, and the mindset that helped him say yes when CAR T finally became possible. Dr. Simmons explains the practical timeline, including the four-to-six-week manufacturing window, and why some patients need urgent “bridge” treatment first. Then we dive into what makes Virginia Oncology Associates’ outpatient CAR T model so meaningful: infusion at the clinic, daily check-ins, and recovery at home rather than hospitalization.

The other thread running through everything is support and trustworthy information. We talk about why “Google medicine” can push patients away from the right care, why you should speak with clinicians who specialize in cellular therapy, and how caregivers make appointments easier for patients by taking notes or recording guidance. Fred shares community resources that help patients feel less alone (check out the show notes).

If you found this helpful, subscribe, share the episode with someone navigating multiple myeloma, and leave a review so more patients and caregivers can find these conversations.

Dr. Gary L. Simmons is a recognized national leader in the advancement of community-based oncology. Within the US Oncology Network, he has been instrumental in bridging the gap between academic research and community access, with a specific clinical focus on CAR T-Cell Therapy and its evolving role in patient care, the treatment of complex Hematologic malignancies, and expanding the reach of advanced cellular therapies beyond the traditional university hospital setting.

Resources:

https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1712533/full

https://www.polygonhealth.co/map

https://www.facebook.com/groups/239866928407935

Southeastern Virginia (SEVA) Multiple Myeloma Support Group. Email Brenda Riggs or Stephanie Kailos at seva@imfsupport.org

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.

Cancer doesn’t just change lab results; it reshapes daily life. Our Virginia Oncology Associates Social Work team opens the door to whole-person care, starting at diagnosis. They show how early outreach, clear planning, and steady advocacy can turn fear into manageable steps. They share how they coordinate transportation, housing, grants, insurance, and disability applications while offering the kind of emotional support that helps patients and caregivers breathe, decide, and move forward.

Throughout this episode, you’ll hear powerful, practical moments from the field: a rapid housing save that kept a parent connected to her kids, a coordinated relocation that preserved treatment access and family support, and a path from sudden job loss to financial stability through grants, Medicaid, and disability appeals. We also look straight at the quiet worries many carry: being a burden, losing control, or not being heard, and walk through tools that bring relief: caregiver naming and respite, values-based care planning, and family meetings that honor the patient’s voice.

We explain why timing matters. Many resources run on clocks: public housing waitlists, SNAP approvals, Medicaid enrollment, FMLA paperwork, and Social Security reviews. Reaching out early helps you line up the right resources before a crisis hits, protecting treatment schedules and reducing financial strain.

If today’s stories resonate, ask your clinical team to connect you with your social worker, or check whether oncology social work is available where you receive care. Subscribe, share this episode with someone who needs it, and leave a review to help others find support sooner.

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.

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.