Oncology Unscripted With John Marshall cover art

Oncology Unscripted With John Marshall

Oncology Unscripted With John Marshall

By: John Marshall
Listen for free

LIMITED TIME OFFER | £0.99/mo for the first 3 months

Premium Plus auto-renews at £8.99/mo after 3 months. Terms apply.

About this listen

 Oncology Unscripted with John Marshall, MD brings you a unique take on the latest oncology news including business news, gossip, science, and a special in-depth segment relevant to clinical practice. Language Learning
Episodes
  • Oncology Unscripted With John Marshall: Episode 26: Microbes, Mutagens, and Mortality: CRC in a Younger Generation

    Oncology Unscripted With John Marshall: Episode 26: Microbes, Mutagens, and Mortality: CRC in a Younger Generation
    Jan 28 2026
    Oncology Unscripted at ASCO GI: People, Pipelines, and PrecisionJohn Marshall, MD:Hello, everybody, from San Francisco, California. My name is Dr. John Marshall, and you are on—maybe unwisely—Oncology Unscripted. But thanks for joining me. I love this meeting, but let's first talk about the news of 2026.Top of the line is: we're out to get new countries. Now, I'm sort of running for mayor of Havana. I don't know if it's important that I, in fact, speak Spanish—because I don't. I speak a little bit of French. My Spanish is terrible. But maybe it won't matter, because I am who I am, and they're looking for just my kind of person to go be mayor of Havana. So, if you see that and you get a chance to vote, vote me in. I love the whole country of Cuba—it's beautiful.Second, in today's newspaper—I couldn't believe it—this guy named Dr. Oz, you know him, he's an actual cardiologist, believe it or not. Then he became the talk show host. And then, for some reason, he's the head of CMS at this point—one of the head overseers of healthcare here in the country. And he said his position was that alcohol is good. This couldn’t have made me happier. This couldn’t have been a better holiday present, because I'm a big alcohol fan myself, and now I can feel less guilty about it. His rationale is that if you drink more, you'll be with people more, you'll be more relaxed, and the camaraderie will pay off in terms of lessening your anxiety and stress—and the world will be a happier place.So, don’t be smart. We don't want people in our country to be intelligent or educated. Drink more. Be less educated. You'll be happier in the long run. That's the official position of our government today.Probably the most important new news from a healthcare perspective is that the House approved an extension on the Affordable Care Act. This has been an incredible threat and uncertainty for so many of our patients. The people who depend on that health insurance could never afford cancer care without it. Having the extension of the Affordable Care Act—for them—talk about lowering your stress. Maybe better than alcohol is actually being insured.I don’t know if you go to many meetings out there, but this one is called GI ASCO. It's always in San Francisco. It's always in this building that I'm standing in now. I have perfect attendance. I’ve been to every one since they started. You should get a special ribbon for that. I think there’s probably one down there for that.They are a little bit more environmentally conscious—no plastic covering to this. Just a piece of paper. Totally recyclable old name badge. Way to go, ASCO, on that.Do you go to meetings or don’t you? I come to this one for a very, very important reason. I come to this one for the people. It’s a small meeting. It’s just the GI gang, both from the industry side and the academic side. It’s a very heavy global presence that comes. I know almost everybody here, and there are only like 3,000 people here. There’s time to stop and say hello to almost everybody you know—give them a hug, share a little COVID, maybe flu, with each other—but then know that you are connected again. And this is something Zoom doesn’t do. This is something you can’t check on—somebody’s kids—over a meeting. But that’s one of the main reasons I come.I love these people. These are people that share in our values and our motivation to try and cure cancer. We all take care of the group of cancers—GI cancers—which are the most common, most fatal cancers on our planet. We are inspired to do this. We know it’s a steep climb, and we do it together. I’m so very pleased to be a part of this community, and it’s the main reason I come.Main reason—people. Second reason—pipelines. There’s a lot of data out there, and there are a lot of companies here that finally have new products for GI cancers. We’ll talk a little bit about that in more specific detail, but if you just look at the number of groups that are here—the number of people who’ve got innovative, new approaches—whether it’s novel immunotherapy, targeted agents, combinations of those, targeted antibodies that are delivering toxic payloads—we’re seeing waterfall plots that we haven’t seen in decades.So, response rates, survivals, progression-free survivals that really compare favorably to our traditional chemotherapy approaches. We are on the cusp of a true revolution in the world of GI cancer.And, surprisingly, one more—led by the world of pancreatic cancer. So, let’s talk a little bit about precision in GI oncology. The biggest breakthroughs that we are seeing at this meeting have to do with RAS targeting.There are a bunch of RAS drugs out there now. There are some that are more out in front than others. There are some that are degraders that break down the RAS. There are some that block pan-RAS, so they hit a bunch of RAS targets. There are some that are very specific ...
    Show More Show Less
    34 mins
  • Oncology Unscripted With John Marshall: Episode 25: New Hope in GI Cancer Care

    Oncology Unscripted With John Marshall: Episode 25: New Hope in GI Cancer Care
    Dec 18 2025
    MedBuzzTariffs, Taxes, and Trade-Offs: Can Raising Taxes in the UK Get You Cheaper Drugs in the US?John Marshall, MD: John Marshall for Oncology Unscripted. There's been all sorts of stuff going on out there in healthcare—in the business of healthcare—and a recent article that was just published in The New York Times told us something about the relationship between the National Health Service, how patients get access to drugs there in Great Britain, and our relationship with them and the tariffs. You're like, how could the tariffs have anything to do with the National Health Service?Well, let me give you a very short little background, if you don't know already, on the National Health Service—Britain’s public health system. The Brits love it. It's tax-based. It's not fancy, it's not frilly. But if we're going to bring in some new medicine or some new expensive therapy—whatever it is—the budget has to be balanced.So, either they have to remove something from what the patients have access to, or they have to raise taxes. And there is a committee known as the NICE committee, the National Institute of Clinical Excellence—staffed by physicians that, in fact, governs that. You're thinking, where is Marshall going with this?Well, where he is going—and The New York Times presented this—is that because of the tariffs, right? Britain makes some drugs, and we import them here and use them. Well, if the tariffs are in place, those drugs will be more expensive to import. And the whole idea behind the tariffs is to make it so that more Americans are doing the manufacturing.Well, the Trump administration and the National Health Service just made a new deal where the Brits will get access to more drugs—so they'll raise their expenses, if you will. And it's going to hit the bottom line over there...because they're going to have access to medicines that they don’t currently have access to. In exchange, the U.S. is going to say, “Well, we'll waive those tariffs on drugs you import.” So, it is access over here for an economic change—an international economic change—around the tariffs.I have no idea how this is going to work out. I didn’t really understand all the math—were taxes going to go up in Great Britain? Were they going to call it a wash because the tariffs were not going to be in place? I don’t know.The good thing for patients in the UK is that they're going to have more access to more medicines. What I worry about is that it'll come on the backs of either going into debt—if the National Health Service goes into more debt, sort of like our healthcare system—or, in fact, they raise taxes, or somehow they magically make the budgets balance.So, we need to look ahead to 2026 and see just what happens with this UK National Health Service–Trump tariff deal that was just reported in The New York Times.Stay tuned here for more updates on Oncology Unscripted.[03:04]Editorial/Main TopicWhat I Tell Every New Patient With CancerJohn Marshall, MD: John Marshall for Oncology Unscripted.I start almost every new patient appointment by talking with the patient and saying that I—I don't really know why people get cancer. We memorize lists of what we're supposed to do and what we're not supposed to do, but, bluntly, almost everybody sitting across the room from me didn't do anything on the bad list, and yet here they are, sitting there with cancer.It seems to me—and I think this is popular science thinking as well—that we probably all get cancer all the time. But our bodies actually have outstanding spell checkers and an outstanding functional immune system that can see early cancers and fix them before they cause any trouble. So, what that actually means, then, is that those cancers that make it—those cancers that survive through the spell checker or through the immune system—must have figured out a way to get around the spell checker, or have broken the spell checker, or maybe are hiding from the immune system.And so, almost all of our new research going on right now in cancer medicine is either trying to fix the spell checker—and by this, I mean targeted therapies, signaling pathways, et cetera—or it's trying to turn back on, wake back up, or uncover the tumor from the immune system so the immune system can go in and do its job.And so, I think what you see at almost any conference nowadays focuses on those two approaches. It's not some new chemotherapy, although chemo continues to be very important and has cured a whole lot of people, so don't get me wrong about that. But what we're seeing in terms of innovation has a lot to do with improving the immune system, measuring the immune system, having better immunotherapy or immunotherapy combinations, and, at the same time, uncovering the molecular abnormalities of our cancers and having targets to those—and, in some cases, combining those with novel therapies as well.So, be on the lookout for the next innovation: either ...
    Show More Show Less
    22 mins
  • Oncology Unscripted With John Marshall: Episode 24: How Do We Translate MRD Innovation Into Everyday Oncology Practice?

    Oncology Unscripted With John Marshall: Episode 24: How Do We Translate MRD Innovation Into Everyday Oncology Practice?
    Dec 15 2025
    MedBuzz: From Hormones to Heroines: Couric, Cancer, and the Case for ChangeJohn Marshall, MDHello, everybody. John Marshall for Oncology Unscripted, coming to you from my now almost empty office. I've been in this office for, gosh, 20-plus years. It's the big office. You may or may not know I stepped down as the division chief here at Georgetown. We planned it—I wanted to do it a while ago. They said no. So, I finally got to step down because I wanted to do some other things. I get a lot of time back from meetings I really didn’t want to go to in the first place, so I’m happy about that. And it’s enabled me to get back to the world of clinical cancer research and to try and innovate in our space and do a lot less administrative things. So, I am glad for the clean-out, moving down to a smaller office in a fresh region. Probably one of the last times—maybe the last time—I film from this spot. But I wanted to take some time to review some high-level things that have changed in a big way just in the last week or two. The one that struck me the most is that there's been a change in black box warnings around hormones for postmenopausal women. I lived this too, where we went from hormones being a good thing—and all postmenopausal women were more or less taking them—to then it was unopposed estrogens were evil. And then the cancer lobby—and the breast cancer lobby—really was responsible for making it so women stopped taking hormones. We made it so terrifying that hormones were going to cause breast cancer that, you know, certainly oncologists weren’t prescribing it. GYNs stopped doing it. Primary care docs stopped doing it because no one was really willing to take the risk. And I think about the suffering, quite honestly, that postmenopausal women have endured since this time. It is really, really remarkable. And only now—only now—that people have gone back to actually look at the clinical trials and look at the studies, they actually pretty clearly show that hormone replacement is not bad for these people. In fact, if you look at the colon cancer literature, surprisingly, there was evidence that it decreased the risk of getting colon cancer. And even despite that, they didn’t want to change it around. So, I am excited about that black box warning change. If you’re a postmenopausal woman or you know some that are around you, make sure that if they’re interested, there are new options for those patients.But there’s a second warning that has been installed, and this is around 5-FU and DPD testing—dihydropyrimidine dehydrogenase testing—for 5-FU clearance. Why I think it's a big deal is not only is it an updated Black Box, but NCCN has embraced it. I think it’s a big enough deal that I hope you will click in and watch my interview with Howard McLeod, who is really the world’s expert in this space, about what we should be doing, how to do it, and some of the practical aspects of that.So, make sure and click on that interview and watch it. It’ll be worth your time. All you clinicians out there should do it. Now, whether or not it will become routine, whether or not it will become standard of care, whether or not you’ll get sued if you don’t do it—those things will evolve. But I do think it will be part of your everyday life. So, good to keep up to speed on that.And then lastly, sort of an emotional note to make—and that is, this is the actual 25th anniversary of something I bet you remember. That’s when Katie Couric had a colonoscopy on television, and it was on a morning TV program, The Today Show. She did that because, of course, her husband had had colon cancer, and she became quite a strong advocate.Her sister Emily later developed pancreas cancer and died of that, and she’s been very involved in Stand Up to Cancer and so many things. But I think back about that moment when Katie Couric said, “You’ve got to be getting your colonoscopy.”And the reason it comes up is that, one, we’re giving her a 25th anniversary award here at Georgetown—one of our Luminary Awards. So, we’re very excited about that. I’m going to get to see her later this week and thank her in person. But I was also thinking about the impact that I believe she has had on the number of people who get colon cancer.If you really do the math, the interventions that have changed with colonoscopy, etc., in the United States have probably reduced the number of people who get colon cancer every year by about 20,000. Now, 150,000 people get colon cancer every year. It would be much higher than that if we didn’t have effective screening. So, screening works—fewer people in our clinics—and we need to applaud her for all that she has done.So, that’s all the gossip that’s fit to print for this session of Oncology Unscripted. I hope it gives you a little something to think about, look up, or consider as you move forward in your day tomorrow.John Marshall. See you later.Editorial: ...
    Show More Show Less
    24 mins
No reviews yet