WEBVTT - The Doctor Will See You Now

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<v Speaker 1>This is let's be clear with Shannon Dorney. Hi, everyone,

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<v Speaker 1>this is Let's be clear with Shannon Doherty. I want

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<v Speaker 1>to thank you for listening to my podcast and for

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<v Speaker 1>your kind and encouraging words on social media. As you

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<v Speaker 1>may know, there are many people with me on this

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<v Speaker 1>cancer journey, and today I'm joined by someone instrumental in

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<v Speaker 1>my treatment. The Hollywood Reporter named him one of Hollywood's

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<v Speaker 1>top doctors. Please welcome doctor Lawrence Piro.

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<v Speaker 2>Hey, Shannon, happy to be here. Hi.

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<v Speaker 1>How are you.

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<v Speaker 2>I'm good?

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<v Speaker 1>How are you? I'm good. I had a very long day,

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<v Speaker 1>but nothing I would look forward to more than a

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<v Speaker 1>glass of wine and a conversation with you.

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<v Speaker 2>Something we've done quite often and every time it's enjoyable

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<v Speaker 2>and unpredictable.

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<v Speaker 1>Unpredictable it is a really, really good word for it.

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<v Speaker 1>Can you please, just for you know the people listening in,

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<v Speaker 1>tell us your full title, your specialty, and what hospitals

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<v Speaker 1>you're affiliated with.

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<v Speaker 2>Well, I'm doctor Lawrence Pirerou. My title is CEO of

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<v Speaker 2>the Angels Clinic and Research Institute, which is an affiliate

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<v Speaker 2>of Cedar Sinai, which we started about twenty three years ago,

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<v Speaker 2>and I'm an medical oncologist, so kind of the overall

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<v Speaker 2>quarterback of the ecology team in terms of diagnosis and

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<v Speaker 2>planning treatment and coordinating all the treatments.

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<v Speaker 1>And is your oncology specialty breast or a multitude of

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<v Speaker 1>different cancers.

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<v Speaker 2>Well, it's a multitude of different cancers, and I've done

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<v Speaker 2>research in a number of different areas, but breast is

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<v Speaker 2>an area where I've treated in an extensive amount of

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<v Speaker 2>patients over my entire forty year career.

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<v Speaker 1>And you are published, are you not?

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<v Speaker 2>I am?

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<v Speaker 1>Can you tell me a little bit about that.

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<v Speaker 2>Well, I've been a researcher and a developer of treatments

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<v Speaker 2>from the beginning of my career. I was actually still

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<v Speaker 2>a fellow when published on the first which was a

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<v Speaker 2>drug that put a disease called harry sel leukemia into

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<v Speaker 2>remission in ninety eight percent of cases, and it was

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<v Speaker 2>a kind of a worldwide attention item because there was

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<v Speaker 2>almost nothing that would put that number of people into

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<v Speaker 2>a mission with a single treatment. So I was quite

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<v Speaker 2>a breakthrough and that spawned my career starting when I

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<v Speaker 2>was in my late twenties. That spawned my career in

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<v Speaker 2>investigative oncology and creating targeted treatments, and I was part

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<v Speaker 2>of the development team for all of the clinical trials

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<v Speaker 2>that led to the approval over Tuksan, which was the

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<v Speaker 2>first monocle and antibody ever used in Man and approved

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<v Speaker 2>as a drug. So we had a really great experience

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<v Speaker 2>with all that, and that of course opened up a

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<v Speaker 2>whole new field of drugs and now there are you know, many,

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<v Speaker 2>many and a lot of people actually got monocle antibodies

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<v Speaker 2>for COVID. I remember, yes, I'm sure that was a

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<v Speaker 2>fun thing to be involved with. And I have a

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<v Speaker 2>medium to large institute with a lot of oncologists doing

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<v Speaker 2>great work and doing research and all different kinds of things.

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<v Speaker 2>And I treat a wide variety of diseases because a

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<v Speaker 2>lot of times the relationship is the important thing.

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<v Speaker 1>Yeah, So in other words, you're like no joke, You're

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<v Speaker 1>like the no joke doctor. So, just to give our

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<v Speaker 1>listeners a bit of history, I got diagnosed with breast

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<v Speaker 1>cancer in twenty fifteen. I went to a different oncologist

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<v Speaker 1>and had not a very successful sort of treatment in

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<v Speaker 1>the sense of nothing was really changing. I still had,

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<v Speaker 1>you know, a tumor in my breast. I still wasn't

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<v Speaker 1>getting surgery. I kind of was feeling a little bit lost.

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<v Speaker 1>The drug that this particular in college just had me

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<v Speaker 1>on put me in a menopause. I wasn't properly warned

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<v Speaker 1>about that. I was definitely feeling adrift, if you will,

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<v Speaker 1>in my sort of cancer journey, and I knew that

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<v Speaker 1>something needed to change. I just didn't know how to

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<v Speaker 1>change it. And most of the time, a lot of

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<v Speaker 1>patients feel as if they don't have the right to

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<v Speaker 1>ask for a better doctor or to change doctors, or

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<v Speaker 1>they're scared their insurance won't cover a new doctor, or

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<v Speaker 1>they feel like they can't change doctors. And I felt

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<v Speaker 1>that for a minute until I got a phone call

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<v Speaker 1>from my friend Chris, who said he was good friends

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<v Speaker 1>with a mutual friend of ours, David, and David really

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<v Speaker 1>wanted to introduce me to this oncologist that he said

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<v Speaker 1>saved his father's life with cancer and he felt very

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<v Speaker 1>strongly about and that meeting happened to be when I

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<v Speaker 1>met you. Do you want to tell us about it?

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<v Speaker 2>Sure? Well, David Charvey called me and said, would I

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<v Speaker 2>be willing to have dinner over at Chris's house and

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<v Speaker 2>meet Shannon. She was going through a little cancer problem.

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<v Speaker 2>They thought if we'd met up, we might be a

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<v Speaker 2>good team, and so I said, yea, I'm sure, I'm

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<v Speaker 2>happy to. So we had dinner. You know, usually in

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<v Speaker 2>that kind of a situation, it's a it's kind of

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<v Speaker 2>a dance, you know, because you're like, it's like a

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<v Speaker 2>blind date. Two people who are invited to a get

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<v Speaker 2>social gathering for a purpose, and everyone kind of knows

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<v Speaker 2>the purpose, but you're supposed to act like you don't

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<v Speaker 2>know the purpose.

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<v Speaker 1>It's so true, that great way of describing it.

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<v Speaker 2>Yeah, So you usually dance around each other and like, well,

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<v Speaker 2>who's gonna who's going to reveal that they know the

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<v Speaker 2>purpose first and put it out on the table and

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<v Speaker 2>square it all up. And that, however, didn't play out

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<v Speaker 2>that night, because neither you nor I are kind of

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<v Speaker 2>beat around the bush people. So we just like jumped

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<v Speaker 2>right in. Yeah, and within five minutes we were pretty

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<v Speaker 2>connected and pretty sure that we understood one another and

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<v Speaker 2>pretty good, pretty sure that we'd be a great team together.

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<v Speaker 1>Yeah. I felt like you understood why I was feeling

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<v Speaker 1>a bit lost, and you definitely had opinions on what

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<v Speaker 1>should change and what needed to get done immediately, And

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<v Speaker 1>I really respected the fact that you had like a

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<v Speaker 1>strong standpoint and you weren't intimidated by me by who

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<v Speaker 1>I am, but also more importantly by my personality. You

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<v Speaker 1>you know, you have just as bigger for personality as

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<v Speaker 1>I do. So we were able to really mesh on

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<v Speaker 1>that level. And I know that for me personally, I

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<v Speaker 1>kind of felt like, oh, I think that this is

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<v Speaker 1>somebody who is going to really be thoughtful with my care,

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<v Speaker 1>which was incredibly important to me. And he understands that

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<v Speaker 1>there's nothing more integral than me tackling this and getting better.

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<v Speaker 1>And you insisted that I come in like right away.

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<v Speaker 1>You were like, Okay, let's get started. I think we've

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<v Speaker 1>met on like a Friday or Saturday night and you're like, great,

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<v Speaker 1>we're getting you into the clinic on Monday. You were like,

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<v Speaker 1>let's go.

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<v Speaker 2>Yeah. Well, you know, you you had there are a

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<v Speaker 2>lot of things going on in your situation that we

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<v Speaker 2>knew that we needed a change, and I wanted to

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<v Speaker 2>get changed right away because time was of the essence

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<v Speaker 2>for many reasons, not the least of which was you know,

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<v Speaker 2>there were delays and diagnosis, and then you'd been on

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<v Speaker 2>a form of therapy that didn't seem to be really

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<v Speaker 2>you know, anything getting the job done the way, and

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<v Speaker 2>you had a lot of side effects from it. So yeah,

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<v Speaker 2>I wanted to get started right away. And you know,

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<v Speaker 2>I said earlier that you know, sort of who I

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<v Speaker 2>choose to treat is guided in part by how important

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<v Speaker 2>the relationship is. And that is the most important thing,

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<v Speaker 2>because you know, everyone deserves world class self care and

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<v Speaker 2>that's required, but not sufficient. Everyone requires also a world

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<v Speaker 2>class patient experience because if you get even if you

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<v Speaker 2>get great care, if you get PTSD trying to get

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<v Speaker 2>the care, then the coalit of your life is not

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<v Speaker 2>good at all. And so that there are a lot

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<v Speaker 2>of things which affect that process, the patient experience. But

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<v Speaker 2>a big part of it is the doctor patient relationship.

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<v Speaker 2>And that's kind of a hackney term, you know, it

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<v Speaker 2>sounds so especially in our case, it sounds so like

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<v Speaker 2>official and a doctor patient relationship, but it is a

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<v Speaker 2>very important thing and it's about, you know, it's about

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<v Speaker 2>the patient believing that you're going to do everything for them,

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<v Speaker 2>that you're going to think about their case thoughtfully and

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<v Speaker 2>importantly individually. You're going to think about their individual case,

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<v Speaker 2>not just you know, what category you fit into you're

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<v Speaker 2>fit into this stage and this disease and third line

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<v Speaker 2>treatment or whatever, but actually your individual case and what

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<v Speaker 2>are the nuances for for example, we've chosen things at

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<v Speaker 2>times that you know, we're guided by efficacy against the cancer,

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<v Speaker 2>but also by whether it makes you lose hair or not,

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<v Speaker 2>because that sounds like super trivial hair versus cancer, but

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<v Speaker 2>it's not at all, because hair affects your view of yourself,

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<v Speaker 2>and your view your self effects your engagement with the

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<v Speaker 2>treatment and how much you believe in the treatment. It

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<v Speaker 2>affects one's ability to work in some cases. You work

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<v Speaker 2>in a business where you can't work much if you

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<v Speaker 2>look like you're sick. And so there's like so many

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<v Speaker 2>things that come into the factor of individualizing the treatment

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<v Speaker 2>or other side effects that you're willing to have or

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<v Speaker 2>not willing to have, not necessarily because they are visible

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<v Speaker 2>to other people, like hair, but they're important to you personally,

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<v Speaker 2>whoever the patient is. And some people can tolerate certain

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<v Speaker 2>kinds of side effects like they're charging to a war,

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<v Speaker 2>and other people are just completely debilitated by those side effects.

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<v Speaker 2>I don't think that most people realize that patients do

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<v Speaker 2>make choices almost as much by side effects as by efficacy,

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<v Speaker 2>not as much. I mean, there's always more power given

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<v Speaker 2>to efficacy as there should be, but it's a pretty

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<v Speaker 2>close balance because you know, especially in these days where

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<v Speaker 2>fortunately we have lots of treatments that if they can't

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<v Speaker 2>make you go into omission completely, they can keep you

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<v Speaker 2>in our mission for a long period of time with

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<v Speaker 2>a low level of cancer, and then there's going to

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<v Speaker 2>be another thing after that and another thing after that.

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<v Speaker 2>So it's a long journey. And if you are having

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<v Speaker 2>side effects that are just intolerable to you all through

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<v Speaker 2>that journey, then it's a long journey of miserable life.

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<v Speaker 2>And what people's goal is and of course should be,

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<v Speaker 2>and what the doctor's goal should be for you is

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<v Speaker 2>a lot if it's not curable, then a long journey

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<v Speaker 2>of the highest quality life.

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<v Speaker 1>Yeah, I mean, I think quality of life is so

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<v Speaker 1>incredibly important because if your quality of life on a protocol,

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<v Speaker 1>on a treatment is very poor, then you definitely fall

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<v Speaker 1>into a depression, and that depression leads you to kind

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<v Speaker 1>of give up. And I you know, I know there's

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<v Speaker 1>no like science behind my particular kind of thinking that

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<v Speaker 1>you know, med speak for themselves and everything else. But

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<v Speaker 1>I do believe that mind over matters incredibly important. I

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<v Speaker 1>believe in the power of the brain and power of suggestion.

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<v Speaker 1>So if you're feeling really good, if you're in a

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<v Speaker 1>good place, and you're believing in your protocol and you're

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<v Speaker 1>okay with it and it's not totally working your quality

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<v Speaker 1>of life, then you're going to feel all sorts of

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<v Speaker 1>positive energy towards that protocol, which I think ends up

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<v Speaker 1>making the protocol work a little bit better. That's just

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<v Speaker 1>been my experience thus far on the protocols i've been on. Again,

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<v Speaker 1>I know that there's zero science behind that.

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<v Speaker 2>Well, certainly, certainly, you know, there's lots of hormones and

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<v Speaker 2>signals that are released by the brain that you know

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<v Speaker 2>translate into a sense of well being, And if you

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<v Speaker 2>have a sense of well being on a treatment, you

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<v Speaker 2>know it may go better. I mean, in the case

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<v Speaker 2>of breast cancer, for example, there are studies that show

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<v Speaker 2>that you know, if you exercise during chemotherapy, that the

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<v Speaker 2>actual outcome of the chemotherapy may be better. The outcome

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<v Speaker 2>on the tumor may actually be better. So I think that,

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<v Speaker 2>as you know, indirect evidence that doing things with your

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<v Speaker 2>body or your mind may influence the milieu of your

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<v Speaker 2>body while you're getting the chemotherapy and change the outcome.

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<v Speaker 2>So I think what you say is you know, is

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<v Speaker 2>completely correct.

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<v Speaker 1>So we I came into you know, your office on Monday,

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<v Speaker 1>and you had taken the weekend to access, you know,

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<v Speaker 1>all of my medical records, you know, with my authorisation obviously,

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<v Speaker 1>but so that you were completely on top of like

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<v Speaker 1>where I was at. Can you explain, because I don't

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<v Speaker 1>think a lot of people know, particularly with breast cancer,

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<v Speaker 1>like the her positive the her negative, But what is

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<v Speaker 1>the difference between that? People always ask me what I am,

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<v Speaker 1>and I'm like, I kind of don't remember.

0:13:10.960 --> 0:13:14.720
<v Speaker 2>Well, you're a technically a strodener receptor positive progestion receptor

0:13:14.720 --> 0:13:19.720
<v Speaker 2>positive and her too negative. But it's a bit of

0:13:19.720 --> 0:13:23.000
<v Speaker 2>a complicated technicality, but there's the initial way that you

0:13:23.120 --> 0:13:26.040
<v Speaker 2>do that her testing and her is is one of

0:13:26.080 --> 0:13:28.920
<v Speaker 2>the genes that can be expressed in breast cancer, and

0:13:29.000 --> 0:13:31.640
<v Speaker 2>it's actually a target for treatments, some treatments that are

0:13:31.720 --> 0:13:37.240
<v Speaker 2>very very successful at helping in breast cancer, though it's

0:13:37.360 --> 0:13:40.680
<v Speaker 2>expression in the breast cancer can be associated with a

0:13:40.760 --> 0:13:45.839
<v Speaker 2>less good outcome. And you are her too negative, which

0:13:46.640 --> 0:13:50.280
<v Speaker 2>you know is a good prognostic indicator. But the way

0:13:50.320 --> 0:13:52.520
<v Speaker 2>that that test is initially done, it's done in kind

0:13:52.559 --> 0:13:54.839
<v Speaker 2>of a qualitative way. So they test the cells for

0:13:54.920 --> 0:13:57.240
<v Speaker 2>that expression, and you get sort of a one plus

0:13:57.320 --> 0:13:59.920
<v Speaker 2>or two plus or three plus, and a certain cutoff

0:14:00.640 --> 0:14:02.960
<v Speaker 2>of the pluses is considered negative in a certain kind

0:14:02.960 --> 0:14:07.480
<v Speaker 2>of positive. But if you're equivocal, meaning meaning that you're

0:14:07.520 --> 0:14:09.960
<v Speaker 2>in sort of a mid range, then we do a

0:14:09.960 --> 0:14:13.160
<v Speaker 2>more refined test, which is a quantitative test, and it's

0:14:13.280 --> 0:14:17.480
<v Speaker 2>a very accurate quantitative test. So you were in the

0:14:17.520 --> 0:14:22.760
<v Speaker 2>equivocal range, but when we then did the more complicated tests,

0:14:22.760 --> 0:14:26.080
<v Speaker 2>you were negative. So we're happy about that because you

0:14:26.120 --> 0:14:31.000
<v Speaker 2>know it's a better prognostics sign. However, fast forward many

0:14:31.080 --> 0:14:35.960
<v Speaker 2>years later in your treatment, when you're in that equivocal zone,

0:14:36.000 --> 0:14:39.960
<v Speaker 2>it's called HER too expressor, so you're expressing it even

0:14:39.960 --> 0:14:42.160
<v Speaker 2>though you're not technically positive. You're expressing it at a

0:14:42.200 --> 0:14:45.720
<v Speaker 2>low level. And so right when we were needing to

0:14:45.800 --> 0:14:50.280
<v Speaker 2>have another novel therapy in your case, a paper came

0:14:50.320 --> 0:14:54.440
<v Speaker 2>out that shows that patients who are HER two expressors

0:14:54.960 --> 0:14:59.560
<v Speaker 2>respond to one of the newer monocline line of body

0:14:59.640 --> 0:15:05.160
<v Speaker 2>drug conjugates that targets her too, and these people actually

0:15:05.160 --> 0:15:07.640
<v Speaker 2>respond well to it. So the fact that we had

0:15:07.680 --> 0:15:09.760
<v Speaker 2>all that data and we remember that data and we

0:15:10.920 --> 0:15:13.920
<v Speaker 2>access that data when we were having again to think

0:15:14.080 --> 0:15:17.360
<v Speaker 2>novelly and individually about you, because there were reasons why

0:15:17.720 --> 0:15:20.320
<v Speaker 2>going back onto chemotherapy wouldn't have been ideal at this

0:15:20.360 --> 0:15:25.359
<v Speaker 2>particular juncture, so we chose an antibody drug conjugate. Unfortunately

0:15:25.920 --> 0:15:28.840
<v Speaker 2>data had come out just in time. And you know,

0:15:28.880 --> 0:15:30.800
<v Speaker 2>that's something I've talked with you a lot about and

0:15:30.960 --> 0:15:33.520
<v Speaker 2>other people that you know, we know together, that I've treated.

0:15:34.200 --> 0:15:36.240
<v Speaker 2>You know, it's sort of in the beginning of my career,

0:15:36.680 --> 0:15:38.880
<v Speaker 2>we were all focused on you sort of pretty much

0:15:38.920 --> 0:15:44.000
<v Speaker 2>either cure something or you kind of limp along with it.

0:15:45.440 --> 0:15:48.760
<v Speaker 2>But there isn't a long period of being along with it,

0:15:48.840 --> 0:15:50.760
<v Speaker 2>you know, back in the day. Now there are so

0:15:50.840 --> 0:15:54.280
<v Speaker 2>many treatments that and since we've been able to sequence

0:15:54.320 --> 0:15:58.720
<v Speaker 2>the human genome and since we've you know, really unleashed

0:15:58.760 --> 0:16:00.840
<v Speaker 2>a lot of or unlocked the line of the secrets

0:16:00.840 --> 0:16:05.080
<v Speaker 2>that allow us unleash immunotherapy, which is the body's immune system,

0:16:05.680 --> 0:16:08.600
<v Speaker 2>you know, being repped up to fight the cancer. Now,

0:16:08.960 --> 0:16:11.720
<v Speaker 2>there are many different chapters to what we can do.

0:16:11.880 --> 0:16:15.880
<v Speaker 2>And so early on, if you achieved a partial remission

0:16:15.880 --> 0:16:18.840
<v Speaker 2>and we're limping along, it may not have affected your

0:16:18.920 --> 0:16:22.960
<v Speaker 2>overall survival even though you were in remission because because

0:16:22.960 --> 0:16:25.320
<v Speaker 2>it might not last that long. But now, if you

0:16:25.360 --> 0:16:28.040
<v Speaker 2>can achieve a partial remission that lasts for a decent

0:16:28.080 --> 0:16:31.400
<v Speaker 2>amount of time, in that time, developments are so fast

0:16:31.440 --> 0:16:34.360
<v Speaker 2>that something new may show up that might then give

0:16:34.400 --> 0:16:38.000
<v Speaker 2>you a much longer, more meaningful remission. So I always

0:16:38.040 --> 0:16:40.360
<v Speaker 2>say that, you know, it's important to think of each

0:16:40.440 --> 0:16:42.680
<v Speaker 2>therapy as a horse. And you want to ride in

0:16:42.720 --> 0:16:44.600
<v Speaker 2>a horse race, So you want to ride every horse

0:16:44.640 --> 0:16:47.880
<v Speaker 2>as long as it rides, and then you ride the

0:16:47.920 --> 0:16:49.800
<v Speaker 2>next horse as much as possible. When you hope by

0:16:49.840 --> 0:16:52.800
<v Speaker 2>the time you make a few laps, you know there's

0:16:52.880 --> 0:16:56.720
<v Speaker 2>altogether another set of horses to ride, you know, to

0:16:56.720 --> 0:16:58.160
<v Speaker 2>make the race that much longer.

0:17:06.920 --> 0:17:08.960
<v Speaker 1>Somebody was asking me today and they were like, wow,

0:17:09.000 --> 0:17:15.440
<v Speaker 1>you know, like stage four breast cancer says like five years.

0:17:15.640 --> 0:17:18.520
<v Speaker 1>It's like, yeah, but that's like old data that you

0:17:18.640 --> 0:17:22.960
<v Speaker 1>have found on the internet, and things are different. I mean, yes,

0:17:23.040 --> 0:17:27.040
<v Speaker 1>there are people that have only survived five years. You know.

0:17:27.160 --> 0:17:32.080
<v Speaker 1>I think my best friend Dub was one of those.

0:17:32.600 --> 0:17:35.760
<v Speaker 1>But there are so many different things right now, and

0:17:35.800 --> 0:17:38.159
<v Speaker 1>you and I always talk about the fact that, like

0:17:38.200 --> 0:17:40.560
<v Speaker 1>we just need to squeeze out another three to five

0:17:40.640 --> 0:17:43.399
<v Speaker 1>years and then there's going to be you know, T

0:17:43.560 --> 0:17:45.480
<v Speaker 1>cell therapy, or there's gonna be this, or there's going

0:17:45.520 --> 0:17:47.879
<v Speaker 1>to be that, like whatever it is, there's going to

0:17:47.920 --> 0:17:51.000
<v Speaker 1>be a lot more options that will give another five years.

0:17:51.040 --> 0:17:53.199
<v Speaker 1>Then in those five years, there's a whole other, you know,

0:17:53.240 --> 0:17:55.600
<v Speaker 1>group of options, and then eventually there's going to be

0:17:55.640 --> 0:17:58.560
<v Speaker 1>a cure. So I always look at it as I'm

0:17:58.800 --> 0:18:01.560
<v Speaker 1>I'm the horse analogy is a really good one, Like

0:18:01.600 --> 0:18:05.639
<v Speaker 1>I'm constantly chasing I'm riding those horses so that I

0:18:05.680 --> 0:18:07.960
<v Speaker 1>get to the fresh set of horses, and I'm trying

0:18:07.960 --> 0:18:10.480
<v Speaker 1>to get the one that I'm on right now to

0:18:10.640 --> 0:18:13.440
<v Speaker 1>like last for as long as humanly im possible.

0:18:13.640 --> 0:18:15.600
<v Speaker 2>And that's why I like that analogy, because when you're

0:18:15.600 --> 0:18:17.520
<v Speaker 2>the one riding the horse, which is the much more

0:18:17.560 --> 0:18:22.200
<v Speaker 2>difficult job than the one picking the horse, it gets

0:18:22.280 --> 0:18:25.879
<v Speaker 2>exhausting at times, but then you think, well, okay, this

0:18:26.040 --> 0:18:28.560
<v Speaker 2>is still working, right, Yeah, this is hard, but it's

0:18:28.600 --> 0:18:31.600
<v Speaker 2>still working, and we don't want to abandon that because

0:18:31.640 --> 0:18:35.720
<v Speaker 2>if we abandon it too early that one decision could

0:18:35.760 --> 0:18:39.280
<v Speaker 2>foreshorten a lot of other things, and then your timing

0:18:39.320 --> 0:18:43.080
<v Speaker 2>can be just exactly off for the introduction of new therapies,

0:18:43.119 --> 0:18:47.120
<v Speaker 2>like the fact that our timing was so fortunate of

0:18:47.800 --> 0:18:52.240
<v Speaker 2>you know, of finding this study about the Hurtwo expressors

0:18:52.240 --> 0:18:53.440
<v Speaker 2>and being able to put you on that.

0:18:53.800 --> 0:18:56.479
<v Speaker 1>Right which the funny, I mean, the funny story behind

0:18:56.520 --> 0:18:59.640
<v Speaker 1>this is that I kind of bunt my head after

0:19:00.040 --> 0:19:02.840
<v Speaker 1>Ristmas party that I threw and I called you and

0:19:03.080 --> 0:19:05.480
<v Speaker 1>was like, and it was right after New Year's or

0:19:05.520 --> 0:19:08.400
<v Speaker 1>whatever when I called you and I was like, hey,

0:19:08.480 --> 0:19:10.520
<v Speaker 1>you know, over the holidays, I kind of hit my

0:19:10.560 --> 0:19:12.800
<v Speaker 1>head pretty badly, and I know that it was bleeding.

0:19:13.359 --> 0:19:15.359
<v Speaker 1>What do you think. I'm probably fine, right, Like, I

0:19:15.359 --> 0:19:18.600
<v Speaker 1>didn't die in my sleep, so I'm okay. And you're like, no,

0:19:18.760 --> 0:19:21.000
<v Speaker 1>you need to come in for a CT scan like

0:19:21.520 --> 0:19:26.200
<v Speaker 1>pronto and I did, and we found, you know, mets,

0:19:26.240 --> 0:19:29.159
<v Speaker 1>and I guess we can call Bob a tumor.

0:19:29.600 --> 0:19:32.800
<v Speaker 2>He was a tumor, yeah, I mean, And that, interestingly

0:19:32.920 --> 0:19:36.359
<v Speaker 2>is my bigger concern with the way the trauma you had.

0:19:36.560 --> 0:19:40.040
<v Speaker 2>You know, there's something called a subdural humanitoma that is

0:19:40.080 --> 0:19:44.320
<v Speaker 2>a chronic slow oozing of blood that can present with

0:19:44.800 --> 0:19:48.240
<v Speaker 2>symptoms coming you know, a week or ten days after

0:19:49.000 --> 0:19:53.480
<v Speaker 2>the initial trauma. And some very famous people have died

0:19:53.520 --> 0:19:55.439
<v Speaker 2>with that sort of thing and if you don't evacuate

0:19:55.480 --> 0:19:58.719
<v Speaker 2>that blood quickly, and since you were having some symptoms

0:19:58.760 --> 0:20:01.720
<v Speaker 2>a little bit still at that time, that's what I

0:20:01.760 --> 0:20:05.240
<v Speaker 2>was concerned about, more so than a tumor in some ways,

0:20:05.320 --> 0:20:08.000
<v Speaker 2>because you know, you weren't exhibiting any signs which I mean,

0:20:08.040 --> 0:20:10.680
<v Speaker 2>you weren't having paralyzed and anything. You weren't having seizures.

0:20:11.240 --> 0:20:14.000
<v Speaker 2>You know, you were you know, dizzy, and I'm not

0:20:14.080 --> 0:20:17.240
<v Speaker 2>I'm not even still sure, you know, given the you know,

0:20:17.359 --> 0:20:20.800
<v Speaker 2>relatively small size of those things, of whether they were

0:20:20.800 --> 0:20:22.639
<v Speaker 2>definitely causing symptoms.

0:20:22.359 --> 0:20:24.760
<v Speaker 1>Or not right, because what ended up happening is we

0:20:24.840 --> 0:20:27.639
<v Speaker 1>found some mets and we found one that was larger

0:20:27.680 --> 0:20:33.679
<v Speaker 1>than the others, and Dutch Piro said, you need to go, like,

0:20:34.000 --> 0:20:37.560
<v Speaker 1>get this. We're going to go get it removed immediately,

0:20:38.200 --> 0:20:40.760
<v Speaker 1>mainly because I want to, you know, study it, and

0:20:40.760 --> 0:20:42.520
<v Speaker 1>I want the pathology on it, and I want to

0:20:42.560 --> 0:20:46.480
<v Speaker 1>see is this is this breast cancer that's moved into

0:20:46.800 --> 0:20:51.440
<v Speaker 1>Like I need to know specifically the cancer that's there

0:20:51.520 --> 0:20:53.560
<v Speaker 1>that we're dealing with, so I know how to treat

0:20:53.600 --> 0:20:58.359
<v Speaker 1>it properly. And I think like six days later, I

0:20:58.480 --> 0:21:03.840
<v Speaker 1>was at Cedars. I'm getting my head cut open, and

0:21:04.840 --> 0:21:07.800
<v Speaker 1>a you know tumor that's Bob. By the way, I

0:21:07.880 --> 0:21:10.480
<v Speaker 1>named him Bob, no offense to any Bob's. He just

0:21:10.520 --> 0:21:12.840
<v Speaker 1>seemed like a Bob to me. You know, we got

0:21:12.880 --> 0:21:15.359
<v Speaker 1>almost all of him and the rest we handled with

0:21:15.520 --> 0:21:17.080
<v Speaker 1>brain radiation well.

0:21:17.080 --> 0:21:21.600
<v Speaker 2>And the reason why it was so important to study

0:21:21.600 --> 0:21:25.239
<v Speaker 2>the tissue is that sometimes after you've had treatments for

0:21:25.280 --> 0:21:28.840
<v Speaker 2>long periods of time, the tumor's morph in their expressions,

0:21:28.880 --> 0:21:32.840
<v Speaker 2>so it may not have been expressing the same set

0:21:32.840 --> 0:21:37.000
<v Speaker 2>of determinants and markers that the original one had. But secondly,

0:21:37.040 --> 0:21:41.600
<v Speaker 2>and somewhat more importantly, chemotherapy does not penetrate well into

0:21:41.600 --> 0:21:42.679
<v Speaker 2>the brain, right.

0:21:42.560 --> 0:21:45.280
<v Speaker 1>Because there's a blood brain barrier that it's got.

0:21:45.080 --> 0:21:48.800
<v Speaker 2>To break through to sanctuary. And it's intended it's intended

0:21:48.840 --> 0:21:54.440
<v Speaker 2>to leologically because there are toxins. Chemotherapy is a form

0:21:54.480 --> 0:21:58.479
<v Speaker 2>of toxin, right, and their toxins all over in nature, right.

0:21:58.520 --> 0:22:02.160
<v Speaker 2>I mean the drug, the chemotherapy drug vin Christine comes

0:22:02.200 --> 0:22:05.879
<v Speaker 2>from it's a vinca alkaloid. It comes from the vinca plant,

0:22:05.920 --> 0:22:09.080
<v Speaker 2>which is a ground common groundcover. So if you were

0:22:09.680 --> 0:22:12.040
<v Speaker 2>back in your rooting days, when you were rooting around

0:22:12.080 --> 0:22:12.960
<v Speaker 2>in the four.

0:22:12.880 --> 0:22:15.720
<v Speaker 1>It's actually just looking at that by the way plant

0:22:15.760 --> 0:22:19.280
<v Speaker 1>because it's also drought tolerant. If I and I was

0:22:19.440 --> 0:22:22.359
<v Speaker 1>quite attractive, Yeah, it's very attractive. I was looking at

0:22:22.720 --> 0:22:23.800
<v Speaker 1>it for my driveway.

0:22:24.240 --> 0:22:26.879
<v Speaker 2>So if you were like rooting around in nature and

0:22:26.920 --> 0:22:29.639
<v Speaker 2>you were chewing on the vinca plant, you would be

0:22:29.680 --> 0:22:33.479
<v Speaker 2>getting some of the you know, sort of precursor molecule

0:22:33.520 --> 0:22:35.919
<v Speaker 2>of vin christine or the exact one. And so you

0:22:35.960 --> 0:22:38.080
<v Speaker 2>don't want that in your brain because your brains, your

0:22:38.200 --> 0:22:40.720
<v Speaker 2>you know, your central computers and operating zone. We don't

0:22:40.720 --> 0:22:43.239
<v Speaker 2>want toxins in there. So the blood brain barrier has

0:22:43.280 --> 0:22:46.520
<v Speaker 2>pumps that pump those things out, so it can't it

0:22:46.560 --> 0:22:49.919
<v Speaker 2>can't get there. And so as a result, however, therefore,

0:22:49.960 --> 0:22:54.240
<v Speaker 2>when we treat with chemotherapy, sometimes it doesn't penetrate, you know,

0:22:54.320 --> 0:22:56.879
<v Speaker 2>into the brain, and so there are other therapies that

0:22:57.000 --> 0:23:00.320
<v Speaker 2>do and certain chemos will penetrate into the into the brain.

0:23:00.760 --> 0:23:03.640
<v Speaker 2>And so again this is the whole individualizing of the

0:23:03.640 --> 0:23:06.000
<v Speaker 2>therapy thing. We need to choose something. I wanted to

0:23:06.000 --> 0:23:09.040
<v Speaker 2>see if the expressions of the tumor in your body

0:23:09.040 --> 0:23:11.199
<v Speaker 2>and the expressions of the tumoring the brain were the

0:23:11.240 --> 0:23:14.159
<v Speaker 2>same or not, And make sure that whatever we treated

0:23:14.200 --> 0:23:16.840
<v Speaker 2>you within your body would also treat the brain at

0:23:16.840 --> 0:23:18.960
<v Speaker 2>the same time, if possible. Even though we were giving

0:23:19.119 --> 0:23:21.760
<v Speaker 2>we removed the one and we were giving radiations the brain.

0:23:22.600 --> 0:23:24.800
<v Speaker 2>We don't want to treat the whole brain because that

0:23:24.840 --> 0:23:28.080
<v Speaker 2>has too much bad effect on normal brain tissue and

0:23:28.200 --> 0:23:32.720
<v Speaker 2>so and so we want only to treat those few spots.

0:23:32.760 --> 0:23:35.920
<v Speaker 2>And we didn't want any other brain tumors developed, if possible,

0:23:36.000 --> 0:23:39.040
<v Speaker 2>So we really wanted something to penetrate and bathe the brain,

0:23:39.680 --> 0:23:42.320
<v Speaker 2>you know, in that treatment. And therefore, if there were

0:23:42.400 --> 0:23:47.280
<v Speaker 2>seeds of cells that were ultimately destined to create other

0:23:47.359 --> 0:23:52.240
<v Speaker 2>brain tumor, spots of brain tumor, we would kill them

0:23:52.320 --> 0:23:55.679
<v Speaker 2>by using that treatment, and then they would manifest as

0:23:55.720 --> 0:23:58.399
<v Speaker 2>another spot of metastatic breast cancer.

0:23:58.640 --> 0:24:02.320
<v Speaker 1>Right, But we also need did a treatment that didn't

0:24:02.359 --> 0:24:04.760
<v Speaker 1>just take care of the brain mets. We needed the

0:24:04.800 --> 0:24:08.399
<v Speaker 1>whole body. Like everything else that was going on. My

0:24:08.520 --> 0:24:11.479
<v Speaker 1>breast cancer was spread into my bones, so it was

0:24:11.760 --> 0:24:16.720
<v Speaker 1>very important that be kept under control. And we found

0:24:16.760 --> 0:24:20.560
<v Speaker 1>it when we did the pathology on Bob the tumor.

0:24:20.960 --> 0:24:24.919
<v Speaker 1>What was the difference of that pathology that allowed me

0:24:25.200 --> 0:24:27.320
<v Speaker 1>to be okay for this sort of new treatment that

0:24:27.359 --> 0:24:30.959
<v Speaker 1>he was talking about a second ago, that the papers

0:24:31.000 --> 0:24:34.840
<v Speaker 1>had just come out about it being a good alternative

0:24:35.080 --> 0:24:36.479
<v Speaker 1>for something like I was.

0:24:37.040 --> 0:24:40.280
<v Speaker 2>It was also expressing her too. It was not her

0:24:40.320 --> 0:24:42.720
<v Speaker 2>too positive. It was in that expressor zone. It was

0:24:42.760 --> 0:24:46.720
<v Speaker 2>in that low level zone that this paper showed patients

0:24:46.760 --> 0:24:49.119
<v Speaker 2>respond to. And that was, you know, made me very

0:24:49.119 --> 0:24:51.439
<v Speaker 2>happy because we could treat both the body and the

0:24:51.440 --> 0:24:54.880
<v Speaker 2>brain with that, and this drug antibody conjugate penetrates into

0:24:54.920 --> 0:24:58.320
<v Speaker 2>the brain. So it is a perfect particularly good choice

0:24:58.440 --> 0:25:02.600
<v Speaker 2>and that has proved not only was that a reasonable

0:25:02.600 --> 0:25:04.800
<v Speaker 2>theory by which to choose a treatment, but that's proven

0:25:04.840 --> 0:25:07.600
<v Speaker 2>out to be a good result for you as we've had,

0:25:07.720 --> 0:25:10.560
<v Speaker 2>as we know, with some recent scans that let's just say,

0:25:10.560 --> 0:25:11.920
<v Speaker 2>it made us very happy.

0:25:11.720 --> 0:25:14.320
<v Speaker 1>Made us very happy, yeah, which I think is really

0:25:14.400 --> 0:25:17.920
<v Speaker 1>interesting because you know, we scanned me quite often once

0:25:17.960 --> 0:25:20.840
<v Speaker 1>I went on this other treatment. You know, it didn't

0:25:21.119 --> 0:25:23.359
<v Speaker 1>it didn't really look like it was performing that well,

0:25:23.760 --> 0:25:25.760
<v Speaker 1>and I think it was after the fifth treatment that

0:25:25.800 --> 0:25:29.359
<v Speaker 1>you and I had a conversation about it, and the

0:25:29.440 --> 0:25:32.240
<v Speaker 1>conversation was maybe we should move to a different treatment,

0:25:33.000 --> 0:25:36.160
<v Speaker 1>and we sort of both sat with it and took

0:25:36.160 --> 0:25:40.800
<v Speaker 1>our time to think about it reconnected, and you know,

0:25:41.400 --> 0:25:43.440
<v Speaker 1>I think I started by saying I want to give

0:25:43.480 --> 0:25:46.720
<v Speaker 1>it more time, and you really sort of went back

0:25:46.760 --> 0:25:49.360
<v Speaker 1>and did research and then called me and said, actually,

0:25:49.640 --> 0:25:52.200
<v Speaker 1>I ordered a very specific test for you to get done,

0:25:52.240 --> 0:25:54.760
<v Speaker 1>which was for your tumor markers. And it's not something

0:25:54.760 --> 0:25:57.160
<v Speaker 1>that you get done every single month with your blood work.

0:25:57.640 --> 0:26:00.840
<v Speaker 1>It's specific that you have to order and I ordered it,

0:26:00.880 --> 0:26:03.600
<v Speaker 1>and your tumor markers were you know, they're cut in

0:26:03.680 --> 0:26:07.359
<v Speaker 1>half basically, so we know that it's working. And you said, so,

0:26:07.560 --> 0:26:12.880
<v Speaker 1>I feel comfortable with you staying on this as long

0:26:12.880 --> 0:26:15.520
<v Speaker 1>as you agree to get MRIs a little bit more

0:26:15.520 --> 0:26:18.520
<v Speaker 1>often because you wanted to stay on top of it.

0:26:18.760 --> 0:26:22.080
<v Speaker 1>And then after my seventh treatment, you came into my

0:26:22.720 --> 0:26:26.359
<v Speaker 1>infusion room and you were I mean, you came in

0:26:26.440 --> 0:26:31.439
<v Speaker 1>You're like, yes, you were, you know, you were I

0:26:31.440 --> 0:26:33.639
<v Speaker 1>don't want to say more excited than me, but you

0:26:33.680 --> 0:26:37.280
<v Speaker 1>were equally as joyous as me.

0:26:38.160 --> 0:26:40.719
<v Speaker 2>And I almost never do that. And the reason I

0:26:40.720 --> 0:26:43.520
<v Speaker 2>almost never do that isn't because I'm not joyous. It's

0:26:43.600 --> 0:26:47.800
<v Speaker 2>because I fear if I do that, then every subsequent

0:26:48.000 --> 0:26:51.160
<v Speaker 2>time we have scans, if I don't walk in that way,

0:26:51.760 --> 0:26:54.560
<v Speaker 2>people will read and patients will read into it that

0:26:54.600 --> 0:26:57.919
<v Speaker 2>I'm really not joyous, and then they'll think whatever I'm saying,

0:26:58.080 --> 0:27:03.399
<v Speaker 2>you know that I really secretly, you know, upset because

0:27:03.440 --> 0:27:05.480
<v Speaker 2>we didn't get better results or something like that, you know,

0:27:05.600 --> 0:27:08.840
<v Speaker 2>And yeah, and that such an important part. We accidentally

0:27:08.840 --> 0:27:12.840
<v Speaker 2>tripped onto a zone of conversation. It's so important. It's

0:27:12.880 --> 0:27:16.080
<v Speaker 2>really so important as a doctor to realize that people

0:27:16.119 --> 0:27:20.120
<v Speaker 2>are watching every single move you make and every single world.

0:27:20.200 --> 0:27:22.480
<v Speaker 1>So it's your eyebrot. So I'm like, what does that

0:27:22.680 --> 0:27:28.240
<v Speaker 1>mean exactly? But you and I have sort of we

0:27:28.280 --> 0:27:31.000
<v Speaker 1>have established the way of doing things because your clinic,

0:27:31.200 --> 0:27:35.440
<v Speaker 1>the Angelus Clinic in Los Angeles, is it's extraordinary in

0:27:35.480 --> 0:27:38.800
<v Speaker 1>the sense that you can go in, you can go

0:27:38.840 --> 0:27:40.920
<v Speaker 1>get a PET scan, you can go get an MRI,

0:27:41.160 --> 0:27:43.480
<v Speaker 1>you can go get a CT scan. And whereas traditionally

0:27:43.600 --> 0:27:46.040
<v Speaker 1>I know people that have had to wait ten days

0:27:46.040 --> 0:27:49.000
<v Speaker 1>for their results, at your clinic, you get the results

0:27:49.040 --> 0:27:52.479
<v Speaker 1>the same day. And most of your patients, you know,

0:27:52.600 --> 0:27:56.520
<v Speaker 1>wait for their scans. They wait there and then they

0:27:56.560 --> 0:27:58.480
<v Speaker 1>have an appointment with you or one of the other

0:27:58.560 --> 0:28:02.320
<v Speaker 1>doctors like whatever, and they get their results in person

0:28:02.840 --> 0:28:05.960
<v Speaker 1>the same day. And I chose to do it very

0:28:05.960 --> 0:28:08.800
<v Speaker 1>differently from the beginning with you, where I said I

0:28:08.800 --> 0:28:12.840
<v Speaker 1>don't want you, I don't want to know my results

0:28:13.440 --> 0:28:20.080
<v Speaker 1>in person. I let me go home and call me

0:28:20.200 --> 0:28:23.600
<v Speaker 1>with my results at whatever time works for you throughout

0:28:23.640 --> 0:28:26.760
<v Speaker 1>the day, whenever you have a moment, whenever you have

0:28:26.800 --> 0:28:29.240
<v Speaker 1>a break, whenever you know you're not seeing a patient,

0:28:29.359 --> 0:28:31.480
<v Speaker 1>if it's at night, doesn't really matter to me when

0:28:31.960 --> 0:28:37.720
<v Speaker 1>because I didn't want to monitor my reaction for you,

0:28:37.920 --> 0:28:40.360
<v Speaker 1>or for the nurse practitioner, or for anybody that was

0:28:40.400 --> 0:28:42.840
<v Speaker 1>in the room with me, for my mom, like whoever

0:28:42.840 --> 0:28:47.280
<v Speaker 1>it was, right I whatever you told me, good or bad.

0:28:48.000 --> 0:28:52.120
<v Speaker 1>I wanted to be alone so that I could have

0:28:52.680 --> 0:28:58.280
<v Speaker 1>an authentic, like true reaction for myself and not try

0:28:58.320 --> 0:29:00.560
<v Speaker 1>to put on a like game face for everyone. Because

0:29:00.560 --> 0:29:04.280
<v Speaker 1>there's nothing worse than getting bad news face to face,

0:29:05.040 --> 0:29:07.720
<v Speaker 1>and you feel like you have to make the person

0:29:07.800 --> 0:29:11.640
<v Speaker 1>giving you the bad news feel good. And I'm that person.

0:29:11.720 --> 0:29:14.320
<v Speaker 1>It feels like it's my responsibility to make sure everybody

0:29:14.360 --> 0:29:14.959
<v Speaker 1>is okay.

0:29:15.200 --> 0:29:19.080
<v Speaker 2>You're the first person in my entire career whoever wanted

0:29:19.120 --> 0:29:24.680
<v Speaker 2>that format. No, No, it totally works, and it makes

0:29:24.680 --> 0:29:26.880
<v Speaker 2>subtle sense. And to be honest with you, which probably

0:29:27.360 --> 0:29:30.400
<v Speaker 2>you know is part of the underpinning of the closeness

0:29:30.400 --> 0:29:33.480
<v Speaker 2>of our friendship through all these many years, is that

0:29:34.360 --> 0:29:36.800
<v Speaker 2>I realize that I'm probably the same way like I

0:29:36.800 --> 0:29:39.360
<v Speaker 2>would probably you know, be the other person who had

0:29:39.360 --> 0:29:42.280
<v Speaker 2>wanted that way, because I realized that, you know, when

0:29:42.320 --> 0:29:46.000
<v Speaker 2>I hear something, whatever it is, I want to process

0:29:46.080 --> 0:29:49.920
<v Speaker 2>it personally to figure out how I feel about it

0:29:50.000 --> 0:29:52.960
<v Speaker 2>before I want to tell somebody else. Because the minute

0:29:52.960 --> 0:29:55.080
<v Speaker 2>you tell someone else whatever, if it's good news, you've

0:29:55.080 --> 0:29:57.720
<v Speaker 2>got a new job, you know, if it's bad news, whatever,

0:29:58.360 --> 0:30:02.320
<v Speaker 2>people are going to learn out their response. And it's

0:30:02.360 --> 0:30:05.440
<v Speaker 2>hard to hear other people's reaction, especially we're talking about

0:30:05.440 --> 0:30:08.320
<v Speaker 2>cancer and cancer results and all that when you're not

0:30:08.400 --> 0:30:11.800
<v Speaker 2>yet sure what your response is, because therefore you have

0:30:11.920 --> 0:30:17.760
<v Speaker 2>no defense or no ability to reformat their misguided reaction

0:30:17.920 --> 0:30:20.760
<v Speaker 2>to it. And often often the people in one's lives

0:30:21.240 --> 0:30:25.880
<v Speaker 2>have misguided reactions to data they don't you know, they're

0:30:25.880 --> 0:30:29.520
<v Speaker 2>getting bits and parts pieces of your story, and they

0:30:29.600 --> 0:30:34.120
<v Speaker 2>can be very misguided. And it's very hard to unhear something. Yeah,

0:30:34.280 --> 0:30:38.680
<v Speaker 2>and that is an underappreciated axiom. It's very hard to

0:30:38.720 --> 0:30:42.520
<v Speaker 2>unhear things. And if there's anything that in this conversation

0:30:42.600 --> 0:30:46.160
<v Speaker 2>we're having that people who are listening who are caregivers

0:30:46.240 --> 0:30:49.400
<v Speaker 2>or loved ones or people friends, people in the lives

0:30:49.440 --> 0:30:52.400
<v Speaker 2>of people who are going through the cancer journey, is

0:30:53.480 --> 0:30:58.080
<v Speaker 2>be very careful what you say because they can't unhear

0:30:58.160 --> 0:31:02.560
<v Speaker 2>what you say. There's such a desire of well meaning

0:31:02.640 --> 0:31:07.840
<v Speaker 2>people who care about someone to establish to you that

0:31:07.920 --> 0:31:11.640
<v Speaker 2>they understand what you're going through by saying, oh, well, yes,

0:31:11.720 --> 0:31:14.239
<v Speaker 2>you know, my sister had breast cancer too, or my

0:31:14.400 --> 0:31:18.200
<v Speaker 2>so and so had breast cancer too. Unfortunately, it often

0:31:18.360 --> 0:31:21.600
<v Speaker 2>leads most people when they're telling the story, don't think

0:31:21.600 --> 0:31:26.360
<v Speaker 2>about the punchline and whether the punch yeah, and they say, yeah,

0:31:26.360 --> 0:31:28.760
<v Speaker 2>well what happened to your sister? Says the patient, and

0:31:28.800 --> 0:31:31.840
<v Speaker 2>they said, well, yeah, she died three years ago, and like,

0:31:32.040 --> 0:31:34.760
<v Speaker 2>oh my right, I mean, and no one does that intentionally,

0:31:34.800 --> 0:31:37.240
<v Speaker 2>but it's mortifying because if you don't think about where

0:31:37.280 --> 0:31:39.520
<v Speaker 2>the story ends up before you choose to tell it

0:31:39.560 --> 0:31:43.280
<v Speaker 2>to this particular person. It's you know, it doesn't.

0:31:43.000 --> 0:31:47.240
<v Speaker 1>Help that one all the time, all the time. And

0:31:47.360 --> 0:31:49.680
<v Speaker 1>you know, I know that the people are very you know,

0:31:49.800 --> 0:31:53.200
<v Speaker 1>well intentioned. It's like a way of connecting with me

0:31:53.320 --> 0:31:55.440
<v Speaker 1>and of saying, I know what you're going through, and

0:31:56.120 --> 0:31:58.320
<v Speaker 1>you know, I really like they always follow it up

0:31:58.360 --> 0:32:02.080
<v Speaker 1>with like I so admire, like you're journey, but it

0:32:01.680 --> 0:32:05.600
<v Speaker 1>is always sort of my mom, my grandmother, my sister,

0:32:05.760 --> 0:32:10.280
<v Speaker 1>my friend, they died, and I'm always like what do

0:32:10.360 --> 0:32:13.040
<v Speaker 1>I do with that information? It's a hard one. It

0:32:13.120 --> 0:32:17.280
<v Speaker 1>was I was being interviewed today and the woman interviewing

0:32:17.320 --> 0:32:20.080
<v Speaker 1>me her father is a doctor, and so I guess

0:32:20.080 --> 0:32:23.280
<v Speaker 1>she spoke to him about, you know, more in general

0:32:23.400 --> 0:32:28.920
<v Speaker 1>terms of like stage four you know, cancer, like I

0:32:29.080 --> 0:32:32.760
<v Speaker 1>have her knowledge of what I have and gave that

0:32:32.800 --> 0:32:35.480
<v Speaker 1>to her dad, and she kept on using the word

0:32:35.560 --> 0:32:38.280
<v Speaker 1>like terminal and like, you know, there is no cure,

0:32:38.360 --> 0:32:41.160
<v Speaker 1>like this is really bad, and I just I kind

0:32:41.160 --> 0:32:44.600
<v Speaker 1>of was like, based on what because your dad may

0:32:44.640 --> 0:32:47.360
<v Speaker 1>be a doctor, but he doesn't know my particular cancer.

0:32:47.440 --> 0:32:49.880
<v Speaker 1>He doesn't know where my tumor markers is. There are

0:32:49.920 --> 0:32:52.680
<v Speaker 1>so many things. But also I just kind of sat

0:32:52.720 --> 0:32:56.200
<v Speaker 1>there like huh, Like I don't know what you're getting at,

0:32:56.400 --> 0:32:59.080
<v Speaker 1>Like what do you are you looking for me to

0:32:59.120 --> 0:33:02.200
<v Speaker 1>break down and in this conversation because it's on camera

0:33:02.280 --> 0:33:04.200
<v Speaker 1>and that's going to be a great moment for you guys.

0:33:05.000 --> 0:33:08.320
<v Speaker 1>Like I couldn't figure out what the endgame was, except

0:33:08.360 --> 0:33:11.400
<v Speaker 1>that I think she was truly concerned and truly you know,

0:33:11.520 --> 0:33:15.960
<v Speaker 1>tried to come in with knowledge, but probably got fed

0:33:16.000 --> 0:33:18.880
<v Speaker 1>a bunch of stuff that perhaps she shouldn't have repeated

0:33:19.880 --> 0:33:24.160
<v Speaker 1>because I think I think it's very dangerous for other

0:33:24.360 --> 0:33:30.840
<v Speaker 1>people to have the conversation about your cancer besides your doctor.

0:33:30.960 --> 0:33:34.400
<v Speaker 1>I think it is an extremely dangerous conversation.

0:33:34.920 --> 0:33:38.680
<v Speaker 2>Well, I always tell patients at the first diagnosis, I

0:33:38.800 --> 0:33:42.680
<v Speaker 2>say to them that they should tell all of their

0:33:42.720 --> 0:33:46.760
<v Speaker 2>friends who are going to wonder what they're supposed to

0:33:46.760 --> 0:33:51.680
<v Speaker 2>talk about with you. And they think, well, if I

0:33:51.800 --> 0:33:54.880
<v Speaker 2>don't talk about the cancer, they'll think that I'm afraid

0:33:54.960 --> 0:33:59.560
<v Speaker 2>in ignoring it. And if I do talk about the cancer,

0:33:59.680 --> 0:34:02.479
<v Speaker 2>then I might not say the right things. So they

0:34:02.480 --> 0:34:04.240
<v Speaker 2>don't know what to do. But they usually talk about

0:34:04.280 --> 0:34:06.120
<v Speaker 2>the cancer. They're call it how are you, How are

0:34:06.160 --> 0:34:09.160
<v Speaker 2>you doing? Are you okay? Do you need anything? Whatever?

0:34:09.360 --> 0:34:12.080
<v Speaker 2>All of which sounds nice, right, But if these are

0:34:12.080 --> 0:34:14.319
<v Speaker 2>the people who you talked about dropping your kids off

0:34:14.360 --> 0:34:17.960
<v Speaker 2>to school, and you know how the drop offline, you

0:34:18.000 --> 0:34:20.200
<v Speaker 2>know they should manage it better at the school, and

0:34:20.680 --> 0:34:22.680
<v Speaker 2>you know you want to meet to play, you know,

0:34:22.760 --> 0:34:25.160
<v Speaker 2>pick a ball, And I want to have a dinner

0:34:25.160 --> 0:34:27.439
<v Speaker 2>party this weekend. You know, do you want to come?

0:34:27.440 --> 0:34:30.640
<v Speaker 2>And what should we cook? Right instead? There? How are you?

0:34:30.960 --> 0:34:32.920
<v Speaker 2>Are you okay? Do you need anything?

0:34:33.160 --> 0:34:33.239
<v Speaker 1>Like?

0:34:33.320 --> 0:34:36.960
<v Speaker 2>It's just you become not normal, you become a cancer person. Yeah,

0:34:37.000 --> 0:34:38.600
<v Speaker 2>and you don't want to be a cancer person. So

0:34:38.640 --> 0:34:41.359
<v Speaker 2>I tell everyone, Tell your friends to talk about with

0:34:41.440 --> 0:34:44.840
<v Speaker 2>you everything that they always used to talk with you about,

0:34:45.080 --> 0:34:48.359
<v Speaker 2>and don't talk about cancer. And here's the clue. When

0:34:48.400 --> 0:34:50.680
<v Speaker 2>you want to talk about cancer, you'll tell them you'll

0:34:50.680 --> 0:34:53.759
<v Speaker 2>bring it up, and then then go for it. Then

0:34:53.920 --> 0:34:56.719
<v Speaker 2>I'm bringing it up, but I'm guiding you as to

0:34:56.760 --> 0:34:58.879
<v Speaker 2>what why I want to talk about? Do I want

0:34:58.920 --> 0:35:01.680
<v Speaker 2>to talk about how I'm feeling emotionally? Do I want

0:35:01.719 --> 0:35:04.839
<v Speaker 2>to talk about how sad that my personal life has

0:35:05.760 --> 0:35:08.760
<v Speaker 2>been influenced by cancer and this unfortunate thing my personal

0:35:08.760 --> 0:35:11.640
<v Speaker 2>life happened, or wheneverbody just take the lead and focus

0:35:11.719 --> 0:35:14.040
<v Speaker 2>on what they want to talk about. Don't put your

0:35:14.080 --> 0:35:18.239
<v Speaker 2>own stuff into it. And it's complicated, right because people

0:35:18.239 --> 0:35:21.440
<v Speaker 2>are not therapists and they're not aware of cancer and

0:35:21.480 --> 0:35:23.839
<v Speaker 2>they don't have the medical stuff. But this is so

0:35:23.920 --> 0:35:25.840
<v Speaker 2>important to the quality of life of a person with

0:35:25.920 --> 0:35:29.600
<v Speaker 2>cancer because when people are always making you a cancer person,

0:35:30.200 --> 0:35:33.719
<v Speaker 2>it just it attracts from your quality of life and

0:35:33.760 --> 0:35:37.840
<v Speaker 2>it changes yourself image of yourself, like I'm a cancer

0:35:37.880 --> 0:35:38.959
<v Speaker 2>person now, you know.

0:35:38.880 --> 0:35:40.120
<v Speaker 1>And then you start feeling sick.

0:35:40.360 --> 0:35:44.879
<v Speaker 2>Yeah, it feeds the beast, it really does.

0:35:45.480 --> 0:35:49.640
<v Speaker 1>Versus I mean, I don't have many people that I

0:35:49.760 --> 0:35:53.279
<v Speaker 1>talk to cancer about. Like for me, I talk to

0:35:53.320 --> 0:35:56.680
<v Speaker 1>you about cancer because I think you're qualified to talk

0:35:56.719 --> 0:36:01.040
<v Speaker 1>to me about cancer. And everybody else where you getting

0:36:01.040 --> 0:36:05.600
<v Speaker 1>your information from, if it's from the internet, I literally

0:36:05.760 --> 0:36:08.880
<v Speaker 1>no desire to hear one word that comes from the internet,

0:36:09.120 --> 0:36:11.640
<v Speaker 1>not just about cancer, but pretty much about everything at

0:36:11.640 --> 0:36:16.120
<v Speaker 1>this point, but particularly about cancer. And so I want

0:36:16.160 --> 0:36:19.400
<v Speaker 1>to I want to speak to people that are, you know,

0:36:19.520 --> 0:36:23.400
<v Speaker 1>leading the charge in research. I want to. I want honesty.

0:36:23.719 --> 0:36:27.640
<v Speaker 1>I want, you know, hope where there's hope. I want

0:36:29.000 --> 0:36:32.520
<v Speaker 1>someone to be pragmatic where it's called for, Like, but

0:36:32.600 --> 0:36:37.279
<v Speaker 1>I don't want information that can't be verified or backed up.

0:36:37.880 --> 0:36:41.560
<v Speaker 1>And I also don't want to be a cancer person.

0:36:41.719 --> 0:36:44.880
<v Speaker 1>I want to you know, And I've often done some

0:36:45.080 --> 0:36:49.000
<v Speaker 1>very stupid, stupid things since being diagnosed because of my

0:36:49.120 --> 0:36:52.680
<v Speaker 1>desire to be normal, because I've like rejected the idea

0:36:52.840 --> 0:36:58.040
<v Speaker 1>that I'm a cancer in quote patient, Like, i have

0:36:58.200 --> 0:37:01.200
<v Speaker 1>cancer and I'm managing it. I'm managing it with you,

0:37:01.280 --> 0:37:04.080
<v Speaker 1>and I'm managing it with you know, doctor Ju and

0:37:04.120 --> 0:37:07.440
<v Speaker 1>like whoever else we need to bring in to help

0:37:07.680 --> 0:37:11.040
<v Speaker 1>in those moments. But I don't want it to define

0:37:11.239 --> 0:37:12.880
<v Speaker 1>my everyday life.

0:37:13.000 --> 0:37:17.160
<v Speaker 2>Well so much so that you know, And we've always kept,

0:37:17.200 --> 0:37:20.719
<v Speaker 2>which I think is a super healthy and amazing way

0:37:20.760 --> 0:37:24.239
<v Speaker 2>to do it. We've always kept our lane separate. Yeah,

0:37:24.280 --> 0:37:27.279
<v Speaker 2>so when we're together as social aized friends, it's a

0:37:27.320 --> 0:37:30.760
<v Speaker 2>friend lane. When we're doing medical self to medical lane,

0:37:30.840 --> 0:37:32.640
<v Speaker 2>and you know, every once in a while those things

0:37:32.680 --> 0:37:35.160
<v Speaker 2>have to cross over, but it's extremely rare. And you,

0:37:35.560 --> 0:37:39.440
<v Speaker 2>for example, will never ask me anything medical when we're

0:37:39.440 --> 0:37:41.640
<v Speaker 2>doing something social, or if you have to, you'll say, look,

0:37:41.680 --> 0:37:43.640
<v Speaker 2>I'm really sorry for asking this right now when we're

0:37:43.640 --> 0:37:45.480
<v Speaker 2>having dinner, but just blah blah blah blah. It's some

0:37:45.560 --> 0:37:47.200
<v Speaker 2>little knit or whatever that you have to do.

0:37:47.360 --> 0:37:52.680
<v Speaker 1>I've been to dinners with you. I've seen your phone.

0:37:53.000 --> 0:37:55.080
<v Speaker 1>I mean I haven't seen it, but like i've seen it.

0:37:55.080 --> 0:37:59.440
<v Speaker 1>How many you know you were inundated twenty four hours

0:37:59.480 --> 0:38:02.080
<v Speaker 1>a day, days a week. You do not get a

0:38:02.160 --> 0:38:05.520
<v Speaker 1>day off of you know, medical questions, and your patients

0:38:05.640 --> 0:38:08.239
<v Speaker 1>have your cell phone, and you know you've given full

0:38:08.320 --> 0:38:11.080
<v Speaker 1>access to yourself. So when I'm able to steal you

0:38:11.080 --> 0:38:13.640
<v Speaker 1>away and we go to dinner somewhere, I don't want

0:38:13.680 --> 0:38:15.799
<v Speaker 1>to do that. Like, if I have a question for you,

0:38:16.400 --> 0:38:18.879
<v Speaker 1>I'll text you during business hours or I'll come into

0:38:18.920 --> 0:38:22.279
<v Speaker 1>the clinic and I'll ask you. You know, we just

0:38:22.320 --> 0:38:26.319
<v Speaker 1>went to Italy together. You invited me on this amazing

0:38:26.640 --> 0:38:32.120
<v Speaker 1>yacht and with your family, and I got to go

0:38:32.160 --> 0:38:35.480
<v Speaker 1>to Italy with you, which was like bucket list. By

0:38:35.520 --> 0:38:37.600
<v Speaker 1>the way, you knew it was on my bucket list,

0:38:38.080 --> 0:38:40.960
<v Speaker 1>And when you called me, you said, like, it's kind

0:38:41.000 --> 0:38:44.120
<v Speaker 1>of bucket list, Shan, And I was like, I was

0:38:44.200 --> 0:38:45.000
<v Speaker 1>so excited.

0:38:46.239 --> 0:38:47.960
<v Speaker 2>We had the best time, such.

0:38:47.719 --> 0:38:51.000
<v Speaker 1>A good time, what an amazing went, an amazing trip.

0:38:51.239 --> 0:38:53.120
<v Speaker 2>We made some amazing restaurant.

0:38:53.239 --> 0:38:56.120
<v Speaker 1>So yeah, I wish i'd coordinated my outfits better with you.

0:38:56.200 --> 0:38:58.160
<v Speaker 1>But now I know what to expect.

0:38:59.320 --> 0:39:02.239
<v Speaker 2>And she was is you know. I mean, it's just incredible,

0:39:02.760 --> 0:39:06.719
<v Speaker 2>like jumping off of every level of the yacht, even

0:39:06.760 --> 0:39:10.200
<v Speaker 2>the highest of like Shannon is fearless. I mean, she

0:39:10.239 --> 0:39:10.759
<v Speaker 2>truly is.

0:39:10.880 --> 0:39:11.840
<v Speaker 1>I did injure myself.

0:39:11.920 --> 0:39:13.640
<v Speaker 2>Well I know you did, but I was going to

0:39:13.680 --> 0:39:17.600
<v Speaker 2>skip over that. It wasn't It wasn't jumping off the boat, however,

0:39:17.719 --> 0:39:18.040
<v Speaker 2>it was.

0:39:20.760 --> 0:39:23.239
<v Speaker 1>I mean that's the crazy thing, Like you jump off

0:39:23.360 --> 0:39:28.239
<v Speaker 1>like the highest points of this ginormous yacht and you

0:39:28.320 --> 0:39:30.680
<v Speaker 1>go to climb back on, and I got scared of

0:39:30.719 --> 0:39:35.240
<v Speaker 1>the of the jellyfish, so I went the long way.

0:39:35.800 --> 0:39:37.360
<v Speaker 2>That was at night, I think, yeah.

0:39:37.120 --> 0:39:40.920
<v Speaker 1>And the dangerous way, and that's when I gave myself

0:39:40.920 --> 0:39:42.600
<v Speaker 1>that that big bump on my leg.

0:39:42.680 --> 0:39:45.319
<v Speaker 2>And that was really crazy too, because since it was night,

0:39:45.600 --> 0:39:49.640
<v Speaker 2>the crew had the bright light shining onto the sea,

0:39:49.840 --> 0:39:51.920
<v Speaker 2>and all of a sudden we can see all these

0:39:52.000 --> 0:39:55.200
<v Speaker 2>jellyfish floating around in there. That's, of course we never

0:39:55.239 --> 0:39:58.680
<v Speaker 2>saw during the day, and it was like, oh, did

0:39:58.719 --> 0:39:59.879
<v Speaker 2>she really just jump in there?

0:40:00.120 --> 0:40:02.640
<v Speaker 1>Yeah, because they didn't see them when I did the jump.

0:40:02.680 --> 0:40:05.359
<v Speaker 1>It's like jumping in a shark infested waters like I

0:40:05.400 --> 0:40:08.080
<v Speaker 1>never would have done it had I known. But then

0:40:08.120 --> 0:40:12.360
<v Speaker 1>once I was swimming around, I was like, whoa, that's nuts.

0:40:12.400 --> 0:40:13.520
<v Speaker 1>I'm going to go the long way.

0:40:13.719 --> 0:40:15.680
<v Speaker 2>You know, Southern Italy is number for seafood.

0:40:17.920 --> 0:40:18.360
<v Speaker 1>I don't know.

0:40:18.400 --> 0:40:19.920
<v Speaker 2>In this case, you were the seafood.

0:40:20.120 --> 0:40:21.120
<v Speaker 1>I was seafood.

0:40:22.480 --> 0:40:22.760
<v Speaker 2>Wow.

0:40:22.960 --> 0:40:26.320
<v Speaker 1>Yeah, I mean we sort of did it fast forward

0:40:26.760 --> 0:40:30.120
<v Speaker 1>because I was going back to us meeting and you

0:40:30.239 --> 0:40:34.320
<v Speaker 1>sort of taking over my protocol and instantly saying, listen,

0:40:34.320 --> 0:40:37.439
<v Speaker 1>you gotta go get surgery, like that's the first thing.

0:40:37.719 --> 0:40:40.399
<v Speaker 2>Are you surprised that we did a fast forward. Yeah.

0:40:40.719 --> 0:40:44.200
<v Speaker 2>We always start down a road and shortly turned down

0:40:44.200 --> 0:40:44.680
<v Speaker 2>a lane.

0:40:45.040 --> 0:40:47.440
<v Speaker 1>Unpredictable is the word that you use to start with,

0:40:47.520 --> 0:40:48.920
<v Speaker 1>and that still matches and.

0:40:48.920 --> 0:40:51.279
<v Speaker 2>There it goes, and that's the magic at all.

0:40:59.760 --> 0:41:01.719
<v Speaker 1>So you said you got to get the tumor out

0:41:01.760 --> 0:41:04.720
<v Speaker 1>of your breast, like, let's like, that's the first thing.

0:41:05.120 --> 0:41:07.760
<v Speaker 1>And then once that's done, you're going to go on chemo,

0:41:07.880 --> 0:41:11.160
<v Speaker 1>You're going to get radiation, and we did. We did

0:41:11.200 --> 0:41:15.040
<v Speaker 1>all of that, and I made the decision at some

0:41:15.160 --> 0:41:20.560
<v Speaker 1>point to not take tomoxifen, which is you know, obviously

0:41:20.600 --> 0:41:25.640
<v Speaker 1>a drug that everybody recommends that you take because it

0:41:25.680 --> 0:41:28.120
<v Speaker 1>is a hormone blocker.

0:41:27.920 --> 0:41:31.440
<v Speaker 2>And it was adgivant therapy, meaning that you had no

0:41:31.480 --> 0:41:34.200
<v Speaker 2>known cancer and it was being given. It would be

0:41:34.239 --> 0:41:37.480
<v Speaker 2>given to increase the chances that cancer not come back

0:41:37.600 --> 0:41:41.920
<v Speaker 2>by staying in your system and blocking the cell's ability

0:41:41.960 --> 0:41:44.880
<v Speaker 2>to grow. Estringe is a growth factor for cancer cells,

0:41:44.920 --> 0:41:49.520
<v Speaker 2>So tomoxism would block the estrogen to the cancer cell,

0:41:49.760 --> 0:41:55.120
<v Speaker 2>and hopefully any microscopic disease that maybe have been in

0:41:55.160 --> 0:41:57.680
<v Speaker 2>your body that's too small to show up on imaging

0:41:57.719 --> 0:41:59.399
<v Speaker 2>and that we didn't know about that maybe it would

0:41:59.480 --> 0:42:03.160
<v Speaker 2>kill that and increased the odds that it wouldn't come back.

0:42:03.680 --> 0:42:06.960
<v Speaker 2>That was the principle of adgement therapy of demoxmin.

0:42:06.680 --> 0:42:10.120
<v Speaker 1>Which is a you know, solid argument, Like I look

0:42:10.200 --> 0:42:12.759
<v Speaker 1>back and I go, well, maybe how to do that?

0:42:13.160 --> 0:42:15.919
<v Speaker 1>Taking it? You know? I mean, I've had some people

0:42:15.960 --> 0:42:17.759
<v Speaker 1>in my life have sort of forced me to look

0:42:17.840 --> 0:42:21.040
<v Speaker 1>back like that, But I can't, right, because what good

0:42:21.120 --> 0:42:22.680
<v Speaker 1>is it? It doesn't do you.

0:42:22.680 --> 0:42:25.440
<v Speaker 2>You make the best decision you can at the time

0:42:25.480 --> 0:42:29.800
<v Speaker 2>you make it, and in retrospect you often cannot remember

0:42:30.520 --> 0:42:33.200
<v Speaker 2>many of the factors that were influencing you. So when

0:42:33.200 --> 0:42:37.080
<v Speaker 2>you look back, you have an erroneous evaluation of your decision.

0:42:37.480 --> 0:42:41.640
<v Speaker 2>But at the time, you had been on estrogen blockade

0:42:42.440 --> 0:42:46.640
<v Speaker 2>before you ever had surgery, and it wasn't very effective

0:42:46.680 --> 0:42:50.239
<v Speaker 2>on shrinking your tumor, and you had a lot of

0:42:50.640 --> 0:42:53.200
<v Speaker 2>effects on your body that you didn't like. So those

0:42:53.200 --> 0:42:57.359
<v Speaker 2>two factors were influencing you to not choose to take

0:42:57.400 --> 0:43:00.200
<v Speaker 2>that drug at that time. And you were disease free,

0:43:00.760 --> 0:43:03.319
<v Speaker 2>and the balance of things to you at the time

0:43:03.480 --> 0:43:06.600
<v Speaker 2>seemed reasonable. And you did not make that lightly, and

0:43:06.640 --> 0:43:11.040
<v Speaker 2>you made it over and over again because I asked

0:43:11.080 --> 0:43:14.080
<v Speaker 2>you every single time for a year, are you sure

0:43:14.280 --> 0:43:15.719
<v Speaker 2>you don't want to do this? Issue? You want to

0:43:15.719 --> 0:43:19.080
<v Speaker 2>do this? So you were. You were resolute in your decision,

0:43:19.320 --> 0:43:22.040
<v Speaker 2>and you can't judge that decision, and no one else

0:43:22.080 --> 0:43:24.560
<v Speaker 2>can force you to because you made the best decision

0:43:24.560 --> 0:43:26.600
<v Speaker 2>you could at the time. And it's a it's an

0:43:26.760 --> 0:43:29.320
<v Speaker 2>erroneous set of analyzes when you look backwards.

0:43:29.680 --> 0:43:33.600
<v Speaker 1>Yeah, I mean, I also think that I was fairly

0:43:33.640 --> 0:43:38.560
<v Speaker 1>certain it wasn't going to come back, because I believed

0:43:38.680 --> 0:43:41.440
<v Speaker 1>that the reason why I got cancer was because I

0:43:41.520 --> 0:43:45.640
<v Speaker 1>did IVF right. I met my husband at the time.

0:43:45.960 --> 0:43:50.440
<v Speaker 1>Later in years and you know, a multitude of things happen.

0:43:50.560 --> 0:43:53.200
<v Speaker 1>And so when it was time to have that decision,

0:43:54.239 --> 0:43:57.880
<v Speaker 1>we chose to have we needed IVF, and I did

0:43:58.360 --> 0:44:00.799
<v Speaker 1>a bunch of rounds of it, and I i, you know,

0:44:01.120 --> 0:44:03.920
<v Speaker 1>through a lot of other women that I knew that

0:44:04.000 --> 0:44:07.480
<v Speaker 1>did IVF that ended up getting breast cancer as well.

0:44:08.160 --> 0:44:10.480
<v Speaker 1>Sort of the numbers all started stacking up in my

0:44:10.680 --> 0:44:14.160
<v Speaker 1>head that if you know, you sort of have a

0:44:14.280 --> 0:44:16.920
<v Speaker 1>cell that's a little wonky and that's sitting on the

0:44:17.080 --> 0:44:20.960
<v Speaker 1>edge of maybe turning spreading cancer, blah blah blah, that

0:44:22.200 --> 0:44:24.640
<v Speaker 1>the all the hormones that you're pumping into your body

0:44:24.680 --> 0:44:27.920
<v Speaker 1>from IVF are only going to up that chance of it.

0:44:28.640 --> 0:44:31.960
<v Speaker 1>That was at least my thinking. So when I got

0:44:32.040 --> 0:44:35.160
<v Speaker 1>the you know, you're all clear remission after chemo and

0:44:35.280 --> 0:44:38.960
<v Speaker 1>all of that, I knew I wasn't doing IVF anymore

0:44:39.000 --> 0:44:41.759
<v Speaker 1>because I was already a menopause, so like there was

0:44:41.840 --> 0:44:45.000
<v Speaker 1>no need for it. I was pretty sure, you know,

0:44:45.040 --> 0:44:47.120
<v Speaker 1>I don't want to say that I made a very

0:44:48.160 --> 0:44:53.320
<v Speaker 1>uninformed decision, Like I am a researcher. I'm hardcore about

0:44:53.560 --> 0:44:56.040
<v Speaker 1>you know, backing up some of my data, certainly not

0:44:56.120 --> 0:44:59.040
<v Speaker 1>at your level and certainly not at doctor's levels, and

0:45:00.160 --> 0:45:05.320
<v Speaker 1>researchers levels. So my decision was at the time based

0:45:05.320 --> 0:45:08.120
<v Speaker 1>on sort of the facts that I knew that I

0:45:08.160 --> 0:45:12.560
<v Speaker 1>had investigated, and you, in fact, did keep on encouraging

0:45:12.600 --> 0:45:14.920
<v Speaker 1>me to take the demoxifin, and I was just like,

0:45:15.160 --> 0:45:16.040
<v Speaker 1>absolutely not.

0:45:16.400 --> 0:45:20.879
<v Speaker 2>You're a resolute yeah, but also yes, you did research things.

0:45:20.920 --> 0:45:23.200
<v Speaker 2>But also there was another factor in there, which is,

0:45:23.400 --> 0:45:26.480
<v Speaker 2>even though you know, anyone who's sort of close to

0:45:27.160 --> 0:45:32.359
<v Speaker 2>menopause often goes into menopause with chemotherapy, sometimes people who

0:45:32.400 --> 0:45:35.200
<v Speaker 2>are not close to menopause go into it as well,

0:45:35.239 --> 0:45:39.680
<v Speaker 2>but then it sometimes returns, menstruation can return, and you

0:45:39.760 --> 0:45:42.640
<v Speaker 2>were still hopeful that it might return for you because

0:45:42.680 --> 0:45:43.520
<v Speaker 2>you still want.

0:45:43.360 --> 0:45:45.759
<v Speaker 1>To have a baby, yeah, desperately.

0:45:45.320 --> 0:45:48.200
<v Speaker 2>And I think that played a role in the demoxpin thing, which,

0:45:49.000 --> 0:45:52.480
<v Speaker 2>you know, people at this stage where you're at doesn't

0:45:52.680 --> 0:45:54.920
<v Speaker 2>seem like a factor, but that was a factor at

0:45:54.920 --> 0:45:58.080
<v Speaker 2>the time, this sort of hopefulness that maybe you could

0:45:58.320 --> 0:45:59.120
<v Speaker 2>still have a baby.

0:45:59.760 --> 0:46:02.399
<v Speaker 1>Yeah. Yeah, I mean, thank you for reminding me of that,

0:46:02.520 --> 0:46:06.400
<v Speaker 1>because it did definitely play a huge role of you know,

0:46:06.520 --> 0:46:09.600
<v Speaker 1>wanting not only not only did I want a child

0:46:09.600 --> 0:46:12.400
<v Speaker 1>for myself, but I wanted it, you know, for my husband.

0:46:12.440 --> 0:46:15.440
<v Speaker 1>I wanted it for our marriage. I wanted, you know,

0:46:15.840 --> 0:46:18.879
<v Speaker 1>I wanted him to have that part of him self

0:46:18.960 --> 0:46:23.359
<v Speaker 1>fulfilled as well. So it seemed like a calculated risk

0:46:23.440 --> 0:46:27.040
<v Speaker 1>that wasn't too bad of one to take. Plus I

0:46:27.080 --> 0:46:30.920
<v Speaker 1>can't remember, you'll correct me. I think it's cervical cancer.

0:46:31.239 --> 0:46:35.400
<v Speaker 1>That there's a percentage of demoxifensity to increase. You'ine cancer,

0:46:35.480 --> 0:46:37.680
<v Speaker 1>thank you, And I was like, well, you know, that

0:46:37.840 --> 0:46:40.439
<v Speaker 1>just gave me one more reason to say no to it,

0:46:40.800 --> 0:46:42.759
<v Speaker 1>and yeah, and you're right, and I can't look back,

0:46:42.960 --> 0:46:43.960
<v Speaker 1>and so.

0:46:44.000 --> 0:46:46.520
<v Speaker 2>Moving forward, I think, but I think also, don't forget

0:46:46.600 --> 0:46:50.080
<v Speaker 2>that cancer and cancer treatment you know, caused you to

0:46:50.120 --> 0:46:52.400
<v Speaker 2>look back at you know, your own life and to

0:46:52.440 --> 0:46:56.080
<v Speaker 2>be very philosophical. You know, it made you want to

0:46:56.080 --> 0:46:59.000
<v Speaker 2>have a child for another reason too, which is, you know,

0:46:59.080 --> 0:47:02.680
<v Speaker 2>to be able to part you know, the very many

0:47:02.760 --> 0:47:05.200
<v Speaker 2>things that you've learned in life and the many feelings

0:47:05.200 --> 0:47:08.759
<v Speaker 2>that you had into raising a human being, you know,

0:47:08.880 --> 0:47:14.000
<v Speaker 2>I mean, that's that's the ultimate diary, is to raise

0:47:14.040 --> 0:47:17.919
<v Speaker 2>a child and try to infuse their life with all

0:47:17.920 --> 0:47:22.000
<v Speaker 2>the wisdoms that you had and and helping them try

0:47:22.040 --> 0:47:25.640
<v Speaker 2>to avoid the mistakes that you made and that they're

0:47:25.680 --> 0:47:27.719
<v Speaker 2>going to not make some of their own of course

0:47:27.760 --> 0:47:31.160
<v Speaker 2>they will, but there's a you know, you were in

0:47:31.160 --> 0:47:36.879
<v Speaker 2>the spotlight since you were a young girl, and you've

0:47:36.920 --> 0:47:40.640
<v Speaker 2>lived a million lives when most people, you know, we're

0:47:40.719 --> 0:47:42.600
<v Speaker 2>just starting out or we're in the beginning of the careers.

0:47:42.600 --> 0:47:46.440
<v Speaker 2>You've already had two or three careers, and you know

0:47:46.480 --> 0:47:50.319
<v Speaker 2>fought your way, you know, in a Hollywood scene that

0:47:50.600 --> 0:47:53.799
<v Speaker 2>you know didn't necessarily you know, regard what you had

0:47:53.840 --> 0:47:57.319
<v Speaker 2>to say. And I mean, I've never met anybody as

0:47:57.360 --> 0:48:00.319
<v Speaker 2>well educated as you who was schooled on the set.

0:48:00.440 --> 0:48:02.520
<v Speaker 2>And I of course, as you know, many many people

0:48:02.520 --> 0:48:05.040
<v Speaker 2>were schooled on sets. But you have a you know

0:48:05.200 --> 0:48:10.680
<v Speaker 2>a level of comprehension and power of intelligence and use

0:48:10.719 --> 0:48:14.319
<v Speaker 2>of that intelligence, and you know, in a very incisive

0:48:14.360 --> 0:48:17.640
<v Speaker 2>way in cooking as well, for example, there are not

0:48:17.800 --> 0:48:21.720
<v Speaker 2>that many people who go on to be these amazing cooks.

0:48:21.760 --> 0:48:23.960
<v Speaker 2>And I mean everything you do is full tilt. That's

0:48:24.000 --> 0:48:26.960
<v Speaker 2>who you are, and that's how you make your decisions.

0:48:27.640 --> 0:48:32.719
<v Speaker 2>And so I actually find it very gratifying that you

0:48:33.000 --> 0:48:36.640
<v Speaker 2>research things and you you know, make your definitive decision,

0:48:36.760 --> 0:48:41.440
<v Speaker 2>because you see in medical decision making, people want shared

0:48:41.440 --> 0:48:43.799
<v Speaker 2>decisions with the physician, which I'm all about. I mean,

0:48:43.800 --> 0:48:46.440
<v Speaker 2>I'm all about that. I love that, as you know

0:48:46.560 --> 0:48:50.400
<v Speaker 2>and as all my patients know. But part and parcel

0:48:50.480 --> 0:48:53.960
<v Speaker 2>of shared decision making is accepting responsibility for the decision.

0:48:54.800 --> 0:48:59.560
<v Speaker 2>And you always do that. Sometimes people want share decision making,

0:49:00.040 --> 0:49:02.439
<v Speaker 2>and if it's not the right decision, then they want

0:49:02.480 --> 0:49:05.560
<v Speaker 2>to look to everyone else for you know, why the

0:49:05.600 --> 0:49:08.600
<v Speaker 2>wrong decision was made or whatever. But when you when

0:49:08.600 --> 0:49:11.279
<v Speaker 2>you're a person who really owns it, and like all

0:49:11.360 --> 0:49:13.640
<v Speaker 2>my patients do, but you are the you know, the

0:49:13.760 --> 0:49:17.479
<v Speaker 2>prime example of that of someone who you know, wants

0:49:17.480 --> 0:49:19.800
<v Speaker 2>to part, to stay in process, wants to know the data,

0:49:20.400 --> 0:49:22.840
<v Speaker 2>and once you make your decision, you own responsibility for

0:49:22.840 --> 0:49:25.880
<v Speaker 2>your decision. And I love that because that's that's just

0:49:26.080 --> 0:49:28.360
<v Speaker 2>the being a person of truth.

0:49:28.840 --> 0:49:33.640
<v Speaker 1>Accountability I love nothing. Accountability is like my favorite thing.

0:49:34.280 --> 0:49:37.239
<v Speaker 1>So if I made a decision that put me in

0:49:37.280 --> 0:49:41.440
<v Speaker 1>a certain place, then I hold myself accountable like you

0:49:41.560 --> 0:49:41.880
<v Speaker 1>have to.

0:49:42.120 --> 0:49:44.040
<v Speaker 2>I've seen that over and over and over again, and

0:49:44.120 --> 0:49:46.480
<v Speaker 2>everything you've said and done and even in stories we've

0:49:46.480 --> 0:49:50.719
<v Speaker 2>talked about about your career, Yes, and certain decisions that

0:49:51.000 --> 0:49:53.640
<v Speaker 2>you've made in response to things that happened or this

0:49:53.760 --> 0:49:57.200
<v Speaker 2>or that you've you know, you've always accepted responsibility for

0:49:57.239 --> 0:49:59.600
<v Speaker 2>those and you know, the thing is that even when

0:49:59.680 --> 0:50:03.839
<v Speaker 2>when things happened that weren't your responsibility, you will describe it,

0:50:03.920 --> 0:50:07.000
<v Speaker 2>but you're also not You've never been finger pointing of people.

0:50:07.080 --> 0:50:09.120
<v Speaker 2>Say that person did that.

0:50:09.120 --> 0:50:09.719
<v Speaker 1>That's a new thing.

0:50:10.880 --> 0:50:13.600
<v Speaker 2>As that person did that, you'll say what they did,

0:50:13.640 --> 0:50:16.720
<v Speaker 2>but you'll also understand the other factors that we're bearing

0:50:16.760 --> 0:50:20.080
<v Speaker 2>on the scenario. Yeah, and I've always respected.

0:50:19.640 --> 0:50:22.120
<v Speaker 1>That for the most part. I think every you know,

0:50:22.160 --> 0:50:24.919
<v Speaker 1>there's always the exception to the rule where I point

0:50:24.960 --> 0:50:28.759
<v Speaker 1>the finger and go, you're bearing the full brunt of

0:50:28.800 --> 0:50:31.040
<v Speaker 1>this one because this is all on you.

0:50:32.000 --> 0:50:33.880
<v Speaker 2>And when you do that, it's very believable because you

0:50:33.920 --> 0:50:34.760
<v Speaker 2>don't do that often.

0:50:35.200 --> 0:50:39.000
<v Speaker 1>Doctor piro LP. Thank you so much for being on.

0:50:39.719 --> 0:50:41.760
<v Speaker 1>There is so much more for us to talk about.

0:50:41.880 --> 0:50:45.400
<v Speaker 1>So I'm going to have you on for another episode

0:50:46.000 --> 0:50:49.759
<v Speaker 1>and just keep digging and keep exploring because I just

0:50:50.239 --> 0:50:53.279
<v Speaker 1>I think you have so much to offer and this

0:50:53.320 --> 0:50:56.080
<v Speaker 1>conversation is incredibly important to a lot of people. So

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<v Speaker 1>thank you very much and I love you end Yeah,

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<v Speaker 1>see you soon.