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01/27/2012

A supporter for. More than eight years. And not start working the facts are back in 2000 which is when first covering you know. Pretty consistently. And round or four months ago. The content ID. A lot of campaign tool obviously we bounced from one during the next arms several hours the following morning in New Hampshire four years ago I mean when it. Through radio a couple of hours and many went to another town hall meeting and many went to. And I mean from Concord, New Hampshire. You know all of the stated I was in the a couple days. And then he one date to to take direct that you want to take a vote in Washington DC in the next all right there he went South Carolina. For a debate and primary so early. He keep it means he's a very warm nice guy remove all of his political role. Aspects very very nice guy I remember one time I went to an event I believe in the chamber of commerce. And Freeport. And now we had to go to the security and get a shuttle bus. And but he didn't actually got to drop could do the congressman. And it got time to leave I had the lead early in Atlantic district are faster because you know give me a ride like hardly gesture get on it and so agencies that are currently guys that are pretty approachable kind. very accessible as far as talking to that. A lot of those people out sound what we need Paper are written here for like forty years. disorder or hear from other are it doesn't change his message he'd always. Had the same abuse in the same beliefs and most anytime that you would use speech whether it was. You know a got recognition or whatever he would talk about the Federal Reserve ready to talk about the gold standard and foreign policy and stuff like so and and he always had the same message. I think part of what it is I mean he just better than. Earlier closes I and I know that you years talked of our records somewhere between its. Somewhere along the way it is today is the doctor then he would come across the Austrian economics series. And he had really done. Turned really you really like those ideas and he's I think he's been preaching and promote cents. I think he would do you'd news as far as is reaching yet I think it started as the anti war message. It doesn't make that really because Iran Iraq War actually Stovall loans are still fighting in Afghanistan. At the time. I think that true a lot of young people to his campaign but it has you know has that happened ethnic a lot of listening to news. Economic ideals that he didn't like that to you I think that's part of why he was able aren't summoning people. I think. You know you know he really doesn't want to become president but I also think in his mind you know regardless of what happens people are gonna listen to what I have to say. Charity to the I think he's really trying to inspire younger generations. Two Arctic our business community can't do it forever. You know he's he's getting older and he can you know he's not can be able to run around 20s16. So I think he's just he's trying to inspire people he's already created property ticket or campaign functional hostile election. And he turned into a foundation that does you know identifies candidates. Similar believes. And support them campaign and as an example somebody new you know hold the same libertarian leaning believe. I think you'll keep going regardless. What happens Gingrich and Romney because he can't has the finances. We're proud of what anybody thinks about his chance in the morning he gets a lot of time campaign donations. And they haven't stopped. He character elect you know the people the support around. To keep campaign he didn't mountain and you governor had to be camp Randall which are pretty much. Down to September.

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01/27/2012

As we focus on GOP presidential candidate Ron Paul this morning next WB and live line guest is David DiPietro. David as a former mayor of the village of East Aurora businessman autonomy Amber's businessman and a staunch supporter of Ron Paul. Dave good morning thank you for joining us. thank you very much friendly. Why are you such a staunch supporter of Ron Paul we know you brought him and the town of East Aurora village of East Aurora a few months back. And he spoke to are quite a larger audience what does he bring into the campaign what do you see in Ron Paul Dave. things. Authenticity. Or the ability to change. The paradigm of government. The ability to change the paradigm is right now. Both government broken on all sides. And then there's only one person I think the constriction of the way it has to be tricks and that's Paul. Dave he's in the back of the go right now is Ron Paul electable others yet. Perpetual candidate. Let a good question. Right now they're all Robert and He's. He might not be Electability candidate. But he has the candidate. There's gonna make the changes we need to make and that's the that's probably the biggest sector of the sort that tries this level we know that the media's. But it won't pretend he's playing uphill battle there are two other candidates other candidates that are they're more formidable. We're trying to do it oh geez. You're the one that we need to change the paradigm government can feel government broken Ron Paul won I think it's going to be able to exit better than anybody. David do you think Ron Paul will still be in by the time we get to the New York State primary. And are contact are you in contact with them and illusory chance you might come back to Western New York again. All that the good question his hoping western new York and we're looking at now what. Our New York goes What candidate at least. The base and have the elections move forward it's got tickets to all he needs a big victory coming up a little bit and hopefully and he can't let. That was a taker could buy time in New York State comes into play. Can be water to just two candidates. Okay Dave I was not talking with the this morning of an last week and as soon as you learn more about Ron Paul's schedule we hope to hear from you and be in contact thank you again. Here or as David DiPietro the former mayor of the village of East Aurora staunch Ron Paul supporters.

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01/19/2012

Guys I've stated numerous times during the campaign. This campaigns never been about the candidates. It's. Now ran for president because I love America Diana. A lot of people all of our freedom. And matter fact this mission is greater than any one man. As I've traveled across this great country starting here in Charleston going to New Hampshire and Iowa. California. Down end of Florida. Numerous states in between obviously and I discovered. This tremendous purpose of resiliency of our people. They've never lost hope. Despite the circumstances that we fighters I was then. They had stopped believing in the promise of America. They haven't stopped believing in the American dream. Americans are down. But we'd never be counted out. We're too great of people for that. What's broken in America is not our people. Our politics. And what we need in Washington. Is a place that is onboard. With the federal government that is smaller. So there are people can live freer. I this campaign offering a unique perspective. For governor who had a large state leading the nation and job creation. An executive leader who fed implemented conservative principles. A son of tenant farmers. Who is barn with a little more than a good name. But who has experienced. The great opportunity and freedom. Of this country. But I've never believe that the cause of conservatism. Is embodied by one individual. Our party. And the conservative philosophy. Transients. Any one individual. It's a movement of ideas that are greater than anyone of us and will Lil in long past. Any of us in our lives. For the former air force Prada I don't. Get confused. I know we can't lose track of the ultimate objective. In carrying out our mission. And that objective is not only to defeat President Obama. But to replace him what conservative leader who will bring about real change. Our country's make no mistake about that thirteen million people out of work. Fifty million of our citizens on food stamps. Fifteen. Trillion dollar national debt and growing. We need bowl conservative leadership that will take on. The entrenched interest. And give the American people their country back. I've always believed the mission. Is greater than the man. As I've contemplated the future of this campaign. I've come to the conclusion that there is no viable path forward for me in this point twelve campaign. The airport today. I am suspending my campaign. And endorsing Newt Gingrich for president the United States. I believe is a conservative visionary who can transform our country. We differences which campaigns will inevitably. Have. And it is not perfect but who among is. The fact is. There is forgiveness for those. Who seek god. And I believe in the power redemption for it is a central Tenet. Of my Christian thing. I have no question that Newt Gingrich has the heart of a conservative. Reformer the ability to rally. And captivate the conservative movement the courage to tell those Washington interest to take a hike. If that's what's in the best interest of our country. As a Texan. I'm never shied away from five. Particularly when I considered the cause to be righteous. But as someone who's always admired. great if not the greatest Texas governor Sam Houston. I know when it's time. To make a strategic retreat. So betrayal returned home to Texas. Wind down my twentieth twelve campaign. And I will do so pride. Knowing I gave fully. myself of a cause. Worthy of this country. At home. I do so with. The love in my life. My my side. A woman. Who makes every day good. When she is there about me that's my wife and thank you for all you've done. She has been an incredible patriot. During this process. Also want to thank my son Griffin. And is. Beautiful wife Meredith. Sydney who is not this here today. But the fact is. With the good wife. With three loving children. And a loving god. Who is in my I think he's going to be good no matter what I did. I'm proud of the policies we put forward to the American people that believe that we provided. The right path forward for our party and our nation. Overhaul Washington. Providing. I think fit the road map for that. Proclaiming that tenth amendment. And all the goodness of allowing the states to be more competitive in the local governments. Creating energy and energy security energy jobs and energy security. Cutting spending eliminating these unnecessary. Federal agencies. Cutting taxes to that flat and simple 20%. And I'll continue to fight for these conservative reforms. Because the future of our country is at stake. And the road were traveling today. President Obama's. Road. Is a very dangerous form. I want to thank some wonderful individuals who I've come to know and admire him. We've stood by my side in in this state. Patent office. Thank you brother for all the work that you've done in the loyal. Just just be in the loyal supporter that you bin. Strong and a good man in the United States congressman mining. Ambassador Wilkins. Talked all of them this morning and in Canada. That is one thing my supporters the men and women who have come across the country did it to be here in South Carolina they were in. New Hampshire and Iowa. God bless you for loving your country for. You know for volunteering. In and being here and and and making a difference. And particular say thanks to. Governor Bobby Jen doll who this has been a fabulous spokesperson Steve Forbes to. I. As Know him more I admire him greatly. What they've fabulous patriotic American and governor Sam Brownback. Senator Jim an off. Congresswoman Candice Miller. Sam graves congressman Sam graves all just great Americans to. We have come to have such great respect for and reflect their love of country. Analysts are really special effects. 23 distinguished. Veterans who have joined me on the trail. Medal of honor recipient. My form spent the last two days as we traveled across South Carolina. Navy cross recipient Marcus Latrell. Thank you brother. Appreciate you and Malcolm and being with us today and my Christian brother who's up in Green and traveled so many miles with me. Young marine captain. Dan ran. They truly. Represent. What is best. About. America Give them so much of themselves. And they have been. Uplift. For me is. A citizen is the commander in chief of Texas forces. And again. They are truly. My heroes. You know I began this race with a sense of call. I've felt led into the arena to fight for the future this country. And I feel no different today than I did them. Knowing a calling. Never guarantees a particular outcome. But the journey. That tests one's faith. And one's character. So now that journey leads me back to taxes. Neither discouraged and are disenchanted. But instead rewarded highly. By the experience. And resolute to remain in the arena and in the service of my country. Our country needs bold leadership. And real transformation. Our country. Deserves that we must rise to the occasion and elect a conservative champion. To put our nation back on the right track. And this sign out. I'm not done but. For the cause of conservatives. As a matter of fact I have just begun to fight god bless you. God bless this great country of America thank you for coming out below the.

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01/22/2012

This is Roswell. Rookie by Roswell Park Cancer Institute European opinion or your total options your host Welcome back to run smallness of our weekly conversation about all aspects of cancer here treatment diagnosis and research. And we're here at Roswell Park Cancer Institute in Buffalo, New York. A truly comprehensive cancer treatment and research center I'm Tim Wenger and this time on the program will talk about sarcoma. Doctor crucial money is with us today he's an associate professor of oncology chief of melanoma and sarcoma and medical oncology. At Russell park in doctor crucial I think you so much for being here today appreciate it it's my pleasure thank you. And by your side today we have doctor killing in May assistant professor of oncology in the department of radiation medicine here Roswell and doctor may thanks so much. Thank you very much and last but not least doctor John McCain the third uses an associate professor in the department of surgical oncology. And chief of melanoma and sarcoma surgical oncology at Roswell park big title. Welcome thank you thank you don't know what to say That the dollar gets picked precautionary. Well I think it's it's pretty impressive all of you in Indy. Sarcoma I think Z you know a lot of these. Cancers and in areas of cancer care that we talk about. The listeners have some level of knowledge about sarcoma I think is is a little bit of a mystery. Doctor. McCain if you could start by giving us kind of the briefing on what is sarcoma. Actually sarcoma is a very interest thing type of cancer for a couple reasons one it's a very rare cancer only represents about 1% of adult cancers more common in children. It's also a cancer that frequently doesn't have a pre malignant so often times by the time the person has the sarcoma. It's already cancer you can us picked it up early. A good way to think about sarcoma is is there cancers that arise from the glue of the body you have all these tissues your your internal organs that are constantly dividing and growing. And then you have all these other tissues muscle bone fat tendon nerve connective tissue that holds you together. That typically aren't dividing and for various reasons are most bad luck occasionally exposure to toxic chemicals are certain types of radiation or. offer genetic reason some people get circle must look for most people it's really. Nothing they could do about it just happen by bad They can affect anybody from a newborn child to somebody who's a hundred men and women. All ethnic groups races and it's really cancer that doesn't discriminate. Most often when we were we here talking about you know different cancers they're they're cancers attacking certain. Parts of the certain organs certain systems. Sarcoma. It it based on what you're telling me could just by the current you're right that is correct you you because you have those two issues holding you together everywhere. You could have a sarcoma your scalp you your you could have a circle in your liver. Growing behind her liver from one of the main blood vessels in your long there's actually sarcoma is of the heart so because you have all those tissues everywhere in your body it. It's a very unique type of cancer and that you it doesn't. Really respect any particular anatomical location. The other reason that's important is it's a certain type of cancer and as we'll talk about how we are you surgery radiation and there's often role for chemotherapy. But it's very different than other cancers were you have bladder cancer testicular cancer you're going to see a urologist because it's that part of the body. Since you can have a sarcoma anywhere you really wanna see somebody who has expertise in sarcoma not necessarily along surgeon because it's in the longer had neck surgeon because it's in the neck. Because they may not understand the behavior of that tumor and the rules of the various treatments that we used it to try to get control of it and and prevent it from spread and a lot of questions for all of all of you today because if you really do it truly does seem to be a mystery is is her blow most common site where sarcoma appears. Actually the extremities are the most commonly arms in the legs are probably half of them will be the arms in the maybe a third on the legs. A lot of us are commas and extremities may be somebody that notices that there are developing and enlarging mass and verify. I thought maybe they hit it on the door tripped and fell. But it's often that the mass doesn't go away so if you get he would Tomas the bleeding or you've pulled a muscle that would typically a couple weeks. Possibly often tell patients. The types of tumors are you should be concerned about is anything that's bigger than a golf ball and there's a lot of small benign things like almost any tumors they're very common. Something that has persisted longer than four weeks or something that's continuing to grow. That may not mean that it's a sarcoma but it's those are enough concerning factors that it's worth investigating a little bit is gonna ask how we detect it known that with other cancers we have screening etc. and you how do you detect a sarcoma. I guess if you if you see one of these growths on your body obviously you're a red flag goes up but what if you can't see it what do you can't feel it. Basically a lot of patience with circle us will come in by three different pathways one is that they've noticed a mask themselves it's not going away some in their failing noticed it. That prompts getting cat scan and MRI to you get to the bottom of it. Sometimes it's the person's primary care doctor finds that they that they. We're getting a physical examination felt a math and thought it can often be painless so the patient doesn't isn't necessarily aware that. And more and more as we use cat scans for other reasons you go to the emergency room you might have appendicitis. Or sometimes findings are that actually much earlier stages because they had casket and did appendicitis but players. A baseball sized mass behind the left kidney and it gets worked up and biopsies and it comes back myself. Unfortunately because it's a rare cancer. And a lot of there are a lot of benign tumors are masses if you really look at patients with our was. The time it takes from onset of their symptoms or the mass. they're actually diagnosed with a sarcoma can be up to six months and that's true throughout the world that's in great Britain and the United States. We're hoping through public awareness both with physicians and patients. That we get to these tumors a lot faster one of the risks of spreading it's based upon the size of it. So finding it when it's smaller and and treating it you have a better chance of being short long term when it's larger. Okay that's doctor John and kind of a good briefing thank you run you know what we're dealing with and talking about today. And two other folks in the room. One of which is doctor crucial and doctor crucial money who you know no screening right I mean really is no screening for this just to we detected in the need to deal that. That's absolutely correct I mean essentially paraphrasing what doctor just mentioned. This is a disease that people pick up ten to pick up my themselves. And that's when they seek medical attention and again because it is not very common it tends to in some ways be ignored reduce. This is the simple fact is common things are common first and therefore you'll start looking out for things that you would expect at that location. And circle was sort of tends to be a little lower on the totem pole there. So it is not unusual. For it to be several months before you firm definitive diagnosis is made and more importantly war I think confuses matters. Is the head Nady in is the variety that we see there more than fifty different sub types of sarcoma that are currently recognized. And as we are understanding this more and more each one of them tends to have a different or unique behavior unique biology. And we believe a lot of that is determined at a molecular level. Are most are Coleman's. Self detected mean to Doctor King talked a little bit about having Munich. Are most of them found by idea that the patient. Many of them our particularly the ones on the arms and legs so you'll often find someone saying. I had a lump in the right along in the arm or something that was painful. Most of them yes are tend to be detected but in today's hero doing more and more scans we are finding incidental diagnoses as well. And this is a highly individualized situations I think his sense absolutely is reflected in every case seems to be unique and different so. These to be dealt specialized. I equity stressed that point more and that's I think what we find unique here I think. I am privileged to be part of a very good group of individuals that work alongside together very well. It has been involved surgery medicine and radiation oncology. You know prosthesis. Occupational therapy physical therapies are a lot of healthcare providers that are involved in the multi disciplinary management of sarcoma. And given their rarity and given their unique current situation. I think they all should be managed and multi disciplinary circle listen to wherever it is it we have we've surgery expertise in the room we every. Shouldn't expect expertise nerve doctor king's raising his hand let's star review we'll get into some of the treatment options one of the things I just like emphasizes. Roswell perception in the community as the cancer center and many people think you have to have a cancer diagnosis to come to Roswell and and and many aspects that's true for a lot of other cancers. But as we had talked about this is a very rare tumor. And we'll talk about this a little bit later because it's very important we often use multiple ways to treat this week may do surgery and radiation. But for example we might like to get radiation first for a lot of beneficial reasons. If the person's already had the tumor removed before they got here we've lost the ability to do that. When you buy these these tumors if you get a lot of bleeding or you put the incision in the wrong direction you can still tumor and actually complicate the ability to remove it so. And there are also other types of benign tumors that turn out not to be circle was others very unusual tumors that arise from nerves vascular tumors. That we also of expertise and so I really like to emphasize that this is one of the few situations where you can come to Roswell before you have a cancer diagnosis we've actually really trying to emphasize. If you have a suspicious soft tissue mass a a little. Think that the size of a great something that's enlarging your concerned about it your primary care doctors concerned about it. We're happy to figure out what it is will get the appropriate X ray test will set the biopsy. Because if it is a sarcoma if you started on the correct pathway from the beginning that's the best chance for the patient getting in some of these circumstances can be benign and you know just need to be dealt with. Maybe surgically to remove them right I mean that's correct and that would be non sarcoma correct situation is benign fatty tumors like Tomas there are nerve tumors. I but again what's interest thing it's for some of those historically people always remove them. And sometimes with a lot of morbidity for the patient. Since we understand how those tumors behave somebody may have a large tumor behind her kidney. We find out of a minor tumor can simply be watched the patient doesn't need to have surgery maybe do cat scan every few months or every couple years. That was best for the patient I have a good saying as a surgeon that the only minor operation is on somebody else. So I would like to avoid as many operations like absolutely need them. And that's situations sometimes surgery won't be that the best treatment sometimes may be radiation alone or we're just observation if it was a benign tumor. I think I like a surgeon with a sense of humor that I think I think about that for a few few minutes so we can deal of these surgically we can deal with them. Chemotherapy. Medicinal the end we can deal with them. With with radiation and doctor Kelly and Mae is so with us here Roswell park. Is introduced that the beginning expertise here on on radiation when doctor me. Any moment chime in on and some of what your colleagues and here and that's fine but when is it appropriate to these radiation and in dealing with circle. I think the first comment is to have an index of suspicion that something can be a sarcoma so that we can Begin from the here. From the start of symptoms and evaluate the work of approach this on as we would want to have we seen you first and be able to do that. The role of radiation is actually quite varied. and we take each case. Individually. And try to tailor what the best first therapy would additional therapy should be used on any given situation. Typically radiation will play a role in high grade so those that tend to look more aggressive. Two packed colleges from reviewing the cells under the microscope. They tend to clear role for large or deep her but it's really tailored to location. Those features of the individual sarcoma. What surgery would need to be done what radiation can add to that and whether or not we feel it's appropriate to start from the beginning with radiation before surgery. Or whether radiation would be most appropriate after surgery. As a group and these are the issues we discuss free each and every patient and when we what we like to do is. Think about the best way to do the bias if it's not yet been done if there is a biopsy that's been Don we review that is a group with our just. any X ray studies imaging studies including cat scans memorize. Together with radiologists. And then we discuss how to approach. An individual's care. As a group we will do that multiple times that the first decision is to do radiation pre operative leave their specific reasons why that may be and contagious. It's it's unclear that someone would require radiation and we're going to proceed with surgery first. And there are indications after surgery when we consider radiation Suez group we try to take all of that information put it together and come up with the treatment plan. That is doctor Kelly and Mae and you're listening to Roswell listen we're talking today about sarcoma and also in the studio today. doctor John King the third and also doctor Nikhil. Crucial lining doctor may you know 22. Jump off of one of the points you brought up. That this is. A unique and rare may be a better word type of cancer. And you know more the reason to come to a place like Roswell where there's highly specialized. Treatment options and you you work as a team. Talk about that why that's so important in dealing with sarcoma that you have a surgeon next do you have. You know chemotherapy and oncologists with human radiation therapists etc. Problem because sarcoma is are are quite in terms of their differences and and doctor Chris was mentioning there are greater than fifty different types. On some of those differences help tailor therapy so there's some. Select their in which we would not necessarily use radiation and there are individual therapies we think of more systemic therapies that are appropriate. There are certain areas of the body where. Do you roll of radiation and surgery is to preserve function. On and that's very important in the limbs and to do that together and thinking about that as well. So in ten he'll worrying that the role of radiation in tailoring the role of surgery you're trying to give the best outcomes possible. Minimize the chances this sarcoma coming back where it was. And horse and preserving function. Doctor crucial line when it Wendy's your your greeted with case and need to make decisions of what is the best plan what is the best option what what goes into that decision on location and the size. Talk about you know how you decide. Whether it's chemotherapy radiation surgery all 312. Again it it is primarily. Independent or individual decision making that we decide as a group for a given situation. So for example. If one has a young very functional patient. Who has a large are Cuomo of the arm the leg. Typically the best treatment for the general recommended treatment for that would be pre operative radiation followed by surgical recession. The aim of treatment primarily being to completely take out all visible disease with an adequate margin. And that again becomes very very important the role of chemotherapy which is where I come intends to be more individualized there. Because it has not very well been defined particularly in the situation. Whether cancer has not yet spread. If there are patients in whom the cancer has spread either they've already had a previously and it came back a couple of years later. Or they presented with what's called stage four disease which means it's metastatic to all the organs along being the most common sight of protest to That's where my role I think becomes a little bit more important because then we are aiming to try and control the disease at the various sites that it currently is. And the one way to do that would be to give them something systemic which could either be chemotherapy. Or now we are looking into molecular targeted therapy many of which are pills. So they take it at home. And the role of surgery and radiation in those situations then tends to be tailored to. If we have one or two sites in the lungs for example we would still offered and cut it out with surgical recession and that's where our thoracic surgeons come into play as well. So each situation is quite unique. And I think we have made numerous advances from a medical oncology standpoint. Some of the drugs that we use today and we thirty years ago. They have not changed so that emphasizes the importance of clinical trials where we are looking at. Many of the newer drugs. That are actually quite exciting we have a couple clinical trials now that are available for patients with metastatic sarcoma. That are looking at new. Chemotherapy agents that are specifically being tested encirclement so I think from a from an investigative standpoint that indeed is very exciting. One of the major developments over the last probably decade and a half has been the advancement in the understanding of a rare type of circle called gastrointestinal tumor. Where we recognized what the molecular abnormality in circle was. And developed a drug that. specifically targets that abnormality. With exceedingly good results of those patients. Previously who have metastatic. Gist or gastrointestinal stroll tumor previously about two decades ago. Apart from they had very little that we could offer them. Now we have a variety of drugs that are available that has extended their survivorship to three to five years which is quite remarkable. revisit the clinical trial importance and in just a moment doctor came. From a surgical standpoint is it. is that a good thing to get you involved in music isn't good when surgery is required for this that this you can cleanly remove something or. you know I know in some cases you know no one wants surgery that will be income. There's that humor right interest thing with most solid cancers so it that the whole issue with cancer people talk about what we ever cure cancer. The reality is is every cancer is different and that analogy I use a car if I tell him gonna give you car. It could be a Cadillac it could be you go on cinder blocks with no wheels. It was a car but they were very different and whether you were gonna race at Watkins Glen or not would be determined by this specific features. So for many solid cancers you're hoping to remove the tumor get all negative margins get all of the tumor and hopefully it was removed before it spread. What's very interesting what's our cause is they grow with little roots her fingers and their often as we they can be anywhere in the body they're often very close to some major structure. For example if it's close to your site owner of the major for your leg. If you just went in and cut out the tumor and the then delay would be useless it would be no sensation at the muscles network. So prior to the 1980s we actually treated many arm and comes with amputation. And even if you short your quality of life was not very good by not having an not having a leg. If somebody at the circle in the back of their abdomen you can't amputate their bodies so many of those patients would eventually die even just from under control local tumor. Beginning in the 1980s there were trials done by the National Cancer Institute that showed. If you combined less radical surgeries trying to remove the tumor with a negative margin but cutting it close near critical structure and adding radiation. You could have the same survival that you did with the amputation so it was a big fundamental shift in how we treatise or almost. So although yes surgery is going to cure many patients with they're frequently situations where I can't get any closer than need without actually hurting the patient. And that's where doctor and radiation make a big difference that may be the difference of the person saving their armor their the tumor not coming back. Using a combination of treatments we would like to have the chances of coming back be less than 20% for high grade tumors of less than 10% for low rate tumors. Even more interest thing at Ross I tell people you know there's a reason that cancer centers developed. Radiation as a one shot deal you get the Max amount you get one time and hopefully it works hopefully it doesn't. But we're very unique we have a shielded operating room you feel like you're going into a bank vault. And we may have had somebody who's had radiation. Delivered from the outside the arm or leg or abdomen. And if I respect the tumor and it's very close to something important doctor can command and actually give intra operative radiation we can spot one particular area with a very high dose. Protect all the other tissues around it. It gives us an opportunity to give more radiation to a concerning area where we wouldn't have the ability to do that otherwise so it really is truly a team approach there. Each one of us can make up for one of the deficits that are specialty can't do otherwise how doctor how does that work can mean if he's if he's in the middle of you know surgically dealing with with the case. And you know it sounds like a decision is made. Right then and there. Thank you maybe four surgeries are okay again meeting to talk about it we know where it's going to be close looking at the imaging. And we actually set everything up ahead of time the patient gets to doctor ahead of time and we actually know almost exactly where we're gonna treat and we we schedule accordingly there has to be a unique function of of how you're handling things here run document. Oh absolutely I think we have we have a pretty good idea of the areas we're going to be most concerned about at the time of surgery faction. And this particular plays a role in patients who had prior radiation it may have for disease in the past and now this is recurrent. Or more typically a is that patients will receive a course of pre operative. External beam radiation which are tax rates that are tailored designed to treat the areas of concern. And then they will calm and we will meet and discuss what additional role in of every nation me play it's generally would. For the exact reasons doctor mentioned before. And when the tumor is in close proximity to something very important vessels nerves bones. The end when it it would may be more difficult to get a negative margin which is really the main goal of all perceptions for her coma. Based on imaging based on our discussions. We will have a fair idea of where that may be. And so we talk very broadly about what we do intra operative And the final decision for the use of intra operative radiation is obviously real time during surgery. And what will happen is that we will plan in advance to be available and be ready in actually takes quite a bit of support from our physics staff. Quality assurance staff to have everything ready in advance to do we've been dedicated operating room which we need to plan for as well in advance. I'll win doctor Cain is ready and feels that we will be needed I actually go to the end of it and feed. The area of the tumor bad and the are we discussed which areas were both most concerned about. What areas we can safely deliver additional radiation to and what the intent of that treatment and then jointly will make that decision. When we decide to go ahead and use in tropic of radiation therapy and we will design. A customized. Device serve flap that is then used to treat the specific areas. Shielding is done to treat to really prevent the radiation from from treating other areas like the skin surface muscles nerves. And then the treatment is liberty and property of That's pretty impressive and high tech stuff doctor crucial and you mentioned earlier. The concern and I think this is concerned any cancer obviously is if it spreads if it do you goes beyond that that tumor that. Doctor came here and you know so well. Illustrated for us. How often is that the case with sarcoma that we see. That the cancer either spreading a recurring. It's not and it's not infrequent and it primarily again is a function. Both these societies of the grade of the primary cancer so the underlying biology of the tumors that are certain types of sarcoma is. That also have a higher predilection for spreading for example of the brain or these final quarter and the floater on the spinal cord. For example to my circle was in children or NGOs are almost which is a type of sarcoma blood vessels in adults it. So it it really varies from situation to situation so we'll see more. Low grade tumors or these superficial tumors that means cancers you putting it very simplest deadly cancers that are just beneath the skin. Those tend not to have it very high. Risk of spreading to other sites. There certain unique type was for example as more tumors attend broker often within the abdominal within the belly. And have essentially no potential to size but they have this unique ability to keep coming back in the same area. Even after you cut it out or after you've given radiation and that's where. The complications can arise for every one of them is quite unique and different. Last couple of minutes here you'd mentioned earlier I went into some some detail on clinical trials. Very important in dealing with that current cancer cases and then dealing obviously in the future to. Why so important with dealing with sarcoma. I think it's primarily baker is sort of the rarity of these tumors. So the more patience that enroll in clinical trials of more evidence based medicine we can actually prepare for future generations. I think that's a lot of what all of us here do. From an academic standpoint so we can investigate new drugs and I definitely feel that we. Have a long way to go in terms of therapeutics. And that there's a lot of advance that needs to be made and the only way we can make it is by testing new drugs. By understanding what these diseases at the molecular level are. And look at past successes developing drugs that specifically target abnormalities which we are recognizing in sparkle more and more. We also recognize that certain types of sarcoma tend to be more sensitive to chemotherapy. Compared to all the types and in those we would use chemotherapy upfront. Can the other types we would use radiation front and just sarcoma being a classic example where we would chemotherapy surgery in the more chemotherapy. Well interesting indeed and quite an education today doctor crucial money thank you so much for your time my pleasure for doctor Nikhil crucial lining. Associate professor of oncology chief of melanoma and sarcoma medical oncology. Here at Roswell park doctor can't just keep an and everybody's right make sure we if if we do detect something you know. haven't looked yet but thankfully as a rare cancer most lumps or bumps are going to be even lines I don't want people to be scared and they sure every new long they have but. Most people know their bodies pretty well also somethings lasting longer than it should there's no reason to have a bunch of leading haven't been injured. it's it's in the person's best interest to at least start the ball rolling get some imaging and and really try to get to the bottom of that thank you so much for your time today appreciate it that's doctor John McCain the third associate professor in the department of surgical oncology. And also chief of melanoma and sarcoma surgical oncology here at Roswell park. Doctor thanks for you're your expertise today. Very interesting how you you get involved in these cases and quite an education thank you. Thank you doctor assistant professor of oncology in the department of radiation medicine. Here at Roswell park if you'd like to hear the program in its entirety or others just like it you can do so by logging on to. Roswell park dot war. Listen to Roswell this Sunday mornings at 630 young WB EN. by Roswell Park Cancer Institute your team opinion for your total options online at Roswell this god of war. You And hanging. Then.

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Of the common council president go from all day project is with us and I would hope day event. That some of the members before the actual vote is taken on the third would do give a real considerations of the importance of independents. If the council loses their independent voice they lose a lot of their authority to. Once you once you surrender that independence you've handed a lot of the authority you have to the mayor's office and I don't think that's a healthy situation. No not at all and I'm trying to convince of that and you know you can support of mayor. And that's no problem at all which you just can't surrender you were your freedom can't just laid out does have a puppet master just pulling your strings. And and you are you were violating your oath of office you're violating the core of our founding fathers by you you are selling the citizens of the city buffalo. Sharks and and they've got a they've got to you know get a backbone. And and and get it get some integrity that's going on here here we have a case where you know the rich Fontana who sold out because he probably didn't have principles. You don't want to support person wants majority leader who is under. A federal lawsuit for racketeering. Here you have a case for the FBI is in all likelihood looking at this individual that made And that's not the fact that this this person doesn't work but they're just the rubber stamp for the second I don't wanna see the deputy mayor Steve Casey the agenda for the legislative branch of government. Very very dangerous guy. If I want the council. First of all would be disastrous of parliament if I the last thing I would surrenders my independence because once you've done that you've got nothing else Uga no leverage no no safe and that's the whole point. You may agree with a may disagree with the mayor but that independent voice I think is so important. Now we've been reading that that fifteen million dollars just fell on the sky and we're going to be opening the 500 blocked to traffic. A do you think that we'll have any kind of an impact on retail or just make this city more user friendly or when you think the benefits of that. Well I talked to the commissioner strategic planning about he's very happy Brandon happy and I remember in the day. All the retelling used to be their downtown can have that again that they thought you see a cold weather city model walking main street was a good thing but most the time of the Euro and the weird was fifty degrees we probably don't. Can't imagine it. That's what I'm thinking of I can't think of any major cities where retail has made a comeback in this downtown area we have good restaurants downtown we have entertainment. Maybe that'll help with that what what are your thoughts on what's going on senator casino they've scaled down their plans but they seem very anxious. To get involved with helping develop certain projects within the city the city opens amenable. I voted for the casino. And I did because my constituents want it work they jobs. And I'm not gonna dictate you know how people wanna spend the money you know the whole moral shall we shouldn't let people go into that kind of thing I said. So I voted for and I talked to mr. reporter. President wanted you out and he wanted to have the greater impact in the area where that skeleton is you know that's still sky and I'm hoping that they go back to to build this thing eventually I don't know New York State is gonna say no state should be building casinos got to go through two votes away at the. It adds that feeling the process and I see that Cuomo today is kind of backing away there's no rush on this now I don't know why he threw it out there full force and now it's pulling back a little bit maybe a little pressure or politics who knows what's involved right right but he seems very interest it and I had a meeting with an itch a mother you know. They coolers about trying to do ancillary things in the vicinity of the casino moneys though things that that's gonna happen and so that's why you're president you bring him to chefs who all they know yeah you're catch after reading spaghetti parmesan who can say anything that he invited he's always had no other now. great. Regarding. Weeks have a cloud over the city lately with the Wanamaker story about him. Traveling a friendly skies way too much the parking meter scandal things like that. Is the council concerned about. You'll Wanamaker that you see here's the importance and even important that if an independent common council. Because of the common council did not demand wanna makers travel schedule we would never known. American tell rubber council don't vote for asking for this kind of information and and squash it. And the fact is we found out that Wanamaker traveled like thirty tying thirty times in a year. Once and and he went on he went to Las Vegas with mayor brown. Stepping their Casey right lady named Michelle baron secretary and Tim Wanamaker and I'm not saying the and Casey knew. That wanna course to stay longer and I suppose you know he with the mirrors the chairman of the board this development agency this credit card was used and Casey was also on the board. And they didn't think of asking GO when you come home. On these things. I feel any it wasn't aware when I read the print account that he wasn't aware after they were coming back that he was staying that doesn't seem to buck stops in the mayor's office in this issue and I think he should have been more aware well before we I just wanna say one thing to any council members who were listening. If you give boy your independence you've given away everything have you have nothing left to give OK I like I don't know that well but I do know he's an independent voice and I like the way he speaks and I like. An independent voice in the council an independent voice in City Hall if you give it up. Stay home because nothing's gonna get done thank you for coming by it is my pleasure thank you Merry Christmas to you next year at the festival is certain and they care are back tomorrow Beijing company under Israeli and I'm 31 awesome point seven FMW

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