Dr. Parmjot Bains Spills the Tea on Breast Cancer Related Lymphedema & Innovation

[00:00:00] Welcome to the HITea With Grace Podcast, where we spill the tea on HIT. I'm thrilled

[00:00:10] to welcome Dr. Parmjot Baines, CEO of Impedemid. Thanks for joining us Dr. Baines for a special

[00:00:16] lymphedema awareness month episode. Thank you, Grace. It is wonderful to be here and

[00:00:22] thank you for the opportunity. So great to have you and I can't wait to dive into this

[00:00:26] one. Tell me a little bit about the path that brought you to your role at Impedemid. Yes,

[00:00:33] no, absolutely. So I have just started this role. I had been at Impedemid now for two months

[00:00:39] as the CEO. Prior to coming to Impedemid, I was a trained as a medical doctor in Australia

[00:00:45] and New Zealand. And then worked at McKenzie Management Consulting for a number of years

[00:00:50] in drug development. And then was at Pfizer for the last eight years where I was running

[00:00:55] our most recent role was running our Pfizer business in the Gulf cluster of countries. So up

[00:01:00] and Dubai. So now I'm very excited to be able to come and work with Impedemid to really help

[00:01:05] women with lymphedema and with breast cancer. And in fact, people with other cancers that get

[00:01:10] lymphedema to really help bring this breakthrough that will truly change patients' lives.

[00:01:16] Wow, so interesting. I'm thrilled to have you on then for lymphedema awareness month. So we know

[00:01:22] it's lymphedema awareness month this month in March. And it presents us all kind of an opportunity

[00:01:27] to create public awareness of breast cancer related lymphedema. So what is lymphedema? And from

[00:01:33] an industry standpoint, what do you feel needs to be conveyed to raise awareness about this?

[00:01:39] Yeah, so lymphedema is really can be unfortunately a lifelong debilitating condition that results

[00:01:47] in swelling of the limbs, arms legs. Actually, lymphedema can occur anywhere in the body

[00:01:52] with a lymphatic system is for some reason breaking down. What we are looking at specifically at

[00:01:58] Impedemid is where a secondary lymphedema where lymphedema is a result of cancer. Where either

[00:02:05] the lymph nodes have had surgery on them or the had radiation therapy or some other intervention

[00:02:10] that means that the lymphatic system is no longer working properly. As a result, unfortunately,

[00:02:16] with lymphedema, this is treated early. Men and women can end up with chronic swelling of the

[00:02:22] limbs that can actually lead to infection and hospitalise. Oh man. Oh my goodness. So swelling of

[00:02:27] the lungs, what does that look like? Yeah, so early on it might just come up as a very, very kind of

[00:02:33] early swelling. The arm is a little bit bigger. Now technology enables us to measure up to three

[00:02:38] tablespoons of difference of fluid in the arm, which is wonderful because that enables early

[00:02:43] detection and treatment. Unfortunately, if it's not detected early, it can actually progressively

[00:02:48] increase in swelling. In the long term, it can actually lead to fibrosis so the arm can get quite

[00:02:54] kind of fibrodic and it can become very, very chronic. And unfortunately that fibrosis and when

[00:03:00] the fluid is not moving, it can actually lead to chronic swelling and infections. And in fact,

[00:03:05] yesterday I met one of our shareholders from Impedemid. It's a guy. He had melanomy surgery which

[00:03:12] took the lymph nodes out of his pelvic area. He has for his, for the last 10 years been unfortunately

[00:03:18] had severe lymphedema of the left leg and he's been in hospital five times to get this treated.

[00:03:23] So early detection is absolutely critical. So what measures can providers implement to ensure

[00:03:31] this timely intervention for patients that are experiencing this? Yes. So what we've got with

[00:03:38] Impedemid is a device called Sozo. And Sozo's had a very large scale clinical trial with 1200

[00:03:44] patients, or woman with breast cancer. And the intervention has been, patients are tested pre-surgery

[00:03:52] where we get a baseline measurement of fluid that is in their arms. And then immediately post-surgery

[00:03:58] and for the next three years, they tested every three months, that enables us to detect, detect,

[00:04:03] look at them very, very early. And when you can get early detection of lymphedema for what we call

[00:04:09] stage zero or stage one, putting a sleeve on the arm, like a compression sleeve on the arm for four

[00:04:14] weeks will actually completely resolve the lymphedema. So what we've got is patients with stage zero

[00:04:20] and stage one, so very early lymphedema pretty much that sleeve will get rid of, stage zero, the sleeve

[00:04:26] will get rid of all lymphedema. And so they're basically treated going forward. Stage one maybe 80, 90%

[00:04:32] of lymphedema will picked up and will be treated. And our clinical trial 92% of patients

[00:04:38] have their lymphedema resolved. If you leave it to stage three and stage four, it becomes a chronic

[00:04:43] endoblitarin condition. So early detection is absolutely critical. And what's interesting is that

[00:04:49] this device was compared to what was the historical and what was used was standard of practice

[00:04:54] was a tape measure. So a woman would have their arms measured with a tape. What this does is that

[00:04:59] enables the early detection through bio-empedance testing. So measuring an electric current through

[00:05:04] the body and getting a very accurate assessment on the fluid levels and the limbs.

[00:05:09] Wow. And so are you using kind of predictive algorithms as well as part of that or is it mostly

[00:05:16] the physical physiology? So it's actually right now it's using just the electrical currents,

[00:05:22] we basically have a lot of work with this device. The device is over 10 years in development.

[00:05:28] And so we've got a mathematical algorithm that actually looks at what is the fluid level and then

[00:05:32] we compare it to the range of normal. What happens with women and the men that get tested for

[00:05:38] lymphedema, women's breast and you know we're picking up a melanoma and other cancers as we set

[00:05:44] a baseline for that patient. So that's why the pre-op testing is very normal because everybody will

[00:05:48] have a different level of fluid in their arms and legs. So we set a norm in a baseline for them

[00:05:53] and then we'll basically keep testing patients over the next two to three years because people can

[00:05:58] trouble at any point over those next three years. And we've seen that it won't have been immediately

[00:06:03] up the surgery, we've seen patients trouble two years after surgery or three years after surgery

[00:06:08] so it can happen at any time. And so it's very important to give a very close eye on it.

[00:06:13] The true I can't imagine and it's wild that you could help it if you catch it soon enough. So

[00:06:20] which healthcare providers should be prioritizing raising awareness and proactive measures to make

[00:06:25] sure you're getting that timely intervention? Yes so we're talking with most pluses at the moment

[00:06:33] are the breast cancer surgeons or the surgeons that are operating. So lymphedema is if you look

[00:06:40] at women there are about 300,000 breast cancers in the United States, Pranum. What's amazing is

[00:06:47] now they're treatable. A lot of cancer is now treatable but unfortunately the side effects and

[00:06:53] complications of treatment are still there and lymphedema is probably one of the most treated.

[00:06:59] And so we work very closely with breast cancer surgeons to make sure that everybody is aware

[00:07:04] of the risk of lymphedema, we've got patient education material to make sure that patients

[00:07:09] are aware of lymphedema. This is a risk and so we're working with them to make sure that this

[00:07:13] device is available in the breast cancer surgeons offices. What's most interesting and wonderful

[00:07:21] is that because of the importance of this disease and the life long debilitating nature of it,

[00:07:27] the US private payers are also reimbursing this now so the cost is very very important.

[00:07:35] And so the cost of the test is now being covered. So you know we're picking up significant

[00:07:40] momentum on pay coverage. So we have 16 states in the United States, we're over 80% of patients

[00:07:46] are now going to be reimbursed and we are seeing significant momentum that hopefully by the middle

[00:07:51] of this year at least 85% of the country will be covered in terms of this. And Medicare is already

[00:07:56] covering it. Wow that's fantastic news. I mean so critical to be able to support

[00:08:02] these men and women that have breast cancer related and lymphedema. So are there any legislations

[00:08:08] that you're tracking around lymphedema, around breast cancer that impact that people should know

[00:08:14] about and what do they speak to? One great piece of legislation in the United States is the

[00:08:22] Lymphedema Treatment Act which has really helped shape the landscape for lymphedema treatment.

[00:08:28] As recently as a beginning of this year, Medicare coverage has basically provided for reimbursant

[00:08:34] of those compression garments. So that's for lymphedema really for men and for women. So men will often

[00:08:41] get it as a result either primary that for some physiological reason or through surgery, being a

[00:08:48] melanoma surgery or other surgery within the lymph nodes are being impacted. So there are three to

[00:08:53] five million men, women and children living with lymphedema in the United States. So this treatment

[00:08:58] assignment to law in December 2022 now provides coverage for those compression garments which,

[00:09:04] you know, we're there for detection and early detection but we really need the supplies and the

[00:09:09] compression supplies for enable treatment. So what do the compression garments look like?

[00:09:16] To me, like somebody that's having this tremendous swelling because of breast cancer related

[00:09:22] lymphedema, what are what do they like? What would people expect to see when they get one?

[00:09:28] Yes. So they just they can be sleeves. So generally just sleeves or gloves or but you know for

[00:09:33] if it's men or even women that have had surgery in the pelvic region, it will be a stocking. So

[00:09:38] it's basically just a compression garment that will really compress the lymphatic system back up

[00:09:44] and what was interesting is in the clinical trial, you know we had we did our trial on women with

[00:09:48] breast cancer just four weeks of wearing that sleeve resulted in 92% of women resolving the

[00:09:55] lymphedema. So if I were to eat four weeks of wearing the sleeve, yesterday the gentleman that I

[00:10:01] met that had had the melanoma, he has to wear it all the time. So you know four weeks of treatment

[00:10:07] with early detection is you know so much better than a lifetime of wearing that stocking or

[00:10:12] the sleeve garment on your arms. Yeah. Well how does this lymphedema kind of impact the day to day?

[00:10:19] You know what what are the challenges these patients and even their caregivers are facing

[00:10:27] when the people they love or they themselves are experiencing it? Yeah, what's the quality of life?

[00:10:34] Oh look it's just depending on how that disease progresses it can you know it can be a life-long

[00:10:43] disability, it's the arms over time can just will just be really large and can't end up being

[00:10:50] fine-broadic. I actually met with Dr. Lynch who is one of our breast cancer surgeons who's using

[00:10:55] Sozo at Yale in New Haven so very close to you you know Matt Pazzoa going she was telling me the

[00:11:02] story of this young woman who had breast cancer and had the surgery and was really struggling to

[00:11:08] look at that era of her breast just because it's so you know she was a young model, she's a beautiful

[00:11:13] young lady. Came back and then just didn't really want to look at her arm or check under arm and

[00:11:18] she said you know we used the Sozo and she had lymphedema right like very early in the

[00:11:23] day. Just a little bit wrinkling under the arm. So luckily they caught that early but you know can

[00:11:27] you imagine that just that lifelong effect swelling continuing and having picked up it would have

[00:11:33] progressed. This gentleman yesterday that I met had the melanoma he's been in hospital five times

[00:11:39] he said he keeps the weight as a infection of the legs and so it's if not treated early it can be

[00:11:47] a real problem and historically 20% you know the data in the US shows 20% of women got lymphedema

[00:11:56] so it's a lot of not for Dema's sufferers that if we can detect early you know we just don't need to have

[00:12:03] absolutely absolutely. You know what role does patients now sharing their stories play in making

[00:12:10] real change happen you know as it relates to lymphedema or just healthcare generally what is your

[00:12:15] experience been with the power of the patient's story? Yeah the patients are just so

[00:12:21] even even you know I practice medicine but even and even now I the hearing the patient's stories

[00:12:27] just brings it all back to life because really you know we are here to bring these breakthroughs

[00:12:33] that change patients lives right and patients are at heart of everything that we do and they're

[00:12:37] everything that we do here at an end of it as well. And so it just really helps to resonate with

[00:12:44] providers with patients have the strongest voices and are really the best advocates for their

[00:12:50] own healthcare and their own technologies. So it's you know we are sharing patient stories every time

[00:12:57] I hear a story I try to share it and I try to amplify it we've just started a partnership with

[00:13:02] Susan G. Coleman who is the big big breast cancer ad because he grew up in the United States

[00:13:07] just to make sure we are helping elevate that patient voice and that when a woman has breast

[00:13:12] cancer surgery I want her to be googling this and to know that lymphedema is a problem and to be

[00:13:17] asking her surgeon you know or who any of her therapists as she goes through this journey

[00:13:22] you know I would like to be screened early so that I can stop and not have lymphedema for the rest

[00:13:27] of my life you know for what is now a very treatable condition. So powerful so powerful and I love

[00:13:34] that you're doing that you know if you can give our listeners an example of what they should be

[00:13:39] looking for you know in terms of lymphedema can you kind of share a little bit just about what they

[00:13:44] would need to look forward to to think maybe I need to go in and have somebody take a look at it.

[00:13:49] Yes no exactly so with women you know or anyone that's having any kind of surgery or even

[00:13:56] radiotherapy on any of the lymph nodes up in the upper limbs or in the pelvic region is just to be

[00:14:03] aware that lymphedema is a risk right and so what you know the thought is the knowledge and the

[00:14:09] understanding is that for breast cancer patients 80% of women are at risk of lymphedema right so

[00:14:15] 20% will get it but you know pretty much everyone needs to think that they are at risk of lymphedema.

[00:14:20] So pre-op you know if you know that you're going to get some kind of surgery intervention is to make

[00:14:25] sure that you are getting screened you know we are we are working very hard to make sure that

[00:14:30] sozo is available in all centers in the United States but even just to take measure so just

[00:14:35] to screening to say look at someone just checking me and screening me you know the US has a wonderful

[00:14:41] community of lymphedema therapists whose job it is to help manage lymphedema so to make sure that

[00:14:46] are you being screened first and foremost and then just keeping an eye out for any swelling but

[00:14:51] you know the brilliance of the technology is that it will detect it before you can see it

[00:14:56] because it can detect tablespoons of difference of fluid between the two arms and so that's

[00:15:02] when we've got to catch it right it's not when it's visible it's there and you're progressing

[00:15:07] you know further down but still it needs to be traded even if you can see any kind of swelling

[00:15:12] more difference in the arms. Thank you for sharing that so critical you know and I'm wondering how

[00:15:18] does your personal experience of healthcare impact the work that you do you know what has been some

[00:15:23] of the experiences you've had as a physician or as a patient that really just made an impact and

[00:15:29] keeps you going keeps you moving in this kind of role you're in now. Yes absolutely both you know

[00:15:35] physician as a patient as somebody that has worked in healthcare for a number of years it's really

[00:15:41] it's always been about the patient and bringing that medicine or the device or the technology to

[00:15:46] the patient and when our first joint advisor one of my roles which was fantastic and it really

[00:15:51] brought a lot of this home was we were building global public health programs to bring medicine

[00:15:56] to patients and low income settings and so my job was to bring cancer treatment and what we did

[00:16:01] was a partnership with the American Cancer Society and the Clinton Health Access Initiative

[00:16:06] to bring cancer medicines to patients in Africa and so when you're out there you know they really have

[00:16:12] very few products available or the products they were getting were counterfeited or

[00:16:17] and so the doctor would give me stories that would say like we know it's not working because

[00:16:21] people's hair isn't falling out so we actually think that it's there's actually nothing in there

[00:16:25] so it was and then it's just to make sure high quality medicines got to patients because without

[00:16:30] these medicines or devices or drugs you know there's not much you can do is a healthcare provider

[00:16:36] right like they're just so critical so our job is to make sure that we get this to every patient

[00:16:42] that needs it and that's always been just first and foremost in my mind is we live in a wonderful

[00:16:48] world of amazing technologies and amazing products but if we can't communicate to the patients

[00:16:54] and to the doctors to get this out there then we want to get the impact that we want to have.

[00:17:01] Sounds like you're a changemaker you're not someone that could just sit back and let things go

[00:17:05] you've got to make the change and make it happen which I love that so you know as a busy career woman

[00:17:11] you know making an big impact in this area you know I'm wondering what are some things you do in

[00:17:16] your personal life so that you can work your best in and make a difference do you have any habits

[00:17:20] that you do on a day-to-day basis that just keep you going and keep you revving up whether it's

[00:17:26] working out or eating right or even a mindset that you keep. No actually because it's not just

[00:17:33] I'm not just a career mother I'm a mother of three so 21 wow wow yeah 15 year old so yeah no trying

[00:17:43] to try to try to balance and and you know get the most out of everything right you know do the

[00:17:50] children going through university now or college as you understand the US in high school I do exercise

[00:17:57] every day so it is just one of my non-negotiables a number of years ago I decided to make it a habit

[00:18:04] and say you know what I'm going to make an exception if I don't exercise as opposed to if I do exercise

[00:18:11] because you know the past used to be like oh I went to the gym today and then I thought no I need

[00:18:15] to switch that mindset I need to be that oh I didn't go to the gym today so really making things

[00:18:20] a habit differently trying to eat well you know the great thing about the Sozo devices it's not just

[00:18:27] measuring fluid it also measures body composition so it can actually measure your muscle mass and

[00:18:34] your your hydration status and your you know your muscle levels so I've actually started looking at

[00:18:39] that too and just thinking okay well how am I going on muscle and sleep you know sleep is the

[00:18:44] most important thing we just have to you know make sure that you sleep well and fully rest so

[00:18:50] that you're on your best people underestimate the value of sleep you know they know that they need

[00:18:55] to work out they know that they need to eat right but then they're on their phones late into the

[00:18:59] evening and not getting the rest that they need to to have the energy to do the rest of things

[00:19:03] that they need to do so I love that you said that and I hope that you women who are listening in

[00:19:08] get some good rest tonight please for you and for everyone around you it's it's you can't

[00:19:14] or into others when you're pouring from an empty cup I'm so I'm wondering um Dr. Parmjot you know

[00:19:21] what are some things that you do to overcome challenges in your life you know obviously we are hit

[00:19:26] you know nonstop with things happening in society or things happening to us people passing away

[00:19:32] there's lots of I know you've seen a lot of experience a lot of grief in your life just through

[00:19:37] the type of work that you're doing um and so what are things that you do to just stay resilient

[00:19:43] stay on top of things and keep going on yeah no no exactly you know what I think we always have

[00:19:50] our ups and downs and as you said you know life life comes comes full of challenges um I you know

[00:19:57] I've got this underlying philosophy of you never step in the same river twice

[00:20:02] so you know life is always so one thing is the mindset life is always going to change right it will

[00:20:07] never be the same um you will always you will just always need to continue to adjust um and you know

[00:20:14] that water is gonna keep changing and keep flowing and just just learning how to flow with it um

[00:20:19] and and just stay healthy and strong and resilient and an open-foot discussion and dialogue and

[00:20:25] communication um I love that I love that that concept of the river and being one with the flow of it

[00:20:32] right that makes sense if you could give your younger self a piece of advice whether it be personal

[00:20:39] or professional what would it be I know that's one of them but I'm sure you have other things

[00:20:43] you'd love to tell your younger self or somebody else a young woman looking to get into the type

[00:20:48] of career that you are in now yeah I um you know I one of the things I've we didn't realize when

[00:20:55] I did I started doing medicine and I watched as a doctor and you always think you're going to do

[00:20:59] the same thing you're going to do but I have had so many career changes um the things that I would never

[00:21:05] thought I would have done um and so just keep open to what's coming you don't always know what the

[00:21:11] next step is going to be um I've always kind of looked at my career as building sexist capabilities

[00:21:17] and so really lettering up those and so building it up and then eventually it will all come together um

[00:21:22] but just be open to change and be open to new experiences um

[00:21:27] yeah that is a great piece of advice and I'm going to take it for myself so thank you

[00:21:33] so to finish off this conversation right you know we talked a lot about lymphedema awareness

[00:21:39] month and things that people should be aware of and education about it um and about your personal

[00:21:44] life but where can our listeners find you online to keep learning from you and growing from you

[00:21:48] in your insights oh absolutely so um firstly just impediment.com so i-m-p-e-d-i-n-e-d.com

[00:21:56] says a website um lots of just wonderful information there um LinkedIn is the other key area that

[00:22:03] you know I think as a professional uh a LinkedIn person um so yeah just look at those areas and we

[00:22:09] you know we do a lot of social around um particularly around lymphedema awareness and um yeah

[00:22:15] and these wonderful conversations with like with you and Grace.

[00:22:18] So well i'm so happy you got to come on today you know before I forget thank you for sharing

[00:22:23] that with us but before I forget did you happen to bring tea with you and tell me about

[00:22:28] either your tea or your mug. Exactly you know my mug my mug is just a local mug from from a shop

[00:22:33] here in Sydney which which I really love in fact is it's I want to my go-to presence and I give to

[00:22:38] people I think because i love it it's such a nice mug it's like it's like his blue kind of different

[00:22:43] shapes and it looks kind of like it was handcrafted. Very cute but the tea the tea is the one the

[00:22:49] interesting one um when i the last two years i was working up in the golf so i was the country manager

[00:22:54] for Pfizer for the golf cluster of countries based on Dubai looking after five markets but it did a

[00:22:59] lot of travel and so i went with a very close friend to Azerbaijan um barcode. I hadn't realized

[00:23:06] as a birthplace of oil and so it really you go these like oil yeah i know oil and gas literally

[00:23:10] is gas burning um on the mountains because it's like they've had oil and gas there but they have

[00:23:15] amazing tea because it's all very close to Turkey and so we just spent a lot of time drinking tea

[00:23:21] so my Azerbaijanity um is the one these days uh running low because it's you know it was um about three

[00:23:28] four months ago i went um so yeah that's my tea of the day and i have to track some more down.

[00:23:33] Well that sounds delicious thank you for sharing that with us and thanks for coming on the show today.

[00:23:38] Yes thanks for having me, Grace it was a lovely conversation

[00:23:42] and thanks to you folks for joining us too check out the high tea with Grace podcast website

[00:23:47] for more great guests like dr. Parmjat today cheers

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