Live from Stage 4: MBC News for Us, by Us

Triple negative breast cancer isn't one disease. It's a group of very different cancers that share one trait: no estrogen, progesterone, or HER2 receptors. Some are aggressive, and others grow slowly and rarely spread. So how do doctors tell them apart, and why does it matter for your treatment?Dr. Nour Abuhadra, a breast medical oncologist at Memorial Sloan Kettering, joins hosts Victoria Goldberg and Dr. Ellen Landsberger. She leads MSK's rare breast cancer program. The three of them discuss:How pathologists use morphology, meaning how cells look under the microscope, to classify breast cancersPlain-language explanations of ductal and lobular carcinoma and of rare subtypes like metaplastic and adenoid cystic carcinomaWhen and how to ask for a second pathology review, and why it can be worth itWhy inflammatory breast cancer is diagnosed by how it looks and acts, not by what's on the pathology slideHow genomic testing, clinical trials, off-label use, and compassionate use are opening new options for rare subtypesHow antibody drug conjugates are changing care for triple negative disease, including side effects, scheduling, and sequencingWhy PD-L1 testing matters for metastatic triple negative breast cancerWhy Dr. Abuhadra is optimistic about the next five yearsIf you or someone you love is living or was just diagnosed with TNBC or a rare breast cancer, this conversation can help you ask informed questions and take a more active role in your care.This episode is for educational purposes only and is not medical advice. Every patient's situation is different. Please talk to your own healthcare team about your diagnosis and treatment options.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 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.

Every October, the world turns pink. But October 13th is Metastatic Breast Cancer Awareness Day, and for women living with stage 4 disease, it means something very different.In this special episode, recorded over two days, host Victoria Goldberg talks with six women living with metastatic breast cancer about pink-washing, how they found their way into advocacy, and the people they carry with them.What we talk aboutThe Stage 4 Stampede, METAvivor's advocacy event in Washington, DC, and the film Our LivesPink-washing, where the money really goes, and why Kelly Shanahan says October should be Breast Cancer Action MonthLight Up MBC and how local communities mark October 13thHow each guest got into advocacy, and why there's a place for everyoneIs the sense of urgency fading as treatments improve?Loss, remembrance, and the friendships we build onlineWhat the podcast means to us, and what's nextOur guestsDr. Kelly Shanahan, president of METAvivorAmy Russell-ParlimanMelanie SiskLisa BackusMartha CarlsonTeri PollastroResources and linksFind links to the organizations, programs, and people mentioned in this episode at livefromstage4.org.Note: this episode includes strong language and discussion of death and loss.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 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.

When Anne Loeser noticed that MBC patients like her were struggling with crushing side effects from cancer drugs prescribed at maximum tolerated dose (MTD), she asked a radical question: Does it have to be this way? That led her to found the Patient-Centered Dosing Initiative in 2019. It changed everything.In this episode, host Victoria Goldberg interviews the PCDI team: Martha Carlson, Dr. Kelly Shanahan, AJ Veach, Dr. Mya Roberson, and Dr. Liza Lerner Papautsky to explore the groundbreaking research showing that lower doses of targeted therapies can be just as effective while dramatically improving quality of life. They discuss two major new surveys on antibody-drug conjugates (ADCs) and dosing practices, revealing how common dose reductions are in real-world treatment and the barriers patients face in talking to their doctors about adjusting their medication.Whether you're on a single drug or a combination regimen, this episode gives you the information and confidence to ask the questions that matter: Is this the right dose for me? What supportive care options exist? How can I be a partner in my own care?Learn how patients and researchers are working together to change cancer care from the ground up.Resources:Visit PCDI: therightdose.orgEmail: [email protected] episode notes: livefromstage4.orgWebinar Reminder:Join PCDI, Project Life, and Metavivor for a free webinar on Thursday, October 29th at 12:00 PM ET to dive deeper into patient-centered dosing and ask your own questions. Register via the link in the episode notes.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 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.

Learn about osteonecrosis of the jaw (ONJ), a rare but serious side effect of bisphosphonates used to treat bone metastases. In this episode, Abigail Johnston is joined by Victoria Goldberg, executive producer of the podcast and fellow ONJ patient, to discuss their personal experiences navigating diagnosis, treatment, and recovery.Discover what ONJ is, how to recognize early warning signs like pain, white patches, and excessive bleeding, and why finding a knowledgeable dental oncologist is critical. Victoria and Abigail share their surgical procedures, preventive care strategies, and candid advice for managing this complication. Plus, learn about recent clinical trial findings that may change how bisphosphonates  are prescribed, and practical tips for covering dental care costs through medical insurance.Whether you're on bisphosphonates or curious about potential side effects, this spotlight emphasizes that while ONJ is rare, awareness and proactive dental care can make all the difference.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 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.

Twenty-five years ago, the diagnosis of HER2+ breast cancer was a death sentence. Two-year survival was roughly 50%. Today, oncologists are using the word "cure" in the metastatic setting.Co-hosts Victoria Goldberg and Abigail Johnston sit down with Dr. Erika Hamilton (Chief Development Officer of Late Phase Research at Sarah Cannon Research Institute) and Dr. Sarah Premji (Assistant Director of Breast Cancer Research at Sarah Cannon) to walk through the scientific revolution that got us here: from Trastuzumab in 1998 to CLEOPATRA to the game-changing antibody drug conjugates like Enhertu.But this episode isn't just about the wins. the hosts and the doctors get brutally honest about what life on Enhertu (Trastuzumab Deruxtecan T-DXd) really looks like: the nausea that stretches into week two, the fatigue that's hard to quantify, the hair loss that cold capping can't prevent, and the serious side effect that deserves way more attention - interstitial lung disease (ILD). They discuss why some patients need dose reductions, how to manage side effects, and what to watch for.For triple-positive patients (HER2+ and hormone receptor positive), this conversation is essential. The PATINA trial is finally recognizing that these cancers behave differently, and the field is catching up. Victoria also breaks down the emerging trials (SAPPHO and HERizon-Breast) that are asking whether smarter sequencing could mean deeper responses and, for some patients, real cure.Whether you're newly diagnosed, living with HER2+ MBC or HER2-low on Enhertu, or supporting someone who is, this hour covers the science, the lived experience, and the hard conversations that matter.Chapters0:00 – Introduction: The HER2+ Transformation13:44 – Triple-Positive Disease and Pathway Crosstalk17:14 – Antibody Drug Conjugates: What Is Enhertu?21:38 – DESTINY-BREAST-09: Moving Enhertu to First Line25:50 – Curative Intent Trials: SAPPHO and HERizon-Breast28:05 – Side Effects: The Enhertu Reality28:27 – Why Enhertu's Side Effects Last Longer30:01 – Dose Reductions: Why Start High if Lower Works?33:01 – Interstitial Lung Disease (ILD): The Serious Side Effect35:02 – Managing ILD Risk: Screening and Monitoring42:53 – Nausea, Fatigue, and Supportive Care47:06 – PATINA Trial: Triple-Positive Gets Its Own Path50:02 – PI3K Pathway and Future Therapies52:47 – HER2CLIMB-05 and Tucatinib: Maintenance Strategy57:48 – Sequencing Strategies: What Comes First?59:25 – Closing: From Death Sentence to CureThanks 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 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.

This is the first episode of a series we never wanted to make.Jill Tirabassi was a physician in Buffalo, a mother of two little boys, a lifelong athlete, a gardener who was happiest with dirt on her hands, and a member of the Live From Stage IV team who said yes to this podcast before it existed. She was diagnosed with de novo metastatic breast cancer while pregnant with her second son. She died on Monday, September 7th. She was 40.What you'll hear is our team meeting, the first one after we lost her. Nobody was ready to record. We did anyway. Lisa, Alexis, Ellen, Lynda, and Abigail talk about the Bills, Heated Rivalry, postpartum breast cancer, why the term "pregnancy-associated cancer" has to go, and what it means to keep going.Then Abigail Johnston reads the essay she wrote for her blog, No Half Measures, the morning we recorded. It says the thing the rest of us were circling.Read it here: https://nohalfmeasures.blogJill's episodes, including S**t We Deal With and the Heated Rivalry conversation, are in our feed. Her voice is still there.Forever live from Stage IV.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 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.

Chemotherapy-Induced Nausea and Vomiting (CINV): Managing a Common Side EffectNausea and vomiting are common side effects of chemotherapy, but the strategies that work for everyday nausea often fall short. In this episode, Abigail Johnston shares her personal experience navigating CINV and discusses practical approaches to managing this challenging symptom.Topics covered include:Why traditional nausea remedies may not work for chemotherapy-induced symptomsCommon medications used to prevent CINV (Zofran, Emend, and others)The importance of tracking nausea patterns throughout your treatment cycleMulti-intervention strategies for managing delayed nauseaHow to recognize intractable nausea and when to seek medical helpThe role of diet, movement, and other supportive measuresResources and expert webinars on CINV managementWhether you're currently experiencing CINV or want to prepare for treatment ahead, this episode provides practical insights and encouragement from someone who's been there.Learn more: Visit the Multinational Association of Supportive Care in Cancer (MASCC) website for their webinar series on managing chemotherapy side effects.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 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.

Biomarkers are transforming how we understand and treat breast cancer, but what do they actually mean?In this episode, we break down the three layers of biomarker testing: DNA biomarkers that reveal genetic mutations like BRCA1 and BRCA2, RNA biomarkers that show which genes are actively expressed in your tumor, and protein biomarkers like HER2 and PD-L1 that tell us what's actually happening at the cellular level.Understanding the difference matters. Your DNA might carry a mutation, but RNA tells you if it's active. And when your oncologist talks about PD-L1 status or immunotherapy response, they're measuring something very specific about your tumor's protein profile.We also explore emerging research in liquid biopsy — a decentralized platform that's making it easier to monitor tumors through simple blood tests, enrolling women from across the country in real-time studies.Whether you're newly diagnosed, in treatment, or supporting someone through this journey, knowing what your biomarker results actually mean can help you have sharper conversations with your care team and better understand your treatment options.Developing Story brings you the latest in breast cancer science, explained cleaThanks 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 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.

In this Symptoms Spotlight episode, Abigail Johnston and Melanie Sisk are joined by Dr. Jill Tirabassi to talk about ascites, the buildup of fluid in the abdominal cavity that can occur with metastatic breast cancer and liver disease. Dr. Jill shares both her medical expertise and her personal experience, explaining what ascites is, why it happens, and how it shows up on scans.The conversation covers symptoms to watch for, including abdominal pressure and pain, abdominal distension, shortness of breath, back pain, leg swelling, and itching. Dr. Jill describes her own paracentesis, a procedure to drain the fluid, and how life changing the relief was, along with other options like diuretics, dietary changes, and drainage ports that can be managed at home.The hosts also discuss when to bring specialists like hepatologists or interventional radiologists onto your care team, and why ascites is not always caused by cancer itself. Sometimes it is the treatment, and switching therapies can reverse it entirely.Above all, this episode is a reminder to advocate for yourself. Your quality of life matters, and pushing for interventions that help you feel better is always worth the conversation with your care team.This is general information, not medical advice. Always talk with your own doctor about your specific situation.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 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.

This is a disease no one wants, but you meet the best people."Twenty years ago, about 125 people gathered at a hotel outside Philadelphia for the first-ever conference just for those living with metastatic breast cancer, at a time when the community was rarely seen or heard. Today, it's a three-day national event drawing hundreds of attendees and a virtual audience.In this episode, the host Victoria Goldberg sits down with three longtime Living Beyond Breast Cancer leaders: CEO Jean Sachs; Elyse Spatz Caplan, who ended her 14-year tenure with LBBC as the Director of Programs and Partnerships;  and Catherine Ormerod, a retired Executive Vice President for Strategy and Mission.  In a separate conversation, she speaks with Janine Guglielmino, LBBC's former Vice President of Mission Delivery, who was there for that very first conference in 2006.Together they trace the conference's history: the groundbreaking Silent Voices survey that proved a conference exclusively for stage IV patients was urgently needed, the fight to fund travel grants so cost would never be a barrier, the pivot to virtual during the pandemic, and the Hear My Voice advocacy program that turned attendees into leaders, founders, and changemakers.To learn more about LBBC's programs, Hear My Voice advocacy training, and next year's conference, travel grants included, visit lbbc.org.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 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.