Speaker 1: This is Let's Be Clear with Shannon Doherty.
Speaker 2: Welcome to Let's Be Clear. My name is Sarah Sidner.
Speaker 2: You probably don't know me unless you're up very early
Speaker 2: and watch CNN from seven am to ten am Eastern,
Speaker 2: where I do a new show with two of my
Speaker 2: buddies during the week. It was during that show that
Speaker 2: I revealed to the audience and to some of my
Speaker 2: distant relatives who did not know yet, that I had
Speaker 2: stage three breast cancer. I did it while choking back tears.
Speaker 2: But it has now been just over a year since
Speaker 2: my diagnosis, and while I was still recovering, I had
Speaker 2: just returned from my double mistectomy. I ended up reading
Speaker 2: this new story and this was the headline, and I'm
Speaker 2: going to read it to you now. Actress Shannon Doherty
Speaker 2: has died after a year battle with breast cancer. She
Speaker 2: was fifty three years old. I choked down those words,
Speaker 2: thinking in my head, how is this possible. She was
Speaker 2: the queen of the nineties. She was a part of
Speaker 2: our lives. Really all of us watched nine O two
Speaker 2: one zero, We watched all of the shows that she
Speaker 2: took part in. She was just sort of around and
Speaker 2: you sort of feel like you know somebody when they
Speaker 2: are on your television set. And I'm only a year
Speaker 2: younger than her. So with all her resources and with
Speaker 2: all her fame, and with all the people that she
Speaker 2: comes across, how is she gone? That really struck me.
Speaker 2: It turns out we both were diagnosed with the same
Speaker 2: type of cancer, so that sent me down a very
Speaker 2: depressing rabbit hole. But it really isn't important who I am.
Speaker 2: It is important that you get the information that you need.
Speaker 2: And we're going to be real, raw and real. There
Speaker 2: might be some cringe worthy things said during this podcast
Speaker 2: because I want you to know what the experience is
Speaker 2: actually like and some of the things that we never
Speaker 2: talk about, including sexual health and the problems that come
Speaker 2: along with cancer treatment. I will be as honest as
Speaker 2: I can, and embarrassingly so, so I hope that you
Speaker 2: will enjoy this because we have one of the most wonderful,
Speaker 2: knowledgeable guest that is with us today who can give
Speaker 2: you a lot of information. She is Harvard trained, She's
Speaker 2: an oncologist. She wrote this incredible book called All in
Speaker 2: Her Head, The Truth and Lies Early medicine taught us
Speaker 2: about women's bodies and why it matters today. She was
Speaker 2: also in a special with Oprah. So welcome and thank
Speaker 2: you for doing this with me. I am not Oprah Winfrey,
Speaker 2: but I am so happy to have you here to
Speaker 2: talk through this with us.
Speaker 1: And I'm honored truly to be here with you.
Speaker 2: Okay, So can we start with your pet Peeve? And
Speaker 2: I just did it when I announced Shannon Doherty had
Speaker 2: died of cancer. I said she lost her battle with cancer.
Speaker 2: Why do you hate it when people say lost her battle? Yeah?
Speaker 1: I mean the word in and itself in that context
Speaker 1: just makes my heart race and honestly my blood boil,
Speaker 1: because there are no winners and losers in cancer, and
Speaker 1: language is so critical to how we experience illness, the
Speaker 1: stories that are told ourselves, that we tell ourselves, and
Speaker 1: when it comes to cancer, nobody wants to lose that battle.
Speaker 1: And I think about all the patients that will interpret
Speaker 1: and have interpreted that is somehow they're not fighting hard enough,
Speaker 1: when in fact they are truly fighting. And so I
Speaker 1: would wish and hope that the media and the lay
Speaker 1: public would remove that metaphor from a cancer diagnosis. In
Speaker 1: cancer treatment, it's also very violent imagery, as in the
Speaker 1: drugs that we're giving and the treatment that we're doing,
Speaker 1: which we're trying to do to ease suffering and to
Speaker 1: have compassionate care, are really these violent weapons, and it
Speaker 1: perpetuates a narrative that I think is really more harmful
Speaker 1: than beneficial.
Speaker 2: That's such a good point, and I do it all
Speaker 2: the time. I'm like, yeah, I'm battling cancer or I'm
Speaker 2: fighting cancer. And it does put you in a place
Speaker 2: where if you don't win, then you didn't try hard enough. Yeah,
Speaker 2: And what a thing to put on a cancer patient.
Speaker 2: It's like, course, you didn't fight hard enough. I guess
Speaker 2: that's why somebody died. And it's not fair nor true.
Speaker 2: It's not true.
Speaker 1: And it also lends itself to a tremendous amount of
Speaker 1: guilt that I see day in and day out, where
Speaker 1: people will say I was so stressed out that's why
Speaker 1: I got cancer, or I didn't do X, Y and Z,
Speaker 1: or I'm not an e rate or I'm not visualizing
Speaker 1: it away. I would love love to be out of
Speaker 1: a job if we could pray, visualize, and eat our
Speaker 1: way out of cancer. It's not to say that those
Speaker 1: things are not important for how we experience disease and
Speaker 1: a whole host of other things that we can get into,
Speaker 1: but they're not unilaterally causing or curing cancer. And the
Speaker 1: guilt that it saddles patients with. I would love to
Speaker 1: unburden them from that. And what goes along with that
Speaker 1: is this language of battle and fighting.
Speaker 2: Why do we, as women, and not all women, but many,
Speaker 2: many women, because you see them coming in a daily basis,
Speaker 2: Why do we have this need to please our doctors?
Speaker 2: Why do we have such a hard time advocating for ourselves.
Speaker 1: Oh, I think it's so complicated, but I think so
Speaker 1: much about the experience of medicine and what happens in
Speaker 1: the doctor patient exam room reflects history and culture and
Speaker 1: society and in general, you have a lot of women
Speaker 1: that have inherited this sense of needing to please and
Speaker 1: take care of others. And when that is overlaid with
Speaker 1: the power dynamic of the doctor in the exam room,
Speaker 1: you don't want to feel like you're bothering them, burdening them,
Speaker 1: you know, hysterical with them, and it becomes a lot
Speaker 1: harder to advocate for yourself in that context. And I
Speaker 1: have been in that situation myself many many times. I
Speaker 1: think what makes it even harder. And what I've seen
Speaker 1: is when you have strong, powerful women who are on
Speaker 1: TV or her lawyers are advocating for other people or
Speaker 1: who are you know, mothers, whatever it may be, they're
Speaker 1: taking care of everybody else and advocating for everybody else.
Speaker 1: And so when they know in their soul I'm not
Speaker 1: following my intuition or I'm not asking the questions I
Speaker 1: need to, it feels very devaluing of yourself. And you
Speaker 1: don't kind of know how to crawl out of that
Speaker 1: because you think I'm supposed to be this strong person
Speaker 1: and yet I could not ask this basic question that
Speaker 1: I've always wanted to know about myself.
Speaker 2: I want to ask you about some of the things
Speaker 2: that I hear all the time, and you sort of
Speaker 2: alluded to it. Probably once a week I hear someone
Speaker 2: say to me, you know, sugar feeds cancer, you really
Speaker 2: shouldn't eat that. Is that true?
Speaker 1: So there's a lot to unpact there. Sugar is not
Speaker 1: like you remember going into the cancer and feeding it right.
Speaker 1: It's not this like one way train with that eminem
Speaker 1: that you put in your mouth. And that also puts
Speaker 1: a lot of blame on the patient. That being said,
Speaker 1: Excessive sugar can lead to excessive weight, it can change
Speaker 1: your metabolic function, and we know that that is not
Speaker 1: good overall. As but being what's called a host to cancer.
Speaker 1: So cancer cells are living in your body, and we
Speaker 1: want to make them inhospitable. We want to make your
Speaker 1: body and the environment around it less hospitable to cancer.
Speaker 1: So I think about you know, if I have a
Speaker 1: rose seed and I'm trying to grow it in Antarctica,
Speaker 1: it's not going to grow as well because it's frigid,
Speaker 1: it's cold, it's snowy. If I put it in Florida
Speaker 1: with sunshine and great soil, it's going to grow more.
Speaker 1: So to some degree, the habitat that the cancer can
Speaker 1: live in matters. So trying to maintain a healthy diet,
Speaker 1: trying to exercise, is trying to have an overall healthy
Speaker 1: body is important. But it's not some runaway train. If
Speaker 1: you have a bite of cake or you have a cookie.
Speaker 1: We just want to do everything in moderation.
Speaker 2: That is really interesting that you say that, because I
Speaker 2: asked a couple of different oncologists. I was in one
Speaker 2: place and then I came to New York and got
Speaker 2: my treatment here. Because this is where I was working,
Speaker 2: and I wanted to try to work throughout this. I
Speaker 2: don't know that was smart or not, but I did,
Speaker 2: and I asked, is there a cancer diet? Is there
Speaker 2: something I should be doing or changing and that actually
Speaker 2: helps to either shrink cancer or to stop cancer? And
Speaker 2: I was told no twice except when it came to
Speaker 2: drinking alcohol. Three oncologists said, do not drink alcohol. I'm confused,
Speaker 2: is there a cancer diet or not? If there's not
Speaker 2: supposed to drink alcohol, it seems to me that there's
Speaker 2: got to be something to do with nutrition. It's a great,
Speaker 2: great question.
Speaker 1: I'll tell you what I think we know, and then
Speaker 1: we'll hit the alcohol point as well. So we do
Speaker 1: know that maintaining more of a plant forward diet with
Speaker 1: less processed foods. And what is processed foods? I mean,
Speaker 1: there are all these quizzes online about is it process
Speaker 1: is it not processed? In general, if it's got artificial
Speaker 1: dies in it, so it's more likely to be processed.
Speaker 1: If you can't pronounce a laundry list of ingredients there,
Speaker 1: it's more likely to be processed than nuts.
Speaker 2: Not. You want to think.
Speaker 1: About whole foods, whole grains, real foods and limiting especially
Speaker 1: processed red meats, process deli meats, the process salami, the pepperoni,
Speaker 1: things like that, and processed red meats, and doing your
Speaker 1: best to have again a plant four diet that has
Speaker 1: fruits and vegetables in it, and a colorful diet. That's
Speaker 1: the first thing that we know is really important, and
Speaker 1: again trying to avoid the ultra processed foods. The other
Speaker 1: piece that we know that can be helpful is alcohol.
Speaker 1: So in this country especially, we use alcohol to celebrate,
Speaker 1: we use alcohol to numb feelings.
Speaker 2: There's also from the good to the bad.
Speaker 1: Alcohol runs the spectrum of when you see it infiltrating
Speaker 1: as a main character in someone's life.
Speaker 2: My mother is British, so we want to talk about
Speaker 2: alcohol being a main character, like the pub is, like
Speaker 2: where my grandfather lived. Yes, that was the social event.
Speaker 2: So alcohol is just part of the way we live
Speaker 2: and celebrate and.
Speaker 1: Talk exactly exactly, But it's a no for me. It's well,
Speaker 1: let's think about it. So it's we know that it's
Speaker 1: a carcinogen. We know that there's an association the more
Speaker 1: you drink, the higher your risk. However, this is not
Speaker 1: the same risk as having a genetic mutation that leads to,
Speaker 1: you know, an eighty five percent increase risk of cancer
Speaker 1: over your lifetime. But people ask me all the time,
Speaker 1: what can I do that's within my control. You can't
Speaker 1: control what your family history is. You can control what
Speaker 1: you put in your mouth and how you exercise and
Speaker 1: what you drink. And so we do know that there
Speaker 1: is an increase association not only with breast cancer, but
Speaker 1: other types of cancers from alcohol consumption because it is
Speaker 1: a direct carcinogen. So for my patients that ask me
Speaker 1: if they can limit it to you know, limited celebrations
Speaker 1: or think about why are you reaching for that glass?
Speaker 1: Is there something else we could do in its place?
Speaker 1: And with respect to the social component of it, I
Speaker 1: like to invite my patients to think about talking to
Speaker 1: their family members, talking to their friends instead of saying
Speaker 1: you had a bad day, have a beer, or we're
Speaker 1: going to take a toast to you know, with this
Speaker 1: glass of wine. Is there something else we could do
Speaker 1: together as a community.
Speaker 2: That's really poignant because it's such an easy thing. What
Speaker 2: do people always say when you first meet them, Like
Speaker 2: with girlfriends, it's like, hey, we should grab a drink, yeah, right,
Speaker 2: and so I have changed that to, hey, let's go
Speaker 2: grab coffee even if it's four o'clock, you know what
Speaker 2: I mean, just something else that's still sort of social.
Speaker 2: But I want to grab a cob of coffee with
Speaker 2: you girl. You know you even grab a cop of
Speaker 2: coffee any time with me, and.
Speaker 1: Then we can go with for a walk at the
Speaker 1: same time and really knock them down.
Speaker 2: Yeah, but that is one of the things. It's like
Speaker 2: you don't want to say no, and then you get
Speaker 2: the pressure to drink. I have never been. This is
Speaker 2: a miracle because my family on both sides, loves a
Speaker 2: good glass of whatever, usually hard stuff. But I've never
Speaker 2: been a drinker because I just don't like the taste.
Speaker 2: And I finally realized in my thirties that I was
Speaker 2: just drinking socially just because everybody else was and I
Speaker 2: wanted to fit in. And then I grew up and said, like,
Speaker 2: I don't even like this. So I get, for example,
Speaker 2: I'm like seltzer with some cranberry juice and like a
Speaker 2: pretty flower or throw something in there, like a twist
Speaker 2: that makes it seem like I'm drinking, so I don't
Speaker 2: have to hear the amoryam or yam or why aren't
Speaker 2: you drinking? What are you doing? Yeah? Perfect? Now I'm like,
Speaker 2: I have cancer, so I can't really drink that and
Speaker 2: people shut the hell out. That tends to help when
Speaker 2: they're like, oh, okay, yeah, yeah, but you don't have
Speaker 2: to use that excuse. You can just make it look
Speaker 2: like you're drinking and you're just having a Seltzer water
Speaker 2: with you know, lemon in it. I think that's great.
Speaker 2: It tends to work for me. Everybody has their way
Speaker 2: of doing things now too, because you touched on this
Speaker 2: as you always do, because you're the expert being overweight.
Speaker 2: Does being overweight or being obese make you more susceptible
Speaker 2: to cancer? It does, It does.
Speaker 1: So we know that obesity, like tobacco consumption or alcohol consumption,
Speaker 1: is one modifiable risk factor for cancer, but we know
Speaker 1: that it can also be a tremendous battle to fight right,
Speaker 1: and so it's something that we really want patients to
Speaker 1: talk openly with their doctors about about what are their options,
Speaker 1: what are their lifestyle options, what are the medication options
Speaker 1: that they might be able to have so that they
Speaker 1: can start to decrease their risk from that access weight
Speaker 1: and this is my fault.
Speaker 2: Like that's the first thing that stuff jump into my head.
Speaker 1: And there is so much shame around that that I
Speaker 1: think we have to really dismantle and compassionately give patients
Speaker 1: their options.
Speaker 2: Speaking of shame, this is a hard one for me
Speaker 2: to discuss. Uh. And this might be a little cringe worthy, guys,
Speaker 2: So just you know, if you're listening with your younger kids,
Speaker 2: or you're listening with a daughter or a son, you
Speaker 2: may not want to go down this road. But I'm
Speaker 2: going to talk about sex. Where the hell did my
Speaker 2: libido go? Love that you asked that?
Speaker 1: Can we make sex less cringe worthy?
Speaker 2: It's so be fine, I know, but talking to you're
Speaker 2: not a stranger, but you all are like, yeah, literally
Speaker 2: just vanished. Yeah, and I'm married and it's a problem
Speaker 2: and we can pretend that it is and it's like, oh,
Speaker 2: you know, it's fine, we'll work it out. It's like
Speaker 2: you have to talk about it and it's so uncomfortable.
Speaker 2: So what happened? Where does it go when you're in
Speaker 2: cancer treatment?
Speaker 1: I think it's so multifactorial. And again I champion you,
Speaker 1: celebrate you for going there and really authentically talking and
Speaker 1: vulnerably talking about such an important topic and one that
Speaker 1: I bang my head against the wall all the time
Speaker 1: so that we can really honor this, particularly for women.
Speaker 1: We know as a society we are far more likely
Speaker 1: to address sexual needs of men than we are about women,
Speaker 1: and it is a huge bleeping problem. I know we're
Speaker 1: on a recorded line right now, so I can't insert
Speaker 1: all the profanity, but I really I really mean all
Speaker 1: of it, and it's a real that in and of
Speaker 1: itself is a shame. Historically and to the present, we
Speaker 1: are two times more likely to ask men about sexual
Speaker 1: side effects from cancer targeted therapies than we are women.
Speaker 1: And I see this shameplay out day in and day out.
Speaker 1: So when it comes to cancer and breast cancer specifically
Speaker 1: in libido, lots of different things. First of all, the
Speaker 1: stress and trauma of going through a cancer diagnosis is huge.
Speaker 2: That's all you can think about all.
Speaker 1: It's all yes, And our sexual beings and our sexual
Speaker 1: self is so related to how we feel in our
Speaker 1: bodies physically, how we approach things mentally, the ways that
Speaker 1: we access joy, and the things that might inspire us
Speaker 1: throughout the day, especially if we're thinking about a cancer
Speaker 1: diagnosis or cancer treatment, or even just scheduling treatment can
Speaker 1: be exhausting and overwhelming for patients. And then there's the
Speaker 1: biological and physical issues that can go on from cancer treatment,
Speaker 1: and particularly with breast cancer treatment, it can affect hormone levels,
Speaker 1: which can.
Speaker 2: We about to talk about that.
Speaker 1: Let's do it. You want me to just bring it,
Speaker 1: I mean, and we can just go there. But you know,
Speaker 1: particularly with intercourse women, it can feel like I have
Speaker 1: heard so many patients say.
Speaker 2: It's painful, painful.
Speaker 1: They tell me it feels like having knives, yes, right,
Speaker 1: like shards of glass inside your vagina. And we should
Speaker 1: be able to use that language and talk about it
Speaker 1: and de shame it and figure out what we're going
Speaker 1: to do about it. So for breast cancer patients, there
Speaker 1: are lots of things that we can do, including treatments
Speaker 1: that we give directly locally that can improve the hormonal
Speaker 1: function of that area. And we have to not only
Speaker 1: bring more research into this, but more clinical expertise.
Speaker 2: I think that, Okay, you just said something I hadn't heard,
Speaker 2: so I need to yeah, because you know, I know
Speaker 2: down rabbit holes, and you know, I'm one of those
Speaker 2: googling people, which I was warned not to, and you
Speaker 2: can't stop me because it literally is part of my job.
Speaker 2: So I can't help it. But you just said there
Speaker 2: are things that you can use, Yes, estrogen even if
Speaker 2: you have an estrogen.
Speaker 1: Recept Yes, yes, so if you have an estrogen receptor
Speaker 1: positive breast cancer.
Speaker 2: Okay, so we're blowing my mind right out.
Speaker 1: Yes, yes, so even if you have a cancer that
Speaker 1: we're trying to block estrogen with throughout your whole body, right,
Speaker 1: you can use intravaginal forms of estrogen that are not
Speaker 1: systemically absorbed in any appreciable way that we know from
Speaker 1: research is not going to increase your risk of breast cancer,
Speaker 1: but can locally change the tissue and make that what
Speaker 1: it more used to be.
Speaker 2: Like, right, how come I'm just hearing this right now?
Speaker 2: I'm a year. Get in there, girl, I'm a year
Speaker 2: in treatment. Yeah, how come I'm just hearing this? You
Speaker 2: know why? Because I don't bring it up to my
Speaker 2: doctor either. I don't. Now, you can just play the recording.
Speaker 2: I don't want to talk about it. I especially don't
Speaker 2: want to talk I am a grown ass woman and
Speaker 2: I don't want to talk about this with a male
Speaker 2: on cologist. I don't I don't even want to talk
Speaker 2: about it with the female colleges to be perfectly like honest,
Speaker 2: like it gives me all kinds of nervous energy, Like
Speaker 2: even right now.
Speaker 1: Yeah, well, I wish I could come give you a hug,
Speaker 1: but I'm not going to crawl over the microphone. But
Speaker 1: know that every woman that I speak to in some
Speaker 1: measure has struggled with this, particularly going through a cancer diagnosis,
Speaker 1: whether it's something that they want to be doing more
Speaker 1: of or they're afraid of, or it's painful, and it's complex.
Speaker 1: And part of the issue is it shouldn't just be
Speaker 1: for the oncologists. We should have sex therapists that work
Speaker 1: at hospitals. We should have gynecologists that are particularly aware
Speaker 1: of these issues how they relate to cancer patients. Pelvic
Speaker 1: floor physical therapy can be hugely helpful for patients, and
Speaker 1: you know, a lot of hospitals don't have this integrated
Speaker 1: into their care teams, and we really need to push
Speaker 1: for that and make that more a part of our
Speaker 1: society and cultural narrative, so that just like we ask
Speaker 1: about chess pain or exercise tolerance, we ask patients about
Speaker 1: their sexual function and what they want for themselves.
Speaker 2: It's really trying to help the whole body. And I
Speaker 2: know you know where I am right now. That is
Speaker 2: the mentality is like, we are not just treating you
Speaker 2: as a cancer patient. We are treating you as a
Speaker 2: human being. So we want to look at the whole thing.
Speaker 2: And to be fair a nerve, a female nurse asked me, like,
Speaker 2: are you dryness? And I in my in my head,
Speaker 2: I was like, it feels like knives when I'm having sex.
Speaker 2: And honestly, I worried about my marriage, even though my
Speaker 2: husband has been unbelievable, like unbelievably strong and unbelievably supportive.
Speaker 2: And it's like, look at this hurts. We're not doing
Speaker 2: we will just figure something out. And I feel so guilty,
Speaker 2: Like I feel so terrible because I know it's not sustainable.
Speaker 2: And so to hear from you that there's something that
Speaker 2: I can do about it that's different than okay, the
Speaker 2: cream and to try this and the it's a revelation
Speaker 2: to me and I think it will be to a
Speaker 2: lot of women. Yes, we should mention that hormone receptor
Speaker 2: HR two HR hormone receptor positive positive and then her
Speaker 2: too negative is the most common type of cancer, breast cancers.
Speaker 2: When you hear that, I mean that is you have
Speaker 2: to strip yourself of hormones because it feeds off basically
Speaker 2: the hormones. Is that kind of what the cancer is
Speaker 2: right to.
Speaker 1: Some degree, and especially now if you look at social media,
Speaker 1: everyone's talking about menopause and giving everyone hormone yes and
Speaker 1: giving everyone hormone replacement therapy. But we don't have that
Speaker 1: knowledge about what we can really do for patients who
Speaker 1: are going through or have survived breast cancer. That is
Speaker 1: a huge unmet need in terms of breast cancer research.
Speaker 1: Thinking about for patients who've had breast cancer, can we
Speaker 1: give them at some point any form of systemic hormonal
Speaker 1: therapy that can combat some of the issues that women
Speaker 1: are facing with menopause. We need more research into that
Speaker 1: and more clinical expertise into that, and at the very
Speaker 1: least talking to women about local estrogen that they can
Speaker 1: that they can.
Speaker 2: I just had no idea, But I'm about to go
Speaker 2: write the doctor right now and send a message and
Speaker 2: say we need to have a quick meeting so that
Speaker 2: I can get this prescribed.
Speaker 1: And you know, we've talked a lot about guilt here
Speaker 1: and I want to if I had a hazardous waste
Speaker 1: bucket here, I would like to reach into you and
Speaker 1: pull out that guilt that you have over something that
Speaker 1: you have.
Speaker 2: You didn't decide for this, you didn't want this. But
Speaker 2: I hate to see my husband suffering because of it,
Speaker 2: my family, you know what I mean. Oh my god.
Speaker 1: But but that's also human and you can work through this.
Speaker 1: There are people that can help you through this, and
Speaker 1: you deserve that, and you know you didn't. You didn't
Speaker 1: deserve this, and you don't deserve to suffer. And people
Speaker 1: around you clearly love you and want to see you
Speaker 1: happy and thriving. And so if we can have a
Speaker 1: discussion at some point, you know, with your care team
Speaker 1: about what is it that you're missing and what is
Speaker 1: it that you would want back or to access again.
Speaker 2: Oh my god, I want my body back. Yeah, like
Speaker 2: I want my bland bag. I don't want to talk
Speaker 2: to you about yeah, sorry now I'm totally crying. Thank you, doctor, doctor.
Speaker 2: I want to talk to you about menopause and what
Speaker 2: happens and like secrets, Why the hell we have been
Speaker 2: keeping these secrets for so long? I always say to
Speaker 2: my mom, like why didn't you tell me, And there's
Speaker 2: a shame in it. Women have been told that they're
Speaker 2: not worth anything once they're past child bearing years, that
Speaker 2: their life is over, or that they are not worth
Speaker 2: as much in society. And we are all worth just
Speaker 2: as much as we're In fact, I am ten times
Speaker 2: smarter and a better member of society than I was,
Speaker 2: you know, thirty years ago got them old anyway. But
Speaker 2: the brain fog, like I did not know anything about
Speaker 2: menopause except for hot flashes. That's what everyone talks about.
Speaker 2: But they don't tell you about the brain fog, about
Speaker 2: everything being dry from your head to your toes and
Speaker 2: everything in between. About the emotional freakin' roller coaster. I
Speaker 2: feel like I'm a thirteen year old, like ups and downs,
Speaker 2: anxiety and depression and happy and sad and like it's insane,
Speaker 2: and I thought I was going crazy. I literally thought
Speaker 2: for a second I was going crazy. And it's because
Speaker 2: my grandfather once said, you know, when you go through
Speaker 2: that change at a certain age, because again he's British
Speaker 2: and may he rest his soul, and he would he
Speaker 2: would say, you know, because your grandmother went through this
Speaker 2: and she went crazy, And so I internalized that and
Speaker 2: thought for a second, I'm like, am I going crazy
Speaker 2: because I was induced into menopause because of the cancer treatment?
Speaker 2: So am I going crazy?
Speaker 1: No?
Speaker 2: Or is all that symptoms of menopause?
Speaker 1: No, You're not going crazy? And it just really drives
Speaker 1: home for me. You know, the reason why I wrote
Speaker 1: the book with so many stories from the past and
Speaker 1: the present instead of some laundry list of like, here
Speaker 1: are ten things that will help you feel better about
Speaker 1: yourself as a woman, is because these stories that we've
Speaker 1: been told as a society, but also to have people
Speaker 1: think about what are the stories you've been told yourself
Speaker 1: from your family about yourself and what will happen to you?
Speaker 1: And those become so important, as you just talked about
Speaker 1: with the story about your grandfather, and when you think
Speaker 1: about it as a women are damned if they do
Speaker 1: and damned if they don't. When you're when you're menstruating,
Speaker 1: you're hormonal, so you're crazy from that, right, and because
Speaker 1: you have this or that or she must be bleet
Speaker 1: whatever it is, right, And and then and then you
Speaker 1: stop menstruating, and suddenly you're even more crazy.
Speaker 2: Right.
Speaker 1: And there's been this huge movement now to really uncover Okay,
Speaker 1: what is menopause?
Speaker 2: How can we treat it?
Speaker 1: And historically, when hormonal replacement therapy first came out, all
Speaker 1: these women were on it. Then there was a study
Speaker 1: that was erroneously overinterpreted as saying everyone's going to get
Speaker 1: breast cancer from hormone replacement.
Speaker 2: There they thought that, yes, that's how I was trained.
Speaker 2: I thought, yeah, yeah, I was like, you do not
Speaker 2: do hormone replacement therapy. It is dangerous, you will get
Speaker 2: you can't get breast cancer.
Speaker 1: And that's simply you know, those those facts were or
Speaker 1: those numbers were wildly overstated, right, And then now you
Speaker 1: have this huge movement from all sorts of walks of life,
Speaker 1: including from celebrities, really to push what is menopause? How
Speaker 1: do we treat it better? But where we really haven't
Speaker 1: caught up is what do we do for cancer patients?
Speaker 1: And what about the astrom receptors in the brain, what
Speaker 1: about other places in the body. And so there's a
Speaker 1: lot of work being done on that, but not enough,
Speaker 1: not enough, And you are most certainly not going crazy.
Speaker 1: What is crazy is that our medical system has not
Speaker 1: properly addressed this for women and in turn shamed women too,
Speaker 1: thinking that they're absolutely nuts when they're not.
Speaker 2: That makes me feel one hundred percent better. I do
Speaker 2: want to delve into this discomfort or shame or sort
Speaker 2: of how we act in doctors' offices, and maybe you
Speaker 2: can give me some advice and how we can better
Speaker 2: advocate for ourself. And I'm going to do that by
Speaker 2: reading a little bit of your book. I went through
Speaker 2: this book like hot butter or hot knife through butter
Speaker 2: like it was fast. It was a great read because
Speaker 2: you write it almost like a novel, where you've got
Speaker 2: these stories of what women have gone through from the
Speaker 2: very onset of women's health and how women were treated
Speaker 2: basically as non human to now. So here's partly how
Speaker 2: you introduce the book. You say, in those first moments
Speaker 2: after I tell a patient she has cancer, no matter
Speaker 2: who she is, her responses almost invariably follow the same trajectory.
Speaker 2: Am I going to die? Why did this happen to me?
Speaker 2: I'm so sorry for sweating. Yeah, that makes the back
Speaker 2: of the hairs in the back of my neck stand up,
Speaker 2: because I had a moment where I was going to
Speaker 2: the surgeon. It was right before my mistectomy. They have
Speaker 2: to take a look at your anatomy and sort of
Speaker 2: figure out what they're going to do when you can
Speaker 2: ask questions. And after he was done examining me, he says, Okay,
Speaker 2: I'm going to go out, and the nurse says, okay,
Speaker 2: now you're going to go to get your pictures. No
Speaker 2: one had told me anything about pictures. So I walked
Speaker 2: in and this really kind woman said, okay, just remove
Speaker 2: your clothing and we're gonna take some pictures. And so
Speaker 2: I removed my pants and my shirt and left my
Speaker 2: undergarments on because I'm not going to stand there naked,
Speaker 2: and she's like, oh, no, you it's everything. I literally
Speaker 2: felt a wave of shame, like I was five years
Speaker 2: old or thirteen even worse years old, standing naked in
Speaker 2: front of a entire room full of people reading a speech,
Speaker 2: and that there was nothing I could do. I mean,
Speaker 2: my response as a grown woman was I turned into
Speaker 2: a little kid. And the pictures were taken and she's like, okay,
Speaker 2: turn this way, turn that way, and I heard myself saying,
Speaker 2: oh my god, I'm sorry. So I'm so fat here
Speaker 2: like oh, I've been trying to work out, and I
Speaker 2: am explaining to her why I feel so bad about
Speaker 2: my own body, and I'm about to have a double
Speaker 2: mistackt to mey like in a month. That was one
Speaker 2: of those moments that I wish I would have said, Hey,
Speaker 2: I didn't know anything about these pictures. Can you tell
Speaker 2: me a little bit more about why you're doing them?
Speaker 2: Because intellectually, I know they have to take them so
Speaker 2: because they need to figure out where they're going to
Speaker 2: be doing and what they're going to be doing and
Speaker 2: what your body looks like before. But at the moment,
Speaker 2: I didn't say anything, and I still am pissed with
Speaker 2: myself about it. So how do we advocate for ourselves?
Speaker 2: Even in those very simple moments where I could have
Speaker 2: said I don't want to take pictures today, I didn't
Speaker 2: say anything.
Speaker 1: I can imagine. I can't imagine, and I'm trying to
Speaker 1: imagine what a betrayal it feels, too, because you feel
Speaker 1: almost not only just shame about your body, but betrayed
Speaker 1: by this body that you've had a relationship with your
Speaker 1: whole life. And there you have to stand there, literally
Speaker 1: naked in front of a stre you know, bearing everything
Speaker 1: your soul and literally literally literally And I wish that
Speaker 1: had been a far more compassionate process for you.
Speaker 2: And look, it wasn't that there wasn't compassion. She was like,
Speaker 2: oh my god, girl, you you look great. It was
Speaker 2: it was this is how we do things. And I
Speaker 2: think sometimes there's only so much time that the doctor's
Speaker 2: spending you, it's only so much time that nurses can
Speaker 2: spend with you, and so it's it felt a little
Speaker 2: bit like I was on a treadmill and it was like, Okay,
Speaker 2: this is what we do. Go next. And I should
Speaker 2: have known because guess what I was doing before that,
Speaker 2: looking at pictures of other women who had gone through
Speaker 2: and mistectomy to see what it looks like. Because I
Speaker 2: am one curious chick. I want to know everything. I
Speaker 2: even watched a surgery before, like I wanted online. I
Speaker 2: wanted to see what was going to happen. It didn't
Speaker 2: dawn on me how I was going to feel. And
Speaker 2: I walked in there and it was like, you get
Speaker 2: to stand there start naked, in front of a lady
Speaker 2: you've never ever met. I wouldn't stand in front of
Speaker 2: my husband the same way naked. Totally. I'm shocked by this, actually,
Speaker 2: and here's here's why. Because I am probably and I
Speaker 2: still have a one major surgery to go through, which
Speaker 2: is reconstruction. I'm probably going to do what's called a
Speaker 2: deep flat and if you don't know what that is,
Speaker 2: it's where instead of getting breast in plants, where you
Speaker 2: getting a foreign body put in there, they use your
Speaker 2: own tissue, right and so right, they cut you from
Speaker 2: very low. So I wanted to see if I had
Speaker 2: enough tissue, if I had enough fat. I was like, oh, honey,
Speaker 2: I got plenty. You just needed to ask because I
Speaker 2: got plenty of fat for you guys to use. But
Speaker 2: they recreate your breast with your own anatomy, and over
Speaker 2: time it's a very big surgery. But over time, a
Speaker 2: lot of women report that it is better for them.
Speaker 2: Over time, it's easier for them to get the implants
Speaker 2: in the beginning if they just want to do that,
Speaker 2: it's a faster recovery, but over time they tend to
Speaker 2: like to be able to use their own tissue. So
Speaker 2: that's partly why I just didn't know it was going
Speaker 2: to be that day, and that that's how Yeah, it worked.
Speaker 1: And think about it, I mean, you were dealing with
Speaker 1: a new diagnosis, so much trauma, trying to make some
Speaker 1: decisions about how you want your new body to look
Speaker 1: like in the setting of you know, this was not
Speaker 1: elective surgery. This is surgery that you're going to have
Speaker 1: to have with some options for reconstruction, and in that
Speaker 1: moment asking you to advocate for yourself, that's it's almost impossible.
Speaker 1: I've been in that situation myself, and I have my
Speaker 1: own stories of thinking, how could I possibly not have
Speaker 1: said what I would say for a loved one, what
Speaker 1: I would say.
Speaker 2: For a friend? Why am I? You know?
Speaker 1: And in the at the end of my book, before
Speaker 1: I wrote the conclusion, I went through something medical myself
Speaker 1: where here I am. I'm literally writing about empowering yourself.
Speaker 2: You know you're a freaking in colleges. Yes you are
Speaker 2: the doctor of doctors and.
Speaker 1: That women need to be empowered and this is how
Speaker 1: you can do it and don't feel shame about your body.
Speaker 1: Look how history screwed us over. You can live differently today.
Speaker 1: And when it came to my own self, even with
Speaker 1: like speed dial of great doctors, I didn't want to
Speaker 1: bother anybody. I minimized my own pain, I apologized for it,
Speaker 1: and I waited. I ended up in the hospital for
Speaker 1: a week when I didn't need to be there thinking
Speaker 1: everything was okay because people said it was, you know,
Speaker 1: just take some valume literally later.
Speaker 2: That's the thing we usually kind of I.
Speaker 1: Did from the very beginning, and yet I allowed this
Speaker 1: tsunami of other opinions to tell me I was okay
Speaker 1: when I was not. And I would love to say
Speaker 1: that I have a perfect answer for what to do
Speaker 1: in those moments. But I think, if possible, having somebody
Speaker 1: else with you is really important, someone that you can trust,
Speaker 1: someone who will really you can say ahead of time,
Speaker 1: I know you know me in this way, but I
Speaker 1: am scared of who I will become in a doctor's setting,
Speaker 1: and I need someone not just to take notes from me.
Speaker 1: But this is a question I really want to make
Speaker 1: sure is answered for me. I want to understand rationale
Speaker 1: for this. I want to I'm nervous about this. Can
Speaker 1: you help me make sure that this is tackled in
Speaker 1: this appointment and even at the start of the appointment,
Speaker 1: saying to the physician, I know we don't have maybe
Speaker 1: that much time today, this is important to me, and
Speaker 1: making sure that we set the agenda at the beginning,
Speaker 1: or at least if it's not gotten to at the
Speaker 1: very end to make sure that you feel heard. That's
Speaker 1: really good, and find another doctor if you don't, because
Speaker 1: if you feel dismissed, if you feel invalidated, if you
Speaker 1: feel shamed, if you feel guilted, it's not going to
Speaker 1: get any better.
Speaker 2: That's really great advice. You said you didn't think you
Speaker 2: had the answers, but I think that you gave us
Speaker 2: a couple of really good answers. And I have brought
Speaker 2: some things up since then to my oncologists, to the surgeon,
Speaker 2: and they've been nothing but receptive. Good.
Speaker 1: So I stand corrected. It can get better, then it can.
Speaker 1: It can, it can, it can.
Speaker 2: But sometimes the onus is upon us when we are
Speaker 2: at our most vulnerable.
Speaker 1: Yes, it's hard, it's almost impossible. I mean, I think
Speaker 1: back to my own what could I have done differently?
Speaker 1: And I'm so I'm still so mad at myself right
Speaker 1: and it's really hard.
Speaker 2: I think that part is the part that I still
Speaker 2: right now. When I was telling you the story, I
Speaker 2: was embarrassed that I didn't advocate for myself, because here
Speaker 2: I am telling women, you've got to advocate for yourself.
Speaker 2: I was embarrassed and I felt powerless, and those two
Speaker 2: things playing against each other. It makes me want to
Speaker 2: jump out of a window like it's that, like I
Speaker 2: just want to fight or flight, like I want to
Speaker 2: just get out of there. I don't want to feel
Speaker 2: these feelings, and I think it lingers.
Speaker 1: It does linger, and sometimes there's real trauma from that.
Speaker 1: I had this thing during COVID where I thought I
Speaker 1: had foot drop. Basically my foot was not as strong,
Speaker 1: and I kept seeing different people and they'd say, Oh,
Speaker 1: but you're so strong, you can run ten miles and
Speaker 1: I'm like, no, no, something's not right.
Speaker 2: Something's not right.
Speaker 1: And years later it turned out I had a compress
Speaker 1: nerve that's probably irreparable, even though I had surgery compressed
Speaker 1: And every day that I take a step, I feel
Speaker 1: that my left side is weaker than the other. And
Speaker 1: I can choose to have this narrative which I go
Speaker 1: down the rabbit hole many times, being mad at myself.
Speaker 1: Why didn't I say I showed videos, I said I
Speaker 1: thought I had foot drop. Why didn't I push for
Speaker 1: that harder? Why didn't I follow my own intuition? And
Speaker 1: I have to fight the own narrative of being mad
Speaker 1: at myself all the time. It's hard, exhausting, exhausting.
Speaker 2: It really is exhausting. I want to ask you how
Speaker 2: we can talk about cancer because we started this with
Speaker 2: talking about not using the battle ready words, fighting, battling, slaying, whatever,
Speaker 2: because it puts the onus on the patient that if
Speaker 2: they don't fight hard enough and they lose the battle,
Speaker 2: so to speak, that is their fault. Yeah. So when
Speaker 2: someone brings up, for example, that you know, look, I've
Speaker 2: been diagnosed with cancer, what have you heard from your
Speaker 2: patients that responses that are helpful or comforting and responses
Speaker 2: that aren't so helpful. And I will art with myself.
Speaker 2: It's hard for me to say because people just want
Speaker 2: they want to help you, and they want it to
Speaker 2: be better, and they want to make you feel better immediately.
Speaker 2: It doesn't matter who you tell. It could be a
Speaker 2: stranger or your closest best friend, or your mother or
Speaker 2: your aunt, or your coworkers. But what happened to me
Speaker 2: constantly is that if I said so, I just need
Speaker 2: to let you know I'm actually have been diagnosed with
Speaker 2: stage three breast cancer, and probably fifty percent of the
Speaker 2: time I would get You're gonna be fine, You are
Speaker 2: going to be fine, You're gonna fight this and you're
Speaker 2: gonna win and you're gonna be fine, and we're all
Speaker 2: gonna be fine. It's fine. And I would hear that,
Speaker 2: and I'm like, how do you know, because I just learned.
Speaker 2: This happened to me, Like I just learned about this,
Speaker 2: and I know what the statistics are, and I certainly
Speaker 2: know what they are now for black women, which is
Speaker 2: about forty percent more likely to die than my white counterparts.
Speaker 2: So am I going to be fine? And there was
Speaker 2: such an insistence that I felt like I couldn't say
Speaker 2: anything else about it. What do you hear from your patients?
Speaker 1: So I think taking a step back, that your experience,
Speaker 1: a patient's experience, no matter the biology, is theirs and
Speaker 1: theirs alone, and no one can know what it is
Speaker 1: like to be in your shoes. I think the most
Speaker 1: important thing is meeting people where they're at, because everybody
Speaker 1: wants something and needs something different that's entirely related to
Speaker 1: who they are as a person and what they want
Speaker 1: for themselves. Maybe their daughter's getting married, maybe they're going
Speaker 1: for a new job, Maybe they have other things going
Speaker 1: on in their life that this is going to impact,
Speaker 1: and they want to make sure that that's tended.
Speaker 2: To as well.
Speaker 1: I think maybe one of the most basic questions is
Speaker 1: I'm here for you.
Speaker 2: What do you need? What do you need?
Speaker 1: And if you don't even know I'm going to show
Speaker 1: up in these ways. And if I'm going to leave
Speaker 1: you this, if you don't want it, throw it out,
Speaker 1: or I'm gonna help take your kids to school, whatever
Speaker 1: it may be. But saying how can I best show
Speaker 1: up for you? I will be there on whatever terms
Speaker 1: you want me there because none of us have a
Speaker 1: crystal ball, none of us knows what tomorrow brings. But
Speaker 1: I will be by your side in whatever dark tunnel
Speaker 1: you're in, and whenever the sun is shining again, I'll
Speaker 1: be there to celebrate with you. And I will be
Speaker 1: there with the lows, whatever they are, because.
Speaker 2: We just don't know.
Speaker 1: But I think we all don't want that sense of
Speaker 1: unwanted aloneness. And that's what cancer really brings up, is
Speaker 1: this fear that you have as a patient. And even
Speaker 1: some people don't you know, won't even touch somebody with
Speaker 1: cancer because they somehow feel like it's contagious. It is
Speaker 1: not contagious. For goodness sake, Maybe you just need a hug,
Speaker 1: right because a lot of times people rush to fix things,
Speaker 1: and that is for the doctor. Yeah, that's for the doctor.
Speaker 1: That's for the healthcare team to really figure out. One
Speaker 1: of some of the harmful things that I hear happen
Speaker 1: all the time is, oh, my sister went through it,
Speaker 1: and you know she decided to do this, and why
Speaker 1: aren't you getting this surgery? And you have no clue
Speaker 1: when you're talking to someone what actually happened to them.
Speaker 1: And then patients feel this pressure to know this stage,
Speaker 1: to know the grade, to know as if they're like
Speaker 1: reading off a pathology report and is if the person
Speaker 1: that you're talking to trained for fifteen years in that
Speaker 1: cancer and it's going to know exactly what to do
Speaker 1: for your cancer?
Speaker 2: They don't.
Speaker 1: I hate when they're like, oh, what stage is it?
Speaker 2: Okay? Does that help?
Speaker 1: Are you going to now operate on my patient? Stop
Speaker 1: asking that? Or I saw this product and you really
Speaker 1: need to use this right, or like if you just
Speaker 1: sprinkle tumeric in your shampoo, everything's going to be okay.
Speaker 2: Right, okay? Or drink it because or drink it, sprinkle it,
Speaker 2: rub it.
Speaker 1: I don't know, but whatever it is, everyone's got some
Speaker 1: solution and it comes from a good place.
Speaker 2: But I think you can be really damaging. Yeah, that
Speaker 2: is really good, good advice. And I like that you
Speaker 2: sort of talk about some of the things that can
Speaker 2: be damaging, because they sometimes those things get into your head. Yeah,
Speaker 2: and you're like, maybe I should try that, or maybe
Speaker 2: I maybe I should, but I you The one thing
Speaker 2: I did know is that whatever medical advances have been
Speaker 2: made in medicine here in this city of New York,
Speaker 2: where you have one of the most renowned, actually more
Speaker 2: than one of the most renowned cancer specialists in the world,
Speaker 2: that I was going to do that. I was like,
Speaker 2: cut it out, burn it out, poison it out, do
Speaker 2: what you gotta do, but get it out of there.
Speaker 2: And so I did all those things, sixteen rounds of
Speaker 2: chemo over five months, five weeks of daily radiation which
Speaker 2: was exhausting, and a double mistectomy, and then I started thinking,
Speaker 2: because that's when my mental state started to go down,
Speaker 2: was actually after I was in the midst of the crisis.
Speaker 2: And I always say this in my family knows I'm
Speaker 2: better in a crisis. But it's the longevity of all
Speaker 2: this that with the most common breast cancer, if you're
Speaker 2: not already in menopause, you have to take pills for
Speaker 2: the next seven to ten years to try to kill
Speaker 2: your hormones, which is also feels like sometimes killing you right,
Speaker 2: because you're you're different and you're going through all this.
Speaker 2: But then I had this realization and it really freaked
Speaker 2: me out. And we'll end with this. I looked at
Speaker 2: my ancologist after I'd gone through a year of treatment
Speaker 2: double mist deckt tomy and started doing physical therapy, and
Speaker 2: I walked in one day and I said, Doc, Am
Speaker 2: I cancer free. He's like, you're cancer free? How do
Speaker 2: you know? How do you know? And he looked at me,
Speaker 2: and he could tell that I was like searingly, like
Speaker 2: looking with daggers in his face. I'm like, does my
Speaker 2: blood tell you something? Does my He's like, do you
Speaker 2: have any symptoms that indicate otherwise? And I said no,
Speaker 2: But how do you know? How do you know if
Speaker 2: you're cancer free? When you have this cancer that can
Speaker 2: be very sneaky, as I have heard a thousand times
Speaker 2: it can come back, and I have heard from patients
Speaker 2: where it did come back. So how do we know?
Speaker 1: Yeah, well, I would probably offer a different answer, and
Speaker 1: one that's more unsettling but really speaks to the existential
Speaker 1: nature of what it means to be alive.
Speaker 2: We never know.
Speaker 1: Do we know what's going to happen when we walk
Speaker 1: out of that door. No, But we can choose to
Speaker 1: do everything in our power to give us the best
Speaker 1: possible outcome. And that is what your doctor is offering you,
Speaker 1: the best of modern medicine to dramatically decrease the risk
Speaker 1: that this cancer will ever come back. We can throw
Speaker 1: statistics at people, we can give them the best of medicine,
Speaker 1: but at the end of the day, we don't know.
Speaker 1: And I think that that is what makes cancer such
Speaker 1: a challenging diagnosis, is that for all of us, it
Speaker 1: brings up the reality of what it means to be alive,
Speaker 1: and it really throws into high relief that every day
Speaker 1: is a gift. We can hate aging, but on the
Speaker 1: other hand, those wrinkles are a gift, Those gray hairs
Speaker 1: are a gift to the alternative, right, And we know what,
Speaker 1: what's the one statistic we all know? We have one
Speaker 1: hundred percent death rate, all of us, right, And so
Speaker 1: I am grateful that you are getting such spectacular medical care,
Speaker 1: and to the best of our knowledge, you are indeed
Speaker 1: cancer free. But I don't know about myself, about any
Speaker 1: of us sitting here today, and so we have to
Speaker 1: make choices about who we want to surround ourselves with
Speaker 1: the type of medical care. We want what we do
Speaker 1: each and every day for ourselves, and try to approach
Speaker 1: that with grace and humanity for ourselves and everyone else
Speaker 1: around us.
Speaker 2: Doctor Elizabeth Coleman, let's be clear, you are amazing. Thank you,
Speaker 2: thank you for having me