Advertise on podcast: Live from Stage 4: MBC News for Us, by Us

Every October, the world turns pink. But October 13th is Metastatic Breast Cancer Awareness Day, and for women living with stage 4 disease, it means something very different. In this special episode, recorded over two days, host Victoria Goldberg talks with six women living with metastatic breast cancer about pink-washing, how they found their way into advocacy, and the people they carry with them. What we talk about The Stage 4 Stampede, METAvivor's advocacy event in Washington, DC, and the film Our LivesPink-washing, where the money really goes, and why Kelly Shanahan says October should be Breast Cancer Action MonthLight Up MBC and how local communities mark October 13thHow each guest got into advocacy, and why there's a place for everyoneIs the sense of urgency fading as treatments improve?Loss, remembrance, and the friendships we build onlineWhat the podcast means to us, and what's nextOur guests Dr. Kelly Shanahan, president of METAvivorAmy Russell-ParlimanMelanie SiskLisa BackusMartha CarlsonTeri PollastroResources and links Find links to the organizations, programs, and people mentioned in this episode at livefromstage4.org. Note: this episode includes strong language and discussion of death and loss. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

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

Learn about osteonecrosis of the jaw (ONJ), a rare but serious side effect of bisphosphonates used to treat bone metastases. In this episode, Abigail Johnston is joined by Victoria Goldberg, executive producer of the podcast and fellow ONJ patient, to discuss their personal experiences navigating diagnosis, treatment, and recovery. Discover what ONJ is, how to recognize early warning signs like pain, white patches, and excessive bleeding, and why finding a knowledgeable dental oncologist is critical. Victoria and Abigail share their surgical procedures, preventive care strategies, and candid advice for managing this complication. Plus, learn about recent clinical trial findings that may change how bisphosphonates  are prescribed, and practical tips for covering dental care costs through medical insurance. Whether you're on bisphosphonates or curious about potential side effects, this spotlight emphasizes that while ONJ is rare, awareness and proactive dental care can make all the difference. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Twenty-five years ago, the diagnosis of HER2+ breast cancer was a death sentence. Two-year survival was roughly 50%. Today, oncologists are using the word "cure" in the metastatic setting. Co-hosts Victoria Goldberg and Abigail Johnston sit down with Dr. Erika Hamilton (Chief Development Officer of Late Phase Research at Sarah Cannon Research Institute) and Dr. Sarah Premji (Assistant Director of Breast Cancer Research at Sarah Cannon) to walk through the scientific revolution that got us here: from Trastuzumab in 1998 to CLEOPATRA to the game-changing antibody drug conjugates like Enhertu. But this episode isn't just about the wins. the hosts and the doctors get brutally honest about what life on Enhertu (Trastuzumab Deruxtecan T-DXd) really looks like: the nausea that stretches into week two, the fatigue that's hard to quantify, the hair loss that cold capping can't prevent, and the serious side effect that deserves way more attention - interstitial lung disease (ILD). They discuss why some patients need dose reductions, how to manage side effects, and what to watch for. For triple-positive patients (HER2+ and hormone receptor positive), this conversation is essential. The PATINA trial is finally recognizing that these cancers behave differently, and the field is catching up. Victoria also breaks down the emerging trials (SAPPHO and HERizon-Breast) that are asking whether smarter sequencing could mean deeper responses and, for some patients, real cure. Whether you're newly diagnosed, living with HER2+ MBC or HER2-low on Enhertu, or supporting someone who is, this hour covers the science, the lived experience, and the hard conversations that matter. Chapters 0:00 – Introduction: The HER2+ Transformation 13:44 – Triple-Positive Disease and Pathway Crosstalk 17:14 – Antibody Drug Conjugates: What Is Enhertu? 21:38 – DESTINY-BREAST-09: Moving Enhertu to First Line 25:50 – Curative Intent Trials: SAPPHO and HERizon-Breast 28:05 – Side Effects: The Enhertu Reality 28:27 – Why Enhertu's Side Effects Last Longer 30:01 – Dose Reductions: Why Start High if Lower Works? 33:01 – Interstitial Lung Disease (ILD): The Serious Side Effect 35:02 – Managing ILD Risk: Screening and Monitoring 42:53 – Nausea, Fatigue, and Supportive Care 47:06 – PATINA Trial: Triple-Positive Gets Its Own Path 50:02 – PI3K Pathway and Future Therapies 52:47 – HER2CLIMB-05 and Tucatinib: Maintenance Strategy 57:48 – Sequencing Strategies: What Comes First? 59:25 – Closing: From Death Sentence to Cure Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

This is the first episode of a series we never wanted to make. Jill Tirabassi was a physician in Buffalo, a mother of two little boys, a lifelong athlete, a gardener who was happiest with dirt on her hands, and a member of the Live From Stage IV team who said yes to this podcast before it existed. She was diagnosed with de novo metastatic breast cancer while pregnant with her second son. She died on Monday, September 7th. She was 40. What you'll hear is our team meeting, the first one after we lost her. Nobody was ready to record. We did anyway. Lisa, Alexis, Ellen, Lynda, and Abigail talk about the Bills, Heated Rivalry, postpartum breast cancer, why the term "pregnancy-associated cancer" has to go, and what it means to keep going. Then Abigail Johnston reads the essay she wrote for her blog, No Half Measures, the morning we recorded. It says the thing the rest of us were circling. Read it here: https://nohalfmeasures.blog Jill's episodes, including S**t We Deal With and the Heated Rivalry conversation, are in our feed. Her voice is still there. Forever live from Stage IV. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Chemotherapy-Induced Nausea and Vomiting (CINV): Managing a Common Side Effect Nausea and vomiting are common side effects of chemotherapy, but the strategies that work for everyday nausea often fall short. In this episode, Abigail Johnston shares her personal experience navigating CINV and discusses practical approaches to managing this challenging symptom. Topics covered include: Why traditional nausea remedies may not work for chemotherapy-induced symptomsCommon medications used to prevent CINV (Zofran, Emend, and others)The importance of tracking nausea patterns throughout your treatment cycleMulti-intervention strategies for managing delayed nauseaHow to recognize intractable nausea and when to seek medical helpThe role of diet, movement, and other supportive measuresResources and expert webinars on CINV managementWhether you're currently experiencing CINV or want to prepare for treatment ahead, this episode provides practical insights and encouragement from someone who's been there. Learn more: Visit the Multinational Association of Supportive Care in Cancer (MASCC) website for their webinar series on managing chemotherapy side effects. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Biomarkers are transforming how we understand and treat breast cancer, but what do they actually mean? In this episode, we break down the three layers of biomarker testing: DNA biomarkers that reveal genetic mutations like BRCA1 and BRCA2, RNA biomarkers that show which genes are actively expressed in your tumor, and protein biomarkers like HER2 and PD-L1 that tell us what's actually happening at the cellular level. Understanding the difference matters. Your DNA might carry a mutation, but RNA tells you if it's active. And when your oncologist talks about PD-L1 status or immunotherapy response, they're measuring something very specific about your tumor's protein profile. We also explore emerging research in liquid biopsy — a decentralized platform that's making it easier to monitor tumors through simple blood tests, enrolling women from across the country in real-time studies. Whether you're newly diagnosed, in treatment, or supporting someone through this journey, knowing what your biomarker results actually mean can help you have sharper conversations with your care team and better understand your treatment options. Developing Story brings you the latest in breast cancer science, explained clea Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

In this Symptoms Spotlight episode, Abigail Johnston and Melanie Sisk are joined by Dr. Jill Tirabassi to talk about ascites, the buildup of fluid in the abdominal cavity that can occur with metastatic breast cancer and liver disease. Dr. Jill shares both her medical expertise and her personal experience, explaining what ascites is, why it happens, and how it shows up on scans. The conversation covers symptoms to watch for, including abdominal pressure and pain, abdominal distension, shortness of breath, back pain, leg swelling, and itching. Dr. Jill describes her own paracentesis, a procedure to drain the fluid, and how life changing the relief was, along with other options like diuretics, dietary changes, and drainage ports that can be managed at home. The hosts also discuss when to bring specialists like hepatologists or interventional radiologists onto your care team, and why ascites is not always caused by cancer itself. Sometimes it is the treatment, and switching therapies can reverse it entirely. Above all, this episode is a reminder to advocate for yourself. Your quality of life matters, and pushing for interventions that help you feel better is always worth the conversation with your care team. This is general information, not medical advice. Always talk with your own doctor about your specific situation. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

This is a disease no one wants, but you meet the best people." Twenty years ago, about 125 people gathered at a hotel outside Philadelphia for the first-ever conference just for those living with metastatic breast cancer, at a time when the community was rarely seen or heard. Today, it's a three-day national event drawing hundreds of attendees and a virtual audience. In this episode, the host Victoria Goldberg sits down with three longtime Living Beyond Breast Cancer leaders: CEO Jean Sachs; Elyse Spatz Caplan, who ended her 14-year tenure with LBBC as the Director of Programs and Partnerships;  and Catherine Ormerod, a retired Executive Vice President for Strategy and Mission.  In a separate conversation, she speaks with Janine Guglielmino, LBBC's former Vice President of Mission Delivery, who was there for that very first conference in 2006. Together they trace the conference's history: the groundbreaking Silent Voices survey that proved a conference exclusively for stage IV patients was urgently needed, the fight to fund travel grants so cost would never be a barrier, the pivot to virtual during the pandemic, and the Hear My Voice advocacy program that turned attendees into leaders, founders, and changemakers. To learn more about LBBC's programs, Hear My Voice advocacy training, and next year's conference, travel grants included, visit lbbc.org. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Nobody wants to talk about dying. But what happens when we do? On August 5th, 2025, New York becomes one of only a handful of states where Medical Aid in Dying (MAiD) is now legal. For people living with incurable or terminal illness, this isn't an abstract policy debate — it's a deeply personal question about autonomy, dignity, and who gets to decide how life ends. In this first episode of On Our Own Terms, Victoria Goldberg sits down with two remarkable voices: Dr. Yesne Alici, psychiatrist at Memorial Sloan Kettering Cancer Center and chair of MSKCC's Medical Aid in Dying Advisory Council, walks us through what New York's new law actually requires, how MSK is preparing to implement it, and what the psychiatric evaluation process looks like for patients who inquire. Elizabeth Armijo, National Director of Legislative Advocacy at Compassion & Choices, shares what a decade of state-by-state advocacy looks like — and what 85 million Americans now have access to that they didn't before. Together, they explore the questions most of us are afraid to ask: What is medical aid in dying, and what isn't it? Who qualifies? What does "peaceful" really mean — and who gets to define it? "The goal is neither to steer a person toward or away from medical aid in dying. It's to make sure that everybody's heard, fully informed, supported, and never abandoned." — Dr. Yesheene Aleje Topics covered: Medical Aid in Dying (MAiD)  vs. euthanasia — what's the difference?New York's MAiD Act: eligibility requirements and safeguardsHow MSK is building its clinical MAiD teamThe top three reasons people pursue MAiD worldwide: loss of autonomy, loss of dignity, loss of meaningful activityOpposition from faith communities and disability advocatesWhat Compassion & Choices does in states where MAiD isn't yet legalResources for patients, caregivers, and familiesResources mentioned: Compassion & Choices:   1-800-247-7421The Academy of Aid-in-Dying Medicine (formerly the American Clinicians Academy on Medical Aid in Dying)Five Wishes advance directive planningDeath CafeThis episode is for informational purposes only. Nothing shared here constitutes medical or legal advice. Please consult your own medical team regarding any end-of-life decisions. On Our Own Terms is a series from Live from Stage Four, hosted by Victoria Goldberg with co-hosts Abigail Johnston and Dr. Ellen Landsberger. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

Triple negative metastatic breast cancer is one of the most complex and rapidly evolving frontiers in oncology, and this episode is your most comprehensive guide to understanding it. Victoria Goldberg sits down with Dr. Sarah Premji, oncologist and clinical researcher at the Sarah Cannon Research Institute in Nashville, for a deep dive into what makes triple negative MBC so uniquely challenging and why the treatment landscape is changing faster than ever. This conversation was recorded a few months ago and has already been overtaken by history. Since taping, the FDA has approved two major new treatments specifically for triple negative MBC, datopotamab deruxtecan (Datroway) and sacituzumab govitecan (Trodelvy) in the first line setting, a shift that Victoria and Dr. Premji saw coming. Together they break down everything patients and caregivers need to know, including what triple negative actually means and why it is such a heterogeneous diagnosis, the critical role of PD-L1 status and why it acts like a fork in the road for treatment planning, the science behind antibody drug conjugates and how Trodelvy and Datroway compare in terms of efficacy, side effects and administration schedules, the BRCA, PALB2 and PARP inhibitor connection and when germline and somatic testing matter most, brain metastases, how common they are in this subtype and what is being done about them, and the exciting pipeline ahead including bispecific ADCs, new targets like B7H4, and the Emi-Le trial. Even if you are not living with triple negative breast cancer, this episode matters. The approvals and the science discussed here represent a broader shift in how oncology is thinking about precision medicine for all subtypes of MBC. This episode is part of an ongoing series with Dr. Premji exploring the major subtypes of metastatic breast cancer. Previous episodes cover ER positive MBC, and the final installment featuring Dr. Erika Hamilton on HER2 positive MBC is coming soon. As always, nothing in this episode constitutes medical advice. Please consult your oncologist and care team before making any treatment decisions. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

In this episode of Symptoms Spotlights, hosts Abigail Johnston and Melanie Sisk, a metastatic breast cancer patient and a registered nurse living with MBC, dive deep into one of the most serious yet underdiscussed risks facing cancer patients: blood clots (thrombus). Melanie breaks down the science behind how blood clots form, where they can occur in the body including the lungs, brain, heart, and legs, and what terms like DVT, pulmonary embolism, and ischemic stroke actually mean for patients. Abigail shares her own experience being diagnosed with two blood clots in her heart, discovered during a routine echocardiogram while on Enhertu, and what she wishes she had known earlier. In this episode, you'll learn why cancer patients face a 3 to 4 times higher risk of blood clots than the general population, how treatments like tamoxifen, CDK4/6 inhibitors, and chemotherapy increase clot risk, the signs and symptoms to watch for and when to seek immediate care, how ports can be an unexpected risk factor, practical prevention tips including compression stockings and movement breaks during travel, and when to ask for a hematology specialist rather than relying solely on your oncologist. Whether you're newly diagnosed or years into your MBC journey, this episode will help you understand your risk, advocate for yourself, and know when something feels off. Nothing shared in this episode is medical advice. Always consult your healthcare team. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

What if metastatic breast cancer didn't have to mean a lifetime of treatment? For a subset of HER2-positive patients, that question is no longer hypothetical. In this episode of Live from Stage 4, hosts Victoria Goldberg and Dr. Ellen Landsberger sit down with Dr. Pedram Razavi, breast oncologist, translational researcher, and principal investigator at Memorial Sloan Kettering Cancer Center, to discuss his groundbreaking Phase 2 clinical trial, the HERizon Breast Trial. Dr. Razavi breaks down how liquid biopsy and circulating tumor DNA (ctDNA) are changing what's possible in metastatic breast cancer, from detecting microscopic disease invisible to scans, to setting a new gold standard for treatment response: molecular complete response, sensitive enough to find one cancer cell among a million. This is one of our most science-heavy episodes, so we've built in plain-language explainers throughout, covering liquid biopsy, ctDNA, tumor-informed assays, epigenomics, the blood-brain barrier, CNS metastasis, and antibody drug conjugates. No medical degree required. The HERizon Breast Trial is currently enrolling. If you or someone you know has HER2-positive metastatic breast cancer, this episode could be directly relevant to your care. 🔬 Topics covered: What is liquid biopsy and ctDNA?The difference between panel testing and tumor-informed (bespoke) assaysWhat "molecular complete response" means and why it's a higher bar than a clean scanThe HERizon Breast Trial: design, goals, and who qualifiesCould treatment de-escalation become a reality for metastatic breast cancer?Share this one. Someone out there needs to hear it. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

In this episode of Symptoms Spotlight, hosts Abigail Johnston and Melanie Sisk take an honest and personal look at one of the most common yet least talked about side effects of metastatic breast cancer treatment: vaginal dryness. Both living with MBC, Abigail and Melanie share what has worked for them, from water-based lubricants and coconut oil to topical lidocaine cream and low-dose estradiol. They talk openly about the emotional toll of painful intimacy, the importance of a supportive partner, and the challenge of finding the right provider to have these conversations with. The episode also explores a question many MBC patients wrestle with: is vaginal estrogen safe when your cancer is estrogen receptor positive? Podcast team member and retired OB-GYN Dr. Ellen Landsberger weighs in with the latest clinical evidence, including findings from a 2025 systematic review published in the American Journal of Obstetrics and Gynecology, offering cautious reassurance along with practical guidance on recommended formulations. Whether you are newly navigating these symptoms or have been managing them for years, this episode reminds you that you are not alone, that options exist, and that talking about it is the first step. Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.

We've always been told that metastatic breast cancer can't be cured, only managed. But what if that's no longer the whole story? In this episode of Live from Stage 4, hosts Victoria Goldberg and Dr. Ellen Landsberger sit down with Dr. Lior Braunstein, a radiation oncologist at Memorial Sloan Kettering Cancer Center, to talk about the ARCHER trial, a first-of-its-kind clinical study asking a bold question: can surgery and radiation, added on top of standard HER2-targeted therapy, eradicate every last cancer cell in patients with oligometastatic HER2-positive breast cancer? Dr. Braunstein breaks down what "oligometastatic" really means, why HER2-positive disease is uniquely positioned for this kind of approach, what ablative radiation to the liver or lungs actually involves, and why the word "cure" makes oncologists nervous, even when it might be warranted. We also cover: What the ARCHER trial is looking for in eligible patientsWhy previous trials failed to answer this questionHow cancer develops resistance and why treating visible disease early may be the keyThe role of AI in matching patients to clinical trialsWhat comes next if the trial succeedsWho should listen: Anyone living with HER2-positive metastatic breast cancer, their caregivers, oncology professionals, and anyone who believes patients deserve to hear the hard questions asked out loud. 🔗 Find the ARCHER trial: search "ARCHER trial breast cancer" at clinicaltrials.gov 📝 Show notes and resources at https://www.livefromstage4.org/ Nothing in this episode constitutes medical advice. Please consult your own medical team before making any decisions about Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.  Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer. Until next time, take care and keep pushing for progress.