Patient Perspective: COVID Vaccine and Cancer
March 15, 2021Information
March 14, 2021
Yale Cancer Center
visit: http://www.yalecancercenter.org
email: canceranswers@yale.edu
call: 203-785-4095
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- 00:00Support for Yale Cancer Answers
- 00:02comes from AstraZeneca, dedicated
- 00:05to advancing options and providing
- 00:07hope for people living with cancer.
- 00:10More information at astrazeneca-us.com.
- 00:14Welcome to Yale Cancer Answers with
- 00:16your host doctor Anees Chagpar.
- 00:19Yale Cancer Answers features the
- 00:20latest information on cancer care by
- 00:23welcoming oncologists and specialists
- 00:24who are on the forefront of the
- 00:27battle to fight cancer. This week
- 00:28it's a patient perspective on cancer
- 00:30treatment during the pandemic with
- 00:32Christina Allen and Doctor Tara Sanft.
- 00:34Christina is a cancer survivor and doctor
- 00:37Sanft is an associate professor of
- 00:39medicine and medical oncology at the
- 00:42Yale School of Medicine where Doctor Chagpar
- 00:44is a professor of surgical oncology.
- 00:48Let's start with you
- 00:50Christina, tell us a little
- 00:53bit about your story.
- 00:55Sure, thanks so I was 38 years old at
- 00:58the time of my diagnosis and I have a
- 01:03diagnosis of locally advanced breast cancer.
- 01:07I was not experiencing any symptoms prior
- 01:11to my diagnosis and like so many other
- 01:15people I did not have a family history
- 01:19of breast cancer either.
- 01:21So the cancer was found after
- 01:24I felt a small lump,
- 01:26which I initially thought was a bug bite.
- 01:29It was over the summer,
- 01:32this past July I had been swimming and
- 01:35really thought not much of it until the
- 01:39following morning when I woke up
- 01:42and it was still there and felt almost
- 01:46like a little pebble under the surface.
- 01:50And at that point it was
- 01:55a bit of a freeze moment, OK
- 01:57do I do something about this?
- 01:59What do I do?
- 02:02So I reached out and was able to
- 02:06see my OBGYN within a day or two.
- 02:11At which point she had referred
- 02:14me for further imaging,
- 02:16and that's when I became connected to Smilow.
- 02:20I think another important thing
- 02:22to mention is that throughout
- 02:25my treatment and my illness,
- 02:28I have continued working and I
- 02:30am a licensed clinical social
- 02:33worker in healthcare and have been
- 02:36working in hospital systems for a
- 02:39little over 12 years now.
- 02:44So Christina you were diagnosed,
- 02:45I mean this really happened
- 02:48this past July, July of 2020,
- 02:50right in the middle of this pandemic.
- 02:53Talk to us a little bit about,
- 02:56you kind of mentioned this,
- 02:59Oh my gosh, what am I going to do moment,
- 03:02I can only imagine that that was
- 03:05even heightened with what am I
- 03:08going to do in the midst of Covid?
- 03:10Is my doctors office open?
- 03:12Do I do a virtual visit?
- 03:15Do I go into the office?
- 03:17How does that work?
- 03:18Tell us a little bit about that
- 03:20thought process and whether
- 03:22you ended up seeing
- 03:24your doctor using telemedicine,
- 03:26or whether you went into their
- 03:28office and whether you had
- 03:30any challenges with that.
- 03:35That's a great question.
- 03:37Almost right from the beginning,
- 03:40covid sort of felt like this parallel
- 03:47opponent in my treatment and in my
- 03:50illness it was always a consideration,
- 03:53always a factor in the decisions that
- 03:56I was making and the decisions that
- 04:00my treatment team has been making.
- 04:02I knew that getting in for a clinical
- 04:07breast exam was going to be the
- 04:10next step after I felt that lump,
- 04:14so I was pretty specific and persistent
- 04:17with asking for an in person visit with
- 04:21my OBGYN and I really love the flexibility
- 04:24that has come out of covid and the
- 04:28increased availability of telemedicine,
- 04:30but you know some things just
- 04:34have to be done
- 04:35in person and I knew that I
- 04:38wouldn't feel comfortable at that
- 04:40point using a telemedicine visit,
- 04:43so I was able to get the in person visit
- 04:47and then there was a bit of a struggle
- 04:51and delay with trying to get imaging
- 04:55going because my understanding is that
- 04:57a lot of imaging centers had decreased
- 05:00capacity or maybe even temporarily closed.
- 05:03So I did have to
- 05:05advocate for myself to get that imaging
- 05:08done and to be very clear that this was not
- 05:12routine screening, although that should not
- 05:15be deferred either,
- 05:17but rather that this imaging
- 05:20was diagnostic and those days
- 05:24I mean I can remember the seconds, minutes,
- 05:29hours and days between visiting my OBGYN and
- 05:34getting confirmation that yes,
- 05:36this is cancer.
- 05:38That was a really,
- 05:40really difficult time.
- 05:42Tara maybe I'll bring you in here,
- 05:47you know, during the pandemic
- 05:49talk a little bit about how as a
- 05:53health care provider and as
- 05:56a chief patient quality officer,
- 05:59patient experience Officer,
- 06:01things kind of shifted during the pandemic.
- 06:04What were the approaches in terms
- 06:08of clinic visits in terms of imaging?
- 06:12How did facilities shift and what
- 06:16ramifications do you think that had?
- 06:20Thanks Anees,
- 06:22I feel like in recalling and listening
- 06:25to Christina's story, it brings me back.
- 06:28I'm also a breast cancer oncologist,
- 06:31so I treat patients with breast cancer,
- 06:34and I vividly remember the process
- 06:36of going through a national shutdown
- 06:39and talking to many institutions
- 06:41on how they're handling it.
- 06:43And then I remember the Yale
- 06:46response and I have to say that
- 06:50with the guidance of the CDC,
- 06:52we did everything we could
- 06:54to keep our patients safe.
- 06:56It was very disorienting.
- 06:58As a provider, I was in clinic,
- 07:012 1/2 days a week,
- 07:04most weeks,
- 07:05and then we went through a complete
- 07:08shutdown where we really minimized
- 07:10in person visits because of the
- 07:13virus and really tried to focus on
- 07:16the patients who were receiving
- 07:18in person IV chemotherapy.
- 07:20And so you know,
- 07:22patients like Christina coming through,
- 07:24we really stressed over what to
- 07:27do about patients with suspicious
- 07:29findings or needing diagnostic imaging
- 07:32that fortunately at Yale,
- 07:35I think, that never stopped.
- 07:37There were many routine imaging
- 07:40that was deferred.
- 07:42And we're still feeling the effects of that.
- 07:45Yale is a system that I have to say I thought,
- 07:50did a really wonderful job
- 07:53especially in communicating,
- 07:54because this was the first time for
- 07:57any of us to go through a pandemic
- 07:59and so really understanding the
- 08:00protocols and how things are changing
- 08:03everyday was paramount in our response,
- 08:05and as a provider I felt very well
- 08:08informed and I was able to convey
- 08:10those messages to my patients.
- 08:14So Christina ultimately, you
- 08:16were able to advocate for yourself,
- 08:18which I think is such a strong
- 08:21message for patients at large,
- 08:23whether there is a pandemic or no pandemic,
- 08:26but particularly during these times,
- 08:28to advocate for yourself to get
- 08:30the in person visit with your OBGYN
- 08:33to get the diagnostic imaging,
- 08:35and it sounds like ultimately to
- 08:37get the biopsy and the diagnosis.
- 08:40And so then what happened?
- 08:45After the diagnosis was confirmed,
- 08:48I was referred to a medical oncologist
- 08:52and a breast cancer surgeon,
- 08:55and then shortly afterwards,
- 08:58my radiation oncologist,
- 08:59so I started to have that treatment
- 09:03team built up around me and
- 09:07I have an awesome treatment team.
- 09:10Doctor Tristen Park,
- 09:12my breast cancer surgeon, Doctor Knowlton
- 09:15my radiation oncologist and doctor
- 09:18Kanowitz, my medical oncologist.
- 09:21They've all been wonderful,
- 09:23so it may sound a little strange, but
- 09:30once the diagnosis was confirmed,
- 09:32I had this team,
- 09:33we started putting plans in place,
- 09:36it was a little bit less of the unknown.
- 09:39I'm somebody who likes to have a plan.
- 09:42OK, this is what we're going to do.
- 09:46This is how we're going to approach this.
- 09:49These are the people you can contact
- 09:52with questions or when you need help,
- 09:55so getting that ball rolling felt
- 09:57like a bit of a relief to me.
- 10:03And were those visits that you
- 10:06had with those providers in
- 10:08person as well?
- 10:11Some were and some weren't, and now I'm
- 10:15recalling some things from earlier on,
- 10:18I do recall that initially when I was
- 10:22scheduled with my breast cancer surgeon,
- 10:25it was set up as a telemedicine
- 10:28visit and I didn't quite understand
- 10:31the rationale behind that,
- 10:33and was sort of wondering,
- 10:35is this best to meet her for
- 10:38the first time over Tele Medicine
- 10:42when she's somebody who is
- 10:43going to be operating on me so I actually
- 10:47reached out to Doctor Park directly
- 10:50and asked her if she felt that that
- 10:53was the best thing to do clinically to
- 10:56meet for the first time over Tele Medicine,
- 10:59or if she thought it would be more beneficial
- 11:03to come into the office in person.
- 11:06She was extremely responsive,
- 11:07and gracious and said no,
- 11:10I would prefer
- 11:12to see you in person so
- 11:14she switched the visit from Tele Medicine
- 11:18to in person and I really appreciated
- 11:21that flexibility and input from her
- 11:24because this is not my area of expertise,
- 11:28I don't know sometimes is
- 11:31it better to see somebody
- 11:34in person versus telemedicine.
- 11:36The risks versus benefits there.
- 11:38So I really had to depend a lot
- 11:41on the team and let them tell
- 11:44me what's the better way to go.
- 11:47But for example,
- 11:48my first meeting with Doctor Knowlton that
- 11:51was telemedicine and that was more
- 11:54or less to establish a relationship
- 11:56with her and for her to hear a
- 11:59little bit more about my history,
- 12:01knowing that the radiation
- 12:03was going to be at the
- 12:05tail end of my treatment
- 12:11and that even allowed me to
- 12:14work almost a full day
- 12:15and just take
- 12:18an hour out to go somewhere quiet
- 12:20and private and do the telemedicine
- 12:22visit and then get back to work.
- 12:26So certainly, I mean,
- 12:28it seems like the pandemic which
- 12:31caused this versioning of Tele health
- 12:34visits might actually have been a little
- 12:37bit more convenient for some visits.
- 12:44How did you kind of think about
- 12:47which visit should be Tele medicine,
- 12:50which visit should be in person.
- 12:53And going forward, do you think that
- 12:56Tele Medicine might play an increasing role,
- 12:59particularly when you hear
- 13:00stories like Christina's
- 13:01where
- 13:03you can work the whole day and just take
- 13:06an hour off for the visit instead of
- 13:09having to take half a day off,
- 13:13find parking,
- 13:14and go through the whole rigmarole
- 13:16for what might be the same visit.
- 13:21Yeah, when the pandemic first started,
- 13:23we often didn't have a choice.
- 13:26Many of our visits were converted
- 13:28to Tele medicine again in the hopes
- 13:30that we weren't exposing patients
- 13:32to a contagious virus in person.
- 13:34So a lot of our new patient visits
- 13:37where we would normally see them in the
- 13:39office were done on Tele medicine in
- 13:42retrospect some of that was good.
- 13:45It was very disorienting.
- 13:46You know, we're all learning new
- 13:48ways to take care of patients,
- 13:51and I think as time goes forward,
- 13:53the most important thing will
- 13:55be what Christina mentioned,
- 13:56which is a shared decision.
- 13:58Are you comfortable doing this
- 14:00on Tele medicine?
- 14:01Do you feel there is a good reason
- 14:04to be seen and examined in person?
- 14:06And I think providers are learning
- 14:08the value of listening to those
- 14:10patient preferences in order
- 14:12to accommodate and honor
- 14:13what is preferred and
- 14:15probably what's necessary,
- 14:16so patients know inside it's
- 14:18OK to just do this one on video and
- 14:21next time in person or they know
- 14:24I think I need an exam and we
- 14:25need to really pay attention to
- 14:27those preferences and honor that.
- 14:29We're going to take a short
- 14:32break for medical minute and then come
- 14:34back to learn more about Christina's
- 14:36experience with cancer and the Covid
- 14:38vaccine right after this short break.
- 14:40Please stay tuned.
- 14:42Support for Yale Cancer Answers
- 14:44comes from AstraZeneca, working to
- 14:47eliminate cancer as a cause of death.
- 14:50Learn more at astrazeneca-us.com.
- 14:54This is a medical minute about Melanoma.
- 14:57While Melanoma accounts for only
- 14:58about 4% of skin cancer cases,
- 15:01it causes the most skin cancer
- 15:03deaths and when detected early
- 15:05Melanoma is easily
- 15:06treated and highly curable. Clinical
- 15:08trials are currently underway to test
- 15:11innovative new treatments for Melanoma.
- 15:13The goal of the specialized programs
- 15:15of research excellence in skin cancer
- 15:18or SPORE grant is to better understand
- 15:20the biology of skin cancer with a focus
- 15:24on discovering targets that will lead
- 15:26to improved diagnosis and treatment.
- 15:28More information is available
- 15:30at yalecancercenter.org.
- 15:31You're listening to Connecticut Public Radio.
- 15:36Welcome
- 15:36back to Yale Cancer Answers.
- 15:37This is Doctor Anees Chagpar and
- 15:40I'm joined tonight by my guests
- 15:42Christina Allen and Doctor Tara Sanft
- 15:44and we're talking about Christina's
- 15:46journey with cancer through Covid,
- 15:49and ultimately to the Covid vaccine.
- 15:52So Christina right before the break
- 15:55you were telling us how you were
- 15:58diagnosed right during the pandemic
- 16:00and you ended up having some of
- 16:04your visits virtually some of your
- 16:06visits in person tell us a little bit
- 16:09more about how the decision-making
- 16:12went in terms of your treatment strategy.
- 16:18Sure. At the beginning everything
- 16:21was so overwhelming for me and I
- 16:25really didn't realize just how many
- 16:28decisions there are to make about
- 16:31the treatment and about the strategy.
- 16:34And then what the options are.
- 16:39I did my best to educate myself and
- 16:43then of course I have to heavily rely
- 16:48on my treatment providers and really
- 16:52deeply trust them because they are
- 16:56the experts at treating breast cancer.
- 17:00I was worried all throughout that
- 17:04Covid would possibly delay or
- 17:08defer parts of my treatment,
- 17:11although that did not turn
- 17:14out to be the case,
- 17:17so I was starting chemotherapy
- 17:23about a month after we had
- 17:26confirmed the cancer diagnosis,
- 17:29I did make a decision to receive my
- 17:33chemotherapy at one of the outpatient
- 17:37clinics for Smilow in North Haven,
- 17:41which was extremely convenient
- 17:43for me, closer to my home,
- 17:47and also much easier to park,
- 17:51to get in and out of and also just less
- 17:56congestion and traffic then Smilow proper.
- 18:01So it was really,
- 18:03really great to have that option
- 18:07to use the North Haven location
- 18:11for my chemotherapy visits.
- 18:14And I felt very
- 18:16safe there the entire time.
- 18:23Tara, NOTE Confidence: 0.8432569
- 18:25did you find that in your
- 18:28management of breast cancer patients
- 18:31that you may have switched
- 18:34therapies or the sequencing of
- 18:37therapies or the location of therapies
- 18:40given considerations of the pandemic?
- 18:44Yes, we did all of those things.
- 18:48So fortunately we have a robust cancer network
- 18:51here with locations all over the state.
- 18:54And just as Christina got
- 18:56her care in North Haven,
- 18:59I frequently recommended my patients
- 19:01be treated close to home rather than
- 19:04coming down to the main hospital
- 19:07for some period of time.
- 19:09And even during that time,
- 19:12some listeners may remember that
- 19:15the cancer care was temporarily moved outside
- 19:18of Smilow Cancer Hospital for some time,
- 19:20and so I even practiced at a location in
- 19:24Guilford for awhile while we were again
- 19:28minimizing people coming into the hospital.
- 19:31We also made modifications to the timing of
- 19:35some therapies and that was consensus driven,
- 19:38so we really spent some time listening to our
- 19:42leaders and colleagues across the nation.
- 19:46And I remember logging into many webinars
- 19:49where there were conversations about
- 19:51how to best care for patients without
- 19:54compromising their curative treatments,
- 19:57but minimizing their risk of exposure.
- 20:01And I think that we made the best
- 20:03decisions we could make at the
- 20:05time and it was collective.
- 20:07Oncology tends to work really well
- 20:09together for the good of the patients,
- 20:11and I felt that coming through
- 20:13during the pandemic.
- 20:15Yeah, and so Christina you ended
- 20:18up getting your chemotherapy
- 20:201st and then what happened?
- 20:23How long after that did
- 20:25you embark on surgery?
- 20:30I recall asking Doctor Park how soon
- 20:35after chemotherapy can I have
- 20:39my surgery and her response was
- 20:42four weeks would be the minimum and I
- 20:46think my surgery was like 4 weeks to
- 20:51the day that I ended chemotherapy.
- 20:54I was ready for the next step
- 20:58so there really wasn't any disruption.
- 21:02The planning went pretty smoothly.
- 21:05I was extremely fortunate that I
- 21:08did not experience any delays
- 21:12in my chemotherapy,
- 21:13I was able to have the treatments
- 21:16as scheduled.
- 21:17Of course, there were side effects,
- 21:19but they didn't sideline me
- 21:22so I finished as expected and
- 21:25then exactly like 30 days later
- 21:28I went in for surgery.
- 21:31And so what was that experience like?
- 21:34I mean you come into surgery.
- 21:36Were you able to bring your family?
- 21:39Did you have to wear a mask?
- 21:45when you talked about Covid being like
- 21:48this parallel line with your your cancer,
- 21:51tell us how that kind of
- 21:53influenced the surgical management.
- 21:56Sure, so masks of course at
- 22:00that point they were so commonplace,
- 22:03and familiar that it's
- 22:06just what what we do, right?
- 22:09What was a little trickier was figuring out
- 22:12who can be with me?
- 22:15Can my husband be with me if he can?
- 22:19Can he stay? What does he need to do?
- 22:23What do I bring to the hospital
- 22:27with me if he can't stay?
- 22:32So that was a little trickier than
- 22:35even right up to the day that I
- 22:39was being admitted for surgery it
- 22:41still wasn't clear which portions
- 22:44he was going to be able to be there for
- 22:48and how long he might be able to stay for,
- 22:52so I think you get
- 22:53more comfortable,
- 22:55sort of living in gray areas and with
- 22:58the unknown when you have cancer,
- 23:00so that was just another something
- 23:02that we sort of had to roll with.
- 23:07It was more of, this is the bag I'm going to take
- 23:10if you can't come with me.
- 23:12If you can come with me,
- 23:14I have this bigger bag that you're
- 23:16going to take in with you and then there
- 23:19will be another backup plan if needed.
- 23:22So just trying to be flexible.
- 23:25But he was able to stay with
- 23:27me right up until I went
- 23:31over to the operating room.
- 23:34Tara, you know we
- 23:36talk about cancer so often,
- 23:38we talk about having a support
- 23:41system and how important family is
- 23:43and you know clearly the pandemic
- 23:46kind of threw a wrench into familial
- 23:49support where patients often
- 23:51will have their entire families
- 23:53with them at clinic visits or in
- 23:56the hospital room or in the waiting
- 23:59area for their surgeries and so on.
- 24:02Tell us about how that that changed
- 24:04with the pandemic and what adjustments,
- 24:07if any, were made to compensate for that?
- 24:12Yeah, thanks for bringing this up.
- 24:15I think this is one of the most
- 24:18painful changes that came with the
- 24:20pandemic because of the risks,
- 24:22the decision was made to
- 24:25limit or restrict visitors.
- 24:26And as you mentioned,
- 24:28especially in cancer care,
- 24:30those visitors, those loved ones are
- 24:33so important to every step of the way.
- 24:37And I think that that
- 24:39decision was very difficult.
- 24:41It was painful for everyone involved,
- 24:43especially the patients and their loved ones.
- 24:46You know, many efforts were made to
- 24:49try to improve the communication.
- 24:51Once a patient was hospitalized,
- 24:53for instance,
- 24:54we did a lot to try to ensure
- 24:56communication with the family member
- 24:59through all different types of media,
- 25:02including face timing on rounds,
- 25:06lending iPads to each room and then
- 25:08we even had a system where there were
- 25:11volunteers who called with updates every day.
- 25:14I'm not sure that we did
- 25:16that for every patient.
- 25:17I know there were many patients
- 25:19who felt that the communication
- 25:21could have been better.
- 25:23And I think that we
- 25:25need to look at our processes and
- 25:28going forward figure out all the
- 25:30different ways that patients prefer
- 25:32to be communicated with and then try
- 25:35to do everything we can to spend that time
- 25:39doing that communication,
- 25:41in addition to all of this,
- 25:43we were avoiding going into
- 25:45rooms for the risk of exposing the
- 25:48patient and I know that was also
- 25:50a very isolating experience for
- 25:53patients hospitalized during that time.
- 25:55So it's something that
- 25:58in retrospect,
- 25:58we will analyze and understand
- 26:01how we can do better,
- 26:03and we continue every day to try
- 26:05to maximize the chances that
- 26:07patients and their loved ones feel
- 26:10informed and cared for and heard.
- 26:14And so then Christina,
- 26:16you have your surgery and presumably
- 26:20you get out of the hospital.
- 26:24Then what happened?
- 26:28So I was doing well enough that
- 26:32I was able to leave the hospital
- 26:36that evening and that was a
- 26:40decision that was definitely
- 26:44brought on by me and partially
- 26:46because I wasn't able to have
- 26:49family with me during that time.
- 26:52I knew as long as my doctor felt
- 26:56that it was safe for me to go,
- 26:59I knew that it was going to be better
- 27:03for my healing and recovery to be
- 27:07around family and to be back home.
- 27:10So I went in that morning and I was home
- 27:16by like 8:00 PM that evening,
- 27:18but my team, Doctor Park was
- 27:21texting me that evening, the next day
- 27:24checking in on me so I still felt
- 27:27like I had a lot of support but had
- 27:30the luxury of being back home where
- 27:34I was going to get the best rest and
- 27:38have the most help from family so
- 27:41everything went pretty smoothly
- 27:43once I got home.
- 27:46Did you worry about potential covid
- 27:49risk that your family could bring in?
- 27:52That would affect you, particularly?
- 27:55You know, not even after your surgery,
- 27:58but even during your chemotherapy.
- 28:02Was that concerning for you
- 28:04in living with your family,
- 28:06who you know presumably
- 28:08were out in the real world?
- 28:11Potentially exposed to the virus and getting
- 28:15infected yourself?
- 28:20Yes, I live with my husband and he
- 28:22had to make a lot of sacrifices.
- 28:28And think very carefully about who he
- 28:31was around and where did he absolutely
- 28:35have to go versus maybe want to go?
- 28:39And I really didn't see much other family,
- 28:42especially prior to getting vaccinated
- 28:44myself and I also didn't bring my husband
- 28:48into my chemotherapy treatment, even at
- 28:50times when it was better under control.
- 28:53And they said I could bring one person,
- 28:57and I was worried about what he could
- 28:59potentially be bringing into other
- 29:02people receiving treatment as well.
- 29:04So yeah, that was a worry.
- 29:07I mean, it's still a worry.
- 29:09Now, even after being vaccinated,
- 29:11but less so.
- 29:14So in our last minute just tell us
- 29:17about your decision to get
- 29:20vaccinated, when you got vaccinated and
- 29:23how that went.
- 29:26I was extremely fortunate that I'm
- 29:28working in a hospital environment.
- 29:30I work in an emergency room.
- 29:34And my hospital did an amazing
- 29:36job of rolling out the vaccine
- 29:38to staff as soon as possible.
- 29:42It was something I had been thinking about.
- 29:45As soon as we started
- 29:48hearing about a vaccine.
- 29:49And of course I talked it over
- 29:52with my medical oncologist before
- 29:54moving forward with the vaccine.
- 29:57But knowing the potential.
- 29:59devastating effects of covid
- 30:01and seeing what it did,
- 30:04it really seemed like an easy
- 30:06choice and the right choice for me.
- 30:09Christina Allen
- 30:09is a cancer survivor and Doctor Tara
- 30:12Sanft is an associate professor
- 30:14of medicine in medical oncology
- 30:16at the Yale School of Medicine.
- 30:18If you have questions,
- 30:20the address is canceranswers@yale.edu
- 30:21and past editions of the program
- 30:23are available in audio and written
- 30:25form at yalecancercenter.org.
- 30:27We hope you'll join us next week to learn
- 30:30more about the fight against cancer.
- 30:33Here on Connecticut public radio.