Welcome to the Cancer Aware Podcast, where we'll discuss cancer prevention treatments, the latest in research, and important news around cancer. Brought to you by the University of Michigan Health Rogel Cancer Center.

Eric Olsen (Host):
In recent years, researchers have taken a closer look at the relationship between pets and overall cancer patient health outcomes. At the University of Michigan, two researchers are taking a closer look at this relationship within the LBGT community. 

Hello, I'm Eric Olsen, and today we're pleased to talk with Dr. Nina Francis-Levin, National Institutes of Health, postdoctoral research fellow at the Division of Metabolism, Endocrinology & Diabetes at the University of Michigan Medical School and Dr. Jess Francis-Levin, research investigator Life Course Development Program at the Institute for Social Research. Welcome doctors, thank you for being here.

Dr. Nina Francis-Levin:
Thank you for having us.

Dr. Jess Francis-Levin:
Thank you for having us.

Eric Olsen:
Why don't you tell us a little bit about your respective backgrounds?

Dr. Nina Francis-Levin:
My name is Nina Francis Levin. I have a PhD in social work in Anthropology, which I received from the joint program here at the University of Michigan. And I am currently a postdoctoral fellow in the Division of Metabolism, Endocrinology & Diabetes. And my research focus is on adolescents and young adults with cancer. This is an age-defined clinical subpopulation, 15 to 39 years old with unique psychosocial needs in accordance with the very dynamic developmental stages that occur during this age range and in light of a cancer diagnosis bring forth, very particular psychosocial needs. And in particular, I look at family-making because some cancer treatments can make patients in this age group infertile or have impaired fertility. So oncofertility, fertility preservation, and general issues around building familial relationships is the heart of my research.

Dr. Jess Francis-Levin:
And I'm Jess Francis Levin. I received my PhD from Michigan State University in Information and Media Studies. I currently work at the Life Course Development Program here at the Institute for Social Research at the University of Michigan. My research is at the intersection of technology use, aging and social isolation. And broadly speaking, I look at how technology use can promote social connectedness among folks who might be socially isolated due to either geographic location or marginalization. And now I also research pets.

Eric Olsen:
Why don't you tell us a little bit about your study and how you decided to go about this?

Dr. Nina Francis-Levin:
Yeah, so this study was a true case of a couple of researchers sharing some ideas and passions and saying, "We should do a project on that." And so often it doesn't come to fruition, but in this case it actually really did. So this all started... It hatched as an idea. There's a group of researchers in the sexual and gender minority cancer care space that have put together a working group and they held their inaugural Science of Cancer Health Equity in Sexual and Gender Minority Communities conference at New York University last October. And while I was there, I connected with Dr. Miria Kano, who is a professor of public health at the University of Colorado.

And she and I were just chatting outside of the main venue about our work and conversation led naturally to talking about our pets and our families. And then I'm showing her pictures of our pets and she's showing me pictures of her pets. And we were like, "We should really look into this, the salience of pets in our lives and the lives of LGBTQ families." And then certainly because she and I are both cancer researchers, thinking about pets in the lives of cancer patients really just came to the fore as this passion project. And so Miria took the idea back to Colorado and found a group there that has been looking at this very question about cancer patients and their pets.

So we got that group together and then I enlisted Jess who is not only a researcher of her own but is also my spouse. And so I said, "Will you be a part of this with me?" And in fact said, "perhaps you will be a part of this with me."

Dr. Jess Francis-Levin:
Yep.

Dr. Nina Francis-Levin:
And so we came together as a group. So Miria got in touch with Linda Cook, who's at the University of Colorado, and Jennifer Currin McCulloch who's at Colorado State University, as well as Lori Kogan who's at Colorado State University. And this is a multidisciplinary group in veterinary and medicine, social work, and public health that has already done some mixed method studies that look at the role of pets in the lives of breast cancer patients and survivors. So because they've already charted some of this work with research instruments, we wanted to connect with them.

One of the things that they did that really struck me was they took a couple instruments that are established for assessing the concerns of cancer patients. For example, the parenting concerns questionnaire, which is developed for cancer patients to assess parental concerns related to their cancer, especially for cancer patients who have young children. They modified it for assessing parenting concerns about pets. And they found that there was great parity between some of the concerns that cancer patients have for their young children as well as for their pets or animals that they're responsible for during their care. And then our final collaborators at Michigan State University, Bill Chopik, who Jess has worked with in the past.

So we've gotten together as a group and we've hatched plans, some big, some small. Right now we're collecting pilot data, and I know Jess is going to talk a little bit more about that. But in essence, we're this multidisciplinary group here at the University of Michigan with collaborators across the state and the country working on asking these questions about what is the role of pets in the lives of cancer patients? How might they promote wellbeing, connectedness, care, affection during the process of treatment and recovery, which can be very isolating. But then also what are some of the concerns that cancer patients have about caring for their pets if they are temporarily or permanently disabled, if they are burdened financially during their treatment?

So we really wanted to explore this and coming back to where this all started in my conversation with Miria at the conference, it's really that... Our question is really about how pets really are family members and how can we as medical providers understand that our patients have pets as family members that need to be accounted for as part of their care plan when they're undergoing cancer treatment.

Eric Olsen:
Jess, anything to add to that?

Dr. Jess Francis-Levin:
Yeah, I would say that I think this project that we have sort of affectionately titled our pet project has grown out of shared passions and interests to improve overall health outcomes for underserved populations in general, while also recognizing post-pandemic that many of us, to get through the social isolation brought on by COVID lockdowns, turned to our pets or took a lot of comfort from our pets to get us up in the morning and get outside to take them for walks or have something to care for and love.

I'm guessing that many people, whether they're familiar with the research end of this or not, can relate to the importance of their pet beyond just being an animal that they share their house with, but as really more a part of their family and their social network. My research looks at social connections and we started talking about the fact that pets really are a member of our social networks and they are important members of our social networks. And if you've ever lost a pet, you recognize that it is a profound loss because you are losing a buddy.

So another side of this research is looking at pets as social partners in many ways, and especially for folks who might be more socially isolated, either due to illness or social status or age or geographical location. So that's one aspect that's I think really of interest to me, but I know Nina as well.

Eric Olsen:
Are you able to share any preliminary findings from this study so far?

Dr. Nina Francis-Levin:
So we have some longer-term goals with this research that we are building toward by starting with our pilot data. And this group that I described has really identified three key stakeholders that it's important for us to target. The first is patients themselves to build toward educating them on resources that they may benefit from if they have pet caregiving responsibilities during their cancer treatment. The second group is oncology providers. We see this as really important to build an evidence base that can inform comprehensive wraparound services so that providers are aware, and we include multidisciplinary providers in the social workers especially so that they're aware of how to connect patients with resources that they might need to care for their pets. And then finally, we want to target vets because vets may be seeing their own patients, animals and pets, and their owners may be undergoing cancer treatment.

So we see this as a very... Our intervention cross-cuts some of these services that people and pets use. And so our longer-term goal is to build a online interactive resource hub for these three stakeholders, patients, oncology providers, and vets to serve as points of intervention. And then we also want to have our online space be a place where queer cancer patients can connect around their pets and can connect with each other. So it'll also serve as a community-building space.

And I think anybody knows that the easiest way to make friends in this world is through pets. I can't think of a single friend that we've made in the past five years that wasn't because we met them out walking dogs. So if we can bring that to people who might be living in states or in areas or regions that are not as warmed or hospitable or safe for queer folks or if they're isolated due to physical incapacity or they're in the hospital, we want to bring that feeling of connecting with people where you're out walking your dog to the online space and just have that at the fingertips of patients and pet owners.

Dr. Jess Francis-Levin:
So the first step in this research process was to obtain our IRB approval, which is the institutional review board here at the University of Michigan. We presented our proposed plan for data collection and the impact of the data collection and the science and then detailed our protocol in order to ensure that we were performing our science in the most ethical manners possible. So we received our approval from the IRB and then we could proceed to collecting data. First we started with our survey and we developed a roughly 19-minute survey, which is a bit long but contained only the most necessary of measures.

And we have been advertising our survey through the universityofmichiganhealth.org platform for patient recruitment, or participant recruitment rather. And currently we have about 360 responses from LGBTQ individuals. Individuals range in age from roughly 18 years of age to, I believe, 74 currently is the oldest participant that we have. And we asked a series of close-ended Likert type scale questions. And we also asked one question at the end, which just asked participants to tell us anything that they think we should know that we didn't already ask. This is a short answer item, I find it to be a very important item, and I try to include them on all of my surveys because you get a lot of insight into participants from this item.

From there, we got some of our preliminary data that I could address today. But before I do that, the next step, once we do analyze this quantitative data, will be to conduct a series of focus groups with participants who have already indicated that they would be willing to be contacted again for further participation. In these focus groups, we hope to hone in on more specific aspects of the study that we couldn't quite get to in a survey. So in general, in the survey, we can ask more broad questions and look for trends. In focus groups or interviews, we can dive deeper. And so that's what we hope to do with these focus groups. We have not started that yet, but we hope to do that towards the end of the summer.

Dr. Nina Francis-Levin:
We asked the general population to respond to this survey and that included some questions about whether or not they'd ever had a cancer diagnosis. And for those who responded positively to that, meaning that they have a history of cancer, those are the individuals we're going to target for our focus groups. So we started with this general capture of the LGBTQ population and we'll be able to do this focus group work, which is the deeper dive just described, specifically with cancer patients. And that was our way of identifying the cancer patient population within the LGBTQ folks that we've been surveying.

Dr. Jess Francis-Levin:
Right. So with this sub-population for the focus groups, we're going to get more in depth into the roles that pets have in these participants' lives. So in order to do that, one activity we hope to do with our participants is called the Hierarchical Mapping Technique, which was created by Dr. Toni Antonucci right here at the University of Michigan. And what we do there is we ask participants to think about those in their lives who are the closest to them, who are a little bit less close than the closest, and who are in their outer circles. So three concentric circles of social connections. From there, we ask a number of questions related to these individuals whom they have listed.

One thing we're interested in is do pets fall into the social network? This, as far as we can tell, as far as our research has shown, this hasn't been done before, so we're eager and interested to see if our participants would list their pets as a close member of their social network connection, if they see their pets as a social network member at all. This should help give us some insight into the importance of pets in our participants' social lives. There's a lot of research, a lot of which has been conducted here at the University of Michigan, that speaks to the importance and benefit of social networks in our overall health and wellbeing. We're using those principles and that foundation to further explore the impact of pet ownership on participants and patients' wellbeing.

Eric Olsen:
I think that's a really interesting question whether people consider the pets part of their social network. I was just thinking about some people that I know, and we definitely think of them in tandem with their animals because the animals have a whole lot of personality, and when we go visit them, the animals are there too. And so I'd be very curious to hear more about that sort of data. How many people do you hope to recruit for your survey? What's your goal there?

Dr. Jess Francis-Levin:
Currently, we have roughly 365 participants. That should be enough for us to obtain adequate power. So our sample size for the quantitative data is sufficient. Now we move to our focus group recruitment, and we will probably try to conduct a series of three focus groups with five participants in each group. So an additional 15 participants will be recruited to talk more in depth with us about their pets.

Dr. Nina Francis-Levin:
Yeah, I'm very excited for the focus groups because in research, especially medical research, cancer research, we don't often start a focus group with, "Tell us about your pets," but that is a really surefire way to get people talking and sharing. I'm really excited about us leading a focus group that has the promise of having a really engaged and open-hearted conversation. So I think that will be really fun. And to your point, Eric, about pets as family members, we do hear people invoking these kinship terms about their pets, like pet parent or pet grandparent or pet grandchild. We just heard our friend do a play on the economic term, double income, no kids, which is DINK, but now there's DINKWAD, double income no kids with a dog. There's these ways in which these demographic devices interplay with these different cultural terminologies that are... To that sense, we see that pets have a role in our sense of demography and economics and as well as our day-to-day lives. So I think it'll be really interesting and fun, and I think we'll learn a lot too about this population.

Eric Olsen:
When do you anticipate that you'll have some findings to share with us?

Dr. Jess Francis-Levin:
Currently we have some preliminary findings from our short answers. I can elaborate a bit on that. What we're seeing from our participants is a desire for social connection. However, there are many barriers. And these barriers range from sexuality, issues with homophobia, financial resources, health issues, certainly mental health issues, and a real desire for assistance in making meaningful connections while facing those barriers. So that's one overall theme that we're seeing, which I wasn't necessarily anticipating. With regard to pets, most of our participants have pets, and most participants feel that their pets provide them first and foremost with someone to love, someone to care for, and also somebody to keep them active and engaged. Both of those are important and meaningful findings.

What I think will be interesting moving forward as we start to analyze our data further is looking at the importance of pets in the lives of those folks who specifically indicated that they feel socially isolated for whatever reason. One factor and one common theme that we see is, and we hear colloquially as well as in research, is pets provide a sort of unconditional love and acceptance and excitement. And I think for a group who at times has felt unaccepted and unseen and unloved, that's a really important role to be filled. I think that's what I'm most interested in exploring further to see if there is a relationship there. But we do have a lot more data to analyze. Right now, we're targeting that analysis for probably the beginning of the fall semester.

Eric Olsen:
Do you or do you anticipate finding that pets are helping to facilitate connection with others?

Dr. Jess Francis-Levin:
I absolutely anticipate that we will find that, that is a question that we do ask. I have not analyzed that data yet. However, if I'm thinking about my own life and our life, we meet people by walking our dogs or going to the dog park and chatting. And some of these people have become very good friends, and some of these people are now in our social networks. And also some of these people, we never get their names, but we know their dog's names somehow. And whenever we see them, we say hi to the dog, and then we walk away and go, "What was her name?" I'm anticipating that will be something that we find, but we will have to wait and see.

Eric Olsen:

That's interesting. It's almost like the dogs are the ones who are introducing you, and that's your point of contact, that's your connection.

Dr. Jess Francis-Levin:

Absolutely.

Eric Olsen:

You had mentioned that especially in the case of LGBTQ folks, that there is often a sense of isolation. Do you anticipate finding that the pets and the connections are helping to bolster a sense of community, maybe not just within that community, but also maybe a larger connection to community in general?

Dr. Nina Francis-Levin:
Jess mentioned there's this what we call an open response question in our survey, which lets people write in. I'm really new to this work on social isolation, this is what Jess does. Even though I do cancer research, I haven't looked at social isolation as closely. And I was really confronted by some of the responses, the intensity of the loneliness that people are reporting in these open responses. Some people say, many people write and say, "I have no connections, I have no family and I have no friends." And so we're not seeing them write in about their pets, though we don't know if they do have pets, and they're not sharing that as part of their social network. So we want to leverage that and help people who are feeling lonely if they do have pets, to see that from a strengths-based perspective, that indeed they do have a really strong connection and maybe that's a connection that can help them connect with other people.

One of our questions is, if you have pets, does your pet foster your social connections with other people? And so we're really eager to analyze this data. We have a specific question that will let us know this answer. And then there's some other associated questions like, "Does your pet foster your efforts to go outdoors? Does your pet help you maintain a regular schedule? Does your pet help you eat regularly?" And so these are all things that are associated with improved social connectivity. So we're honing in on pets as this possible point of intervention for promoting other modes of connectivity with others. So we're really excited to analyze this data, and this will definitely be what we dive deeper into in our focus groups.

Eric Olsen:
You had previously mentioned somebody I think you were talking to at the beginning who was in veterinary medicine, and previously we've been talking about people and their pets and connections. Are you or is anyone associated with the study looking at it from the animal side?

Dr. Nina Francis-Levin:
Yeah, Lori Kogan is the veterinarian specialist. I don't know if they're looking at it from the animal side. I'd really love to explore that. I think that's a fantastic idea.

Dr. Jess Francis-Levin:
Yeah. In the next phase now of this project that we are just deciding on in this current moment, we will be looking at animal and pet wellbeing overall as well and if there's a mutual benefit there, because you'd have to imagine there was. You'd hope so. You would also have to imagine that if you know that your pet who you love is thriving based on your care and friendship and love, then that's got to make you feel better as well. It makes me feel better. So I think that's a great question and one that we should look into.

Dr. Nina Francis-Levin:
Yeah, definitely. And we do know that pets have to be re-homed when people fall ill or can't afford to care for them or not physically able anymore. So certainly this... And that's devastating to pets because... Some of them anyway are so dedicated. I will there's one question that asks, "Does your pet have the ability to listen to you when you talk?" And I don't know that I'd answer yes about my own pet if I were asked that question. I don't think he always listens when I talk.

Eric Olsen:
I think you'd mentioned earlier that for some folks it's very powerful and meaningful to have something to love, to have something to care for. Are you planning to unpack that a little bit more?

Dr. Jess Francis-Levin:
Yes, definitely. So one of the instruments that we employ in our survey is a mattering series of questions. And so mattering is a term that most of us are very familiar with, but it is also a concept in social psychology related to the feeling that we matter to others, that others find us as a source of importance and that others rely on us. And that has been linked to self-esteem and overall well-being and lower levels of depression among people of all ages. And that's one area that I'm particularly interested in my work overall, but also one that I identified as maybe playing a part in this particular research as well, in that especially folks who are dealing with an illness that may lead them to become more dependent on others, may experience a blow to their own sense of mattering because they may be less physically capable, emotionally capable of actively caring for others in the way that they used to and that can really psychologically and emotionally damaging.

There's a way though that caring for a pet may not require as much burden as caring for another adult or another human, but still provide the benefits of feeling as though you matter, your presence matters, your companionship matters regardless of how well you feel or how capable you feel in that given moment. So that is an area that I think we're both very interested in looking at. And I know that Nina in some of her past work and interviews has been able to speak with some folks who are going through cancer treatment or have gone through cancer treatment about their pets and the role of their pets during their treatment. Is that right?

Dr. Nina Francis-Levin:
I do a lot of my interviews with young adults with cancer over Zoom, and they call in from their homes and their pets are usually present with them. And so sometimes when I'm doing interviews with participants, they may not be feeling well, they're at home, they're in pajamas, but they're calling to participate in this research. And you can just see that their pet is right beside them, cuddled up or interrupting the call, or just playing a very present role in their home. And so you can get a little... I get a little snapshot of what their lives might be like when they're at home on the couch not feeling great, and they have their pet with them. And I think it can just make a world of difference to somebody to have a little creature that just loves you so much with you when you're feeling at your worst.

Eric Olsen:
We've talked a lot about the social and even some of the emotional implications from this. Do you have anyone in the study who's looking at perhaps a clinical impact, something measurable on the physical health of patients?

Dr. Nina Francis-Levin:
That's a great question. So in our study, we're not looking at that, but I will refer to Dr. Brad Zebrack's work. He's doing some research on social genomics for adolescents and young adults with cancer. And his study involves cross-analyzing blood samples and different measures in their blood assays with a number of psycho-social metrics. And he and I had a discussion when we were designing some of the demographic data collection measures. So we will be able, through Dr. Zebrack's study perhaps, to explore some connection between some of the social genomic outcomes that he's looking at and this reported presence or role of pets in the lives of participants. So who knows, down the line we could learn more about it, but in our study specifically, we don't have somebody with that particular expertise.

Dr. Jess Francis-Levin:
We do, however, ask a question related to depressive symptomology, which is I believe technically a clinical measure, but certainly not a physiological measure.

Eric Olsen:
Do you anticipate the data that you're collecting from this survey to be useful for other studies in the future, perhaps even including some clinical components at some point?

Dr. Jess Francis-Levin:
Yes. So we are collecting this data with an eye towards the future and growing certainly to incorporate multiple sites. As we've mentioned, we have collaborators all over the country currently, but also to investigate more in depth the impact of pets on health. One area that I look at in my research occasionally is cognition. That's certainly an area for older adults that's very relevant. So that would be one possible segue from the data that we collect. Did you have anything?

Dr. Nina Francis-Levin:
Yeah, I'll just say, so the Sexual & Gender Minority Research Office at the National Institutes of Health has done a major push in recent years to bring attention to different work that focuses on the LGBTQ population. And they've coordinated with the National Cancer Institute to put out a special call for a number of funding mechanisms with a specific focus on health equity for sexual and gender minority communities. The hope is to be able to use this pilot data to make a case for a future R01 application in line with this special call. And I think that we would hope there to innovate toward developing and testing and intervention similar to the intervention I described earlier with the focus on patients, providers, and vets in line with thinking about the broader reach and the impact of this work in other sectors.

I think of this work as in the spirit of this really amazing initiative that Purina has called the Purple Leash Project. This is an exemplar, in my opinion, of looking at the relationship between pets and people as a site to intervene on other social issues. The Purple Leash Project supports people, primarily women, who are leaving domestic violence situations. And some of the research that they've partnered to conduct has shown that pet ownership is one of the reasons that people sometimes stay in unsafe domestic situations because many shelters for abused women don't accept pets. And so the Purple Leash Project, it found pets as this point of intervention to promote safety for women and families. And our project is, of course, very different, but in the spirit of cross-cutting these different sectors and really getting at some other social problems with pets as the starting point. We hope to do that in the cancer space, something in that spirit.

Eric Olsen:
What is the most surprising thing that you've learned about this?

Dr. Jess Francis-Levin:
What has struck me, although I don't know that I should be so surprised, is that when we tell people what we're doing or the research we are embarking on, whether it's somebody in our personal lives or colleagues, people in the research community at large, so many are so excited by this idea, have stories to share about their pets or stories to share about researchers who have looked at similar ideas but not the same idea in the past. And it just, I think, goes to show people from all different backgrounds and walks of life really care about their pets and want to know more about how their pets are impacting their lives and all have a pretty good idea that their pets are benefiting their lives and are looking forward to hearing about what we find. It's always just so surprising to me when we hear about other people doing the same work, or not the same, but work related to pets, that they're from all different backgrounds, and it's just we love our pets and we just want to learn more about them.

Dr. Nina Francis-Levin:
Yeah, and I think, like I mentioned before, the intensity of the loneliness that some of the participants report in the surveys, it's stunning. There is a loneliness epidemic in this country. So if connecting with pets is a way to intervene on that, I think human relationships are really complicated. And there's a certain way, and Jess mentioned this before, that relationships with pets can be such pure love without all of the complications of human relationships. And especially when you have cancer, you're profoundly vulnerable. And so to have that kind of love. I know my love for my dog has been a life-changing experience. I think it's just something really vital that we need to know because we are living in a world where we live really closely with animals, and this is part of the social fabric of our lives, and it needs to be part of our understanding of medical care as well.

Eric Olsen:
This has been great. It's very interesting. When can people anticipate reading more about your work, maybe the published findings of your study?

Dr. Nina Francis-Levin:
Yeah, we're really excited to publish the findings from the pilot survey we've talked about today and our upcoming focus groups by the beginning of the 2025 calendar year. So look out shortly after the new year for us to share some of our findings on our pets.

Eric Olsen:
So you are pet parents, as it were. How do you feel about this study? What is your relationship with your dog?

Dr. Jess Francis-Levin:
We have two dogs. We are a blended family. I brought my dog into the relationship and she is a Korean Jindo who I adopted from a rescue who brought her over from Korea from a dog meat farm where they kill dogs for consumption. And it is a practice that has been outlawed in Korea, and there are some amazing vets all throughout the country who are finding these illegal operations, shutting them down, rescuing and vetting the dogs, and then shipping them overseas, usually to the US, Canada, or the UK for adoption. That's where my dog came from. She's absolutely perfect in every way. And talking about having dogs instead of kids currently, that's our situation. And I do think it is fairly indicative of how we will be as parents.

I used to... Right after I adopted my dog, she was very traumatized, as you might imagine. So every night when we would go to bed, I would do nightly affirmations with her where I would tell her how important and talented and beautiful and loved she was and is. And I still do that from time to time at the very least. We always have a moment before we go to sleep, but she's definitely my main buddy. She has traveled with me. She has lived in so many different places with me. She has gotten me through very tough times. I'd like to think I got hurt through some tough times as well. Blessedly, she gets along with Nina's dog, who is also equally loved and important to our family. And I'll let Nina tell you a bit about him.

Dr. Nina Francis-Levin:
Yeah, so I brought Moon, a little black cocker spaniel. He's not perfect in every way. I love him so much, but I can't say that he's perfect. He's really anxious. He's really needy. He's obsessed with his ball, but he's so much fun. The love I feel in my heart for him is overwhelming. We're not parents, but I imagine that it's a version of what parents feel for their child. It's just a really overwhelming love. And he's just... He cracks me up. He's my buddy. And I think about times when I've felt unwell and he's just there with me, and it means the world. And I think about how worried I would be about him, especially because he is an anxious dog and he doesn't do very well in unfamiliar situations. And it would be really hard if suddenly I weren't able to take care of him. And we did have somebody ask if we were a blended family. That was really funny. And then not to forget, but we do have a kitten as well that we got together.

Dr. Jess Francis-Levin:
She's a whole other story for a different day.

Dr. Nina Francis-Levin:
Yes.

Eric Olsen:
Was there anything that I didn't ask? Anything that we didn't talk about that you guys feel is-

Dr. Nina Francis-Levin:
I'm just so glad that we're able to talk about this today on the podcast. I think it's exciting to share. It's always a little bit tentative to share such preliminary. We are in the process of gathering our pilot data, so our findings are preliminary preliminary, and for researchers, it's always a little nerve-wracking to talk about that. But I am so glad you invited us because I do think it speaks to the importance and the relatability of this work, and we're really excited about it. We hope that others join us in our excitement about advancing this work.

Eric Olsen:
Thank you doctors for coming in to speak with us today. Very interesting and we are definitely looking forward to seeing more about this fascinating study. Our guests today were Dr. Nina Francis Levin and Dr. Jess Francis Levin. For the Rogel Cancer Center and the Cancer Aware podcast, I'm Eric Olsen.

Thank you for listening and tell us what you think of this podcast by rating and reviewing us. To stay up to date on what's happening in the cancer world, follow us on X @UMRogelCancer. Cancer Aware is part of the Michigan Medicine Podcast Network.