Author: Joanne Dragun, M.D.

If you have been enjoying the talent, dedication, twists and turns of the wonderful winter Olympics this week, then you know that the podium is often just split seconds or centimeters away.

It’s like cancer. Really, Joanne isn’t that a stretch? Nope. Just like the cross country skier risking a major groin strain, stretching his ski just ahead to gain second place at the finish line, so too, the smallest maneuvers matter.

Last week the ACRO meeting was filled with ways to address cancers with minimal side effects and minimal doses of radiation and chemo. Even the benign disease category of treating various arthritis regions (not spine yet) presented by a professor from Germany was detailing minute doses for maximum effect. The “TARGET” trial at MD Anderson is finding that hanging our hats on immunotherapies may only garner limited effects. So a study is out for GBM, hard to treat, with ways to kick the T cells in the ass and keep them responsive to treatments, instead of having the cancer win.* Again, small tweaks in an already burgeoning area make all the difference.

It is one of the reasons I don’t object to AI in the cancer fight. It takes thousands of iterations in record time to find the minutia that matters. No longer one bench scientist at a desk. However that doctor must use his amazing mind to even consider options or paths to reconfigure cells for treatment.

Medicine and cancer treatment have become extremely nuanced. No, everyone will not be cured. Sadly bringing the light to colo-rectal cancer in younger people found us losing that battle for James Van Der Beek. Why didn’t new therapies do the job? Too often many factors still unknown are part of the complexity in younger people for all cancers. As we age, we expect illness, a wearing down of sorts, less ability to snap back or even respond or tolerate therapies. For young, fit people, there are still unknown factors that interfere, even with the best of medicine.

So, is there hope? Is there a chance that you can face a difficult time and still succeed and enjoy life? Yes, because that day begins today. Love your loved ones, embrace your family and friends, pray and trust, make plans even if they do not come to fruition, because anticipation and joy is a big part of wellness. We do not give up hope, even if the obstacles seem insurmountable. The definition of success is in the effort, not the result. Just look to the Olympians for inspiration. Their spirit, energy, and determination remind us that winning lies within, even in the tiny moments of a smile, a held hand, words of support and comfort. We can all be champions and recognize that we can champion others. God Bless my friends and family on this journey and you and your families, dear reader. Valentine’s (my grandfathers name!) Day is a great time to remember that even when the body fails, love triumphs.

PS: Since it is Valentines Day weekend, even a smooch minutia will brighten someone’s day, so give freely, with love in your heart…… everyday.

*Lang,et.al, Clinical Cancer Research, Systemic immune correlates of long term survival after Delta 24-RGD based on Therapeutic Adenovirus for recurrent Glioblastoma Effect Trial ( TARGET), Jan.29,2026.

While many bundle up in the fierce snows and wind chills even in south Florida, the falling iguanas may require us to invest in more gear! No one needs a clonk on the head by an enormous creepy lizard with a long tail and claws when we are already dealing with other surprises in life. However, after a week or two, even down here, we begin to adjust. Why is that? Because we have all become masters of acclimation. Haven’t we learned in life that complaining doesn’t move the needle? The tough stance and bravery necessary for success starts with the first shiver of a diagnosis, but we are quickly wrapped in support, knowledge, strength and we confidently meet expectations everyday,

We actually begin to develop muscle memory quickly. You gather the necessary gear, adjust behavior, nutrition, activities and search for knowledge. Gradually, you become less bothered. The weather, travel, and commute are less threatening. If undergoing care, the side effects are dismissed quickly and you develop patience with each treatment and even find they are less noxious.

Take Amy- her triple negative breast cancer mets are met with a shrug. New treatments are on her agenda as she seeks spending as much time as possible with her three teens. Jasper’s son transferred from a University in Arizona to on line classes while he helps his Dad run the business, realizing there is no promise of time. Peggy is quickly retooling plans as more data shows systemic therapy is in her future following her colon cancer surgery.

Every single patient is plugged in and adjusting. As varied as cancer scenarios are, the common thread that binds and leads – no fear, just determination.
The chill these weeks is dismissed, the iguanas can be dodged, the trepidation can be avoided. You acclimate and empower yourself, because cancer isn’t all that you have, you choose more.

PS, As the Winter Olympics begin, good luck awesome team USA; show us what determination looks like.

Wouldn’t you love to reach your full potential? It’s a great goal, not just for you, but your children and grandchildren. Well, now researchers are finding ways to help your immune system work to its full potential. No, there is not a pill and it will take some time, but tweaking our mRNA, bone marrow, and waking up dormant cells are action items for controlling the immune process of aging, super charging T cells and helping us fight inflammation and infectious diseases. Much of the research came from Covid and studies at NIH allergy and infectious diseases, evaluating how to target immunity to slow aging. Scientists at MIT have found ways to boost immunity with mRNA therapy, even making cancer immune therapy work better. Stanford is examining swapping out and transplanting cells to revitalize immune systems. Not to be ignored, even the brain gets involved with neuroscientists uncovering immune cells in brain by clearing toxic debris that accumulates.

All of this work is so exciting because for years we blamed aging on genetics and environment, and we too often worked on diseases after the fact. Most of medical care is finding disease and treating, especially cancer. To avoid disease and improve the integrity of our own systems to stay healthy longer is game changing.

While the mice are mostly getting all of the attention in these studies, trust rapid improvement in trials and roll out to humans quickly. So, what can you do in the meantime? Step into making yourself the best specimen for treatment. MD Anderson last month offered 6 simple ways: eat healthy, exercise regularly, get enough sleep, reduce stress, stay up to date with vaccinations.

“Very Well Health” this month added, manage weight, wash hands regularly, get a pet ! , build social networks, finds ways to laugh, no smoking, avoid alcohol, Harvard doubled down on all of above.

The mice can’t do all the work. What I like about the research is how this is now a priority and at just the right time. Too bad we had to go through covid to find the exciting mRNA data. However we do have to take some responsibility. We can’t expect to get a thymus transplant (filled with fresh T cells) but then not make good decisions. So, plump up your immune system for longevity. If you have cancer, you want to be able to maximize your response to immune therapy (used for many even hard to treat cancers today).

While we will not live forever, even with cancer, we should still demand the very best from ourselves. Take responsibility and plan that, when improved treatments do arrive, such as the immunotherapies, biologics, and soon anti aging therapies, we are our very best specimens. Spend the time that we do have with enthusiasm and joy, ultimately reaching our full potential daily.

Please take note: check with your Doc if you are on immune treatments. Be sure they know everything you are taking. There are over the counter meds found to interfere with them… From Duke Health, Jan.7, 2026 researchers published that some widely used drugs like acetaminophen, stomach proton pump inhibitors ( like Prilosec or nexium) and steroids can reduce efficacy of immunotherapy. While antihistamines, statins, antidepressants (SSRI) may enhance immune therapy. (from JCO, Dr N.DeVito).

While the fierce snow, ice and chaos reign in much of the US this weekend, I recall practicing in snowy NW PA. I quickly learned to navigate treacherous roads, throw the shovel in the car and show up. Nothing deterred patients with cancer. They were already brave, so the center (and even schools) never closed. I leaned on their bravery. I was also the director of the hospice program and had concern for the nurses driving into rural areas. The chief nurse said, “Dr. Dragun, it is no problem. Just go.” Funny how many times that phrase comes to mind. The literal directive in hurricanes and storms here in Florida, the psychological or emotional moments of confusion and crisis, and even at times of pain and distress. Plowing ahead through challenges is something we have all gotten pretty good at.

People learn to navigate quickly and soon the threat is less intense. The challenges are faced down. You continue again and again to “ Just go” and never look back. You value time, friends, loved ones, even work and a daily walk more. You become resilient with renewed power and focus. You never cower. For some, you may need the snow plow, blower and shovel to make your way, but you get on that road and expect success at every turn.

You surprise your spouse and family and they also breathe relief as you power through whatever comes your way. They can hug you again and again but they no longer need to pat your head. You are lifting everyone, helping them all to just go.

The news and weather channel reports this weekend are leaning into fright and dismay. At least they keep people from heading out foolishly. But, if you have cancer and the center is open, if there are tests and treatments, if you in the midst of your struggle, we know you will be there. You are never frightened. You never give up or give in, because you have learned in a long life of successes and challenges, that the directive to “ Just go” will propel you to victory.

Stay safe friends and family. This storm is a good reason to tuck into a cozy Sunday of playoff football. Don’t overdo the shoveling. Perhaps even enjoy the wintery beauty, but most of all, let nothing deter your own mission. God Bless.

As we dive deeper into 2026 (no worries, dry (or moist) January is almost over!), tremendous changes in cancer management will continue. Our national convention in Orlando is Superbowl weekend and I will have plenty of room in my suitcase, since there will be no Eagles, Jaguars or even Pittsburgh team gear to wear, so sad. What is also impacting the meeting, are even more dramatic changes. Professors scheduled to speak are up-tooling their presentations as rapid changes in treatment evolve. Smug “National guidelines”, annoying insurance approvals, chatty cancer websites and even chat GPT can not keep up. The amazing developments continue to make cancer, even tough to treat diagnoses, a chronic disease. No, it will not magically disappear, but giving each of us more time is the blessing we need. Let’s not waste it.

Meg will take her new immune shot, then head to snowy Michigan for her new grandchild. Frank will have less days of radiation with a new protocol (5 instead of 49!) and use the time wisely to hold his wife’s hand and remind her failing memory of their 60 years together. Jake will decline hormone therapy for his prostate cancer since last week new research found no improvement in survival or outcomes for men over 80 with intermediate prostate cancer. He is happy to maintain that fierce tennis serve and knows the camaraderie on the court influences wellness more than drugs.

There isn’t a patient at this point not benefiting. The new year, new research, new treatments are opening opportunities for your own renewal. You are grabbing the reigns and ready for anything. New experiences, new challenges, new therapies, new people, new discoveries even your own renewed fortitude. You are going to surprise yourself this year. As you dismantle the Christmas lights, it is your own light within that will burst forth. Nothing artificial here.

And so, a suggestion……when the Doc enters the room and asks how you are…. instead of “Fine” or a litany of complaints for them to fix, I suggest that you ask a question. “What’s new, Doc?” Every single specialty, and especially Oncology, is rapidly expanding. Even clinical trials going on for years are closing as new evidence comes to light and treatments shift. Be a part of the new. Expect greatness from yourself and your team, and always bring forth your own shining light of hope with new expectations.

The very tiny 8 week old puppy already owns the sidewalk. My friend proudly “walks” this little piece of heaven. He is so wiggly-giggly and excited and I jump from the car to welcome him to the neighborhood. Later in the day, there is a gathering of senior dogs, “parents” and puppies by the pond, organically sprung to celebrate the new addition. It’s as if the entire complex has adopted this precious pup.

On a different but same (?!) topic, I watch a little of the Indiana Bowl game. The sheer joy and excitement the young fresh-faced college players exhibit brings a smile to us all (except Oregon fans). No spiking, in- your -face stances, hubris- just giggling with each other over sheer surprise and luck (and skill).

As we open each day of this new year, many will be facing challenges- even cancer. Some are already in the mix of it. You may not think there is much to giggle about (tsk ending w preposition) The moment usually comes unexpectedly.

Jessie brings “Garfield”, the big white furry Clumber Spaniel into the waiting room- all hands reach for the gentle loving creature- smiles break out and cancer is forgotten. Alice leaves her 4 year old grandson as she heads to the radiation unit, Marlene, another patient, is found sitting on the floor reading to him and they bond quickly.

As the future unfolds, we all need to stop and appreciate. There is enough to trouble us, so let’s get out of our own way. The healing Oxytocin hormone boost comes, not with chemo, radiation, bloodwork or scans. It comes and is available daily for the taking when we are aware. Once again, I encourage us all to be part of our own cure. The mind-body connection is fierce. Opportunities exist daily to heal.

My own decision today is to try pickelball. Pull on the knee braces, pretend to have hand-eye coordination and for sure laugh with friends. Ridiculousness is always available. While cancer and challenges nip at our heels, let’s commit to kicking up those heels and finding even a moment to giggle today. Your mind, heart and body will thank you.

Note: Movement is medicine. Out this week, In first of its kind study (“Structured exercise after adjuvant chemo for colon cancer”, Courneys et al, NEJM 2025) Follow up of almost 900 patients on trial, revealed structured exercise program (120-150 min per week- about 3-4 brisk walks) soon after chemo had significantly longer disease free survival and longer overall survival. 37% lower risk of death from any cause after 8 years. Lower inflammation, regulate hormones, boost immunity, slow tumor growth). Let’s lace up!

This week you may have been tempted to set some resolutions for the new year. But we all know that it is a change in life that directs a new course, not a change in the calendar. A common theme is that patients always reassess the moment the doctor says “cancer”. They consider every life decision: smoking, drinking, activity, sun exposure, screenings, even where they live and if family or support is available. If you have faced this challenge, you know what entered your awareness with that singular discussion.

While you gather the team of docs and precede through procedures, you begin to wonder about your part in this new dynamic. Can you take some responsible action? Can you control your response to the drama to insinuate yourself into the healing? Can you elevate your game plan, focus your mind and improve your body for the treatment? Of course you can and you must.
Allow me to help with this new dynamic, and provide recommendations for your personal resolutions in the context of a diagnosis.

The first thing the doctor notices and documents is your fitness for treatment (ECOG) status. We actually design therapy considering this factor and so some patients will not be able to tolerate even the standard of care. Vow to be your best “ specimen”. To improve your fitness, hydrate, sleep, walk or exercise, eat or take nutritional supplements, now is not the time to lose weight. Gather your team of supporters. Get help with meals, cleaning, transportation and don’t try to handle other drama. This is enough now, so be a little selfish.

If diet is an issue, ask for a dietitian consult. Usually cancer takes a toll before we are aware of the diagnosis, often with weakness and weight loss. Ask for physical therapy evaluation for reconditioning. Resolve to be the strongest you can at the most challenging time of your life. Don’t let cancer make a wimp out of you.

Do make plans around your treatment. Don’t give cancer all the power. See family, friends, take short trips, don’t postpone enjoying yourself until therapy is over. You will be more fit, better prepared and more resilient if you reclaim your time. Take vitamin D 3, be honest about your pain so you can be treated, and discuss depression with your Doc. Bring your side effects to attention of the team so they can help you. Be honest with family. Listen to music. Go to church. Tell friends how they can help.

These recommendations sound simple, but you would be surprised how many abdicate all attention to the disease, not to their wellness. Let’s have the courage to be our best, regardless the challenges this new year. Cancer is a stinkin’ thief. Resolve to come to the battle prepared and confident. Now those are resolutions worthy of your effort.

Let’s all plan for a wonderful new year because you are brilliant and brave.

Wouldn’t it be great if every new year was actually new and improved? We have no clue what is in store as we head into 2026, but trust it will be interesting! Be assured that you, who have navigated so much, will have every strength required. Also be open to, and even more aware of, triumphs and many fun filled moments which are sure to be found in this new year. There will be successes. There will be surprises. And yes there will be difficulty. Again and again you have proven resilient. At this point, you have learned to face new developments, even cancer with a calm assurance. You’ve witnessed family and friends manage their own challenges so you know that you have sterling examples of bravery and fortitude.

As together we step into 2026, let’s all rejoice as we reclaim. Rest assured, no matter the issues, that we are well able and prepared. Let’s enjoy, celebrate and cheer for every victory sure to arrive. Let’s face every revelation with courage. If cancer is a focus for you or a loved one, then let’s all have confidence that the universe is still conspiring to offer new, exciting, developing and ever-evolving treatments (I have inundated you here over the past months with so many new therapies and many on the horizon).
2026 is going to be amazing in cancer care. You will benefit. Together we may all be stepping into the unknown, but fear is not an option. Fearless and fabulous is what the new year with new opportunities offers. I say that we are all up for the challenge. Embrace 2026 dear friends, and all that is ahead with enthusiasm, anticipation, love and confidence. Happy, healthy and safe new year!

This magical holy day arrives with delightful fanfare undeterred every single year. Christmas isn’t waiting for you to complete therapy. It isn’t changing the date because the snows obliterate the country. It doesn’t stop festivities as you set the treatment schedule and are too busy to celebrate. No, Christmas presents with its chaotic festival of sparkling lights and glory ready or not.
Isn’t that the very best way to recharge and refocus us? Every year regardless the drama, we find ourselves forced to participate. Sure there will be frenetic gifting, travel, traditional meals and usually cheesy decorations, maybe more than a little of shoveling thrown in to remember it is winter. But we are the ones being gifted with this sentimental momentous holiday of Christ’s birthday. Everyone will play their part to make the holiday special, especially for challenged loved ones. Many of us will recall when we were all together and preparations, wrapping, cooking, baking and holiday spirit filled our homes and hearts. We will attempt to recreate, especially for our little ones and develop new traditions they will cherish long into their lives.
We will be required to be unbothered for at least a day or perhaps over the next 2 weeks into the new year by sickness, treatments, and self-centeredness. We will appreciate each other even more. We will grab this holiday to create memories. We will hug and kiss those close and send prayers and love to those afar. We will take the blessings God has provided this Christmas and Hanukkah and infuse our own spirits with rebirth. The lights in the trees and spectacles will be dim compared to the bright hope and joy we will each project.
Patients will arrive to the centers with Santa hats jauntily placed to bring a smile to staff who themselves sport lighted reindeer ears. Everyone is in on it. We all know to not take one day or one Christmas for granted and we don’t.
So, this week, dear friends, as you gather, celebrate, and enjoy a wonder-filled holiday, please remember that the real gift of the season lies within and your generosity of love will bring hope to others far beyond this day. That is God working through your spirit, 2025 years in the making and still going strong.
May the peace of the Lord live in your heart everyday and His light shine upon you. Merry Christmas, Happy Hanukkah.

Is cancer everywhere or are we just more aware? The crazy thing about it is how really unprepared we are. We’ve accomplished so much- education, careers, families, hobbies and the successes seem to come routinely. Sure there are many challenges along the way but you learned to take them in stride with expectation that you will manage and move forward. We really do not have a frame of reference for this or any major disease. So often it strikes as we retire, or interrupts a new adventure. You know what I am saying and you nod your head. Ok Joanne, so now what? Well, may I gingerly suggest perspective? “Oh come on, this is a pain in the ass, and frankly I am a little frightened so don’t tell me to suck it up”. Ok I won’t but how about instead of “Ugh! now with everything on my plate, I have to treat cancer!” Change the dialogue to, “I get to manage this new threat”. For those who are family, ” I get to help, research, explore, support”. Don’t let cancer stress you into trepidation. You are bigger than that- look at all you have accomplished in this long and bumpy life. “Put up your dukes” and don’t let dis-ease push you around.

While you may feel as if the rug has been pulled out from under you, remember that the earth is still there supporting you. Lean into the light times and find new perspective to be appreciative and maybe even joyful. Take Charlie who is in his own words “An old hillbilly!” He is taking his disease in stride and his playful nature lifts the whole dept. “Doc, I’m a youngster! Get a load of this… my 100 year old neighbor mows her own lawn. When I was coming for radiation, she offered to do mine as well!”

Stay grounded, Stay in the game, like Charlie find humor. Enjoy today. Don’t be overly serious. I love Voltaire’s perspective: “The art of medicine consists of amusing the patient while nature cures the disease”. Trust me. You got this God Bless !