 Good morning. Let's try and we will try and stay on time today. Thank you so much for taking time out of your busy schedules to come and visit with us. I'm Bob Figlin. I have lots of titles but it really doesn't matter. I'm here to support kidney cancer patients and their families and to talk about where we are where we're going and and educate you about a disease that I've spent over three decades of my life studying and today's conference is really when Nancy Moldauer and I started to think about how to formulate this you see from the agenda that that we basically ask the questions that you ask us. So rather than coming at this from the perspective of a physician who talks about kidney cancer in a very specific way we wanted to look at the kinds of things that are we're asked all the time in relationship to the disease that you are dealing with know about struggling with or being cured from. So we hope that it's going to be a productive day. We've tried to address the questions in a way that's at a level that's commensurate with how you'll understand and and most of our speakers today will be available for kind of off the off the side conversations as well. There are a few ground rules. I kind of say this every year but I just want to just reiterate this. We're here to talk about the approaches to kidney cancer the things that we think about and the challenges that exist. Many of you have individual questions about your individual situations but we try and keep this conference really not about a single individual but about approaches to people who are are challenged by this disease. So when you ask questions and we encourage you obviously to do so please be sensitive to the fact that there are other people in the audience that are at different stages different places different therapies and and we try and make it so that everybody can understand you know the question and the comments and be instructive. Bathrooms are right outside coffee will be there all day we'll have a break for lunch where you'll be able to meet additional people and a couple of acknowledgements. So we've done this with the kidney cancer association now this is the second time we've done it at Cedars last one was in December of 2012 about a year after I got here and it's nice to see some old faces because as I've traveled throughout Los Angeles for my days at UCLA where I spent almost two and a half decades to my time at City of Hope and now at Cedars it's wonderful to see people that I've met along the way and and and worked with and helped. So one of the things that I almost always do is is ask you in the audience to and it helps me and it helps other people because a decade or two ago this room would have been much smaller the participants would have been much fewer and the successes would have been more infrequent. So I think we've arrived at a time in our in our history of kidney cancer that is really quite remarkable and one of the ways to to get at that is to see and ask you in the audience where you are in the process by looking at it from the perspective of how long it's been since you're in effect to me. So let's start with the question of how many have had their surgery more than a year ago. How many have had their surgeries more than five years ago? Look around the room don't look at me. I know I can see all of you but you can't. How many of you had your surgeries more than 10 years ago? How many of you have had surgeries more than 15 years ago? Any of you with surgeries more than 20 years ago? Well that's you know that's you know it's it warms my heart to be able to see people in the audience who've had this disease for more than a decade and a half go and still going. And for those of you that have had metastatic disease are any of you in the audience that have had metastatic disease free of your cancer or controlled your cancer for more than five years? Please look around the room. Any of you for more than 10 years? Any of you more than 15 years? You can raise it it's almost 15. So you know that's I want I want you to just take that in and keep in perspective of the fact that in when I started my career in 1980 treating kidney cancer almost 35 years ago there wouldn't have been this group there wouldn't have been these survivors there wouldn't have been the opportunity for long-term control even in the face of metastatic disease and and am I satisfied with the outcomes? No. Am I encouraged by the outcomes? Yes. Can we still make incredible strides to continue to move the the goalpost further and further away? Absolutely and hopefully today you'll hear you know some of the ways that we're gonna do that and how we approach this disease from trying to make more people in this audience trying to create more opportunities for the people that are challenged by this disease and some of the discoveries that we're thinking about kind of every day. So thanks so much for coming.