Kim
Welcome to The Cancer SIGNAL, a podcast presented by GRAIL where we discuss the impact of early cancer detection, the science behind multi-cancer early detection and insight into how this approach has the potential to shift the cancer paradigm. I’m your host, Kim Thiboldeaux. Our guest today is Roger who lives in Silicon Valley, California. He recently took the Galleri test, which found a cancer signal with two cancer signal origins. And he’s joining us today to share his experience. Welcome to the show, Roger.

Roger
Yeah, happy to be here. Thanks for having me.

Kim
Absolutely, Roger. So before we jump in, on the Galleri test, I’d love to just learn a little bit about you. So tell us about yourself. Roger, again, a little bit more about where you live. Are you? Are you working? Are you retired? What do you like to do in your free time?

Roger
Okay, thank you. I’m a lawyer. I live and work in Palo Alto, Silicon Valley. I do, um. So, I guess, I could have what you could call a high stress job. Because I do venture capital transactions primarily. I do work full time. I’m a partner at a law firm. But I live a very active life. I work out at least once, usually twice a day. I, especially lately, I prioritize health. I’m super careful about my diet. I monitor everything very carefully. I’ve always been that way. And it served me well as we’ll talk about. So exercise, nutrition, mindfulness, you know, everything I can do. I’m very interested in longevity, of course. [Kim: Yes.] And in terms of what I do, I run, bike and swim by doing resistance training, strength training. I do a lot of hiking these days, in terms of hobbies, mountaineering, and rock climbing. I sometimes even ice climbing. So it’s a pretty active lifestyle.

Kim
Fantastic. Fantastic. Good for you, I think an inspiration to many of us, Roger, I love hearing that. That’s great. Roger, tell us, do you have a family history of cancer or any known particular cancer risk factors that you were aware of?

Roger
Well, I don’t think any more than anybody else. You know, I’ve come to find out that cancer is just so prevalent in our society, almost everybody has a family member who has had an experience with cancer. My father had stomach cancer. He was 69 when he was diagnosed. He went into surgery. It’s an interesting story, because his and mine are a little bit alike. I remember standing there in a room and his doctor telling me he had a 1 percent chance of survival. And he completely beat it. And he lived another 15 years and died of something totally unrelated. But so my father had cancer, and I had an uncle that had leukemia. So it’s there in my family, but I never viewed it as a risk factor. It didn’t seem to me I had any more cancer than anybody else I knew in my family.

Kim
Yeah. And, Roger, it’s a really interesting story about your father. Given the fact that you’ve shared so much about how diligent you are about your health, I’m assuming that you have been diligent about getting, you know, recommended cancer screenings and things along those lines.

Roger
Yeah, all of that, you know, the colonoscopy negative, negative. And I, you know, I’m a little bit of a hypochondriac I think. But, you know, I think, as I tell my doctor, you know, hypochondriacs can get sick once in a while. So let’s check these out. So every time I get acid reflux, or food poisoning, you know, I’d ask let’s find out, let’s make sure. And, you know, and I’ve had lots of cancer screenings, and nothing ever came up. In fact, just a year before I took the Galleri test, I had a sonogram that showed nothing at all. I know now that it simply missed it. But yeah, I’m pretty diligent.

Kim
Yeah, yeah, it sounds like it. So Roger, how did you hear about the Galleri test? And why were you interested in pursuing the test, in taking the test?

Roger
You know, I’m, I work in technology. So I tend to keep up on this stuff. And I especially do some work in biotech. So I had been vaguely aware that there were, that there was such a thing as cancer detection through liquid biopsy or blood, but that was a developing technology, people were working on it. So it was, you know, was in the back of my mind. And I knew I remember thinking many years ago that you know, someday that will be available and I’ll do that. But I hadn’t heard about it. And my doctor didn’t know that it existed, in fact he denied pretty vigorously that there was such a thing. Because I asked him every physical and April of 2022, sitting on an airplane traveling across the country, I was reading a book. And they happen to mention the Galleri test. And I’ve gone back to that book. And notice that I, you know, I, dog eared the page, I circled the text, I put a big star and a checkmark next to it. You know, I’m reminded my, I think I even sent myself a note saying, hey, we need to follow up on this when you get back. And that’s how I found out about it. And then I just made a note that yeah, I definitely want to do that. Because it seems so simple.

Kim
Yeah. And then so you went and you went ahead and have the test. So walk us through your testing experience, and tell us how long did it take to get your results? And what were the results? And how did you hear about the results?

Roger
Yeah. So went online, took me a little, took me a couple of months. I didn’t get the test until June, actually. So it took me I guess, a couple of months to three months to, to get around to it, which is not usually like me. But anyway, so I went online, they sent somebody out – mobile phlebotomist to my house, took 10 minutes. I didn’t even stop working while they’re taking, I remember I was sitting in front of my computer while they were drawing my blood. It was that easy, was 10 minutes. And a week later, six, seven days later, I got a call from a doctor who said I’d like to go over the test results with you. So it was super easy once I actually got around to doing it.

Kim
And then they told you you had a cancer signal. Tell us about that. What did they tell you? And what was your sort of reaction? How did you feel in that moment?

Roger
Yeah, I remember, it’s one of those things. You know, people say they remember where they were when Kennedy was shot, you know, and all this. I remember where I was when I got that call. The first question a doctor asked, he says, let me ask you, why did you get this test? Any symptoms, anything like that? And I said no. So any, any idea that there’s something wrong? I said, no, nothing at all. I’m just, I’m just getting, I just monitor. And at the time, I remember thinking ‘please don’t be pancreas’ because I know how bad that one is. And he said, the first one is pancreatic. And then there was another for stomach gallbladder, I believe. So and then he just told me. This means that you should do further testing to find out if this is something or not.

Kim
And you said your doctor was a bit of a skeptic, did you go back to your doctor? Did you, were you referred to an oncologist for a workup?

Roger
Yeah, I was a little more proactive than that. I did eventually go back to them. But there’s, especially in my area, there’s just I think, because of COVID it’s just hard to get appointments, it’s hard to get people’s attention. It’s hard to get them to, you know, to get in and this is in the summer, everybody’s on vacation. And with pancreatic cancer, you don’t wait around for a couple of months until they can get around to seeing you. [Kim: Yes.] So I went in I had an MRI on my own and 6am the next morning. And while I was waiting for the MRI, I did find a doctor that would order up the tests. And it took a little while, there’s some machinery, had to get into a different medical institution that had what I consider to be a little bit more extensive oncology department and started getting the process in motion. I got the MRI results back in about a week. They said we found a mass, it’s suspicious you should get further testing. Within a week or two after that, we did a CT scan and a biopsy and then I got my diagnosis in July.

Kim
And what was the diagnosis Roger?

Roger
Pancreatic cancer stage two.

Kim
Stage two. And after those results, after you’ve received the results after the workup, diagnostic workup, what was the recommended treatment plan? And when did that begin?

Roger
Yeah, well, fortunately, it’s what they call borderline resectable. Which means that the tumor could probably be surgically removed. And so I went into the standard treatment. They started me off on a regimen of chemotherapy. But then I had a series of decisions to make. You know, when to have the surgery. You know, how much chemo to have before the surgery. Do I even want to chemo? All of that, but it was a, but that was a treatment plan. Chemo, and then surgery. No radiation thankfully. They didn’t feel it warranted that.

Kim
And so you went through the treatment? And Roger, you know, again, I mean, you’re so diligent about your health. Just tell us more about your sort of emotions, through this process, what you were, what you were feeling? And did you have, you know, support around you through this process?

Roger
Yeah, I think I went through all of the stages of grief within about 24 hours of first getting a clue. First I was just really angry with myself for not doing this earlier. Because with cancer, especially a fast, aggressive pancreatic cancer, the sooner the better. The sooner you know, the better. And I remember thinking, you know, I wish I’d done this in April instead of June, I don’t know if those two, three months made a big difference, but they might have. So I was just kind of angry with myself for that. And of course, I went through, and the next question every cancer patient asked himself – was why me? You know, what, what did I do to bring this on me? You know, what was it? I must, I did something to bring this on. And nobody really knows, you know? I’ve heard doctors say, look, this is just luck of the draw. It’s just a gamble. It’s a mutation lottery. But other people say, well, you know, your lifestyle environment play a big role. So who knows? But I went through all of that. But I went quickly from why me to why not me? You know, after I got after a little research a little thinking about it. I mean, you know, probably 40% of the people in this country are going to experience cancer at some point in their life. Why not me, you know? I for a long period of my life, ate the standard American diet, which I think is a risk factor in itself. You know, there was a period when I was carrying too much weight, when I wasn’t active enough. So yeah, emotionally, that was kind of the first thing, but that shifted pretty immediately to how this is going to impact people around me. You know, I have a daughter, she’s, she was in high school at the time. And especially after diagnosis, because diagnosis, the prognosis is not good. And your lifespan, your life expectancy, all of a sudden, goes from being measured in years to being measured in months. My thought was, you know, I really want to stay alive long enough to see my daughter graduate high school. She was a senior, just about to become a senior at the time. She has graduated by the year, by the way, just last week. So that was the next thing. And like I said, you go through all the emotions, and eventually come upon, well, just acceptance, you know, this is gonna be a long, painful journey, if I get through it at all. So just gotta put your head down and, you know, accept what’s about to happen.

Kim
Well, congrats to you and your daughter for that important milestone. And I know those milestones become even more important when folks are, are facing cancer. Roger, tell us how you’re feeling today. What’s your health status? And, and how are you feeling as we chat today?

Roger
Well, I’m very lucky. I feel great. By the way, in fact, I just got off my bike. You know, made it back in time to talk to you. I feel great. I’m currently no evidence of disease. [Kim: Great] I had surgery. It was a very successful surgery. I did the full six months of chemotherapy. That was worse than anything I ever imagined. But just kind of, you know, suffered through it. Glad that’s it’s over with. And right now it’s seven months from surgery, no evidence of disease, you know, and hoping to keep it that way.

Kim
Yeah. May I ask you your age Roger?

Roger
I’m 63. I was 62 when I was diagnosed.

Kim
Okay. Roger, tell me. Do you feel that, that catching the cancer early made an impact on how you do feel today and how things have turned out for you?

Roger
Yeah, absolutely. And in fact, I had a radiologist called me up, I didn’t call him. He called me for one reason, just one reason was – I was not a candidate for radiology – he called me just to tell me that I’m the luckiest person he’s ever met. He said, because he said he’s seen a lot of these tumors like the one I had. And he said just where it was and the way it was growing. He said, that I caught it at a time that it is curable. And that’s a big word in cancer. Curable is a big word you don’t often hear doctors say, especially in pancreatic cancer, you don’t often have, hear them say this is curable. That doesn’t mean I’m cured, it just means I’m a possibility of cure. And here and the implication is this had gone on a little bit further, cure would not even be an option. You know, it would simply be a matter of keeping me alive on chemicals as long as possible, and maybe improving quality of whatever life I would have left. So early detection for me was I think, super key and super important.

Kim
And did this experience change how you think about or view a cancer diagnosis?

Roger
Yes, absolutely. Because I guess I’m maybe a little more optimistic, first of all, just generally, but also a little more optimistic because of my experience with my father. But we all know that cancer is a very scary word. [Kim: Yes.] And when we hear cancer, you know, we think the worst. And if you go Google pancreatic cancer, the words death sentence are going to come up pretty quickly. So and that is, and that’s old technology. That’s how things have been in the past. And that’s what we used to have to live with. But through a lot of the new tools and the new technologies, especially early diagnosis, that doesn’t have to be true anymore. Cancer doesn’t have to be a death sentence. Pancreatic cancer doesn’t have to be a death sentence. You know, 10 years ago, maybe it did, but today, certainly not. So yeah, this whole experience has changed my view.

Kim
And Roger, has it changed? Has it changed how you think about your life or how you think about your future? You know, I’ve worked in, in cancer for 27 years, and you know, I’ve had a lot of folks say, oh, yeah, I’m gonna take that trip that I’ve been putting off, or I’m gonna, you know, do that particular hobby or engage in other things or, you know, has it influenced sort of how you think about your life and your future?

Roger
Absolutely. It’s changed the way I live tremendously. I, up until then, almost exactly a year ago now, when I took the Galleri test. Up until then, I worked 24/7, 7 days a week. You know, I get up, I meditate, I’d work out and then I’d work. And that was my lifestyle. And then I’d sleep and I’d do it all over again. Rinse, wash, repeat. But I worked every day, and I worked all day. And I hadn’t taken a vacation since 2007. That was my last one. I took a couple long weekends, but nothing more than four days. But since that diagnosis, I don’t work weekends. I mean, not very often, sometimes I have to but I take time off on weekends. I’m spending more time out on the bike. I’m spending, I’m traveling a lot more than I ever did. Last month, I saw Zion National Park. It’s been on my bucket list for 20 years, I finally just took a week and went and did it. And I’m glad I did. [Kim: Beautiful.] But yeah, I’ve been gathering all those experiences that I was always just too busy for in the past. So it certainly has changed the way I think in a way I live and my perspective. It’s changed a lot of things. But you know, that’s, that’s one big thing. It’s changed how I relate to people. It’s changed, you certainly find out who your friends are in a hurry, and who they’re not when something like this happens. So yeah, it’s lifestyle and much more focused on health. I mean, I was pretty, I thought I was pretty good before. But now I’m just hard to be around. I’ve got like, you can’t sit down and have lunch with me without me, you know, entering all the data into my iPhone while we’re talking, while we’re eating. So it’s changed everything.

Kim
Yeah, yeah. Well, I’m glad it’s opened you up to some of those opportunities and things that you’ve been wanting to do. Sometimes that’s a, that’s an unexpected and positive, you know, positive side effect of a cancer diagnosis that I’ve witnessed over these many years. Roger, I want to thank you so much for joining us today. for sharing your story. It certainly is an inspiration. This is The Cancer SIGNAL presented by GRAIL. I’m Kim Thiboldeaux. Please rate our podcast or leave a review and subscribe to learn more about the impact of early cancer detection on future episodes. Thank you.

Based on a clinical study of people ages 50 to 79 around 1% are expected to receive a cancer signal detected result which includes predicted cancer signal origins. After diagnostic evaluation, around 40% of people are expected to have a confirmed cancer diagnosis.

The overall sensitivity in study participants with pancreas cancer was 83.7% (61.9% for stage I, 60.0% for stage II, 85.7% stage III, 95.9% stage IV).

The Galleri test is prescription only the Galleri test is recommended for use in adults with an elevated risk for cancer such as those age 50 or older. It is not recommended for individuals who are pregnant, 21 years or younger, or undergoing active cancer treatment. Galleri does not detect all cancers and should be used in addition to routine cancer screening. False positive and false negative results do occur. For more information, including important safety information, please visit galleri.com

Important Safety Information
The Galleri test is recommended for use in adults with an elevated risk for cancer, such as those aged 50 or older. The Galleri test does not detect all cancers and should be used in addition to routine cancer screening tests recommended by a healthcare provider. Galleri is intended to detect cancer signals and predict where in the body the cancer signal is located. Use of Galleri is not recommended in individuals who are pregnant, 21 years old or younger, or undergoing active cancer treatment. Results should be interpreted by a healthcare provider in the context of medical history, clinical signs and symptoms. A test result of “No Cancer Signal Detected” does not rule out cancer. A test result of “Cancer Signal Detected” requires confirmatory diagnostic evaluation by medically established procedures (e.g. imaging) to confirm cancer.

If cancer is not confirmed with further testing, it could mean that cancer is not present or testing was insufficient to detect cancer, including due to the cancer being located in a different part of the body. False-positive (a cancer signal detected when cancer is not present) and false-negative (a cancer signal not detected when cancer is present) test results do occur. Rx only.

Laboratory/Test Information
GRAIL’s clinical laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accredited by the College of American Pathologists (CAP). The Galleri test was developed, and its performance characteristics were determined by GRAIL. The Galleri test has not been cleared or approved by the Food and Drug Administration. GRAIL’s clinical laboratory is regulated under CLIA to perform high complexity testing. The Galleri test is intended for clinical purposes.