NEAL:
Hello, and welcome to the American Cancer Society's Cancer Survivors Network, a service created by and for cancer survivors. I'm your discussion leader, Neal Sofian. We have three guests on the phone today who will give us some insight into the issues of being African-American and having cancer, and understanding that the African-American community is not a singular community but is actually a diverse collection of communities, each with its own unique needs. Also, we'll discuss ways to help yourself and take care of others.

Before we move to our guests, I'd also like to introduce my cohost, Michael Samuelson. Michael is the chairman of the National Consumer Advisory Council of cancerfacts.com, and is also a breast cancer survivor. Welcome, Michael.

MICHAEL:
Thanks, Neal. It's a pleasure to be here. And this will be a very interesting show. We talk a lot about cancer in general, and specifically within the disease, but also there are some cultural differences, and it's important to take a look at both the differences and the similarities. So we have our first guest, Freeman, from Southern California. Hi, Freeman.

FREEMAN:
Hi, how you doing?

MICHAEL:
I'm fine. Thanks for joining us. Freeman, you are 67 and a prostate cancer survivor, is that right?

FREEMAN:
Yeah, well, I've added a birthday since the last time we chatted and I'm now 68.

MICHAEL:
Good for you. Every one of those birthdays are reasons to celebrate. I also understand that you have not been sitting back and just resting, but that you are very actively involved in the whole advocacy issue of cancer, and that you are the director of the Prostate Activities for Marin County. Is that right?

FREEMAN:
Well, Marin County, San Francisco, and San Mateo.

MICHAEL:
Great, great. Why don't you give us some information about how you came to be in this position. I guess that goes back to your story, which I think is kind of interesting in that you had, according to our notes here, a normal PSA.

FREEMAN:
That's right, I did have a normal PSA, and had been checked annually in my physical exam by an internist. Oddly enough, I happened to notice on a bulletin board that there was an announcement for males who were over 55 needed for a prostate cancer screening research program. So I signed up for it and I went over to it and they did the usual things, took a blood sample. A urologist examined me and he says, "Hey, your prostate feels like a rusty piece of metal. I'm going to send this report to your doctor, and you should really see a urologist." And I did that, and I did have prostate cancer. I think my recent numbers were three and two. However, they were very close to the capsule, which meant that even though it was slow growing, I didn't have too much time to procrastinate. I did wait about three or four months, and decided to go ahead with surgery, even after a second opinion. So I chose surgery primarily because they assured me that it was still contained in the capsule. And that my life clock should still work. In other words, if you survive the surgery, you should live as long as you probably would have lived. So I chose to do that and I feel good about my decision. I don't feel that there was anything wrong with that decision, and I won't debate whether I would do something differently, because it's impossible to do that.

MICHAEL:
I think of two things. One is just a realization that what is, is. And you move forward with it. And also the fact that what you did was actually unusual regardless of any culture, and that's the fact that as a man, even though you were looking at a normal PSA, you still went forward and got more information.

FREEMAN:
That's right. When we say normal PSA, my PSA was less than four. I spent many years in medical research, anesthesia research, cardiovascular research, and those kinds of things, so therefore my curiosity is perhaps somewhat keener and refined than some other males. I was really in a position to say, "Hey, I want to get this behind me. Let's do something about it."

MICHAEL:
That certainly is a different perspective in general for the black American, African-American population. Is there a hesitancy, is there a reluctance? How does the culture respond?

FREEMAN:
Well, I do know that that six-letter word just knocks the wind out of everyone. How you go about dealing with it is one thing. My late wife was a medical social worker, and she always commented that African-Americans and Hispanics and so forth, once a person was ill, if they had a stroke or something...her specialty was neurosurgery...they would always take the person back home. The family would encompass this problem, absorb the problem, would be part of the problem. And I think this gets into how we were brought up. I don't know if my folks ever sat down and said, "this is your culture, this is how we have to behave, this is how your grandfather did it, this is how I'm doing it, this is how you shall do it." I think, because we sort of tend to isolate ourselves for protection, like in communities and so forth in major cities, we tend also to keep things to ourselves. And so we don't get up and broadcast. As an example, I wouldn't go out and walk around with a sign saying, "I have a problem between my hip and my kneecap." I don't think any man is going to do that. I may talk something in the barbershop, but that's basically it. And so I was really alone. And thank goodness, too, for my current wife. She was the one who really pushed me, and I'm thankful to her for that.

MICHAEL:
Does that tend to be part of the norm, that the women tend to be the ones who both probe the gentlemen to take action and...

FREEMAN:
I don't think that's an African-American thing. I think that's a tendency for all males.

MICHAEL:
Absolutely. I agree with you.

FREEMAN:
Yeah, I don't think... I would like the black community to take credit for something, but that's not one we can take credit for. So we all need the wives. Actually, my wife was the one who really found the prostate cancer support group, and got me to go to it.

MICHAEL:
So, issues like men and women, that's really not a cultural issue, all of us men tend to be that way. What are some of the cultural issues that you see that really are different between us?

FREEMAN:
Well, one is probably the lack of primary care. Or health care. A lot of African-Americans don't have the jobs that provide health care delivery or insurance, the benefits and things like that, so it gets to be expensive. And so therefore I think a lot of the numbers that I see in the tables before me now may be skewed a little bit, because we tend not to have the best of health care, only because we can't afford it. And so therefore by the time one is diagnosed with having prostate cancer, the numbers seem to be higher.

MICHAEL:
So it's not simply a racial issue.

FREEMAN:
But when you really get into the race issue...we put on a program at an all-black church here in San Mateo. It took a couple of months to put it together, and we had it right after service on a Sunday. The health committee of that church sponsored it, and we had an unusual turnout. We had like 23 men that showed up, all black, and quite a bit came out of it. They were curious, once someone broke the ice. It took about a half hour for the ice to be broken, now. Everyone was rather quiet, so we made presentations, and testimonials, you might say. "I have it and I've done something about it. I'm doing pretty good, and I'm here because I would like you to know about it so if you ever have it, you can get something done about it. And hopefully one day you can stand up here and say the same thing I'm saying to you." Those kinds of things. And eventually there got to be a lot of questions and answers, which was the ultimate goal. There really was an educational, I won't say show, but the purpose was to educate that audience about prostate cancer and what you can do about it.

MICHAEL:
We talked a little bit earlier before we went on the air and you seem to have a wonderful attitude and wonderful spirit. We often hear the whole issue of humor as being an important part of the whole surviving and thriving aspect of it. Have you found that in your situation?

FREEMAN:
Oh, of course, I would never disagree with that. In fact, I think that's true in any avenue, in any walk of life. You've got to laugh your way through it. I mean somewhere along the line, you perhaps can recall seeing on television shows, or have read about it or even witnessed yourself, that the black church itself-it's not a comedy, but we tend to enjoy ourselves at it. The songs, and the beat to the song, and the music and so forth, gets you to clap your hands, pat your foot, shake your head a little bit, and I think you need to do that in anything else you do in life.

It really is all in your mind. I think that that speaks for a lot of the prostate cancer survivors. You have to have a good mind to approach life, and you need to deal with your quality of life. Once you start really laughing at things and put some humor back into your life, you'll find out that there are lots of surprises out there for you.

MICHAEL:
What I'm hearing is it's a whole issue of attitude and how you view things, and the way that you kind of structure your own future, and this is an important part of it. I'm also real pleased to hear by the sound of the chimes in the back, that Lois has joined us from Allen, Texas. Hi, Lois.

FREEMAN:
Hello, there, Lois.

LOIS:
Hello there, how are you doing?

FREEMAN:
I'm just fine. Where are you, Lois.

LOIS:
Well, I'm in Allen, Texas, in the Dallas metroplex. I'm a prosthetic technician there. I was just listening to your story. It's quite interesting.

MICHAEL:
Well, Lois you've got an interesting story as well. You're a 25-year breast cancer survivor. Congratulations.

LOIS:
Yes, and I'm a breast cancer advocate and I'm an activist, also.

MICHEAL:
Well, Lois, I am an 8-month breast cancer survivor, so you and I have something in common.

LOIS:
That's great! I know quite a few males who are.

MICHAEL:
Wonderful. And you're also involved in Reach to Recovery.

LOIS:
I am a Reach to Recovery volunteer, also.

MICHAEL:
Great.

MICHAEL:
Lois, I'm very interested in your story, too, because you were diagnosed back in 1975. So that's quite a few years ago. You're still a young woman at 62, but you were considerably younger at that time. Tell us a little bit about your story. In particular, because you've come from a healthcare background, you've worked in that setting, the differences you've observed culturally with black women as opposed to women of other ethnic backgrounds.

LOIS:
That's true. When I discovered my lump, as everybody, you're frightened to death. So, for four days I saw four different physicians, finally the fourth physician I saw is the one that I was pleased with. I trusted him enough to remove the breast. Now, 1975 is when I had my surgery, and there wasn't a lot of information around. So we had to accept a lot more than we have to accept now, because there wasn't a lot offered.

MICHAEL:
Lois, did you find that in particular in the black community?

LOIS:
I did not. There were lots of ladies who were having surgery in 1975, but they were not talking about it. In 1975 it was just a hush-hush type thing. And we had to try and research and get the best information we could from whomever we could get it from. The literature was not as popular as it is now.

MICHAEL:
And in terms of today, have you noticed any differences with regard to cultural needs or attitudes on the part of black women in regard to discussion or treatment?

LOIS:
Sure. For the last 22 years I have been working with breast cancer survivors. A lot of them did not survive, but they did have breast cancer. Now younger adults, from 40 or 45 years old on back, seem to be a bit more inquisitive and more educated now and they are searching for all the answers that they can get. The older ladies, for some reason, they are not into reading, or they don't like to read, and they let quite a few things pass them by. Also, working with lots of ladies, I find that we have ladies who are caught between the insurance tracks. They either do not have insurance or they are between Medicare, or they are not the Medicare age, and some of them are on Medicaid. And some do not have insurance at all. So that does make a difference in how you feel as to the treatments that you're being administered.

MICHAEL:
Lois, does it also affect a woman's concern, or her coming forward for examinations, because of a fear of insurance?

LOIS:
That's true. That's true. We have lots of ladies who will do nothing about it until it's too late, and that is because of insurance. We have lots of ladies that don't feel good about themselves if they have to beg for health care. They would come forward more if the health care was more accessible for them. But when they feel like they have to beg for every treatment that's offered them, it does make a big difference in their lifestyle.

MICHAEL:
Lois, this is an issue that concerns all women; in fact, all patients who are involved with cancer. But are there any specific advocacy groups that are designed to help the African-American woman?

LOIS:
Yes. I am president of the Sister's Network, which is an African-American support group here in the Dallas metroplex. We are there as a support group, to give them support, and to try and tempt them to know how to access and get information, and where to go. There are several African-American groups out now that are trying to educate and help promote health care awareness for the African-American woman.

MICHAEL:
Well, I can tell from the notes and I can tell just by hearing your voice that you have a wonderful attitude, in that your religion and your family have played a very important role. Let's talk about that for a second. Attitude and belief in God and the strength of the family are not cultural issues because they're important for everybody. But do you seem to find a strength that comes in traditional values associated with the black family?

LOIS:
That's true.

MICHAEL:
And how has that helped you, Lois?

LOIS:
Knowing that you have people around you that really love you, that definitely does make a big difference in your health and well-being. Your physical, mental, spiritual, the whole bit, the whole being of the family, that does have a lot to do with how you react to life's problems and life health issues. All of those things that have anything to do with some tragedy that could be affecting your life.

MICHAEL:
Right now, what I'd like to do is to bring on Wesley. Wesley joins us from Rancho Palos Verdes in California. Hi, Wesley.

WESLEY:
Hi. Good afternoon, everyone.

MICHAEL:
How you doing?

WESLEY:
Great, thank you.

MICHAEL:
Wesley, my notes say that you're 59 years old, and you are a prostate cancer survivor.

WESLEY:
That's correct.

MICHAEL:
Also, you've spent your career in a medical care setting as a hospital administrator, but you were very proactive in going out and finding out about your own personal health, and then investigating what to do about it. Can you tell us about it?

WESLEY:
Yes, my background in my entire career has been in healthcare. First as a biochemist, and later I moved into administration. I recognized fairly early that I had some increased risk factors. As you know, I'm African-American. In my mid-40s I saw that I was developing BPH, and I sought relief from that. I concluded that because of those two factors, and the fact that my father expired from prostate cancer, that I was at a moderate to very high risk. So I decided that rather than just relying on the digital exams and the PSA, I wanted to take a different route, so I asked a urologist friend of mine to do a baseline ultrasound and biopsy. I said that I would just use annual or semiannual exams to observe my gland as time went on. Well, as it turned out, the first one, which I thought was going to be a baseline examination, came back "suspicious." That was in April of '97. We repeated the exam in August of '97, and it came back positive. I elected for the radical, which took place in October of '97. So that's how the disease was confirmed. I, too, as Freeman, had a relatively normal PSA-on the day of my surgery, my PSA was 1.8. There is a possibility, because of some anti-BPH medications I was taking, my PSA could have been artificially depressed. But nonetheless, it was very normal.

MICHAEL:
Now, you say that you did some watchful waiting and you thought you were going to go on for a while, but you ultimately went for surgery. Do you think that within the African-American community, people are presented with as many treatment options and alternatives? Or do you see differences between communities in terms of how treatment progresses?

WESLEY:
I agree with just about everything that Freeman said. I have difficulty with this particular point because, as you know, there is a fairly large middle class in the black community, on a percentage basis. Those people, by and large, have access to health care through their employment. But access to care doesn't guarantee anything. You have to take advantage of that access, and I find that's where a lot of attitudes come in. I think the attitude of linking prostate disease with sexuality is a big problem amongst black males. Many males defer treatment because they have reached the conclusion that any treatment for a prostate problem is a death knell to their sex life.

MICHAEL:
And so there's a lot of denial because of that?

WESLEY:
Yeah, I think so, and most of the people that I have spoken to on this issue were my close friends and fraternity brothers and people like that. It appears there's an attitude, a higher number of people who just don't want to hear it, if you will.

MICHAEL:
Wesley, how do you deal with that whole notion that sexuality and prostate cancer are such that men don't want to talk about it? How can we turn that into a positive, with regard to awareness?

WESLEY:
Well, that's the $64,000 question. I have basically said to people that I've spoken to individually, as well as in a group setting, that, you know, I'm not like I used to be, but I'm better than being dead. You know, you just have to be creative, and you have to set a different standard. When I'm talking to just men, I sometimes say to them, "You know, I've talked to some of the wives and they've whispered to me that, you know, you weren't really tearing down any walls before, so how significant is the difference?"

MICHAEL:
You know, Freeman, we talked earlier of the fact that there is a lot of hesitancy around this whole issue, and the importance of having awareness of early detection. That perhaps you don't have to deal with these issues of lost or decreased sexuality. Is that an issue that's been approached and dealt with in the community?

FREEMAN:
It has been approached in the community. But most males don't want to talk about that.

MICHAEL:
Absolutely.

FREEMAN:
I don't know of any of my friends who actually got out and talked about those kinds of problems. I'll give you a good situation: I play golf each year in Myrtle Beach, South Carolina, and have been doing so for about 30 years. And I do this with a bunch of my friends who were college classmates. We're all the same age, and when I retired, I went back to Myrtle Beach, in October. I asked the question, "Who has had prostate cancer? Are you all getting checked?" And you would think I had asked them to sell a dozen golf balls for ten thousand dollars. I mean, it was awfully quiet. So I started talking to them, and eventually one fellow did say that he gets up four or five times a night, and so forth, but that doesn't mean he had cancer. But, to close the story down, the next two years, two of the other members also had the diagnosis of prostate cancer. Only because of our age, really. But I think my asking the questions... They went back to Philadelphia, New York, etc., and got themselves checked. So two others now have had treatment for prostate cancer.

WESLEY:
I'd like to reiterate something that Freeman said earlier, and that is the word cancer... Based upon my observations, there's a stigma in the black community associated with cancer. I think more than any other disease. Somehow, you're considered a fallen angel, or fallen soldier, once you get cancer. It's a death sentence. The new attitudes, the new knowledge regarding treatment, and new longevities possible with cancer have not yet been communicated, or maybe accepted, in the black community, as it may have been in other communities.

MICHAEL:
Are you aware of any ways that you think might be more effective to get the word out in the African-American community?

WESLEY:
Well, what I have discovered in my own limited experience is you have to be persistent in talking with people. Freeman described his experience with his golf buddies. I had an identical experience with many of my friends, and I just had to keep prodding. I found that if I spoke to them on an individual basis, I was far more successful than I was in trying to talk to a group. And once you find one or two people who have influence with the group, that should only help. But I don't think that's any different than any other ethnic group.

MICHAEL:
Let me bring Lois back in for a second. Lois, we just talked about stigma, and we hear this across racial lines in terms of men. How about in your situation? Let's talk about black women for a second. Is there any stigma associated with cancer for black women?

LOIS:
Well, yes, to a degree. In this society that we are in now, there are lots of ladies that like to live better lives. There are ladies I see who are married, and they have reservations in really talking about it because of their husbands. A lot of them still feel as if the husband won't feel the same about them as before they had the surgery. And again, I must say that when I have patients that have been diagnosed with cancer, I just tell them that cancer is like arthritis or any other health problem. Left unattended, it will get worse. There are so many different kinds of treatment, now, for cancer, and if detected early, we can arrest it or we can slow it most of the time.

MICHEAL:
A couple of things... Is there an embarrassment aspect to it? Is there concern on the part of the black women that they will be loved less or desired less by the men in their lives, if they are public with this particular concern?

LOIS:
Yes. I have lots of ladies now, and I'm seeing more young, professional women who are either not married or are divorced or are single parents. When this happens to them, and by this I mean when they've been diagnosed with breast cancer, they do have some reservations as to what will happen to them later on. And these women are like early 40s, late 40s, early 50s, and they want to continue their life and their lifestyle in certain ways. They are concerned. They all worry about it. They do not want to talk about it openly, and they really need to.

MICHAEL:
Are you saying that they're hesitant, and they make decision choices based on how well they'll be accepted?

LOIS:
That is so true. That is true. I've tried to get them into all different support groups, because I'd like for them to hear other ebony groups talk, or hear other groups of women talk. I have a lot of them that I cannot get them in an integrated group, because they don't seem to think that everybody is having the same problem. So we are still having a few problems with that. They feel as if because they are black, they should be in an all-black group. And I have a little bit of a problem in trying to get them to intermingle with everybody, so we can hear everybody's problems.

MICHAEL:
Wesley, Freeman, do you also find that situation? That black men prefer to be with other black men discussing the issues, or is there more openness toward being in an integrated setting?

FREEMAN:
My friends, and those that come to my support group, and black males generally, I would say tend to talk more in their own circles. I have a few that, how can I say it, are socially aggressive, who will say anything, anyplace. But the average black male here in San Mateo County will more than likely talk only in his own inner circles.

MICHAEL:
Would this also apply in terms of seeking treatment primarily from an African-American physician?

FREEMAN:
No. Because there aren't that many African-American physicians. You see, that's the other thing. How can I say this? Wesley alluded to the fact, which is true, that there are a lot of middle class African-Americans, and we tend to not necessarily seek out African-American physicians. But we do have, through our own insurances, I won't say carte blanche, but we at least have a buffet. I mean we can look at the whole deal and determine which way we like to go, and we do ask questions about who is good, who's not so good, etc. But, when you get into it, I think white males would be the same way. I don't think a white male is going to get in a circle of black males and say a lot of things. I think that's just the nature of how we are.

WESLEY:
I agree a hundred percent with Freeman's observations. This is still a very functionally segregated society, and that situation is manifested quite significantly when we're dealing with issues that are of a very personal nature, like prostate cancer, or breast cancer.

MICHAEL:
Wesley, Lois mentioned that there is an organization for black women in terms of cancer. Recognizing that there is an inherent need to spend time in like demographics when we have issues that are very personal, are there organizations that are specifically set up to help the black male with regard to prostate cancer?

WESLEY:
Well, not really. But on the other hand, there is an organization that has been formed in the last year, of four guys, myself being one. It's called "Brother to Brother." We kept running into each other in the last couple years at a lot of these meetings dealing with this issue of African-American males in particular, and decided that we would bind ourselves together to try and do something about this. And we have done that. So this is a very small step in that direction.

MICHAEL:
Wesley, let me interrupt just for a second because that's very important. If I was a young black man who was recently diagnosed with prostate cancer and felt a little uncomfortable discussing it in a situation with other African-American men, how could I get in touch with you or with your organization so I could get more information about that?

WESLEY:
Well, you have my phone number. I can give you my e-mail address, which is wsholes@yahoo.com, and of course I can be an entry point for my colleagues. And one of the key reasons we formed that organization is that, as we went from place to place, we would hear Caucasians talk about a) the dilemma they had in identifying African-American organizations; and b) their difficulty in motivating them to do something. So we said, well, okay, we're here. We're tired of listening to this, so let's see if we can do something about that.

MICHAEL:
So you'd be happy if more than a couple people from here on the network contacted your e-mail and spread the word, so to speak.

WESLEY:
Oh, absolutely.

MICHAEL:
What I'm hearing you say, and this is very, very important, is that there may be number of men out there, literally hundreds of thousands of men, who do have prostate cancer but are very reluctant because they would like to find an organization like the one you are discussing.

WESLEY:
And there are some. If I could just take the opportunity to mention, there's a very interesting project under way. A joint project between the American Cancer Society and a Hundred Black Men, which is a national social organization for black males. The objective is to have a prostate cancer awareness and educational program to be administered through the local chapters of the Hundred Black Men clubs. A bunch of us were working on the development of that, and that appears to be very, very successful, through the sororities, and the fraternities, and the churches, as the others on the line have mentioned. In my view, that is the way to really get to the black community. You get the socially and financially upper classes through the sororities and the fraternities, and you get the entire community through the church.

MICHAEL:
And you make it a whole community effort. I'd like to ask all three of you, as we kind of begin to come to an end of this particular show, to reflect for a second, and share with us in a rather succinct way, what this experience has meant to you. We all know that there's pain and there's suffering and there's lots of fear associated with cancer, but there also can be some very glorious, spiritual, and transcending moments as well. In a positive sense... Wesley, we'll start with you, and then we'll go from there. What has been the most positive aspect of this for you?

WESLEY:
Well, I start off with the operating notion that every problem is an opportunity in disguise. After I was probably five to six weeks post-op, and I was reflecting on going back to my consulting business, I said, "No, I think there's a problem here. I think I need to work on this at least for a year." As a result of that, I've come to know just many, many, many very wonderful people like each of you on this call. I've had an opportunity to do things like this, and I think I may have done just a little good. So that year has long passed, and I'm dedicated to continuing this type of work.

NEAL:
So it's literally given you a new purpose.

WESLEY:
Yes.

MICHAEL:
And you've found a passion and you're able to move forward with it. Lois, how about you? You've been so active, but for you personally, what has this meant? What has having cancer meant to you?

LOIS:
Well, to be very honest, before I had cancer, I had run a pre-school. I've always been very active, and I can say I started public school at age 4. At age 4 I was in the first grade. When I was diagnosed with cancer, I think all I was thinking about was getting rid of the breast or whatever the area of the cancer was, because I had a wonderful husband, and a family at that time, and the only thing that I could think of was living. I did NOT want to die. Now, since I've had the surgery, I haven't been quiet for a moment. I have been very active in different kinds of organizations with the American Cancer Society, and then working with ladies who were breast cancer survivors, and trying to help them to cope. So that's just part of my life, reaching out trying to help someone else. I love people.

MICHAEL:
And it comes through. Freeman, how about you? What has been the positive aspect of being a cancer survivor?

FREEMAN:
Well, I actually get a charge out of education. To qualify that, I also conduct tours in a museum for kids, and you know you've reached a child when their eyes really open wide and they get nice and starry. Well, I do that in my support group. I realize I've reached someone, just getting the males to know that we're all here to help ourselves, and we need to get on to the communities.

But I need to add something to this conversation, and that is that I think we all are doing something now for the educational process of our cancer. So 25 or 30 years from now, hopefully all males and all females will be able to look upon cancer as something that is treatable, hopefully curable, and that we are not where we are now. And I have to say it that way, because one of the reasons why I'm doing what I'm doing now is in memory of my aunt and also my mother, who died of colorectal cancer. It's just one of those things. I'm here to do whatever I can. And so I have a very relaxed feeling in the evening when the sun goes down. I don't make a blues song out of it. I feel good about what I've accomplished during my day.

NEAL:
So I hear you saying, there's still a long way to go, but we've come a long way. And we need to recognize how far we've come, because that's what gives us the tenacity to keep right on going, because we can make it.

FREEMAN:
That is exactly right. Exactly right.

NEAL:
Well, just listening to the three of you, it certainly gives me hope that there will be, not just the three of you, but literally hundreds of thousands and millions of other people who have the same attitude you do, and that's going to move us all forward. That might actually be the right place to close today. So, Michael, I'd like to thank you for your assistance here in being my cohost, and I'd like to thank the three of you for being part of the discussion today. It's been very enlightening and educational, certainly for the two of us, and hopefully for all our listeners today. For the American Cancer Society's Cancer Survivors Network, I'm Neal Sofian.