The Other Shoe: Cancer Risk & CF
With Steven Freedman, MD, PhD and Chelsea Lau, MD
People with CF are used to waiting for the other shoe to drop—but a cancer diagnosis? That one still lands with a thud. In this episode, Ahmet—who kicks things off with a story that somehow involves gelato, a heat dome, and a medical conference in Italy—and Andrea sit down with Dr. Steve Freedman and Dr. Chelsea Lau to talk about something that’s been in the medical literature for decades, but is still rarely discussed: cancer risk in CF.
As more people live longer with CF—many well into adulthood and post-transplant—questions about increased cancer risk are becoming more urgent. Steve and Chelsea walk us through the science behind CFTR as a tumor suppressor gene, how chronic inflammation and disrupted gut environments may set the stage for certain cancers, and why the modulator era, while revolutionary for lungs, might not offer the same protection in the GI tract.
We talk screening, colonoscopies, and what we do (and don’t) know about breast, pancreatic, and post-transplant lymphoma risks. Andrea asks about cancer diets specific to CF, and Steve tries not to geek out about mice and microbiota.
Also: organic produce, telomeres, and a musical finale you might want to skip—but shouldn’t.
Dr. Steven Freedman is Director of the Pancreas Center at Beth Israel Deaconess Medical Center, Chief of the Division of Translational Research, and Professor of Medicine at Harvard Medical School. He has played a leadership role in clinical/translational research across Harvard through his prior role as the Associate Dean for Clinical and Translational Research and Co-Director of the Harvard CTSA (Harvard Catalyst). He is Director of the Grant Review and Support Program, a unique longitudinal program that provides project management support and grant writing tools to enhance the transition from an NIH K to R01 grant for junior faculty across Harvard.
Dr. Freedman’s expertise is in exocrine pancreatic disease with a focus on pancreatitis, pancreatic cancer, pancreatic enzyme development and cystic fibrosis as well as diseases of premature infants with a translational research focus on fatty acid metabolism. He helped establish the CF Foundation funded DIGEST program to train pediatric and adult gastroenterologists in the GI aspects of CF and plays a leadership role for the CF Foundation to design, develop and carry out GI-related CF research.
Dr. Chelsea Lau is a third year Hematology/Oncology fellow at Northwestern’s Robert H. Lurie Comprehensive Cancer Center. She completed her medical school and residency, including chief residency, and the University of Virginia Medical Center prior to joining the Hematology/Oncology program at Northwestern where she participated in quality improvement in multidisciplinary care of people with cystic fibrosis under the mentorship of Dr. Dana Albon.
She is currently a trainee under the Northwestern University Translational Research in Hematology and Oncology NIH T32 training grant, and her primary research involves investigating the impact of underlying conditions on risks of immunotoxicity in thoracic, genitourinary, and cutaneous malignancies. She plans to pursue a career as an academic oncologist and clinical investigator after completion of her fellowship training.