Dr. Ruslander: I think that when you sign on to be a veterinarian, I think you're signing on for a life long endeavor. And it's easy to get complacent. And complacency is the enemy. Read, read, read. So I think that those things are, you know, critical to staying engaged and keeping it current and keeping you excited about what you're doing.
Dr. Venable: Welcome to the Veterinary Cancer Pioneers Podcast, the show where we delve into the groundbreaking work of veterinary professionals who are dedicated to advancing the field of veterinary oncology. I'm your host, Dr. Rachel Venable, and I'm thrilled to embark on this journey with you. This episode is produced and brought to you by ImpriMed, pioneers in an AI-driven precision medicine for veterinary oncology. ImpriMed’s personalized prediction Profile helps you make confident treatment decisions for canine lymphoma and leukemia patients by predicting how your patient will respond to multiple chemotherapy protocol options. Learn more at imprimedicine.com. That is imprimedicine.com.
Dr. Venable: Hello and welcome to the Veterinary Cancer Pioneers podcast today. I'm so excited to have Dr. David Ruslander and we're really going to dive in and learn more about the different aspects of his career. He is both a medical and radiation veterinary oncologist, and he's also practiced in private practice, academia, and corporations. So we're really just going to dive in and see how things have changed and just learn more about what he's seeing throughout his career. Dr. Ruslander, he integrates surgery, chemo, radiation and immunotherapy to improve outcomes and quality of life for pets with cancer. He earned his veterinary degree from Cornell, completed a medical oncology residency at Tufts, and received radiation training at the University of Zurich. And he's also the past president of the Veterinary Cancer Society. Dr. Ruslander, thank you so much for being on our show today.
Dr. Ruslander: Thank you very much. Are very excited to have this talk.
Dr. Venable: Oh, thank you. And you know, I always like to start with what got you into either veterinary medicine or certainly oncology. You know, a lot of people, you know, when I was a kid, I didn't even know there were veterinary oncologists. So what got you down this path?
Dr. Ruslander: Yeah, I kind of got involved in it early in my career. Initially I started out in equine medicine, and then I transitioned to small animal medicine. And during my education, oncology was kind of the forgotten specialty. And you know, we had a lot of patients that were being treated for kidney disease and heart disease. And then when they got the diagnosis of cancer, there weren't a lot of options at the time. And it seemed to me that there was, you know, an opportunity not only for myself but also for clients that didn't want to give up when a patient was diagnosed with cancer.
Dr. Venable: It is hard, I think, for a long time and even now, a lot of people don't realize what options are out there or how animals tolerate chemo. It's also interesting you said equine. Dr. Vail was the same. He was thinking about equine actually initially too. So it is kind of funny how a lot of people don't think about oncology. I mean, I didn't even know it existed when I got into vet school either. So it is really interesting seeing that. And the other thing I wanted to know more about is you went to the University of Zurich. That sounds really fun to me. How did you end up in Zurich?
Dr. Ruslander: Well, it was very interesting. So I was a clinical instructor at NC State, non-tenure track position. There was a woman, Dr. Kaza Hodes, who had trained at Colorado State University, and she was building the program in Europe, and they didn't have many oncologists in Europe at the time. So she was looking for someone to balance the radiation oncology that she did. And with medical oncology. And at the time, my wife, we talked about it and it was no tenure, no mortgage, no kids. And so it was a no brainer to go there. And as I look back 25 years ago, it seems like a dream because it was an amazing experience.
Dr. Venable: I can only imagine just, you know, I, I really haven't been to Zurich is on my list, but it seems like a really pretty place. And that was probably exciting to be one of the first people really building up a program. What was that experience like?
Dr. Ruslander: Oh, it was amazing because, you know, at the time, Europe did not have many oncologists and it was a little bit like it was in the States. And so a lot of people had a lot of misconceptions about treating patients with cancer. And so it was an amazing experience to kind of educate not only the clients, but also the veterinarians at the time.
Dr. Venable: As I, you know, like we were saying, it is interesting, a lot of people don't understand, you know, even today how oncology in animals is very different and, and sometimes even the veterinary community, you know, I think with anything you have a couple cases that, you know, just the outcomes were off. Maybe it's a bad disease. And so then you just kind of get that stuck in your mind and don't think about the other statistics and things.
Dr. Venable: It's something we had talked about at a conference recently. It was just the back story of a lot of people why they come and see the oncologist. And I think a lot of times people also don't understand that. Would you mind sharing maybe a story or two?
Dr. Ruslander: Absolutely. You know, you don't know what you don't know. And whenever I talk with an owner, the first thing I always ask is, where did you get the name of the patient? Especially if they're unusual names and just kind of get a sense of, you know, where they're coming from and, you know, ask the questions that sometimes are difficult questions to ask, but a lot of times people will volunteer the information.
Dr. Ruslander: And, you know, one, two that comes to mind were a patient of a dog that had a brain tumor. And the owner spoke to me, you know, candidly. And he said that he had two little kids and his wife was diagnosed with cancer, and she chose not to go through the chemotherapy and the radiation therapy. And he told me that he wanted to teach his kids not to give up when things get tough. And it was like very touching, very touching conversation we had.
And then another patient that I just saw recently with a dog with a mast cell tumor that had a very advanced disease, a very difficult tumor to treat. And we ended up losing the patient early on in treatment and when things were going downhill and they still wanted to treat I spoke with the owner and they volunteered the information that, you know, this dog belonged to their daughter. It was a young couple. So I think that the daughter was very young when they died, when she died and they said that, you know, this is the last thing to remember her by. And so, you know, you don't know what you don't know. And I think that it really is testimony to making sure you get, as you say, the back story and understand kind of where the people are coming from and what their motivations are.
Dr. Venable: Oh, yeah. I mean, those are just heartbreaking. And it makes sense why they want to see an oncologist, why they want to do everything they can. And I think it's important also for just the veterinary community as a whole to know that and to remember, you know, referral. And even in cases like you said, that one was really bad. Mast cell tumor. Like, they may be thinking like, hey, there's not much that we can do here. But sometimes just for those people knowing that they crossed every bridge, right, that they, they did everything they could like, I can't imagine, you know, I mean, if that pet was all I had a connection to someone I love so much, like a daughter or son or, you know, any kind of family member, I would want to do everything, you know, it's just hard to let go.
So. Yeah, that's tough. And, you know, you said that you will ask questions and sometimes they're hard questions. How do you get people to kind of open up about maybe why, you know, other than just their pet, why they're coming. Do you have any tips on that? Or is it just how the conversation flows?
Dr. Ruslander: Well, you know, the key is to let them talk. I think that a lot of times with conversations, they tend to be one way conversations with the owners. And we talk and they listen. And I think that now we're seeing courses and education in client communication. And I think that no one like uncomfortable pauses in conversations. But I think that that's where a lot of the information comes from. If you just take a step back, let them collect their thoughts and then they will open up.
Dr. Venable: That's true. I 100% agree. I think there's just so much power in that pause. You know, when I used to work with training vet students, I remember we would talk about, you know, after the consult, we would talk later and they would always say it was so hard, like it was awkward, you know, when no one's talking, like when the pet owners crying, but then they saw how powerful it was. So just give them a minute. So I yeah, I 100% agree. And you know and you are in academia and just private practice and corporate you know, how would you compare all those different settings.
Dr. Ruslander: Their variations on a common theme. I think I talk about academia. You have a lot of hats that you have to wear 50% teaching, 50% clinics, 50% clinics. And so you're wearing a lot of hats. I think when you go to private practice, it shifts a lot, obviously, towards the clinics. But you also have a lot of opportunities to get involved in research. You know, either in, you know, multi-institutional studies or submitting cases for retrospective studies, it's all what you want to do with your time. And it really has been very rewarding for me to be involved with research at other vet schools that are doing the primary research.
Dr. Venable: Yeah, I like to get involved in research too. And, and it's sometimes I find it can be a bit challenging in private practice just trying to corner out the time and things. Well, how would you recommend for people that are in private practice, but they still want to stay involved at some level of research? Like is there anyone you recommend maybe reaching out to, or just how can they kind of get into that niche?
Dr. Ruslander: Well, I always say start with your mentors, where you've done your residency programs and most people stay in contact with their mentors and find out what they're doing, find out where the research is being done. I think that between VCS, ACVIM and ACVR, there are a lot of collaborative projects that are being done. And so I encourage people to get involved in these organizations. It's not on committees, but getting involved in a lot of these collaborative groups that are doing research that can get the job done and provide the infrastructure to do the research.
Dr. Venable: And I think it is so important to really work with private practice and academia, because I think private practice, you just see such a higher volume, you know, you're more apt to be able to enroll and see those cases versus academia. They may have the set up for really the sample collection and all the back side of things, but they don't really just have the caseload so much, especially not as much anymore as more and more specialty hospitals pop up. And, you know, what would you say just kind of even comparing academia and private practice, you know, what were some of your, your favorite highlights and, and maybe some of the things that were challenging between those two?
Dr. Ruslander: Well, I think in academia you're involved with a lot of cutting edge research, cutting edge technologies. I think historically when I came out of my residency, there were very few private practice jobs. And so if you wanted to be involved in any kind of research or frankly, even having a job, there were not a lot of jobs in private practice when I came out. Now it's kind of flipped where there's a lot of jobs in private practice. And so I think that, you know, it really is, again, variations on a common theme. I think that there is a lot of work in academia with clinics, as you say, the caseload may not be as great, but you're also doing the research, you're teaching the students, you're teaching the residents. And I think that that consumes a lot of time.
In private practice. You can have residents, you can have interns. We have externs, interns. We have residents that spend time in our clinic. But it is kind of definitely front loaded with the clinical work.
Dr. Venable: Well, and I think that's great that you're also still doing the teaching, you know, having them rotate through different things. Because I do think it's important for them to see how, you know, a busy private practice and, and what that looks like now when you treat. So you're medical and radiation oncology. So you're two specialists in one. How do you think that really changes how you approach cases? Or is there anything you would recommend for other medical or radiation oncologists about maybe how we could work together better?
Dr. Ruslander: Well, I think that collaboration is key. I think that when I go into a room, if a patient is coming in for treatment, I go in with my oncologist hat, not with my radiation oncologist hat. So I will look at the way I phrase it, “What makes sense for the disease? What makes sense for the patient and what makes sense for the caretakers?”
And so I don't come in saying, okay, you're here for radiation therapy, you're getting radiation therapy. And I think that getting everybody's opinion before you give chemo, before you give surgery, do recommend surgery. Radiation therapy is figuring out what's best. And then that is, you know, communicating with the specialist. And as you say, I you know, I have a background in both, but, you know, I'm doing more radiation therapy.
And so I, you know, usually will speak to all of our medical oncologists that are in the hospital before I make any kind of final decisions. We're very fortunate in our group, with multiple surgeons, multiple medical oncologists. We have surgical oncology rounds once a week for difficult cases that may benefit from the insight of not one surgeon, but all the surgeons and all the medical oncologists. They get everybody's opinion because everybody's trained differently. And, you know, their experience is what matters. And I think that that makes a difference of having a good outcome and or not a good outcome.
Dr. Venable: And it's interesting. There's some things that we have a lot of research and data because I feel like oncology, you know, everybody wants to know numbers. But then there's other things where we really don't. And I do think you get a lot of difference of opinions, sort of rightfully, because we don't have a lot of data on those.
So that is really nice that you guys are able to do rounds and have all the different specialists there. What would you say, you know, it sounds like client communication is certainly a big part of your practice, which I agree, I actually really like client communication. I think it can kind of make or break you. You know, we've all met or even in our own experiences with doctors, you know, or if they just have a terrible bedside manner like that it's hard. So when you have people come in to see you and maybe they're, they're planning on radiation, but you're thinking, well, maybe chemo might make more sense. Like what? How what's, I guess, in a sense, to sort of help other oncologists, maybe with their communication. Do you have, like, almost a certain stepwise that usually goes through or asking specific questions? And we talked about the pause. Any other kind of tips for people trying to figure out the best way to communicate with someone, especially if maybe you're changing what they were originally thinking they were going to do.
Dr. Ruslander: Well, I think they need to understand, or we need to understand that we have to be honest. And not promise things that we can't deliver on. You know, I try to be as optimistic as the situation allows and not be negative from the beginning. Being a negative oncologist doesn't help anybody. And but I also want to have realistic goals. And I think asking people what their goals are, you know, why are you here. And we have people that come in and they say, I just want to slow down the process, make him feel better. And we have people that want to spare no expense and want their dogs to benefit from everything that we can deliver on. And so it's really I think goal setting is very important. And having realistic goal setting.
Dr. Venable: And I like that you bring that up because I think it is extremely important to be both that balance of optimistic but yet realistic. Right. So that they have a sense of what's going on. And with the goals. I will admit I've had trouble in the past trying to ask that question because sometimes if I outright say, what are your goals? It seems like it throws some people off. So do you have a certain way that you phrase that? Sometimes I'll say, you know, what are your questions before I really start going into things? Because that gives me a sense of what their goals are. But do you outright say, what are your goals? Or how do you phrase it? Because I've struggled with it.
Dr. Ruslander: With this a little bit, right? I often do that. I start, you know, I don't start with that, but I interject that during the conversation as we kind of have the back and forth about that when I give them, because sometimes people come in with a lot of knowledge, especially with the internet and whatnot. And I think that they have come in and they may say, I'm here for stereotactic radiation therapy, not understanding that may not be indicated in this particular case. And so, you know, once we kind of have this back and forth conversation, I'll kind of take a step back in that I literally will say, well, you know, what are your goals for your pet? Most people can articulate it fairly well and you get a sense of that, and then you guide the conversation from there. And then if their goal is to have the dog live a long time but not spend a lot of money, then you navigate sometimes more to palliative care and not concentrate on, you know, the more expensive options that may be appropriate, but not in the owner's pocketbook.
Dr. Venable: But I think a big thing too, is trying to figure out finances. And, you know, I think that's something that's a bit different between us and human medicine, where it seems like with people they just kind of say, okay, this is what we're going to do versus with us. We kind of have to give levels of, you know, different things. So yeah, I think that makes a lot of sense. And just sort of thinking about, you know, what people come in for their goals and what they're wanting. How would you say just veterinary oncology in general has changed over the years?
Dr. Ruslander: Yeah. I you know, it gets changed tremendously. As you say. You know, when I first started out and I told people I was a veterinary oncologist, they said I didn't even do dogs got cancer. And now when I tell people most people have had a dog, did have cancer and many people have treated dogs for cancer. And I think that it is, ever evolving specialty. I used to joke that the shortest book in the world was evidence based veterinary oncology. But now it's no longer the case. We're not obviously at the point where we are in human medicine, but I think that we do have, as you say, a lot more data on biology, the disease treatment and the disease. It used to be, we would say it was surgery or radiation therapy or chemotherapy. Now, you know, we have surgery and radiation and chemotherapy and now we have immunotherapy. So that this multimodality therapy that really was not utilized, historically is now being utilized. You know, it's very common place.
Dr. Venable: And radiation, I think it's really changed a lot. You know, you're talking about SRT or SBRT. I'm not really sure why. Sometimes we use the different acronyms or SRS like we're I'm never really sure which one to use, but how is that technology changed how you treat or approach radiation with some of these different cancers?
Dr. Ruslander: Tremendously so because, you know, historically, radiation therapy. And then as I look back now that we have very state of the art technology, I now refer to what we used to do as doing watch repair with the sledgehammer, a lot of collateral damage, a lot of, normal organs that have potential to be damaged from radiation therapy. But now with the technology, it's much more precise. It's much more accurate. And the things that we previously couldn't treat with radiation therapy, now we can, you know, we treat adrenal tumors, thyroid tumors, lung tumors, where previously we really couldn't do that at the doses that were effective. And so now we can treat, you know, with curative intent definitive intent therapy with low risk of negative impact.
Dr. Venable: Yeah, it really has changed a lot. And even as a medical oncologist it's been good. And also just trying to remember like okay what is a good candidate for radiation. You know versus in the past maybe we wouldn't have used radiation. So much for that. And something I'd be curious just your thoughts on a couple different tumors, with radiation. So I, you know, you hear a lot now about bladder tumors where we didn't used to really radiate, but now we're radiating and anal sac tumors. What do you think about those two? What's your recommendation or approach with those?
Dr. Ruslander: Yeah, those are very difficult tumors. I think that, you know, the jury's out exactly how they're best managed. I think that, you know, especially if you talk about bladder tumors, you know, a lot of times we treat with surgery if we can, but based on location, surgery is often not an option. You know, there have been some studies that do suggest that, you know, radiation therapy prior to chemotherapy may lower the tumor burden. And certainly when we have, you know, bladder tumors where there's obstruction, radiation therapy is very helpful to, you know, de-obstruct them prior to do trying to do chemotherapy, you know, anal sac tumors, you know, again, historically when we did radiation therapy for, anal sac tumors, you know, most of these anal sac tumors cannot be removed with big margins. And often we would follow up with radiation therapy for incompletely or narrow excised, anal sac tumors. But now the literature suggests that we may not need to radiate them because recurrence in the anal sac itself is relatively low. And so now we utilize radiation therapy for the anal tumors in situations where we have lymph node involvement or large tumors that can't be removed surgically. And they do tend to respond well to radiation therapy. So again, that's a situation as I talked about, that the multi-modality therapy definitely plays a large role.
Dr. Venable: Yeah. Those cancers can certainly be tricky for sure. So and the other one that I heard more at the conference and kind of just buzz about recently has been like, there's half body radiation for lymphoma. I feel like it keeps going in and out of vogue. Really. What do you guys or what's the radiation community, I don't know if you can speak for that, but what are you guys thoughts on have body radiation for lymphoma?
Dr. Ruslander: Yeah, I think having body radiation therapy may play a role. As you say, the literature is a little bit all over the map. Again, I think that, you know, some of it is the technology will allow us to treat more effectively, more precisely, even with half body radiation therapy, you still have to have concerns, you know, of the kidneys and bone marrow. There are a lot of factors in how the half body is delivered. We, used to use high dose rate radiation therapy. Now we have a lower dose rate. And the current thinking is that the lower dose rate is more effective than the higher dose rate. It can be somewhat challenging depending upon the machine. You have to deliver it at a low dose rate. And without getting into the physics behind it. But, you know, sometimes we can't do it. Like, for instance, our machine, it's very difficult to get the dose rate low. Because we can't lower the gantry to allow the dose rate to be low enough to get to the low dose rate that some of the studies have been doing recently.
Dr. Venable: Oh, that's really interesting. I didn't realize the low dose. And how does the physics with the machines that that can be a challenge to. So that is really interesting. And you know you mentioned immunotherapy as well. What are some different immunotherapies or approaches that you guys are using.
Dr. Ruslander: Well, primarily we use immunotherapy for our melanomas. Melanoma vaccine and the Oncept. And also the gilvetmab, which are different strategies. I think immunotherapy has come to the forefront in the sense that, you know, development of monoclonal antibodies, development of strategies to stimulate the immune system. There's also a big interplay between, you know, radiation therapy that can stimulate the immune system.
Dr. Ruslander: And then adding, you know, a lot of these immunotherapies, once you, as they say, have a cold tumor that you can turn hot, that allows immunotherapy to work better. I think the challenge is like anything, whether surgery or radiation or chemotherapy, you know, with the exception of lymphoma when you have big bulky disease, many of these strategies are not as effective as when you we have kind of more microscopic or minimal residual disease.
Dr. Venable: And it it is interesting. And you know, I also heard some like you were talking about big bulky or, you know, trying to get down to minimal about maybe trying gilvetmab before surgery so the immune system recognizes it and then really following up after surgery because then you have less disease there. So I haven't done that. But it sounds certainly like an interesting concept with a lot of these. Have you guys done that approach or have you seen kind of things like that?
Dr. Ruslander: Yeah, we're early in the gilvetmab experience. And so we've only treated a few patient and not used it in a preoperative setting. More in a post-radiation or post-surgery setting.
Dr. Venable: Yeah, yeah. No, it's interesting. I'll be interested to see, you know, there's a lot of stuff coming down the pipeline. So hopefully we'll have some more things to use and kind of going along with that. What is some interesting technology that you're excited about or that you're seeing maybe, maybe even in human medicine that hopefully will get into animals? Is there anything on the horizon that you're excited about?
Dr. Ruslander: Well, talking about radiation therapy is moving at lightning speed with the new technology. You know, currently when we do radiation therapy, we do radiation therapy using CT scan planning. We can often use MRI to fuze the studies. So a brain tumor that we don't see on a CT scan, where we see it on an MRI, we can use that. And the information from the MRI to the CT scan allows us to treat more effectively. They're now starting to have MRI-based planning systems. The other aspect of radiation therapy is what's called adaptive radiation therapy, where we can dynamically change the field, you know, real time and be able to adapt what dose that's being delivered based upon the size of the tumor or the position of the tumor within the patient. And that's especially important for tumors that have an initial response to radiation therapy, because a big tumor that gets smaller, the plan is based upon the big tumor. And so we have to change the plan pretty quickly or risk damage to the normal organ.
Dr. Venable: Do you think AI will be involved with trying to help planning? Because I know it can be really tricky. And just the physics, it's sort of beyond me sometimes with radiation. So do you see, is anyone looking at maybe AI to help you guys with some of these planning tools.
Dr. Ruslander: Yeah, we definitely, many people in the radiology community are concerned about AI taking their jobs away because the AI could read the radiographs in radiation oncology. We use it very commonly already with what we call auto-contouring, where the AI can figure out what's the brain, what's the lung. And it can auto-contour. So it can make our jobs easier and make it so that we don't have to spend hours doing the planning when the AI can do it. I do think that obviously it requires, a real person to make sure that the AI is doing what it's supposed to do, but I think a lot of the first steps, which are often the laborious steps in terms of the planning, so it's already in place.
Dr. Venable: Oh, that's awesome. I just remember, you know, radiation oncologist working on plans and it could just take forever. Right. So that's where it would make sense to me that I could come in and really help with that. So that's really cool and neat. Glad you guys are getting some good use with it. And certainly. Yeah, I think it'll be interesting to see just healthcare in general where AI is going to take us over the next few years. Honestly, probably faster than we think in some ways. So the other question is just, you know, kind of looking through your career and, and people that are up and coming, maybe veterinarians or newer veterinary oncologists, what advice or suggestions would you give them, even just from, you know, academia, private practice? What would be some good tips for them?
Dr. Ruslander: I think that the most important thing is stay involved, keep current, give back. I think that serving on committees is very engaging. It's very helpful. It helps with networking. You meet people that you wouldn't have met otherwise. And you really, you know, whether it's residency training committees or any really any committee, I think that those things are really helpful. I think that when you sign on to be a veterinarian, I think you're signing on for a lifelong endeavor, and it's easy to get complacent. And complacency is the enemy. And so, you know, I say the same thing that I say to the students and the interns, read, read, read and now where that information is really at the tip of your fingers at the keyboard is there's really no excuse not to stay current when we have patients that come in and it may be an unusual tumor. You know, before I go in, I do a little search and see if something has come up in the last month. And sometimes it is, and it may be something as simple as a retrospective study, but that information, it's a building block. And I think that is key to doing that. So I think that those things are, you know, critical to staying engaged and keeping it current and keeping you excited about what you're doing.
Dr. Venable: I think that is great advice and so true. I think if you just get complacent and don't really grow or challenge yourself, you get bored. And I think that's where some of the burnout comes from, too. You know, you just got to keep growing. And I like the suggestions on committees. I should probably be better about helping out with some of the committees, but that's a good tip to just stay involved. You know, you were the president of VCS. So you've certainly been highly involved in how was that experience?
Dr. Ruslander: A learning experience. I think that I never had a position like that. But you get to meet a lot of people. And I always say, yeah, it's I, you know, I work hard. It's not what you do 9 to 5, it's what you do from 5 to 9. And so, I have a previous mentor of mine and I used to say I need more time in the, you know, I need to find the time. And he goes, you know, we need to find the time. You need to take the time. You know, that is challenging. But I think that when you're seeing cases every day, you know, that becomes the norm. And I think that the things that you do outside of your 9 to 5, I think that that's what gives you the real rewards. And I think that, you know, going back to like, practice, you know, you, you know, there are tremendous opportunities in consulting, tremendous opportunities to interact with academic institutions. And I think that previously veterinarians, veterinary oncologists were kind of not thought of as helpful. But I think especially in the, you know, in the pharmaceutical industry and the biotech world, now that dogs are, you know, and to a lesser extent, cats are models for human disease. I think that, the biotech world is embraced, that I think that when you meet people that know about it, they're, you know, they're very enthusiastic when you meet people that don't know about it and you educate them, it's like, a window is open for them to utilize, you know, the value of, of veterinary oncology.
Dr. Venable: And I, I totally agree. And, I do think it is interesting how it's changed. Like you said before, we weren't maybe considered as valuable. But now, you know, just with the technology and the dog is being such a good model for people. And, and I think that you're 100% that there's so much more we can do. And I really like that thinking about what you do from 5 to 9, you know, what are you doing after hours and taking the time, not trying to find it. That's a good mind shift change and something for everybody to keep in mind, because we all get the exact same amount of time, right? There's always 24 hours in a day. So I really like that. And this has just been such a great conversation. I love learning more about your experiences and just tips on so many things, and just how kind and empathetic you are with your patients and just really enjoyed this.
And before we wrap up, I always like to ask everybody who's someone that you would recommend for this podcast?
Dr. Ruslander: Mike Nolan. He's a radiation oncologist, PhD at NC State. He's a real successful researcher and, you know, a great guy.
Dr. Venable: I totally agree. That's a fantastic guest. So I will definitely reach out to Dr. Nolan. So again, Dr. Ruslander, thank you so much for being on this podcast today. I know it's really going to help a lot of our audience.
Dr. Ruslander: My pleasure.
Dr. Venable: Well, that's it for this episode of the Veterinary Cancer Pioneers podcast. If you enjoyed this episode and gained valuable insight, we would be so grateful if you could share our podcast with your friends and colleagues. And it would be even more wonderful if you want to give us a five-star rating, positive review, or any kind of feedback on Apple Podcasts or wherever you listen. The Veterinary Cancer Pioneers Podcast is presented to you by ImpriMed.