Speaker 1: Hey, besties, Hello Sunshine.
Speaker 2: Today on the bright Side, it's Wellness Wednesday. We're honoring
Speaker 2: Breast Cancer Awareness Month with breast cancer surgeon and women's
Speaker 2: health advocate, doctor Christy Funk. She's breaking down the latest
Speaker 2: in breast cancer research and prevention, including changes we can
Speaker 2: all make to lower our risk. It's Wednesday, October second.
Speaker 2: I'm Danielle Robe and.
Speaker 3: I'm Simone Boyce. This is the bright Side from Hello Sunshine,
Speaker 3: a daily show where we come together to share women's stories, laugh,
Speaker 3: learn and brighten your day. Today's Wellness Wednesday is presented
Speaker 3: by Coligard. All Right, y'all. October is Breast Cancer Awareness Month,
Speaker 3: and to be honest, I don't know a woman who
Speaker 3: doesn't have a personal connection to breast cancer. Danielle, have
Speaker 3: you seen this show up in your own life? Oh
Speaker 3: my goodness, yes, I will never forget.
Speaker 2: When I was in fifth I would say, and one
Speaker 2: of my mom's best friends was diagnosed with breast cancer,
Speaker 2: and we would go to her house at night and
Speaker 2: bring her plants and cookies and sit with her on
Speaker 2: the couch and talk. And I just remember how difficult
Speaker 2: it was for everybody who loved her. And I think
Speaker 2: as I've gotten older, I know so many women who
Speaker 2: have been diagnosed with breast cancer. Statistically, one in eight
Speaker 2: women in the US will develop it in their lifetime.
Speaker 2: Do you do you have a personal touch point to it, Simone.
Speaker 3: Yeah, breast cancer is something that really loomed large over
Speaker 3: my whole childhood. It was kind of this like medical
Speaker 3: boogeyman in my family because I grew up hearing all
Speaker 3: these stories about my wonderful grandmother, Bonnie, my mom's mom,
Speaker 3: but I never actually got to meet her because she
Speaker 3: died a few months after I was born, when she
Speaker 3: was fifty eight years old, because of breast cancer. So
Speaker 3: it was of course something that my mom talked about
Speaker 3: a lot in terms of preventative measure and I actually
Speaker 3: in high school, when I was like sixteen years old,
Speaker 3: had my first brush with a potential breast cancer diagnosis. Thankfully,
Speaker 3: it was not cancerous, but I did have a benign
Speaker 3: lump at the time, so I had to go through
Speaker 3: surgery and get it removed from my breast. But I'm
Speaker 3: thankful for that experience because I think it helped me
Speaker 3: gain a deeper awareness of my body and just know
Speaker 3: what to look out for.
Speaker 2: Sixteen is really young to experience something like that. That
Speaker 2: must have been scary. Yeah, it was.
Speaker 3: I had the best friends, though, Like I can remember
Speaker 3: coming home from surgery and they all just came over
Speaker 3: and hung out on my couch while I was like
Speaker 3: knocked out from painkillers. And so it's all about support,
Speaker 3: like you were talking about, do.
Speaker 2: You think about that moment now today?
Speaker 1: I have a scar.
Speaker 3: I have a scar, so you know, when I'm looking
Speaker 3: at myself in a mirror, it's one of the scars
Speaker 3: that is visible, and it certainly takes me back to
Speaker 3: that time. But I'm kind of glad that I have
Speaker 3: the scar because that scar reminds me to take care
Speaker 3: of myself, and it reminds me to go get my
Speaker 3: annual checkups and do my exams at home. And I
Speaker 3: just got my first mammogram this year. I'm thirty six
Speaker 3: years old, and I got it done a little bit earlier,
Speaker 3: perhaps by some standards, but given my family's medical history,
Speaker 3: I feel so much better having it done. I have
Speaker 3: this tremendous peace of mind because of it.
Speaker 2: Well, I think part of what you're sharing is that
Speaker 2: early detection is so helpful. It really increases the chances
Speaker 2: of successful treatment and survival, and I think opening up
Speaker 2: these conversations about breast health can really save lives. Every
Speaker 2: time The Today's Show or Good Morning America does a
Speaker 2: segment on this and there's a live mammogram, viewers write
Speaker 2: in talking about how somebody was triggered to go to
Speaker 2: the doctor and it saved their life. And so today
Speaker 2: we're hoping to do the same. We're going to be
Speaker 2: talking about early detection along with so much more. So
Speaker 2: we're joined by doctor Christy Funk. She's a board certified
Speaker 2: breast cancer surgeon and physician.
Speaker 3: Doctor Funk runs the Pink Lotus Breast Center in Santa Monica,
Speaker 3: where she's counseled and treated thousands of women just like
Speaker 3: me and Danielle. And she's also the author of Breast
Speaker 3: the Owner's Manual, Doctor Christy Funk, Welcome to the bright Side.
Speaker 1: Welcome, Thank you, so excited to be here.
Speaker 3: Something that Danielle and I have both felt convicted about
Speaker 3: is the fact that so many women have stories of
Speaker 3: how breast cancer has impacted their families or ripped loved
Speaker 3: ones away from them, or exists in the back of
Speaker 3: their mind as this you know, fear that kind of
Speaker 3: looms over their medical history. So we're really excited to
Speaker 3: talk to you and start off with this. How pervasive
Speaker 3: is breast cancer? I mean, we know that the rates
Speaker 3: are going up. I'd love to know from you, just
Speaker 3: get this kind of lay of the lane and an
Speaker 3: update on the landscape. How many people are diagnosed each
Speaker 3: year in the US and how does that compare to
Speaker 3: when you started in the field.
Speaker 1: Oh, what a great question. Okay. So in twenty twenty,
Speaker 1: breast cancer surpassed lung to become the number one malignant
Speaker 1: tumor in the world men and women combined. Wow, with
Speaker 1: about two point three million cases every single year and
Speaker 1: six hundred and eighty five thousand deaths worldwide last year,
Speaker 1: this year, even more next year. And as you were
Speaker 1: just saying, the numbers seem to be going up because
Speaker 1: they are going up in our own backyard, as you
Speaker 1: were asking, this year twenty twenty four, we're expecting between
Speaker 1: two hundred and eighty eight thousand and three hundred and
Speaker 1: ten thousand new cases of invasive breast cancer, with about
Speaker 1: forty three thousand, two hundred and fifty deaths this year
Speaker 1: alone from breast cancer. One of the most alarming things
Speaker 1: to me is that while the death rate has been
Speaker 1: steadily going down about one point three percent per year
Speaker 1: since twenty eleven, that's owing largely to earlier detection and
Speaker 1: better treatments, the incident's rate has been a very steady
Speaker 1: zero point four percent per year after year increase for
Speaker 1: the last twenty years, since two thousand and four. I
Speaker 1: started my practice in two thousand and two, so twenty
Speaker 1: two years ago, and the incident's rate was something like
Speaker 1: two hundred and ten thousand. That was the number. It
Speaker 1: was two hundred and ten thousand women per year diagnosed
Speaker 1: with invasi of kids. So we've gone up about another
Speaker 1: one hundred thousand. How do you stay hopeful? I stay
Speaker 1: hopeful because I know something that most people don't know.
Speaker 1: I know that the vast majority of all breast cancer
Speaker 1: is under your control. What you eat or don't eat,
Speaker 1: drink or don't drink, do or don't do, think or
Speaker 1: don't think eat, even down to like if you forgive
Speaker 1: or don't forgive, it alters the cell micro environment inside
Speaker 1: of you, pushing you toward cancer or away. And you
Speaker 1: have so much control in your choices. So I'm hopeful
Speaker 1: because I know this message is not getting out, and
Speaker 1: so I get to preach it from the mountaintop. I
Speaker 1: get to try every chance. I get to help empower
Speaker 1: women and men to understand that their daily choices impact
Speaker 1: cellular health, which impacts cancer incidents, recurrence, mortality, and not
Speaker 1: just cancer, heart disease, stroke, diabetes, Alzheimer's, obesity, All the
Speaker 1: things that contribute to the major killers in our lives
Speaker 1: are largely related to diet and lifestyle.
Speaker 3: I'm so glad you brought up lifestyle. This is one
Speaker 3: of those big risk factors that we hear a lot about.
Speaker 3: And there's actually a very fresh study that just came
Speaker 3: out end of September that gives us more insight into
Speaker 3: how life style plays into this. So, this new study
Speaker 3: suggested that many commonly used food packaging products contain known
Speaker 3: breast cancer causing chemicals. And the packaging they're talking about
Speaker 3: is the type of thing we see all the time
Speaker 3: in our own homes or at restaurants, shrink wrap, cardboard trays,
Speaker 3: or paper containers. What do you make of this study
Speaker 3: and how should we interpret the results.
Speaker 1: Okay, this study is absolutely accurate. What I make of
Speaker 1: it is that we are bombarded day in and day out.
Speaker 1: With all of these endocrine disruptors. There are literally an
Speaker 1: estimated one hundred thousand, one hundred thousand synthetic chemicals used
Speaker 1: in the United States. A substantial number of these are
Speaker 1: bound to be zeno estrogens. By that, I mean chemicals
Speaker 1: that mimic the action of estrogen in your body. This
Speaker 1: is important because eighty percent of all breast cancers are
Speaker 1: fed and fueled by estrogen, and yet no regulatory body
Speaker 1: has mandated that we test products for zeno estrogen levels
Speaker 1: or their effects, so we don't really even know what happens.
Speaker 1: They attached to the same receptors as your natural estrogen will,
Speaker 1: But do they cause a stronger downstream reaction than normal hormones,
Speaker 1: A weaker one, a totally different one like your guess
Speaker 1: is as good as mine. And the EPA, the Environmental
Speaker 1: Protection Agency, formed the Endocrine Disruptor Screening Program. Okay, their
Speaker 1: first update came in August twenty twenty fifteen e ish.
Speaker 1: And when they came guess how many of the one
Speaker 1: hundred thousand chemicals they looked at, I'll just tell you
Speaker 1: fifty two.
Speaker 3: Oh my gosh.
Speaker 1: So if every seventeen years we look at fifty two
Speaker 1: of the one hundred thousand chemicals. We're going to finish
Speaker 1: with all of them in thirty three thousand years. That's
Speaker 1: when we'll get our final update. So when this study
Speaker 1: came out, I was intrigued by it because I love
Speaker 1: that it gets some attention and press to find out that, Yeah,
Speaker 1: in our daily lives, we are bombarded by these endocrine disruptors,
Speaker 1: and it's always good to be aware of it. But
Speaker 1: the thing is these are everywhere, right, Like you wake
Speaker 1: up in the morning and that sunscreen you put on
Speaker 1: endocrine disruptor EDC, right, endocrine disrupting compound, the gas pump
Speaker 1: that you handled at the station, etc. The plastic fork
Speaker 1: and water bottle that you had at your takeout lunch, etc.
Speaker 1: The detergent you washed your pillow case with that you're
Speaker 1: sleeping on, maybe an EEDC. So they are everywhere. So
Speaker 1: what I like to tell people is, look, they're so ubiquitous,
Speaker 1: these environmental toxicities. All you can do is live your
Speaker 1: life well with some attention, particularly to the things that
Speaker 1: are on you, on your skin, or that you are
Speaker 1: swallowing down, because those have the closest proximity to impact
Speaker 1: cellular health. Right, doesn't that make the most sense. So practically,
Speaker 1: what this means is have a look at your ingredients.
Speaker 1: A lot of people never thought about it. They never
Speaker 1: thought like, oh, I should actually read what's in my
Speaker 1: laundry detergent, the lotion I'm putting on my skin, the
Speaker 1: toothpaste I'm putting all over my gums, the stuff I
Speaker 1: wash my dishes with and then eat food off of
Speaker 1: plastics is the big was the big This report was
Speaker 1: talking about plastics, right, and per fluorocarbonated alkophenols, right, These
Speaker 1: pfast chemicals, they're called forever chemicals because they get into fat.
Speaker 1: I mean, forever is a good thing if you're talking
Speaker 1: about like the stability of a relationship or maybe your job.
Speaker 1: But beyond that, you do not want these stable chemicals
Speaker 1: inside your body. So you want to just limit them
Speaker 1: with your cooking. Look at your cookware. Store everything in
Speaker 1: glass or ceramic. Never ever, ever, ever microwave or heat
Speaker 1: anything that is in plastic. And I don't know where
Speaker 1: this idea came from. I was a kid in the
Speaker 1: seventies and we microwave dinners like I think they just started,
Speaker 1: and the microwaves were fascinating, and you'd put the food
Speaker 1: in there and you'd stare at it while it was cooking,
Speaker 1: and then it would come out and you just remember
Speaker 1: you're supposed to peel up the corner of the I
Speaker 1: can't even believe people think about doing that. And this
Speaker 1: idea that you need to have it in the packaging
Speaker 1: and order for it to heat well is a farce.
Speaker 1: Like anything, if I'm having some frozen vegetables or something
Speaker 1: that I need to cook up, I just dump them
Speaker 1: into a glass dish and put them in the microwave.
Speaker 1: You can heat them on the stove, put them in
Speaker 1: an instapot. Just get away from all the plastics, all
Speaker 1: the baby bottles and the sippy cups and the infant
Speaker 1: formula cans and all of that. Like, just make sure
Speaker 1: everything is glass or ceramic.
Speaker 2: People on our show always make fun of me because
Speaker 2: I don't wear any fragrance, and it's for this reason, actually,
Speaker 2: doctor Funk. But I've found that the EWG, the Environmental
Speaker 2: Working Group, is a great resource, particularly because you mentioned
Speaker 2: the EPA hasn't updated many of their many of their lists, right.
Speaker 1: Yeah, I love the EWG. Yeah, they've also got that
Speaker 1: Dirty Dozen in the Clean fifteen. Yes, because eating organic
Speaker 1: is a great weight to be avoiding a lot of
Speaker 1: these toxicities. And probably the best way of all, by
Speaker 1: the way, is to be eating plant based because whenever
Speaker 1: you cook barbecue grill meat, you are creating these pfast
Speaker 1: chemicals and swallowing them down, and they are potent carcinogens.
Speaker 2: We need to take a quick break, but we'll be
Speaker 2: right back to wellness Wednesday with doctor Christy Funk. And
Speaker 2: we're back. There's a study I'm curious about. It was
Speaker 2: from Susan g. Coman, and they linked weight gain to
Speaker 2: breast cancer. And I know you're talking about the chemicals
Speaker 2: in food, but can weight gain increase our chance of
Speaker 2: getting breast cancer.
Speaker 1: One hundred percent? Yes, So, for reasons that are not
Speaker 1: entirely clear, premenopausal weight gain and being overweight or obese
Speaker 1: is somehow protective against pre menopausal breast cancer. But the
Speaker 1: second you hit menopause, there is no question, in no
Speaker 1: controversy that obese women have fifty to two hundred and
Speaker 1: fifty percent more breast cancer, more breast cancer recurrence, and
Speaker 1: more breast cancer related death. Wow, there are multiple reasons. Yeah, No,
Speaker 1: weight is a really big deal. The beauty in this
Speaker 1: statement is that if you lose the weight, you lose
Speaker 1: the risk. So it's not like you've locked into this
Speaker 1: risk at a certain weight and there's no way to
Speaker 1: undo it. But a couple things I'll say so. One,
Speaker 1: there was a study that looked at gaining more than
Speaker 1: five percent of your initial body weight during or after
Speaker 1: breast cancer treatment, irrespective of your baseline body mass index,
Speaker 1: so you didn't even have to be overweight. If you
Speaker 1: just gained five percent of your initial body weight, it
Speaker 1: increased the risk of recurrence in survival by four hundred percent.
Speaker 1: That's staggering. What fat is doing is a number of things,
Speaker 1: but it's under recognized by like the quick blanket statement
Speaker 1: that you might hear in media in that estrogen feeds
Speaker 1: and fuels eighty percent of breast cancers. Once your ovary
Speaker 1: shuts down, either because of natural menopause or perhaps you
Speaker 1: had premature ovarian failure or chemical menopause, which is meaning
Speaker 1: chemo therapy kind of destroyed your ovarian production, or you
Speaker 1: had them surgically removed. Okay, that estrogen source is gone.
Speaker 1: That was your main estrogen source. One percent of the
Speaker 1: amount of estrogen that your ovary was making is made
Speaker 1: by you from your fat. So you've got these fat
Speaker 1: cells predominantly in the fat itself. But there's an enzyme
Speaker 1: in the fat called aroma tase, and some of this
Speaker 1: is also found in liver in the ovary itself, so
Speaker 1: it's not the ovarian production, but it's from the fat
Speaker 1: in the ovary in muscle. And believe it or not,
Speaker 1: these sinister cancers, if they've already formed, they have their
Speaker 1: own aromatase enzyme. Maybe got like a little backpack, like
Speaker 1: one of those little running backpack water bottle things, Like
Speaker 1: it's like, oh, I need some more estrogen. Let me
Speaker 1: just sip out of my backpack here and get some more.
Speaker 1: Aromatase is an enzyme in all these places. It's turning
Speaker 1: adrenal gland steroids into estrogen. So it's not enough to
Speaker 1: stop a hot flash if you're menopausal, but it is
Speaker 1: sure enough to feed and fuel that cancer. That's usually
Speaker 1: where the story ends for people who make the connection
Speaker 1: between weight, overweight, obesity and breast cancer, but that is
Speaker 1: hardly the story. The real sinister mechanisms of how weight
Speaker 1: intersects with breast cancer have to do with inflammation. So
Speaker 1: the number one, two and three things are leptin, chronic
Speaker 1: inflammation produced by fat cells, and insulin. So lectin. It's
Speaker 1: created mostly by adipose tissue and it's secreted into circulation,
Speaker 1: and once leptin binds to its receptor, it crosstalks with
Speaker 1: all of these oncogenes, with all of these genetic switches
Speaker 1: that you flip on and off to suit a cancer's need.
Speaker 1: It ignites this signaling pathway multiple pathway that release growth
Speaker 1: factors and cidokinds. And the endgame is breast cancer initiation, progression,
Speaker 1: and metastases. If it's already there, So that's leptin. The
Speaker 1: second thing fat does is it activates. It has these
Speaker 1: macrophases in the adipose tissue of obese women that produce
Speaker 1: inflammatory mediators, things that have letters and numbers TNF, alpha,
Speaker 1: interluken six. The specifics do matter so much as the
Speaker 1: endgame again chronic inflammation, which is promoting this cancer growth
Speaker 1: in metastatic spread. And the other thing it makes happen
Speaker 1: is angiogenesis. Angio means blood vessel genesis is birth. If
Speaker 1: you are a breast cancer cell and you aspire to
Speaker 1: be bigger than the tip of a ballpoint pen, which
Speaker 1: every cancer aspires to be. You must create your own
Speaker 1: blood supply, and you must have this environment around you
Speaker 1: that's conducive to doing that. Angiogenesis the birth of these
Speaker 1: blood vessels, so you can bring your own new nutrients
Speaker 1: to yourself, and then when you get big enough, shoot
Speaker 1: them exit strategy straight through those same blood vessels to
Speaker 1: the brain, to the lung, to the liver, to the bone.
Speaker 1: That's how it all goes down. And the activated macrophases
Speaker 1: in fat create angiogenesis and modify your immune response so
Speaker 1: much so that this is probably the reason why we
Speaker 1: know that obese women don't respond as well to both
Speaker 1: the anti estrogen therapies and the chemo therapy we give
Speaker 1: them when they have breast cancer. They have uniformly worse prognoses.
Speaker 2: Doctor funk I think that we hear a lot about
Speaker 2: the effects of alcohol on our healths, and a study
Speaker 2: published this September looks specifically at the potential link between
Speaker 2: alcohol and increased breast cancer diagnosis and patients under fifty.
Speaker 2: What should we know about alcohol consumption and breast cancer?
Speaker 1: Okay, so pick your poison. What is alcohol? It's five
Speaker 1: ounces of wine equals one point five ounces of hard
Speaker 1: liquor equals a twelve ounce beer. A drink a day
Speaker 1: and a premenopausal woman increases breast cancer by seven percent.
Speaker 1: A drink a day in a postmenopausal woman thirteen percent.
Speaker 1: Every drink thereafter adds about another ten percent. So two
Speaker 1: drinks a day seventeen percent pre menopausal, it's twenty three
Speaker 1: percent postmenopausal, and onwards and upwards from there.
Speaker 2: I do want to say, one drink a day is
Speaker 2: quite a lot of drinks. So if you're just like
Speaker 2: you know, drinking once a week or once every two weeks,
Speaker 2: you're pretty much okay with alcohol as it relates to
Speaker 2: breast cancer.
Speaker 1: Yes, that amount of drinking is not going to really
Speaker 1: become carcinogenic, but a seegl aaldehyde is the carcinogen that
Speaker 1: you form. Even if you just use your alcohol as mouthwashed,
Speaker 1: which would be a terrible waste of an excellent wine draft.
Speaker 1: But if you just fish and spad swallow down, you
Speaker 1: are already swallowing down a carcinogen that then even becomes
Speaker 1: more prevalent as it gets broken down by your liver
Speaker 1: into a cel aaldehyde. One of the main reasons why
Speaker 1: alcohol causes breast cancer though. Back to that is its
Speaker 1: interference with an enzyme called MTHFR, which sounds like bad
Speaker 1: word MTFR. It stands for methyl tas or hydrofolate reductase,
Speaker 1: And what that enzyme is doing is that's taking full
Speaker 1: eight from your leafy grains and full of acid from
Speaker 1: your vitamins and turning it into methyl fulate. Methyl Fulate
Speaker 1: in its active form is babysitting DNA as it divides.
Speaker 1: So when your body makes a mistake, which it does
Speaker 1: millions of time miss every day, methyl fullate swoops in
Speaker 1: and fixes it or throws it out so it doesn't
Speaker 1: set as a mutation that then gets propagated. One cell
Speaker 1: becomes two, becomes four until you have a cancer. Right
Speaker 1: when you drink you knock out that enzyme. Thirty to
Speaker 1: fifty percent of all people already have a suboptimal NTHFR,
Speaker 1: so they have a mutation. It's not complete, but it's partial.
Speaker 1: And then the alcohol on top of it is just like,
Speaker 1: forget it, lady, I'm not making any methyl fool. I
Speaker 1: did a good luck with that mutation.
Speaker 3: We need to take another short break, but we'll be
Speaker 3: right back and we're back with breast cancer surgeon and
Speaker 3: women's health advocate, doctor Christy Funk. So we've talked about lifestyle, diet, alcohol,
Speaker 3: we want to talk about genetics next. This is something
Speaker 3: that directly impacts me. My maternal grandmother passed away from
Speaker 3: breast cancer when she was fifty eight, and so it's
Speaker 3: always been something that my mom has warned me about
Speaker 3: growing up, and especially the power of early detection when
Speaker 3: we think about lifestyle and genetics, which is more of
Speaker 3: a determining factor when it comes to breast cancer diagnoses.
Speaker 1: Genetics, for sure, there are about nineteen of these gene
Speaker 1: mutations that we know are strongly associated with the predisposition
Speaker 1: to getting breast cancer. Can diet and lifestyle circumvent or
Speaker 1: overrule the problems with this gene mutation that you may
Speaker 1: have inherited, Probably not, or at least not yet with
Speaker 1: any real certainty. However, and this is a really important point,
Speaker 1: only five to ten percent of all women diagnosed with
Speaker 1: breast cancer carry a genetic mutation they've inherited from mom
Speaker 1: or dad, which means that ninety to ninety five percent
Speaker 1: of all women with breast cancer did not get it
Speaker 1: from a genetic predisposition.
Speaker 3: Whose environmental you're saying, I.
Speaker 1: Think diet and lifestyle. There's a saying that I like,
Speaker 1: and it's that genetics load the gun, but your choice
Speaker 1: is pulled the trigger.
Speaker 3: And then in terms of figuring out where you stand genetically,
Speaker 3: it's DNA testing, right, those are the options. Yes, talk
Speaker 3: to us about the options that are available.
Speaker 1: So think about your family tree for second and third
Speaker 1: degree relatives on both sides of the family, and let's
Speaker 1: analyze that. If you have two relatives on the same
Speaker 1: side with breast cancer prior to age fifty or ovarian
Speaker 1: cancer at any age, then you should consider genetic testing
Speaker 1: because your risk of carrying a G mutation is ten
Speaker 1: percent or higher. If you are Ashkenazi Jewish in heritage,
Speaker 1: then you only need one of those one breast cancer
Speaker 1: prior to fifty one, ovarian cancer any age, if you
Speaker 1: yourself have had breast cancer. I test everybody now because
Speaker 1: it's so affordable. It used to be very cost prohibitive.
Speaker 1: It was literally if you wasn't covered by insurance, it
Speaker 1: was forty five one hundred dollars and that was just
Speaker 1: to find out if you carried BRCA. Now, if you
Speaker 1: don't qualify by insurance criteria. For two hundred and fifty dollars,
Speaker 1: you can get a full genetic panel of eighty five
Speaker 1: genetic mutations. So again, two relatives with breast under fifty.
Speaker 1: One relative with ovarian cancer at any age, if you
Speaker 1: yourself had breast cancer, particularly prior to age fifty a
Speaker 1: triple negative subtype, which if you had that you would know,
Speaker 1: and or if you yourself have had breast cancer twice,
Speaker 1: not a recurrence of the same one, but two totally
Speaker 1: separate breast cancers, if there are any men in the
Speaker 1: family tree with breast cancer, or if anybody had pancreatic melanoma,
Speaker 1: gastric prostate. These are all like associated with certain syndromes,
Speaker 1: So the breast, ovarian and then all the other cancers.
Speaker 1: There's just a whole lot going on, three or more
Speaker 1: relatives than I would consider testing.
Speaker 2: I feel like we've all heard how important early detection is.
Speaker 2: I know this may sound silly, but I grew up
Speaker 2: hearing about it on the Today Show in Good Morning America.
Speaker 2: I think traditionally the advice has been to start getting
Speaker 2: mammograms at the age of forty. Is that still the recommendation?
Speaker 1: It is different societies have different recommendations, but we are
Speaker 1: all sort of trending back hearing about oh you can
Speaker 1: start at fifty, you can do every other year. The
Speaker 1: United States Preventive Task Force as now dialed it back
Speaker 1: again to beginning at age forty. Look, especially in life
Speaker 1: with the conversation we were just having. Knowing that breast
Speaker 1: cancer is getting diagnosed earlier than ever before in women
Speaker 1: under fifty, there's no reason to be excluding them from screening.
Speaker 1: So I signed with the America Society of Breast Surgeons,
Speaker 1: and we advise women of normal breast cancer risks to
Speaker 1: begin in age forty and don't stop or skip years
Speaker 1: until your life expectancy is less than five years, which
Speaker 1: is admittedly a little hard to predict when you're going
Speaker 1: to die. But you know certain people, it's obvious that
Speaker 1: their heart disease or their advanced COPD, etc. Is more
Speaker 1: critical than a breast cancer diagnosis would be, because it
Speaker 1: would potentially cause too much harm to treat that cancer,
Speaker 1: which was never going to be the reason why they
Speaker 1: died if they already have something else more serious looming,
Speaker 1: like advanced cardiac for lung disease.
Speaker 2: What about for women in their twenties and thirties. What
Speaker 2: do you think they should be paying attention to in
Speaker 2: terms of their breasts.
Speaker 1: I always encourage women to be breast aware, so to me,
Speaker 1: that involves monthly self breast exams. The official rule on
Speaker 1: the street is that doing self breast exams don't save lives,
Speaker 1: but in my practice, I've just seen it to be otherwise.
Speaker 1: I think you're with your breasts every day, all day,
Speaker 1: and I might be with them once a year or so.
Speaker 1: I think it's smart to not get creeped out by
Speaker 1: feeling the lumpy bumpiness of your breast, and the only
Speaker 1: way to have that self confidence in doing an exam
Speaker 1: is to do it regularly and develop this unconscious sort
Speaker 1: of memory of where the lumpy bumpiness is, where it's
Speaker 1: tender when you press, and not. So you want to
Speaker 1: begin doing self breast exams. I believe, in my opinion,
Speaker 1: as young as when you start having periods. I don't
Speaker 1: think that you're going to ever have a breast cancer
Speaker 1: at sixteen or twenty one, but I want you to
Speaker 1: have had that unconscious memory developing along with the development
Speaker 1: of your breasts. So I suggest women do it every
Speaker 1: single month. One week after their periods. That's when your
Speaker 1: breast are going to be less tender and less lumpy.
Speaker 1: And then don't worry about finding a cancer. I just
Speaker 1: want you to pick a method of examining your breast
Speaker 1: that is a repeat pattern, so that one day, God forbid.
Speaker 1: But if you ever do feel something, you'll be like
Speaker 1: that was not there before, Like hands down, I know
Speaker 1: that wasn't there before. I created a nice five minute
Speaker 1: tutorial on how to do a self breast exam. It's
Speaker 1: an easybreastexam dot com. There's a video there that I made,
Speaker 1: and I think it's an excellent thing to view because
Speaker 1: you for sure are not doing your self breast exam correctly.
Speaker 3: I'm really tempted to do one right now, but I
Speaker 3: don't want to make everyone in the studio uncomfortable, so
Speaker 3: I'll move on. So, when it comes to breast cancer detection,
Speaker 3: we've always heard that mammograms are the gold standard. However,
Speaker 3: we've been seeing some news stories lately about mammograms potentially
Speaker 3: missing early stages of breast cancer. Perhaps this has to
Speaker 3: do with the density of breast tissue. What factors contribute
Speaker 3: to a mammogram missing a diagnosis.
Speaker 1: Mammograms miss breast cancer largely due to density, so we
Speaker 1: grade density A through D season DS are dense as
Speaker 1: and bs are not. It's simply a visual ratio of
Speaker 1: the white, splotchy stuff to the dark gray stuff. The
Speaker 1: denser your breast, the whiter your mammogram appears. And that's
Speaker 1: a problem for two reasons. Number One, cancer is always white,
Speaker 1: so now you're looking for a snowball in a snowstorm.
Speaker 1: If you are graded C with your density, which has
Speaker 1: word correlates, so the c's are called heterogeneously dense on
Speaker 1: the report, we will miss twenty five percent of breast
Speaker 1: cancers when present. If you are D, called extremely dense
Speaker 1: in word form on the report, we miss forty percent
Speaker 1: of breast cancer. Part two of that is not just
Speaker 1: that we miss the cancers, but you have more of
Speaker 1: the stuff underneath your breast skin that actually makes cancer.
Speaker 1: So the milk producing lobules and the hair thin little
Speaker 1: ducks in there as opposed to fat and blood vessels
Speaker 1: and connective tissue, etc. You have more of the stuff
Speaker 1: that makes cancer. That's what's making it white. So your
Speaker 1: higher risk to make a breast cancer versus the woman
Speaker 1: with fattier, less dense breasts, and we are higher risks
Speaker 1: to miss that cancer if you make one. Actually, a
Speaker 1: new national federal law went into effects September tenth, twenty
Speaker 1: twenty four that mandates every single imaging facility in the
Speaker 1: United States to report two women getting a mammogram whether
Speaker 1: or not their breasts are dense. They have to use
Speaker 1: this extremely specific language. It's a cut and paste. It's
Speaker 1: a uniform for every imaging center, and to paraphrase it,
Speaker 1: it says, Hey, your mammograms fine, but your breasts are dense,
Speaker 1: which means we could mis cancer. Good luck with that.
Speaker 3: At least, you know, I got one of those after
Speaker 3: my mammogram, right.
Speaker 1: It's very disconcerting, right because you're like, well, yeah, it is.
Speaker 1: What did you do with that information?
Speaker 3: You know, it's something that I've always known, just because
Speaker 3: I've talked about it with my mom. My mom has
Speaker 3: the same thing. But I think it. You know, it's
Speaker 3: got me on like a healthy high alert. I'd say,
Speaker 3: it just makes me want to stay on top of
Speaker 3: it more.
Speaker 1: Doctor funk.
Speaker 2: I want to end on a positive note. There's been
Speaker 2: so much new research out lately. What's an exciting development
Speaker 2: or treatment that you've seen that's giving you hope for
Speaker 2: better patient outcomes.
Speaker 1: Immunotherapy, So when it comes to an existing breast cancer patient,
Speaker 1: immunotherapy has become such an exciting new intervention and so
Speaker 1: successful in the advanced stage cancer patients that they are
Speaker 1: now using it in the early stages one and two
Speaker 1: when they're diagnosed, because we know it'll improve their prognosis
Speaker 1: and dramatically decrease the chances that they deal with the recurrence.
Speaker 1: And the second thing I think is exciting to me
Speaker 1: is the awareness and openness of women at large to
Speaker 1: the idea that they do have control over their health
Speaker 1: destiny and in the context of this conversation, their breast
Speaker 1: health density. I've created a campaign with the Physicians Committee
Speaker 1: for Responsible Medicine. It's called Let's Beat Breast Cancer dot org.
Speaker 1: We have over fifty rallies across the country, their drum
Speaker 1: rallies to beat the Drum to beat breast cancer, to
Speaker 1: get communities excited. It's all about raising eyebrows and awareness,
Speaker 1: not funds. And if you go to Let's Beat Breast
Speaker 1: Cancer dot org, we invite you to sign up for
Speaker 1: free to accept this challenge that we put out there.
Speaker 1: To adopt a four approach to beating breast cancer, and
Speaker 1: those four problems are to eat a plant based diet,
Speaker 1: to exercise regularly, to maintain ideal body weight, and to
Speaker 1: limit or eliminate alcohol. And as soon as you sign up,
Speaker 1: we send you a free e starter kit and a
Speaker 1: vegan cookbook that we've created specifically surrounding foods that maximize
Speaker 1: breast health and reduce occurrence and recurrence risk for breast cancer.
Speaker 1: It's a really fun campaign and people get very excited
Speaker 1: about it.
Speaker 3: That sounds awesome, Doctor Funk, Thank you so much for
Speaker 3: sharing that. I just love the way that you approach
Speaker 3: this whole topic. Even though I'm not gonna lie, part
Speaker 3: of me is terrified after hearing everything you said. You
Speaker 3: also did a wonderful job of putting my mind at
Speaker 3: ease in terms of providing information and resources and options,
Speaker 3: because at the end of the day, it all comes
Speaker 3: back to agency and as you mentioned, having agency over
Speaker 3: our health destinies as much as we possibly can.
Speaker 2: Absolutely, Yeah, I feel really empowered by the information you shared.
Speaker 2: Thank you.
Speaker 1: Oh You're so welcome.
Speaker 3: Thank you so much for joining us on the bright side,
Speaker 3: Doctor Funk, Thanks for.
Speaker 1: Having me.
Speaker 2: Doctor Christy Funk is a Board certified breast cancer surgeon
Speaker 2: and women's health advocate. She also runs the Pink Lotus
Speaker 2: Breast Center in Santa Monica, California, and is the author
Speaker 2: of Bress, the Owner's Manual.
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