1 00:00:03,920 --> 00:00:06,960 Speaker 1: We're partnering with Eli Lilly and Company for Breast Cancer 2 00:00:07,000 --> 00:00:11,040 Speaker 1: Awareness Month. A cancer diagnosis can impact every aspect of 3 00:00:11,080 --> 00:00:14,960 Speaker 1: someone's life, but they shouldn't face it alone. Research shows 4 00:00:15,000 --> 00:00:18,560 Speaker 1: that support and human connection play a significant role in 5 00:00:18,600 --> 00:00:22,120 Speaker 1: one's healing and mental health. That's why Lily is working 6 00:00:22,160 --> 00:00:27,680 Speaker 1: with patients, caregivers, and advocates to amplify voices, advanced treatment, 7 00:00:27,920 --> 00:00:32,159 Speaker 1: and empower the early and metastatic breast cancer community. Learn 8 00:00:32,200 --> 00:00:35,320 Speaker 1: more about how Lily is making a difference at Lily 9 00:00:35,520 --> 00:00:41,479 Speaker 1: dot com. Hi everyone, I'm Kitty Kuric and this is 10 00:00:41,640 --> 00:00:47,080 Speaker 1: next question. As many of you might know, I've been 11 00:00:47,120 --> 00:00:49,520 Speaker 1: through my own breast cancer journey and the one thing 12 00:00:49,680 --> 00:00:52,720 Speaker 1: I've learned is that the story doesn't necessarily stop when 13 00:00:52,760 --> 00:00:55,840 Speaker 1: treatment ends. In fact, for so many women, that's when 14 00:00:55,840 --> 00:00:59,520 Speaker 1: a whole new chapter begins. Today I'm talking with doctor 15 00:00:59,560 --> 00:01:03,240 Speaker 1: Lilly Smith, Senior Vice president and Global Development head for 16 00:01:03,320 --> 00:01:06,600 Speaker 1: breast Cancer at Eli Lilly and Company, as well as 17 00:01:06,640 --> 00:01:10,960 Speaker 1: breast cancer patient advocate and Lily partner Lecha Role. We're 18 00:01:11,000 --> 00:01:14,440 Speaker 1: talking about life after diagnosis and treatment. Why knowing your 19 00:01:14,480 --> 00:01:18,120 Speaker 1: body's normal is so critical, how to understand your risk 20 00:01:18,160 --> 00:01:21,800 Speaker 1: of recurrence, especially when diagnosed with early breast cancer that 21 00:01:21,880 --> 00:01:24,759 Speaker 1: does have a high risk of coming back, and what 22 00:01:24,800 --> 00:01:28,160 Speaker 1: it means to be your own advocate and follow up care. 23 00:01:30,160 --> 00:01:32,880 Speaker 1: Doctor Smith and Leshay, Welcome to both of you. I'm 24 00:01:32,920 --> 00:01:35,360 Speaker 1: so excited to be with you and have this important 25 00:01:35,400 --> 00:01:40,560 Speaker 1: conversation about breast cancer and really life after breast cancer treatment. 26 00:01:41,080 --> 00:01:42,800 Speaker 1: And doctor Smith, may I call you Lily? 27 00:01:42,959 --> 00:01:43,640 Speaker 2: You may, of course. 28 00:01:43,720 --> 00:01:46,080 Speaker 1: Let me start with you. I know you went into 29 00:01:46,120 --> 00:01:50,640 Speaker 1: oncology and then you decided to really focus on breast cancer. 30 00:01:51,120 --> 00:01:53,559 Speaker 1: What led you down this path? What was it about 31 00:01:53,680 --> 00:01:56,160 Speaker 1: breast cancer in particular that interested you? 32 00:01:56,880 --> 00:01:59,080 Speaker 2: So you know, honestly, it was the patients that drew 33 00:01:59,120 --> 00:02:02,880 Speaker 2: me in. I mean, obviously, breast cancer predominantly affects women, 34 00:02:03,440 --> 00:02:05,760 Speaker 2: and I got the sense really early on in my 35 00:02:05,880 --> 00:02:08,040 Speaker 2: training that these were the women and the patients that 36 00:02:08,080 --> 00:02:11,040 Speaker 2: I wanted to look after. It just always felt like 37 00:02:11,160 --> 00:02:15,160 Speaker 2: critically important work. And then I would say, added to that, 38 00:02:15,200 --> 00:02:17,239 Speaker 2: the science pulled me in. Breast cancer is one of 39 00:02:17,280 --> 00:02:20,600 Speaker 2: the fastest moving feels in oncology, and the more I 40 00:02:20,639 --> 00:02:24,040 Speaker 2: treated patients, the more motivated I became to really try 41 00:02:24,120 --> 00:02:28,320 Speaker 2: and find new and improved ways to care for those patients. Ultimately, 42 00:02:28,560 --> 00:02:31,080 Speaker 2: I just wanted to be part of driving improved outcomes 43 00:02:31,080 --> 00:02:32,320 Speaker 2: for patients with this disease. 44 00:02:32,800 --> 00:02:36,000 Speaker 1: Lche. I know that you share a lot of interest 45 00:02:36,520 --> 00:02:41,760 Speaker 1: with Lilian and that you were studying breast cancer prevention 46 00:02:42,560 --> 00:02:45,560 Speaker 1: and you were getting a PhD and still are in 47 00:02:45,639 --> 00:02:52,160 Speaker 1: public health when ironically you were diagnosed yourself with breast cancer. 48 00:02:52,720 --> 00:02:54,960 Speaker 1: Tell me about that, and that was I know, in 49 00:02:55,000 --> 00:02:57,760 Speaker 1: twenty twenty four, you were just twenty six years old. 50 00:02:57,880 --> 00:03:03,000 Speaker 3: Liche, Yeah, I was young. So for me, basically, I 51 00:03:03,040 --> 00:03:05,120 Speaker 3: was in the middle of my PhD. Second year of 52 00:03:05,200 --> 00:03:09,560 Speaker 3: my PhD, and I thought, I'm doing cancer research, cancer 53 00:03:09,600 --> 00:03:13,720 Speaker 3: prevention in particular, and I felt a lump. I was like, hmm, 54 00:03:14,360 --> 00:03:17,560 Speaker 3: that's one of those things that I tell people might 55 00:03:17,600 --> 00:03:19,720 Speaker 3: be a risk factor. And I felt a little pain 56 00:03:19,760 --> 00:03:22,840 Speaker 3: in my breast and I was like, that's another red flag. 57 00:03:23,040 --> 00:03:24,720 Speaker 4: And so I did with. 58 00:03:24,680 --> 00:03:27,960 Speaker 3: What I hope many people do when they find that 59 00:03:28,040 --> 00:03:30,440 Speaker 3: something is wrong, they going to get checked out. So 60 00:03:30,480 --> 00:03:32,320 Speaker 3: I went to do a woman's health exam at the 61 00:03:32,360 --> 00:03:36,080 Speaker 3: student Health Center and they let me know that, hmm, 62 00:03:36,280 --> 00:03:39,040 Speaker 3: you have a lump there. Maybe it could be something 63 00:03:39,080 --> 00:03:41,360 Speaker 3: could not be most likely due to your age. It's 64 00:03:41,760 --> 00:03:44,960 Speaker 3: fibrus tissue. But they went and sent me off to 65 00:03:45,000 --> 00:03:48,600 Speaker 3: do a mamma gramina ultrasound anyway, and we all know 66 00:03:48,800 --> 00:03:52,560 Speaker 3: that story ended. They found that I did indeed have cancer. 67 00:03:53,040 --> 00:03:56,640 Speaker 3: And I credit me doing my PhD in this field 68 00:03:56,720 --> 00:03:59,560 Speaker 3: to finding that because I think had I been in 69 00:03:59,600 --> 00:04:02,200 Speaker 3: a different place in my life or not in this field, 70 00:04:02,560 --> 00:04:05,000 Speaker 3: I would not have been alarmed by those things, and 71 00:04:05,360 --> 00:04:07,840 Speaker 3: I maybe would not have known that that was something 72 00:04:07,840 --> 00:04:10,440 Speaker 3: that could be related to cancer. And so my biggest 73 00:04:10,440 --> 00:04:12,760 Speaker 3: thing that I tell people all the time is get 74 00:04:12,760 --> 00:04:15,080 Speaker 3: to know your body and what is your normal, so 75 00:04:15,120 --> 00:04:18,080 Speaker 3: that if something is wrong, you know to get checked. 76 00:04:18,200 --> 00:04:23,000 Speaker 1: Well. Thank goodness, Lilian that Leche was studying this, knew 77 00:04:23,040 --> 00:04:26,920 Speaker 1: that this needed medical attention, did not blow it off 78 00:04:27,480 --> 00:04:30,640 Speaker 1: when and got it taken care of, but goodness she 79 00:04:30,760 --> 00:04:34,520 Speaker 1: would just she's twenty eight now, just twenty six years old. 80 00:04:35,440 --> 00:04:40,240 Speaker 1: We're seeing many more people, many more women getting diagnosed 81 00:04:40,480 --> 00:04:44,559 Speaker 1: with breast cancer at an earlier and earlier age, aren't 82 00:04:44,560 --> 00:04:45,400 Speaker 1: we We are? 83 00:04:45,600 --> 00:04:49,040 Speaker 2: I mean, in fact, it has resulted in US sort 84 00:04:49,040 --> 00:04:52,240 Speaker 2: of adjusting the screening guidelines within the US to lower 85 00:04:52,320 --> 00:04:55,440 Speaker 2: that age to forty, where the recommendation is to have 86 00:04:55,560 --> 00:05:00,360 Speaker 2: yearly mammograms from that age, So there is no doubt 87 00:05:00,920 --> 00:05:05,760 Speaker 2: that younger age a diagnosis breast cancer is rising in incidents, 88 00:05:06,040 --> 00:05:09,599 Speaker 2: both globally and specifically within the US. So it's really 89 00:05:09,800 --> 00:05:13,360 Speaker 2: important that folks remain aware of that. And I think 90 00:05:13,400 --> 00:05:16,719 Speaker 2: telling stories like Ache is describing today is just hugely 91 00:05:16,760 --> 00:05:20,160 Speaker 2: important for everyone to understand the changes that are happening 92 00:05:20,160 --> 00:05:20,600 Speaker 2: out there. 93 00:05:20,680 --> 00:05:24,640 Speaker 1: Because at her age, she was well below the guidelines 94 00:05:24,760 --> 00:05:28,640 Speaker 1: for getting screened, and yet you were aware enough to 95 00:05:28,760 --> 00:05:31,479 Speaker 1: notice a change in your body and Lechee, I really 96 00:05:31,520 --> 00:05:37,640 Speaker 1: admired the fact that you have shared your experience very publicly. 97 00:05:38,200 --> 00:05:41,640 Speaker 1: You've created a platform you talk about what happened to you. 98 00:05:42,279 --> 00:05:44,440 Speaker 1: Why has that been so important to you? 99 00:05:45,279 --> 00:05:48,760 Speaker 3: It's been extremely important for me because at the time 100 00:05:48,800 --> 00:05:51,360 Speaker 3: when I was diagnosed, I went to Instagram, I went 101 00:05:51,440 --> 00:05:54,000 Speaker 3: all over the internet and I tried to find somebody 102 00:05:54,040 --> 00:05:57,040 Speaker 3: who was like me, that was sharing maybe some aspect, 103 00:05:57,160 --> 00:06:00,159 Speaker 3: not even the full story like I am. And I 104 00:06:00,160 --> 00:06:03,240 Speaker 3: couldn't find anyone. I couldn't find anyone my age, I 105 00:06:03,240 --> 00:06:05,680 Speaker 3: couldn't find anyone that looked like me. I couldn't find 106 00:06:05,720 --> 00:06:07,560 Speaker 3: anyone who was powerlifting. 107 00:06:08,240 --> 00:06:12,039 Speaker 1: And yes, Bury the lead You're a power left. I'll 108 00:06:12,080 --> 00:06:12,719 Speaker 1: get to that. 109 00:06:12,600 --> 00:06:13,200 Speaker 4: In a moment. 110 00:06:14,040 --> 00:06:16,680 Speaker 3: Yes, And so what I wanted to do was I 111 00:06:16,800 --> 00:06:20,800 Speaker 3: wanted to create that person for other women who are 112 00:06:20,800 --> 00:06:23,400 Speaker 3: going to be diagnosed young, or who want to engage 113 00:06:23,440 --> 00:06:26,640 Speaker 3: in those activities, or or who have similarities to me. 114 00:06:27,200 --> 00:06:29,800 Speaker 3: And so that's why I want to share that, to 115 00:06:29,880 --> 00:06:33,080 Speaker 3: spread awareness and to have somebody who was out there 116 00:06:33,120 --> 00:06:35,040 Speaker 3: to be that person that I needed at the time. 117 00:06:35,160 --> 00:06:37,400 Speaker 1: What kind of feedback have you gotten, Liche? Has it 118 00:06:37,480 --> 00:06:41,120 Speaker 1: been gratifying to see that you're striking a chord and 119 00:06:41,440 --> 00:06:44,960 Speaker 1: educating so many women who not only look like you, 120 00:06:45,160 --> 00:06:47,440 Speaker 1: but who don't look like you and need to be 121 00:06:47,520 --> 00:06:50,800 Speaker 1: aware of the symptoms of breast cancer, especially at an 122 00:06:50,800 --> 00:06:51,560 Speaker 1: early age. 123 00:06:52,000 --> 00:06:57,920 Speaker 3: Yes, so it's been monumental. It's taken off much more 124 00:06:57,960 --> 00:07:01,640 Speaker 3: than I even thought. So initially I just posted that night. 125 00:07:01,880 --> 00:07:03,560 Speaker 3: I did want to share it with some people, and 126 00:07:03,560 --> 00:07:05,880 Speaker 3: I did want to make an impact, but it's made 127 00:07:06,040 --> 00:07:07,800 Speaker 3: much more of an impact than I could have ever 128 00:07:07,880 --> 00:07:11,200 Speaker 3: thought of, reaching people in different countries, like you said, 129 00:07:11,280 --> 00:07:14,640 Speaker 3: not just to look like me, everybody, and getting people 130 00:07:14,760 --> 00:07:18,120 Speaker 3: moving and people tagging me and saying I'm working out 131 00:07:18,200 --> 00:07:21,240 Speaker 3: today because I'm channeling my inner strong after cancer, and 132 00:07:21,280 --> 00:07:25,680 Speaker 3: I'm like, wow, this is incredible, And people are messaging 133 00:07:25,680 --> 00:07:28,480 Speaker 3: me saying they got their first mama around because they 134 00:07:28,560 --> 00:07:31,160 Speaker 3: realized that I was diagnosed so young and it actually 135 00:07:31,240 --> 00:07:35,600 Speaker 3: runs in their family and they weren't just getting screened 136 00:07:35,640 --> 00:07:38,000 Speaker 3: even though it runs in your family. And I'm sure 137 00:07:38,360 --> 00:07:41,760 Speaker 3: that many people can get screened because when you have 138 00:07:41,800 --> 00:07:44,640 Speaker 3: a genetic history, they do allow you to get it 139 00:07:44,680 --> 00:07:48,560 Speaker 3: covered and screened. And you know, I just A'm very 140 00:07:48,600 --> 00:07:52,640 Speaker 3: proud of what has happened, and I think that I 141 00:07:52,720 --> 00:07:53,640 Speaker 3: have no regrets. 142 00:07:53,880 --> 00:07:57,680 Speaker 1: Well, I'm so proud of you that you have shared 143 00:07:57,720 --> 00:08:01,040 Speaker 1: your story, and I want to mention something because I 144 00:08:01,040 --> 00:08:07,000 Speaker 1: think sometimes family history is used as an excuse or 145 00:08:07,080 --> 00:08:10,400 Speaker 1: no family history, I should say, for not really pay 146 00:08:10,520 --> 00:08:15,280 Speaker 1: attention to many cancers, including breast cancer. And the fact 147 00:08:15,360 --> 00:08:18,520 Speaker 1: of the matter is Lilian that most women who are 148 00:08:18,520 --> 00:08:22,520 Speaker 1: diagnosed with breast cancer have no family history, right. 149 00:08:22,480 --> 00:08:26,160 Speaker 2: Correct, entirely true, exactly. So I mean I think that 150 00:08:26,160 --> 00:08:30,440 Speaker 2: that's to your point. It's about understanding that you need 151 00:08:30,480 --> 00:08:33,560 Speaker 2: to know what normal is for your body and to 152 00:08:33,679 --> 00:08:37,360 Speaker 2: report any symptoms or red flags as you term them, 153 00:08:37,400 --> 00:08:40,600 Speaker 2: like new lumps, pains, issues. You really have to talk 154 00:08:40,640 --> 00:08:43,880 Speaker 2: to your doctor about them and don't dismiss them and think, oh, well, 155 00:08:43,920 --> 00:08:45,839 Speaker 2: this would never happen to me, or it doesn't. 156 00:08:45,640 --> 00:08:48,520 Speaker 1: Run in my family, right because it didn't run in 157 00:08:48,600 --> 00:08:53,240 Speaker 1: Lache's family. Absolutely, Let's talk about the steps you need 158 00:08:53,280 --> 00:08:57,840 Speaker 1: to take after you're diagnosed, and just having experienced it 159 00:08:57,960 --> 00:09:03,800 Speaker 1: myself a few years years ago, the staging is critically important. 160 00:09:04,320 --> 00:09:08,040 Speaker 1: So can you help people understand who haven't gone through 161 00:09:08,679 --> 00:09:12,320 Speaker 1: what Leche and I have or don't have your background, Lilian, 162 00:09:13,200 --> 00:09:17,000 Speaker 1: what the difference is between early stage breast cancer and 163 00:09:17,200 --> 00:09:18,679 Speaker 1: metastatic breast cancer. 164 00:09:19,040 --> 00:09:22,640 Speaker 2: Yeah, absolutely, so it's a critical distinction, and it's the 165 00:09:22,679 --> 00:09:26,120 Speaker 2: distinction that we make right at the time of diagnosis. 166 00:09:26,559 --> 00:09:29,560 Speaker 2: So early stage breast cancer is by far the most 167 00:09:29,600 --> 00:09:34,080 Speaker 2: common presentation, and that basically consists of breast cancer that 168 00:09:34,200 --> 00:09:37,880 Speaker 2: is confined to the breast or the local lymphnotes, and 169 00:09:37,920 --> 00:09:42,520 Speaker 2: the treatment intent for early breast cancer is cure. Typically 170 00:09:42,559 --> 00:09:46,960 Speaker 2: it consists of surgery first, so either a partial removal 171 00:09:46,960 --> 00:09:49,400 Speaker 2: of breast tissue or full removal of breast so. 172 00:09:49,440 --> 00:09:53,280 Speaker 1: You're talking about a lumpa lump versus aspect. 173 00:09:52,480 --> 00:09:55,960 Speaker 2: To me exactly, and then often that's followed by radiation 174 00:09:56,160 --> 00:10:01,079 Speaker 2: therapy and then in some cases chemotherapy or targeted therapy 175 00:10:01,120 --> 00:10:05,120 Speaker 2: like hormone therapies are offered. So that's early stage breast cancer. 176 00:10:05,600 --> 00:10:09,520 Speaker 2: Metastatic or advanced breast cancer is breast cancer that has 177 00:10:09,600 --> 00:10:13,680 Speaker 2: spread beyond the breast and local lymph node area to 178 00:10:13,800 --> 00:10:17,880 Speaker 2: a distant organ like long liver or bone, and the 179 00:10:17,920 --> 00:10:21,880 Speaker 2: treatment intent in that scenario is different. It is long 180 00:10:22,040 --> 00:10:26,640 Speaker 2: term treatment that is focusing on disease control and maintaining 181 00:10:26,720 --> 00:10:28,200 Speaker 2: quality of life for as long. 182 00:10:28,080 --> 00:10:32,240 Speaker 1: As we can. That's why early detection is so critically 183 00:10:32,280 --> 00:10:36,960 Speaker 1: most important, because it is much easier to eradicate the 184 00:10:37,000 --> 00:10:40,640 Speaker 1: disease when it's caught early instead of just managing the. 185 00:10:40,600 --> 00:10:41,920 Speaker 2: Disease correct andentarly. 186 00:10:42,600 --> 00:10:49,360 Speaker 1: Absolutely, let's talk lche about life after treatment. Your breast 187 00:10:49,360 --> 00:10:55,160 Speaker 1: cancer was stage two B, so that meant lymph node 188 00:10:55,160 --> 00:10:56,360 Speaker 1: involvement correct. 189 00:10:56,679 --> 00:10:58,880 Speaker 4: Yes, So I had lymph node involvement. 190 00:10:58,920 --> 00:11:03,120 Speaker 1: So that meant you needed chemotherapy and you got a mestectomy. 191 00:11:03,480 --> 00:11:03,800 Speaker 4: Yes. 192 00:11:04,440 --> 00:11:08,800 Speaker 1: So first of all, how was that treatment for you? 193 00:11:09,880 --> 00:11:14,880 Speaker 3: So for me, it honestly was it was a lot. 194 00:11:15,120 --> 00:11:18,760 Speaker 3: So being so young and having to have my breast removed, 195 00:11:19,360 --> 00:11:22,120 Speaker 3: it was just something I was not thinking about at all, 196 00:11:22,760 --> 00:11:26,880 Speaker 3: and it's something that's it feels so feminine, like it 197 00:11:26,920 --> 00:11:30,280 Speaker 3: feels like something that all women have. You have your breast. 198 00:11:30,360 --> 00:11:32,240 Speaker 3: That's one of the things that really sets us apart. 199 00:11:32,800 --> 00:11:35,160 Speaker 3: And so I had that removed and that was a 200 00:11:35,160 --> 00:11:38,520 Speaker 3: big thing. But then when I found out later that 201 00:11:38,960 --> 00:11:41,080 Speaker 3: it had spread all my lymph nodes because we were 202 00:11:41,120 --> 00:11:44,000 Speaker 3: still waiting for how many positive lymph nodes I had. 203 00:11:44,040 --> 00:11:46,720 Speaker 3: After surgery, found out I had to do chemo, and 204 00:11:47,160 --> 00:11:49,840 Speaker 3: you know when you hear the word chemo, it's very intimidating. 205 00:11:50,480 --> 00:11:54,640 Speaker 3: And so I had to do taxitair and cyclophosphamide that's 206 00:11:54,720 --> 00:11:59,040 Speaker 3: TC for four cycles and I lost all of my 207 00:11:59,160 --> 00:12:02,920 Speaker 3: hair and it was very, very emotional for me. But 208 00:12:03,640 --> 00:12:05,880 Speaker 3: you know, after I lost my hair, I was like, well, 209 00:12:06,400 --> 00:12:09,240 Speaker 3: that's it smooth sailing from hair. I was trying to 210 00:12:09,240 --> 00:12:12,440 Speaker 3: avoid losing my hair. That was the biggest thing. And 211 00:12:12,679 --> 00:12:14,560 Speaker 3: I just powered through it. And with the help of 212 00:12:14,600 --> 00:12:17,680 Speaker 3: my family and my dog. He was a big part. 213 00:12:17,800 --> 00:12:19,920 Speaker 3: He was a big part of my journey. I was 214 00:12:19,960 --> 00:12:23,280 Speaker 3: able to get through those two parts. And then I 215 00:12:23,320 --> 00:12:25,000 Speaker 3: had radiation after wood. 216 00:12:25,640 --> 00:12:27,720 Speaker 1: And which can make you very tired. 217 00:12:28,240 --> 00:12:31,720 Speaker 3: Oh yes, I had a lot of fatigue and there 218 00:12:31,960 --> 00:12:35,800 Speaker 3: was some mark, so it had some burning and discoloration 219 00:12:35,920 --> 00:12:39,280 Speaker 3: in that area. But just like chemotherapy, I got through it, 220 00:12:39,600 --> 00:12:43,000 Speaker 3: and I didn't stop doing anything throughout it. Throughout all 221 00:12:43,120 --> 00:12:46,400 Speaker 3: my treatment, I was still doing my PhD, I was 222 00:12:46,440 --> 00:12:48,760 Speaker 3: still working out, I was still living my life, and 223 00:12:49,160 --> 00:12:51,800 Speaker 3: I didn't let it stop me. So it might have 224 00:12:51,880 --> 00:12:54,920 Speaker 3: been hard, but you know what, I'm tougher than cancer. 225 00:12:55,360 --> 00:12:58,120 Speaker 1: I think a lot of people focus on the treatment liche, 226 00:12:58,240 --> 00:13:02,559 Speaker 1: but there's also life after treatment, something that I think 227 00:13:04,240 --> 00:13:08,440 Speaker 1: patients aren't necessarily prepared for. Lillian, what do you tell 228 00:13:08,520 --> 00:13:13,640 Speaker 1: patients who are saying, Okay, I'm done about the things 229 00:13:13,679 --> 00:13:17,040 Speaker 1: they might experience once the treatment is actually over. 230 00:13:17,280 --> 00:13:19,800 Speaker 2: Yeah, it's such an important question. So I would say, 231 00:13:19,920 --> 00:13:24,760 Speaker 2: once the upfront treatment of surgery, radiation, and chemotherapy is completed, 232 00:13:25,160 --> 00:13:29,839 Speaker 2: patients move into this active follow up schedule of follow 233 00:13:29,920 --> 00:13:32,840 Speaker 2: up visits. So typically what that looks like is they 234 00:13:32,840 --> 00:13:36,559 Speaker 2: will be seeing their clinician every three to four months 235 00:13:36,800 --> 00:13:39,080 Speaker 2: for the first two years, then it sort of moves 236 00:13:39,120 --> 00:13:42,640 Speaker 2: out every six to twelve months up until year five, 237 00:13:43,080 --> 00:13:45,959 Speaker 2: and then after that fifth year they're really just coming 238 00:13:46,000 --> 00:13:49,600 Speaker 2: in every year, And the purpose of those visits is 239 00:13:49,640 --> 00:13:52,000 Speaker 2: really a check in to see how are you doing, 240 00:13:52,360 --> 00:13:55,000 Speaker 2: do you have any worries or concerns, do you have 241 00:13:55,080 --> 00:13:58,400 Speaker 2: any symptoms that are new, have you any side effects 242 00:13:58,400 --> 00:14:00,720 Speaker 2: from treatment, or are you expect lear and seeing new 243 00:14:00,760 --> 00:14:04,840 Speaker 2: side effects from ongoing treatment. It's really an opportunity to 244 00:14:04,920 --> 00:14:08,840 Speaker 2: support those patients who are still on ongoing treatment because, 245 00:14:08,880 --> 00:14:12,640 Speaker 2: as you may know, many breast cancers are hormone receptor 246 00:14:12,679 --> 00:14:16,720 Speaker 2: positive and for those patients, they're recommended hormone therapy for 247 00:14:16,800 --> 00:14:19,440 Speaker 2: at least five years and sometimes up to ten years. 248 00:14:19,800 --> 00:14:22,080 Speaker 2: So it's actually really important to check in with those 249 00:14:22,120 --> 00:14:25,000 Speaker 2: patients and see how they're doing. Are you actually taking 250 00:14:25,040 --> 00:14:28,840 Speaker 2: your medication, how does that feel, do you have side effects? 251 00:14:29,160 --> 00:14:31,280 Speaker 2: And you know, the typical issues that we would be 252 00:14:31,320 --> 00:14:35,479 Speaker 2: discussing in clinic are things like sexual health, hot flashes, 253 00:14:35,880 --> 00:14:39,720 Speaker 2: bone health, and it's just really important that patients feel 254 00:14:39,760 --> 00:14:43,360 Speaker 2: comfortable to bring up these topics in the clinic. I 255 00:14:43,360 --> 00:14:47,400 Speaker 2: would say from an imaging perspective, their follow up usually 256 00:14:47,560 --> 00:14:51,240 Speaker 2: looks like a mammogram every year. We follow bone health 257 00:14:51,280 --> 00:14:54,000 Speaker 2: with a dexa scan every other year, and that's really 258 00:14:54,040 --> 00:14:58,360 Speaker 2: important for postmenopausal patients and patients who are on hormone therapy, 259 00:14:58,840 --> 00:15:02,240 Speaker 2: and then, as you mentioned history and genetics, if we 260 00:15:02,360 --> 00:15:05,600 Speaker 2: identify that a patient has a family history or an 261 00:15:05,680 --> 00:15:09,040 Speaker 2: increased risk a genetic risk, then we have to tailor 262 00:15:09,120 --> 00:15:12,120 Speaker 2: their treatment plan and their follow up appropriately. So I 263 00:15:12,120 --> 00:15:15,640 Speaker 2: guess I would say high level life sort of after 264 00:15:16,080 --> 00:15:20,520 Speaker 2: the upfront treatment really looks like staying very connected with 265 00:15:20,600 --> 00:15:24,920 Speaker 2: your care team, being proactive, and you know, for us 266 00:15:25,040 --> 00:15:27,880 Speaker 2: as providers, it's just about giving patients the tools to 267 00:15:28,000 --> 00:15:31,560 Speaker 2: live well so that all issues can be flagged early. 268 00:15:37,120 --> 00:15:40,200 Speaker 1: We're partnering with Eli Lilly and Company for Breast Cancer 269 00:15:40,240 --> 00:15:44,360 Speaker 1: Awareness Month. A cancer diagnosis can impact every aspect of 270 00:15:44,400 --> 00:15:48,280 Speaker 1: someone's life, but they shouldn't face it alone. Research shows 271 00:15:48,320 --> 00:15:51,880 Speaker 1: that support and human connection play a significant role in 272 00:15:51,920 --> 00:15:55,480 Speaker 1: one's healing and mental health. That's why Lily is working 273 00:15:55,480 --> 00:16:01,000 Speaker 1: with patients, caregivers, and advocates to amplify voices, advanced treatment, 274 00:16:01,280 --> 00:16:05,480 Speaker 1: and empowered the early and metastatic breast cancer community. Learn 275 00:16:05,520 --> 00:16:08,640 Speaker 1: more about how Lily is making a difference at Lily 276 00:16:08,800 --> 00:16:18,680 Speaker 1: dot com. Lyche you have been a very vocal advocate 277 00:16:18,760 --> 00:16:22,000 Speaker 1: for your own follow up care. Tell us about that 278 00:16:22,440 --> 00:16:26,800 Speaker 1: and examples of how you have spoken up and made 279 00:16:26,840 --> 00:16:30,640 Speaker 1: your needs known to your healthcare providers. 280 00:16:31,200 --> 00:16:33,240 Speaker 3: Yeah, so one of the biggest things I do is 281 00:16:33,280 --> 00:16:37,520 Speaker 3: I share with people on Instagram that if there's anything 282 00:16:37,680 --> 00:16:40,840 Speaker 3: wrong or you have any issues, make sure that you 283 00:16:40,960 --> 00:16:43,320 Speaker 3: tell your care team that because it's very important. Like 284 00:16:43,360 --> 00:16:47,800 Speaker 3: doctor said, you must, you know, keep your team informed. 285 00:16:48,360 --> 00:16:52,680 Speaker 3: And so for me, like doctor touched on a lot 286 00:16:52,720 --> 00:16:56,400 Speaker 3: of those things like hot flashes, etc. Because I'm also 287 00:16:56,480 --> 00:17:01,120 Speaker 3: hormone positive, there are a lot of things after cancer treatment, 288 00:17:01,200 --> 00:17:03,800 Speaker 3: and so for me, I just would share those things 289 00:17:03,840 --> 00:17:06,520 Speaker 3: with my doctor and I would let her know and 290 00:17:06,560 --> 00:17:09,879 Speaker 3: she would basically tailor a lot of those hormone therapies 291 00:17:09,960 --> 00:17:13,200 Speaker 3: and just help me have an overall much better experience. 292 00:17:13,240 --> 00:17:16,320 Speaker 3: And I've been able to maintain and stay on all 293 00:17:16,400 --> 00:17:18,800 Speaker 3: of the drugs and I'm in a good place. All 294 00:17:18,840 --> 00:17:21,760 Speaker 3: of my scans are clear and everything's going well. So 295 00:17:22,040 --> 00:17:24,480 Speaker 3: I would just say having that open line of communication 296 00:17:25,160 --> 00:17:28,240 Speaker 3: and just being aware that your body is still going 297 00:17:28,280 --> 00:17:31,000 Speaker 3: through a lot and trying to recover after treatment. I 298 00:17:31,000 --> 00:17:34,359 Speaker 3: would say that cancer patients, no matter what the type 299 00:17:34,400 --> 00:17:36,800 Speaker 3: of cancer, just know that your body went through a 300 00:17:36,840 --> 00:17:40,320 Speaker 3: lot and just be gentle with yourself and try to 301 00:17:40,359 --> 00:17:41,000 Speaker 3: build back. 302 00:17:41,200 --> 00:17:43,280 Speaker 1: But I think you're so right. I mean, I think 303 00:17:43,320 --> 00:17:48,640 Speaker 1: it's so important for patients to talk to their physicians about, say, 304 00:17:48,720 --> 00:17:51,680 Speaker 1: the side effects of follow up care. For example, a 305 00:17:51,800 --> 00:17:57,200 Speaker 1: romantase inhibitors. Right, if you have hormone receptor positive breast cancer, 306 00:17:57,320 --> 00:18:01,760 Speaker 1: you have to take these inhibitors that basically suppress estrogen 307 00:18:01,840 --> 00:18:04,399 Speaker 1: because the cancer feeds on estrogen. Am I getting that 308 00:18:04,480 --> 00:18:05,359 Speaker 1: right there, Darley? 309 00:18:05,520 --> 00:18:05,680 Speaker 4: Yes? 310 00:18:05,840 --> 00:18:07,960 Speaker 1: And there are ways to mitigate some of the side 311 00:18:08,000 --> 00:18:11,240 Speaker 1: effects from taking those drugs, and a lot of women 312 00:18:12,000 --> 00:18:14,640 Speaker 1: do not take the drugs because of the side effects, 313 00:18:14,920 --> 00:18:17,440 Speaker 1: and it's really important to talk to your healthcare provider 314 00:18:17,520 --> 00:18:20,720 Speaker 1: about that so they can help you manage the side 315 00:18:20,720 --> 00:18:22,400 Speaker 1: effects and you still take the drugs. 316 00:18:22,680 --> 00:18:24,200 Speaker 2: Absolutely, that's the message. 317 00:18:24,320 --> 00:18:27,040 Speaker 1: How do you get women to feel comfortable and feel 318 00:18:27,080 --> 00:18:30,880 Speaker 1: like they're not bothering you by saying, hey, Lillian or 319 00:18:30,960 --> 00:18:35,200 Speaker 1: doctor Smith, you know I feel like hell because of this, 320 00:18:35,640 --> 00:18:40,399 Speaker 1: you know, follow up medication, and you know sex is 321 00:18:40,440 --> 00:18:43,080 Speaker 1: painful or my bones really hurt. I mean, there are 322 00:18:43,080 --> 00:18:45,840 Speaker 1: all kinds of things that sometimes come with that. And 323 00:18:46,000 --> 00:18:49,480 Speaker 1: how would you encourage women to be open and honest 324 00:18:49,680 --> 00:18:53,720 Speaker 1: and assertive about that without worrying that they're whining? 325 00:18:54,080 --> 00:18:56,960 Speaker 2: Oh my god, Yes, I mean I think It starts 326 00:18:57,040 --> 00:19:00,959 Speaker 2: with just giving yourself permission to ask questions right and 327 00:19:01,119 --> 00:19:03,800 Speaker 2: lots of them, and start broad. You know, if you 328 00:19:04,240 --> 00:19:06,960 Speaker 2: don't understand what follow up looks like, ask the question, 329 00:19:07,080 --> 00:19:08,840 Speaker 2: what does my follow up look like? What should I 330 00:19:08,840 --> 00:19:12,400 Speaker 2: expect from these clinic visits? I mean, I always say 331 00:19:12,440 --> 00:19:15,720 Speaker 2: to patients before a clinic visit, just take a few 332 00:19:15,760 --> 00:19:18,320 Speaker 2: minutes to sit with yourself and think about how am 333 00:19:18,320 --> 00:19:20,880 Speaker 2: I feeling. You know, do I have any new symptoms? 334 00:19:20,920 --> 00:19:22,359 Speaker 1: And write down? Write it down. 335 00:19:22,400 --> 00:19:24,399 Speaker 2: That's exactly what I was going to say, right, Like, 336 00:19:24,800 --> 00:19:27,919 Speaker 2: make a note of your symptoms, your side effects, your questions, 337 00:19:27,960 --> 00:19:30,800 Speaker 2: your worries, your concerns, and just bring that in with 338 00:19:30,840 --> 00:19:34,160 Speaker 2: you into the clinic visit, because you know, often patients 339 00:19:34,160 --> 00:19:35,919 Speaker 2: are like a deer in a headlight right when they 340 00:19:36,040 --> 00:19:38,760 Speaker 2: arrive at the clinic visit. And I think it's important 341 00:19:38,800 --> 00:19:41,639 Speaker 2: for you as a patient to feel like you've used 342 00:19:41,640 --> 00:19:44,560 Speaker 2: your time well and that you leave that clinic visit 343 00:19:44,640 --> 00:19:47,320 Speaker 2: satisfied that you've gotten that opportunity to ask all of 344 00:19:47,359 --> 00:19:50,119 Speaker 2: those questions. And I will say I do think the 345 00:19:50,160 --> 00:19:53,800 Speaker 2: clinicians are genuinely of the mind that they want patients 346 00:19:53,840 --> 00:19:57,520 Speaker 2: to feel empowered to talk to them openly, and you know, 347 00:19:57,840 --> 00:20:00,920 Speaker 2: open and honest communication is a good This can improve 348 00:20:00,960 --> 00:20:03,560 Speaker 2: outcomes because it will keep patients on therapy longer. 349 00:20:04,119 --> 00:20:07,639 Speaker 1: Let's talk about recurrence because obviously that's what you really 350 00:20:07,680 --> 00:20:11,760 Speaker 1: are trying to avoid for breast cancer patients. And how 351 00:20:11,800 --> 00:20:17,240 Speaker 1: do you determine the likelihood of recurrence? Today, breast cancer 352 00:20:17,400 --> 00:20:20,520 Speaker 1: doctors on coologists have all kinds of tools at their 353 00:20:20,560 --> 00:20:25,560 Speaker 1: disposal that they didn't have even ten years ago that 354 00:20:25,640 --> 00:20:29,600 Speaker 1: can help really determine the kind of care of breast 355 00:20:29,640 --> 00:20:33,000 Speaker 1: cancer patient gets. So let's talk about recurrence. 356 00:20:33,200 --> 00:20:36,560 Speaker 2: Yeah, so recurrence is a term, or risk of recurrence 357 00:20:36,640 --> 00:20:39,160 Speaker 2: is a term that we use a lot, and really 358 00:20:39,200 --> 00:20:42,200 Speaker 2: what that means is the chance of the breast cancer 359 00:20:42,280 --> 00:20:46,960 Speaker 2: coming back after you've completed treatment. So we think about 360 00:20:47,119 --> 00:20:50,200 Speaker 2: risk of recurrence. When we're trying to estimate that risk, 361 00:20:50,359 --> 00:20:53,639 Speaker 2: we look at patient factors and we look at tumor factors. 362 00:20:54,080 --> 00:20:58,199 Speaker 2: So the things we consider in patient factors are, you know, 363 00:20:58,359 --> 00:21:02,640 Speaker 2: agent diagnosis that's critically important, is there a family history? 364 00:21:03,119 --> 00:21:06,320 Speaker 2: And then the tumor factors that we're especially interested in 365 00:21:06,480 --> 00:21:09,720 Speaker 2: are how big is that tumor, has the tumor spread 366 00:21:09,760 --> 00:21:12,520 Speaker 2: to the local lymph, nodes, what is the grade of 367 00:21:12,560 --> 00:21:15,159 Speaker 2: that tumor, which is really just a pathologist way of 368 00:21:15,200 --> 00:21:19,600 Speaker 2: describing how different that cancer cell looks to normal cells. 369 00:21:20,240 --> 00:21:22,679 Speaker 2: And then we look at the tumor biology. So you 370 00:21:22,760 --> 00:21:26,600 Speaker 2: mentioned the estrogen receptor, so we stain the breast tumor 371 00:21:26,680 --> 00:21:30,560 Speaker 2: tissue for the estrogen receptor and for the herto receptor, 372 00:21:30,920 --> 00:21:32,960 Speaker 2: and if a patient is found to be positive for 373 00:21:33,040 --> 00:21:37,400 Speaker 2: those receptors, that information tells us that we should consider 374 00:21:37,440 --> 00:21:41,480 Speaker 2: a specific type of targeted therapy for those patients. I 375 00:21:41,520 --> 00:21:45,000 Speaker 2: would say that we also, as you mentioned, have lots 376 00:21:45,000 --> 00:21:49,920 Speaker 2: of new tools, so we sometimes use validated risk scores, 377 00:21:49,960 --> 00:21:54,200 Speaker 2: which basically pool all of that information together. We use 378 00:21:54,359 --> 00:21:59,440 Speaker 2: genomic tests, and all of these information factors essentially give 379 00:21:59,520 --> 00:22:03,800 Speaker 2: us a more acise estimate of risk. Once we understand 380 00:22:03,880 --> 00:22:06,439 Speaker 2: what that risk of recurrence is, then we can tailor 381 00:22:06,480 --> 00:22:09,800 Speaker 2: the treatment plan. We can decide with the patient whether 382 00:22:10,160 --> 00:22:14,639 Speaker 2: chemotherapy or targeted therapy like hormone therapy is needed. I 383 00:22:14,680 --> 00:22:18,320 Speaker 2: would say it's important to recognize that talking about risk 384 00:22:18,359 --> 00:22:22,199 Speaker 2: of recurrence is not about creating fear. It is about 385 00:22:22,280 --> 00:22:25,960 Speaker 2: ensuring that patients are getting the right treatment plan that 386 00:22:26,080 --> 00:22:30,280 Speaker 2: is individualized to their situation. So you know, information is power. 387 00:22:30,480 --> 00:22:31,960 Speaker 2: That's the reality. 388 00:22:32,040 --> 00:22:36,160 Speaker 1: Amen to that, sister, And I am so thrilled that 389 00:22:36,440 --> 00:22:42,359 Speaker 1: doctors like yourself have this whole panoply of tools now 390 00:22:42,920 --> 00:22:47,879 Speaker 1: that can be really evaluated in concert and help a 391 00:22:48,000 --> 00:22:53,760 Speaker 1: patient navigate and determine the course of treatment. And Leche 392 00:22:54,240 --> 00:22:58,000 Speaker 1: miss PhD and public health. You know somebody who really 393 00:22:58,119 --> 00:23:03,160 Speaker 1: understands whose specialty is cancer prevention. How did these tools 394 00:23:03,240 --> 00:23:08,720 Speaker 1: help you navigate your own treatment and life after treatment? 395 00:23:09,200 --> 00:23:09,320 Speaker 4: Oh? 396 00:23:09,359 --> 00:23:12,200 Speaker 3: It helped me a lot. It helped me understand more 397 00:23:12,240 --> 00:23:14,840 Speaker 3: about what was going on because a lot of the 398 00:23:14,840 --> 00:23:18,439 Speaker 3: things that from the patient perspective, you just confuse and 399 00:23:18,520 --> 00:23:20,160 Speaker 3: you don't know what's going on. 400 00:23:20,320 --> 00:23:22,679 Speaker 1: Right, that's a lot to kind of digest all that 401 00:23:22,720 --> 00:23:23,960 Speaker 1: stuff that Lilian was. 402 00:23:23,920 --> 00:23:27,520 Speaker 3: Talking about, Right, You're like, what, like imagine if you 403 00:23:27,640 --> 00:23:32,439 Speaker 3: know just nothing not right? What is ER positive? What 404 00:23:32,560 --> 00:23:36,960 Speaker 3: is PR positive? And what is a mama print? And 405 00:23:37,000 --> 00:23:37,920 Speaker 3: an oncode type? 406 00:23:38,040 --> 00:23:38,920 Speaker 4: What is RAT? 407 00:23:39,440 --> 00:23:42,240 Speaker 3: And so for me being able to break those things 408 00:23:42,280 --> 00:23:45,360 Speaker 3: down read studies, it helped me a lot with my treatment. 409 00:23:45,400 --> 00:23:50,679 Speaker 3: For example, with my surgery, I had a unilateral mastectomy, 410 00:23:50,800 --> 00:23:53,240 Speaker 3: so only one side the brast that was affected was 411 00:23:53,280 --> 00:23:56,720 Speaker 3: removed because studies have found that there was no benefit 412 00:23:56,760 --> 00:24:00,199 Speaker 3: to doing a bilateral mastectomy, and so together with me 413 00:24:00,280 --> 00:24:04,720 Speaker 3: and my surgeon, we decided on just removing the disease tissue. 414 00:24:05,240 --> 00:24:07,439 Speaker 3: And so me being able to break that down and 415 00:24:07,480 --> 00:24:11,399 Speaker 3: read things as an epidemiologist and understand statistics, it helped 416 00:24:11,440 --> 00:24:12,520 Speaker 3: me a lot. 417 00:24:12,720 --> 00:24:14,200 Speaker 4: And so then also. 418 00:24:14,280 --> 00:24:16,720 Speaker 3: Being able to look at the oncotype and mamma print 419 00:24:16,800 --> 00:24:18,960 Speaker 3: results that I got, I was able to look at 420 00:24:19,000 --> 00:24:22,640 Speaker 3: my risk of recurrence and so I saw, Okay, if 421 00:24:22,680 --> 00:24:26,239 Speaker 3: I take on aroma taste inhibitor or something similar to that, 422 00:24:26,680 --> 00:24:30,119 Speaker 3: my risk goes down by this much. If I have chemo, 423 00:24:30,240 --> 00:24:33,160 Speaker 3: my risk goes down by this much, if I have radiation. 424 00:24:33,640 --> 00:24:35,760 Speaker 3: And so because of that, I think that's one of 425 00:24:35,800 --> 00:24:38,159 Speaker 3: the reasons I ended up opting for everything, give me 426 00:24:38,680 --> 00:24:42,480 Speaker 3: everything to make sure this does not come back, particularly 427 00:24:42,520 --> 00:24:46,480 Speaker 3: because of my age, because just because I'm younger, I'm 428 00:24:46,520 --> 00:24:49,520 Speaker 3: going to be around longer, So inherently I'm going to 429 00:24:49,600 --> 00:24:52,480 Speaker 3: have an increased risk just because of the mere fact 430 00:24:52,520 --> 00:24:55,240 Speaker 3: that I'm younger. So I wanted to have my best 431 00:24:55,280 --> 00:24:58,720 Speaker 3: bet of never seeing this disease again, and so it 432 00:24:58,760 --> 00:25:02,240 Speaker 3: helped me a lot with that, and then also doing 433 00:25:02,240 --> 00:25:04,960 Speaker 3: a lot of the complimentary treatment, so being able to 434 00:25:05,480 --> 00:25:08,840 Speaker 3: lessen my stress, eat more fruits and vegetables, and following 435 00:25:08,840 --> 00:25:12,719 Speaker 3: some of those guidelines, working out, and just working together 436 00:25:12,760 --> 00:25:14,639 Speaker 3: with some of my mentors. 437 00:25:14,080 --> 00:25:16,200 Speaker 4: It was just great. 438 00:25:16,560 --> 00:25:20,280 Speaker 1: You know, we talked about treatment and follow up after 439 00:25:20,840 --> 00:25:23,919 Speaker 1: your initial treatment, but one of the things I didn't 440 00:25:23,960 --> 00:25:28,560 Speaker 1: ask you about, Leche was some of the sort of 441 00:25:28,840 --> 00:25:34,760 Speaker 1: psychological and physical challenges that one faces after breast cancer 442 00:25:34,800 --> 00:25:39,440 Speaker 1: treatment as they continue on this path. And as somebody 443 00:25:39,520 --> 00:25:43,520 Speaker 1: who is a powerlifter, which what does that mean exactly? 444 00:25:43,560 --> 00:25:45,920 Speaker 1: You just lift super heavyweights? Is that the deal? 445 00:25:46,359 --> 00:25:51,200 Speaker 3: Yeah, So with powerlifting, it's three lifts, So it's squat, 446 00:25:51,480 --> 00:25:54,600 Speaker 3: bench press, and dad lift, and so it's the CUMU 447 00:25:54,680 --> 00:25:57,760 Speaker 3: lift total of those three lifts, and so you try 448 00:25:57,760 --> 00:26:00,000 Speaker 3: to lift as much as you can for one lift. 449 00:26:00,040 --> 00:26:03,639 Speaker 3: Then you have three attempts in a competition. So, yes, 450 00:26:03,920 --> 00:26:06,000 Speaker 3: how did you get into that? By the way, So 451 00:26:06,080 --> 00:26:09,200 Speaker 3: I played college basketball and during the training we would 452 00:26:09,200 --> 00:26:11,760 Speaker 3: do a lot of lifting in the gym to strengthen up, 453 00:26:12,240 --> 00:26:14,439 Speaker 3: and I noticed, wow, I'm pretty strong. 454 00:26:14,520 --> 00:26:16,719 Speaker 4: I'm strong, and then a lot of the people around me. 455 00:26:17,440 --> 00:26:21,800 Speaker 3: And so once I completed playing college basketball, I said, oh, 456 00:26:21,840 --> 00:26:23,720 Speaker 3: I'm just I'm not going to just sit around and 457 00:26:24,119 --> 00:26:26,399 Speaker 3: do nothing. I need to work out and do something. 458 00:26:26,400 --> 00:26:29,320 Speaker 3: And I wanted to compete as well, because I'm a competitor. 459 00:26:29,320 --> 00:26:32,400 Speaker 3: I've been competing my whole life. And so I said, okay, 460 00:26:32,720 --> 00:26:35,639 Speaker 3: this is the best of both worlds. I can work 461 00:26:35,680 --> 00:26:38,200 Speaker 3: out and not do too much running and stuff, because 462 00:26:38,200 --> 00:26:41,480 Speaker 3: all that running was it was a lot with powerlifting, 463 00:26:41,880 --> 00:26:45,000 Speaker 3: and I can compete, and so then that's what I did. 464 00:26:45,480 --> 00:26:48,439 Speaker 1: So I'm thinking about you as a powerlifter and somebody 465 00:26:48,520 --> 00:26:52,080 Speaker 1: who is a competitor and loves doing that. And you 466 00:26:52,240 --> 00:26:58,000 Speaker 1: get a mastectomy, right, which often affects your mobility and 467 00:26:58,440 --> 00:27:03,119 Speaker 1: also your energy. Love, so that was something that you 468 00:27:03,240 --> 00:27:06,720 Speaker 1: had to overcome following your treatment. What was that like? 469 00:27:07,720 --> 00:27:12,119 Speaker 3: It was very difficult, mainly because I just it's like 470 00:27:12,160 --> 00:27:12,719 Speaker 3: a block. 471 00:27:12,840 --> 00:27:14,040 Speaker 4: It was a mental block. 472 00:27:14,160 --> 00:27:17,080 Speaker 3: It's like, you know, that area is removed. How am 473 00:27:17,080 --> 00:27:18,320 Speaker 3: I gonna listen? 474 00:27:18,400 --> 00:27:22,640 Speaker 1: I'm sure it accepted, right, You're just physically how much 475 00:27:22,680 --> 00:27:25,119 Speaker 1: you could move your arm right for a while. 476 00:27:25,119 --> 00:27:25,880 Speaker 4: In the beginning. 477 00:27:26,040 --> 00:27:29,240 Speaker 3: Yes, so about a month after my mastectomy, I had 478 00:27:29,280 --> 00:27:32,120 Speaker 3: full range of motion only because I did a lot 479 00:27:32,160 --> 00:27:35,760 Speaker 3: of prehab. I met with a physical therapist, and due 480 00:27:35,800 --> 00:27:40,480 Speaker 3: to my background working in lifestyle medicine oncology, I just 481 00:27:40,560 --> 00:27:43,680 Speaker 3: knew the blueprint and what to do and I prepared 482 00:27:43,680 --> 00:27:47,280 Speaker 3: for it. So I think a month turnaround is just 483 00:27:47,640 --> 00:27:50,520 Speaker 3: insane when I look back at it. But for me, yeah, 484 00:27:50,560 --> 00:27:52,480 Speaker 3: it was. It was a period of time where I 485 00:27:52,520 --> 00:27:55,840 Speaker 3: did not have that mobility or the strength. But at 486 00:27:55,840 --> 00:27:59,600 Speaker 3: the time I reached chemotherapy, I was bench pressing two 487 00:27:59,720 --> 00:28:03,200 Speaker 3: hundred and fifty then bounds. 488 00:28:02,119 --> 00:28:06,520 Speaker 1: So that's amazing. I mean, Lilyan in many ways, Leche 489 00:28:06,760 --> 00:28:09,720 Speaker 1: is such an ideal patient because she had a deep 490 00:28:09,880 --> 00:28:15,560 Speaker 1: understanding of cancer, cancer prevention, she did prehab, rehab, so 491 00:28:15,600 --> 00:28:18,679 Speaker 1: she gets like a gold star in every category. But 492 00:28:18,760 --> 00:28:22,280 Speaker 1: a lot of people don't have this understanding of cancer. 493 00:28:22,320 --> 00:28:26,680 Speaker 1: Why do you think conversations like this are so important? 494 00:28:26,800 --> 00:28:30,120 Speaker 1: And I'm really asking both of you in the public 495 00:28:30,400 --> 00:28:35,199 Speaker 1: sphere for people to feel less afraid for breast cancer 496 00:28:35,240 --> 00:28:39,400 Speaker 1: and really all cancers to be less stigmatized. Why do 497 00:28:39,440 --> 00:28:42,560 Speaker 1: you think this is so valuable for someone who doesn't 498 00:28:42,600 --> 00:28:45,680 Speaker 1: have Lchee's background, your background, or even my background. 499 00:28:46,720 --> 00:28:48,640 Speaker 2: It's such a good point. I mean, I think that 500 00:28:48,880 --> 00:28:52,280 Speaker 2: at a minimum, it gives folks a language to even 501 00:28:52,320 --> 00:28:55,680 Speaker 2: talk about, right, because all of these terms that we're using, 502 00:28:56,280 --> 00:28:58,760 Speaker 2: you know, if you're not dealing with cancer care or 503 00:28:58,800 --> 00:29:01,600 Speaker 2: you don't know someone who has been affected by cancer, 504 00:29:01,720 --> 00:29:06,440 Speaker 2: it's alien concepts talking about tumor size and grade and receptors. 505 00:29:06,880 --> 00:29:09,800 Speaker 2: So I think that the more and more that the 506 00:29:09,840 --> 00:29:14,280 Speaker 2: community can understand and have an awareness of what's going 507 00:29:14,320 --> 00:29:16,880 Speaker 2: on with respect to cancer, it's just a good thing. 508 00:29:17,360 --> 00:29:17,560 Speaker 4: You know. 509 00:29:17,600 --> 00:29:19,760 Speaker 2: It's not that we want to normalize, but in some 510 00:29:19,800 --> 00:29:22,280 Speaker 2: ways you sort of do because it's part of life, 511 00:29:22,320 --> 00:29:25,880 Speaker 2: and it's really understanding that if you have a problem, 512 00:29:26,280 --> 00:29:29,760 Speaker 2: go to a physician, get yourself checked out. You know. 513 00:29:30,080 --> 00:29:34,560 Speaker 2: I think giving information to the community is just always valuable. 514 00:29:34,600 --> 00:29:35,640 Speaker 2: It's never a bad thing. 515 00:29:36,720 --> 00:29:41,240 Speaker 1: Lache, I know that, as I said, you have been 516 00:29:41,280 --> 00:29:46,120 Speaker 1: able to translate your academic understanding of cancer as well 517 00:29:46,160 --> 00:29:51,320 Speaker 1: as your personal understanding of cancer to all kinds of people. 518 00:29:52,440 --> 00:29:55,960 Speaker 1: Why do you think that's so valuable in terms of 519 00:29:56,760 --> 00:30:00,840 Speaker 1: sharing your journey with complete strangers by the way, yeah. 520 00:30:01,400 --> 00:30:05,720 Speaker 3: I think it's very important because you need somebody out 521 00:30:05,720 --> 00:30:08,680 Speaker 3: there to look up to and who's going through a 522 00:30:08,720 --> 00:30:12,160 Speaker 3: similar thing. We all need that support person. We all 523 00:30:12,200 --> 00:30:14,720 Speaker 3: need that person to saying Oh, but she went through 524 00:30:14,720 --> 00:30:17,040 Speaker 3: the same thing, and she can do it, maybe I 525 00:30:17,080 --> 00:30:19,280 Speaker 3: can do it. And I think you also need people 526 00:30:19,680 --> 00:30:22,320 Speaker 3: who understand what's going on to break it down in 527 00:30:22,360 --> 00:30:23,720 Speaker 3: the language you could understand. 528 00:30:23,840 --> 00:30:26,640 Speaker 1: I was going to say, I think you need someone 529 00:30:26,720 --> 00:30:31,800 Speaker 1: to translate all this science and no offense. Lilian, you're it. 530 00:30:32,360 --> 00:30:35,640 Speaker 1: You're really good at explaining. But a lot of doctors 531 00:30:35,680 --> 00:30:39,320 Speaker 1: and scientists are so used to kind of talking about 532 00:30:39,360 --> 00:30:42,400 Speaker 1: something at this level, they're not very good at dumbing 533 00:30:42,400 --> 00:30:47,120 Speaker 1: it down because they're so smart basically, And I think, 534 00:30:47,600 --> 00:30:50,880 Speaker 1: you know, for you to do that, Lche is so 535 00:30:51,120 --> 00:30:52,200 Speaker 1: helpful for people. 536 00:30:52,760 --> 00:30:55,480 Speaker 3: Yes, I think it's a big benefit to to public 537 00:30:55,520 --> 00:30:58,080 Speaker 3: health and public health training. What they teach us is 538 00:30:58,160 --> 00:31:00,120 Speaker 3: you have to find ways to break down for any 539 00:31:00,120 --> 00:31:04,240 Speaker 3: disease messages out of fifth grade level so that everybody, 540 00:31:04,280 --> 00:31:07,720 Speaker 3: no matter what, they can understand. And so that's something 541 00:31:07,760 --> 00:31:10,240 Speaker 3: I already had with my training, was that you have 542 00:31:10,280 --> 00:31:12,959 Speaker 3: to be able to give messages in small bursts because 543 00:31:13,040 --> 00:31:15,240 Speaker 3: people might not want to pay attention for as long 544 00:31:15,640 --> 00:31:17,680 Speaker 3: and just let them know the key things. And so 545 00:31:17,840 --> 00:31:20,960 Speaker 3: with early breast cancer detection, the biggest thing that I 546 00:31:21,040 --> 00:31:23,400 Speaker 3: try to send a message about is if you get 547 00:31:23,440 --> 00:31:26,040 Speaker 3: screened early. So when you look at the American Cancer 548 00:31:26,080 --> 00:31:28,400 Speaker 3: Society and you look at some of the things they have, 549 00:31:29,240 --> 00:31:32,400 Speaker 3: if you get screened, then you find it early, you 550 00:31:32,480 --> 00:31:35,800 Speaker 3: have a high likely or a high chance of being around. 551 00:31:35,880 --> 00:31:38,880 Speaker 3: So you know it shouldn't be that scared and see 552 00:31:38,960 --> 00:31:41,360 Speaker 3: nice people like doctor Smith. She'll get you in a 553 00:31:41,360 --> 00:31:42,040 Speaker 3: good physician. 554 00:31:43,080 --> 00:31:47,680 Speaker 1: And I applaud you for so many things lche that 555 00:31:47,760 --> 00:31:51,120 Speaker 1: you were doing. I think you're taking a personal challenge 556 00:31:51,480 --> 00:31:54,959 Speaker 1: and I'm sure what was a very frightening experience, and 557 00:31:56,120 --> 00:31:58,880 Speaker 1: you're using it to really help other people, which I 558 00:31:58,920 --> 00:32:02,240 Speaker 1: think is very therapeutic. It was certainly therapeutic for me 559 00:32:02,840 --> 00:32:05,280 Speaker 1: when I lost my husband a calling cancer, and really 560 00:32:05,320 --> 00:32:09,200 Speaker 1: therapeutic when I experienced breast cancer myself to be able 561 00:32:09,240 --> 00:32:13,200 Speaker 1: to share what I learned to other people. But I 562 00:32:13,280 --> 00:32:17,719 Speaker 1: also so appreciate the fact that you're participating in some 563 00:32:17,920 --> 00:32:25,680 Speaker 1: studies that will really help doctors like Lilian understand some 564 00:32:25,800 --> 00:32:29,960 Speaker 1: of the biology of this disease. Tell us about that. 565 00:32:30,680 --> 00:32:34,080 Speaker 3: Yeah, So I thought it was extremely important because one 566 00:32:34,120 --> 00:32:37,320 Speaker 3: of the things we tend to look at is genetic mutations, 567 00:32:37,680 --> 00:32:39,480 Speaker 3: and for me, when I did the test to the 568 00:32:39,600 --> 00:32:43,280 Speaker 3: comprehensive test. There were no genetic mutations that I had 569 00:32:43,320 --> 00:32:45,600 Speaker 3: linked to anti cancers, not just breast cancer. 570 00:32:45,640 --> 00:32:48,400 Speaker 1: Not known genetics takes about to get. 571 00:32:48,280 --> 00:32:51,200 Speaker 3: To and so what I did was I donated my 572 00:32:51,280 --> 00:32:54,920 Speaker 3: tissue because right now at UM they're doing studies. 573 00:32:54,520 --> 00:32:56,600 Speaker 1: Where they're University of Miami and oh yes. 574 00:32:56,400 --> 00:32:58,840 Speaker 3: At University of Miami, they're doing studies where they're looking 575 00:32:58,880 --> 00:33:02,560 Speaker 3: at people of West African genetic ancestry, which I happen 576 00:33:02,640 --> 00:33:04,680 Speaker 3: to be a part of, and they're looking at our 577 00:33:04,720 --> 00:33:08,800 Speaker 3: tumor biology to see if there's another gene that we're 578 00:33:08,880 --> 00:33:11,000 Speaker 3: unaware of on other genetic factors. 579 00:33:11,040 --> 00:33:13,120 Speaker 4: And so that's one of the things. 580 00:33:13,160 --> 00:33:17,560 Speaker 3: Maybe down the line there might be a reason I 581 00:33:17,600 --> 00:33:20,000 Speaker 3: got this because right now we don't know none of 582 00:33:20,040 --> 00:33:23,400 Speaker 3: the known risk factors. I have none of those, So 583 00:33:23,440 --> 00:33:27,680 Speaker 3: no faunily history. I exercise ate, right, all those nice things, 584 00:33:27,720 --> 00:33:31,160 Speaker 3: never smoked, don't drink nothing, And so you know, I 585 00:33:31,200 --> 00:33:33,600 Speaker 3: want to pay it forward because me as a researcher, 586 00:33:34,200 --> 00:33:37,320 Speaker 3: I want to get data. I want people to participate, 587 00:33:37,400 --> 00:33:40,120 Speaker 3: and so I want to be a part of pushing 588 00:33:40,120 --> 00:33:43,120 Speaker 3: the science forward. And I think it's so important because 589 00:33:43,440 --> 00:33:46,840 Speaker 3: it helps not only you but others. And if you 590 00:33:46,920 --> 00:33:50,000 Speaker 3: participate in clinical trials, you get more appointments, you get 591 00:33:50,000 --> 00:33:53,440 Speaker 3: to see your doctor, you get extended care. Who doesn't 592 00:33:53,440 --> 00:33:53,800 Speaker 3: want that. 593 00:33:54,440 --> 00:33:58,479 Speaker 1: It is really important that the data represents a broad 594 00:33:58,720 --> 00:34:03,720 Speaker 1: swath of human biology, isn't it. 595 00:34:03,720 --> 00:34:06,120 Speaker 2: It's incredibly important And Lashaye and I were chatting about 596 00:34:06,120 --> 00:34:10,960 Speaker 2: this before the recording. It is just unbelievably amazing to 597 00:34:11,120 --> 00:34:16,439 Speaker 2: advocate for improving research and breast cancer clinical trial participation. 598 00:34:16,920 --> 00:34:20,320 Speaker 2: I mean, we are going to learn so much more 599 00:34:20,400 --> 00:34:24,480 Speaker 2: if we all work together, contribute tissue samples, participate in 600 00:34:24,520 --> 00:34:27,720 Speaker 2: clinical trials. It's how we learn, it's how we advance 601 00:34:27,800 --> 00:34:30,480 Speaker 2: the field. And I just commend you for doing that 602 00:34:30,600 --> 00:34:34,000 Speaker 2: because someone will benefit from that. It really that's how 603 00:34:34,000 --> 00:34:34,640 Speaker 2: it works. 604 00:34:35,080 --> 00:34:38,400 Speaker 1: Yes, what is the most important thing for both of 605 00:34:38,440 --> 00:34:45,080 Speaker 1: you to leave patients or just people who are perfectly healthy? 606 00:34:45,320 --> 00:34:49,759 Speaker 1: What do you want them to know after watching this? 607 00:34:50,000 --> 00:34:52,680 Speaker 1: What are sort of the top line messages you would 608 00:34:52,760 --> 00:34:53,520 Speaker 1: like to impart. 609 00:34:54,800 --> 00:34:57,200 Speaker 3: One of the biggest things I'd like to impart is 610 00:34:57,239 --> 00:35:02,120 Speaker 3: that if for some reason you do get cancer, it's 611 00:35:02,160 --> 00:35:04,880 Speaker 3: not a death sentence and you can be like me. 612 00:35:05,440 --> 00:35:08,760 Speaker 3: You can go through treatment and you can be cancer free. 613 00:35:09,160 --> 00:35:12,240 Speaker 3: You can look quote unquote normal like nothing ever happened 614 00:35:12,239 --> 00:35:14,880 Speaker 3: to you lift four hundred and eight pounds for your 615 00:35:14,960 --> 00:35:19,920 Speaker 3: last chemotherapy treatment, and yeah, you can just live an 616 00:35:19,960 --> 00:35:24,360 Speaker 3: amazing life. And also just be aware of your body. 617 00:35:24,520 --> 00:35:26,360 Speaker 3: Get to know your body, if it's one thing you 618 00:35:26,480 --> 00:35:30,160 Speaker 3: learn from this session and watching us here, get to 619 00:35:30,160 --> 00:35:32,600 Speaker 3: know what is your normal and if you see something wrong, 620 00:35:33,080 --> 00:35:33,760 Speaker 3: get it checked. 621 00:35:34,320 --> 00:35:37,640 Speaker 1: And what about you, Lilyan, Especially for people once their 622 00:35:37,680 --> 00:35:41,720 Speaker 1: treatment is complete, what do you want those people watching 623 00:35:41,880 --> 00:35:42,680 Speaker 1: to understand? 624 00:35:42,840 --> 00:35:46,279 Speaker 2: Yes, I have a very similar message to Lache there 625 00:35:46,360 --> 00:35:50,160 Speaker 2: is life after breast cancer. Most patients who were diagnosed 626 00:35:50,200 --> 00:35:54,160 Speaker 2: with early breast cancer, once they've completed treatment, this becomes 627 00:35:54,160 --> 00:35:57,200 Speaker 2: something in their rear viewmer it is very unlikely to 628 00:35:57,200 --> 00:36:00,040 Speaker 2: be an issue for them again. And I think that 629 00:36:00,040 --> 00:36:03,360 Speaker 2: that's a piece of information that isn't out there, and 630 00:36:03,440 --> 00:36:06,880 Speaker 2: I would like to emphasize that. I would also say, 631 00:36:07,080 --> 00:36:09,239 Speaker 2: you know, we've touched on this. For the patients who 632 00:36:09,239 --> 00:36:13,920 Speaker 2: are hormone receptor positive who've been recommended hormone therapy, do 633 00:36:14,080 --> 00:36:16,759 Speaker 2: try to stick with it. I know it's hard. We 634 00:36:16,880 --> 00:36:20,160 Speaker 2: know that adherents can be hard. We know that patients 635 00:36:20,719 --> 00:36:23,879 Speaker 2: often struggle to even admit to their provider that they're 636 00:36:23,880 --> 00:36:26,560 Speaker 2: struggling with the side effects. But I would say, if 637 00:36:26,600 --> 00:36:30,320 Speaker 2: you are struggling, speak up, speak to your doctor, because 638 00:36:30,360 --> 00:36:32,600 Speaker 2: there are ways that we can help. There are other 639 00:36:32,680 --> 00:36:36,840 Speaker 2: options that we consider, so I think that's an important message. 640 00:36:36,880 --> 00:36:39,239 Speaker 2: And then I would say, you know, it's like all 641 00:36:39,280 --> 00:36:42,640 Speaker 2: of us. Try to do as best you can. Exercise, 642 00:36:42,800 --> 00:36:45,520 Speaker 2: eat well, reduce alcohol, avoid. 643 00:36:45,239 --> 00:36:48,920 Speaker 1: Smoking, and just get back to living your life well. 644 00:36:49,040 --> 00:36:52,560 Speaker 1: This has been such an important conversation. Lyche, I'm so 645 00:36:52,680 --> 00:36:58,200 Speaker 1: grateful for you talking about this and sharing your story. 646 00:36:58,440 --> 00:37:03,160 Speaker 1: And doctor Smith, Lillian, I'm so grateful for your dedication 647 00:37:03,520 --> 00:37:09,480 Speaker 1: to all your patients and to breast cancer research. I 648 00:37:09,560 --> 00:37:13,400 Speaker 1: applaud you and all your fellow clinicians and scientists. You 649 00:37:13,520 --> 00:37:17,200 Speaker 1: are my heroes and I've added you to my list too. 650 00:37:17,800 --> 00:37:20,799 Speaker 4: Oh, thank you so much. You're ready on my list. 651 00:37:22,480 --> 00:37:25,000 Speaker 1: Thanks so much to both of you. Really appreciate thanks 652 00:37:25,040 --> 00:37:25,560 Speaker 1: for having me. 653 00:37:25,680 --> 00:37:27,040 Speaker 4: Thank you so much. Thank you. 654 00:37:27,120 --> 00:37:31,759 Speaker 1: All conversations like this remind us that breast cancer isn't 655 00:37:31,880 --> 00:37:34,960 Speaker 1: just about diagnosis and treatment. It's about what comes after 656 00:37:35,520 --> 00:37:39,440 Speaker 1: and how we can empower patients to feel informed, supported 657 00:37:39,480 --> 00:37:42,560 Speaker 1: and hopeful every step of the way. I'm grateful to 658 00:37:42,640 --> 00:37:46,040 Speaker 1: Eli Lilly for making these important discussions possible, and for 659 00:37:46,120 --> 00:37:51,320 Speaker 1: their ongoing commitment to advancing science and amplifying patient voices. 660 00:37:51,840 --> 00:37:55,279 Speaker 1: And to all of you listening and watching, remember you 661 00:37:55,360 --> 00:37:58,680 Speaker 1: are your own best advocate. Pay attention to your body, 662 00:37:59,040 --> 00:38:02,480 Speaker 1: stay informed, and take care of yourself and the people 663 00:38:02,520 --> 00:38:07,319 Speaker 1: you love. Thanks for listening everyone. If you have a 664 00:38:07,400 --> 00:38:10,160 Speaker 1: question for me, a subject you want us to cover, 665 00:38:10,520 --> 00:38:12,799 Speaker 1: or you want to share your thoughts about how you 666 00:38:12,920 --> 00:38:16,560 Speaker 1: navigate this crazy world, reach out send me a DM 667 00:38:16,600 --> 00:38:19,879 Speaker 1: on Instagram. I would love to hear from you. Next 668 00:38:20,000 --> 00:38:23,680 Speaker 1: Question is a production of iHeartMedia and Katie Couric Media. 669 00:38:24,160 --> 00:38:27,760 Speaker 1: The executive producers are Me, Katie Kuric, and Courtney Ltz. 670 00:38:28,080 --> 00:38:32,319 Speaker 1: Our supervising producer is Ryan Martz, and our producers are 671 00:38:32,360 --> 00:38:38,080 Speaker 1: Adriana Fazzio and Meredith Barnes. Julian Weller composed our theme music. 672 00:38:38,920 --> 00:38:42,040 Speaker 1: For more information about today's episode, or to sign up 673 00:38:42,080 --> 00:38:45,160 Speaker 1: for my newsletter wake Up Call, go to the description 674 00:38:45,280 --> 00:38:49,120 Speaker 1: in the podcast app, or visit us at Katiecuric dot com. 675 00:38:49,400 --> 00:38:51,840 Speaker 1: You can also find me on Instagram and all my 676 00:38:51,960 --> 00:38:56,600 Speaker 1: social media channels. For more podcasts from iHeartRadio, visit the 677 00:38:56,719 --> 00:39:00,879 Speaker 1: iHeartRadio app Apple Podcasts or wherever you listen to your 678 00:39:00,880 --> 00:39:05,840 Speaker 1: favorite shows. We're partnering with Eli Lilly and Company for 679 00:39:05,920 --> 00:39:09,959 Speaker 1: Breast Cancer Awareness Month. A cancer diagnosis can impact every 680 00:39:10,120 --> 00:39:13,080 Speaker 1: aspect of someone's life, but they shouldn't face it alone. 681 00:39:13,640 --> 00:39:17,799 Speaker 1: Research shows that support and human connection play a significant 682 00:39:17,880 --> 00:39:21,160 Speaker 1: role in one's healing and mental health. That's why Lily 683 00:39:21,360 --> 00:39:26,120 Speaker 1: is working with patients, caregivers, and advocates to amplify voices, 684 00:39:26,400 --> 00:39:31,040 Speaker 1: advanced treatment, and empower the early and metastatic breast cancer community. 685 00:39:31,560 --> 00:39:34,600 Speaker 1: Learn more about how Lily is making a difference at 686 00:39:34,680 --> 00:39:35,960 Speaker 1: lily dot com.