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Speaker 1: Hi everyone, it's Katiekuric. If you're looking for smart, comfortable

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Speaker 1: at easyspirit dot com. Today, listeners get twenty percent off

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Speaker 1: with the code next twenty. Hi everyone, I'm Katikuric and

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Speaker 1: this is Next Question. Welcome everyone to this live taping

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Speaker 1: of Next Question with me Katiekuric. I am very excited

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Speaker 1: to be having this important conversation produced in partnership with

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Speaker 1: Easy Spirit here at the Pailey Center for Media in

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Speaker 1: New York City in honor Breast Cancer Awareness Month. And

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Speaker 1: in our audience are lots of breast cancer survivors, people

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Speaker 1: who may be in treatment right now, and people who

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Speaker 1: are trying to raise money and awareness for this disease. This,

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Speaker 1: of course, is a topic that is very near and

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Speaker 1: dear to my heart. Literally, as some of you might

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Speaker 1: know and some of you listeners out there, I was

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Speaker 1: diagnosed with stage one A breast cancer in twenty twenty two.

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Speaker 1: I had spent the previous twenty four years as a

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Speaker 1: cancer advocate after losing my husband when he was forty

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Speaker 1: two years old to colon cancer, going as far as

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Speaker 1: getting a colonoscopy on the Today Show, because let's face it,

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Speaker 1: nothing says good morning like showing your calling on national

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Speaker 1: television at seven thirty am. Then a number of years later,

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Speaker 1: after a mammogram and a breast ultrasound, I went from

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Speaker 1: advocate to patient myself. I was really grateful through my

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Speaker 1: breast cancer journey to have access us to incredible care.

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Speaker 1: And one of our guests today is actually my rest surgeon,

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Speaker 1: doctor Lisa Newman, who held my hand and gave me

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Speaker 1: a ton of confidence and reassurance throughout the entire process.

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Speaker 1: I cannot say enough nice things about Lisa, who said

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Speaker 1: I could call her Lisa.

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Speaker 2: An easy spirit.

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Speaker 1: I am very grateful they've been able to help fund

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Speaker 1: some of doctor Newman's critically important life saving research. The

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Speaker 1: two of us are joined by another one of doctor

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Speaker 1: Newman's patients. It's like a little Lisa Newman fanclick very much.

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Speaker 1: Sharon Joseph. Sharon is the CEO of Boys and Girls

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Speaker 1: Club of Harlem and is still in the middle of

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Speaker 1: her treatment. So thank you both so much for joining

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Speaker 1: us today. And since this is a live podcast, I

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Speaker 1: think it's okay to ask you all to give these

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Speaker 1: ladies around ubform and our hope is that so many

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Speaker 1: women will listen to this podcast, So I hope you'll

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Speaker 1: spread the word because we hope to impart a lot

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Speaker 1: of important, as I said, life saving information to everyone listening.

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Speaker 1: So I think, Sharon, many of us our media thought

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Speaker 1: after being diagnosed, is I have cancer?

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Speaker 2: Now what?

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Speaker 1: And I'm hoping that today's conversation will shed some light

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Speaker 1: not only on the physical changes and treatment that you undergo,

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Speaker 1: but the mental and emotional toll it can also have

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Speaker 1: on you. You were diagnosed earlier this year, Sharon, tell me

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Speaker 1: about that day and how you felt hearing the news.

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Speaker 3: Needless to say, I was shocked. I don't know what

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Speaker 3: I thought a cancer pation looked like, but I didn't

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Speaker 3: you looked like me, which is such an arrogant assumption.

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Speaker 3: I had watched my mother have breast cancer and metastasized

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Speaker 3: her brain. I'd taken a BRACA test and it came

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Speaker 3: back negative, so I really thought I was clear. So

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Speaker 3: I knew I had dense bress, and I consistently had

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Speaker 3: my mammograms, and ironically, they had told me that I

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Speaker 3: couldn't get my mammogram until November December of this year,

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Speaker 3: and I advocated for having it earlier and I wound

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Speaker 3: up having it on Mother's Day. And I remember joking around, going,

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Speaker 3: this is the best Mother's Day gift I can give myself.

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Speaker 3: I didn't realize how true that statement was going to become.

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Speaker 3: And I always have a mammogram and ultra sound together.

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Speaker 3: And so I was on my way to church and

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Speaker 3: they kept bringing me back into the room and I'm like, hey, guys,

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Speaker 3: what's going on here? I gotta go, And then they

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Speaker 3: said we found something and I wasn't surprised. I have

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Speaker 3: dense bress. And then they sent me for a buyof

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Speaker 3: see and then I was joking around there too, still thinking,

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Speaker 3: you know, this is just what happens when you have

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Speaker 3: dense breass. And then I got the news. And when

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Speaker 3: I got it, I was shocked, but I was also like, going, okay, mom,

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Speaker 3: this is you right telling me now. You make your

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Speaker 3: own decisions. You were judgmental, but mind, let's see how

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Speaker 3: you handle this. And I remember my radiologist. I had

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Speaker 3: asked her for her help. I said, well, where do

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Speaker 3: I start? I need a good recommendation of a doctor.

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Speaker 3: And she said, the best one I know is doctor

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Speaker 3: Lisa Numan. And She's like, she's really busy, but I'm gonna,

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Speaker 3: you know, tell her about you and you call her.

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Speaker 3: And I called her, and from the very first moment

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Speaker 3: I met her, I was like wow, but I was emotional.

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Speaker 3: I went from being a little overwhelmed to then jumping

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Speaker 3: into a problem solving mode. Okay, this is a problem.

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Speaker 3: What am I going to do? What steps am I

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Speaker 3: going to take? And realizing that I wasn't going to

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Speaker 3: do this by myself, and thinking about all the people

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Speaker 3: that I needed to be here for, like my daughter,

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Speaker 3: a daughter's and wondering, okay, what do I do? I'm strong,

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Speaker 3: I can do this, but you're alone, you're sad, you're mad,

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Speaker 3: You're going why me? And then there's a why not me?

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Speaker 3: And how are we going to turn this around? That

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Speaker 3: I'm not a victim, I'm a victor, And how am

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Speaker 3: I going to use this to bless somebody else? And

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Speaker 3: that's how we started this journey.

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Speaker 2: That's beautiful.

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Speaker 1: Actually, Karen A couple of questions. So my understanding was

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Speaker 1: your mom kept her breast cancer diagnosis a secret that

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Speaker 1: when you were helping her and driving her to the

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Speaker 1: doctor's office or driving her to the hospital, she never

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Speaker 1: came out and said to you, Sharon, this is what

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Speaker 1: is going on.

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Speaker 2: Tell me about that. I left my mother.

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Speaker 3: My mother, and I think I inherited too, this kind

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Speaker 3: of strong woman persona that many of us in this

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Speaker 3: room probably also have. And we're Caribbean, and so it's

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Speaker 3: not only strong woman persona, but it's keep it to yourself.

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Speaker 3: And maybe she thought she was also protecting me, but

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Speaker 3: she said, I have a procedure and I said where,

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Speaker 3: because I'm nosy. She told me it was all the

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Speaker 3: way downtown and she was going to take two buses

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Speaker 3: and a train and I said, no way, Mom, I said,

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Speaker 3: what's the procedure? She said, do don't worry about it.

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Speaker 3: I'm okay. And so I literally drove my mother down

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Speaker 3: and she got out the car, and I started calling

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Speaker 3: all my relatives, including my relatives in the Caribbean, and

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Speaker 3: I'm like, Mommy's having a procedure and I don't know

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Speaker 3: what this is. Do you know what this is? And

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Speaker 3: finally someone said, we think your mom has breast cancer

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Speaker 3: and she's doing something about it.

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Speaker 2: And that was it. You never discussed it with her.

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Speaker 3: I went upstairs and found her in the room, and

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Speaker 3: when she was coming out and I'm like, mom, she's like,

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Speaker 3: I'm fine, what happened today? Oh, don't worry.

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Speaker 1: That's so interesting. You know, culturally, it sounds like there's

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Speaker 1: still a lot of secrecy surrounding cancer diagnosis, And when

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Speaker 1: you think about it, it's not all that's surprising, because

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Speaker 1: I think it's really within the last gosh, maybe twenty

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Speaker 1: five years, and it's hard to remember how people just

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Speaker 1: didn't discuss cancer and they were sort of embarrassed or

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Speaker 1: secretive about it. And then, as Sharon mentioned, culturally for

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Speaker 1: some black women, it's still like that. Can you describe

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Speaker 1: what you've seen among your patient population with that trend

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Speaker 1: or the women you've been studying?

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Speaker 4: Yeah? Thanksana.

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Speaker 5: First of all, your story sharing is just incredible. Thank

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Speaker 5: you for sharing it is so so very powerful.

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Speaker 4: Appreciate it.

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Speaker 5: But it is true that unfortunately, many women do feel

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Speaker 5: this stigma associated with a breast cancer diagnosis. And I

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Speaker 5: can remember in my own family similaria is a lot

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Speaker 5: of the reluctance to say the word I can call

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Speaker 5: my mom talking about the Big Sea. It was as

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Speaker 5: if saying the word was somehow going to make it

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Speaker 5: real and ignoring it was going to make the problem

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Speaker 5: going go away. And one of the organizations that I

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Speaker 5: work with quite a bit, the Sisters Network, Incorporated, which

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Speaker 5: is an African American breast cancer survivor's organization, a national organization.

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Speaker 5: Their logo is to stop the silence, specifically to counteract

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Speaker 5: that pervasive impression that you shouldn't talk about breast can answer.

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Speaker 5: We are empowering ourselves if we talk about the diagnosis

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Speaker 5: and we share with each other how to protect ourselves

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Speaker 5: against the threat of breast cancer. And we do have

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Speaker 5: so many ways that we can protect ourselves. Between screening, treatment,

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Speaker 5: survivorship medalities, we can protect ourselves against this disease.

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Speaker 1: And just talking about it is so critically important. I

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Speaker 1: remember reading in The Emperor of All Maladies. I might

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Speaker 1: have mentioned this to you before, Lisa, by Siddartha Mukherjee.

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Speaker 1: It's a great book. You want to pull a surprise.

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Speaker 1: It's about the history of cancer. It's fascinating and in

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Speaker 1: the nineteen fifties when women who had breast cancer were

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Speaker 1: looking for a support group. I think the New York

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Speaker 1: Times wouldn't allow them to put in the classifies that

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Speaker 1: they were looking for other breast cancer patients. They would

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Speaker 1: have to say looking for women who have been diagnosed

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Speaker 1: with cancer of the chest cavity, because they didn't want

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Speaker 1: to write the word breast, which is just so unbelievable.

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Speaker 1: And that was in the nineteen fifties. So we have

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Speaker 1: come a long way, but clearly not far enough when

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Speaker 1: it comes to bringing this topic out into the open.

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Speaker 1: And when I heard Sharon's story, I was like, Wow,

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Speaker 1: she actually is one of those women who has done

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Speaker 1: everything right because she knows she has dense breast. Forty

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Speaker 1: two percent of women over the age of forty have

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Speaker 1: dense breast, and we're going to talk about that some

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Speaker 1: more in a moment. But because of that, she got

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Speaker 1: a mammogram and an ultrasound, which was your usual routine

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Speaker 1: every year or every two years, or every year I guess, right.

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Speaker 3: A year, almost every six months if I could.

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Speaker 1: Really And was it because of the family history that

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Speaker 1: you got both of them or how.

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Speaker 2: Did you find out?

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Speaker 1: By the way, this is going to be very instructive

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Speaker 1: because so many women don't really know about dense breass.

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Speaker 1: How did you find out you had dense breass?

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Speaker 3: Really through my doc when we talked about it. I

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Speaker 3: had had a benign syst in my left breast and

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Speaker 3: we've been monitoring that. And again because my mother's breast

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Speaker 3: cancer atasthtsized to her brain, I was very very aggressive

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Speaker 3: about trying to make sure I had my mammograms and

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Speaker 3: ultrasounds both on the same day so that I could

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Speaker 3: constantly test, and also doing self checks. So I was

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Speaker 3: very religious about them.

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Speaker 1: That's wonderful because first of all, just so everyone knows,

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Speaker 1: and Lisa should be saying this, but I'm like the

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Speaker 1: dense breast lunatic now because I have dense breasts. And

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Speaker 1: number one, if you have dense breast, you have a

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Speaker 1: higher risk of being diagnosed with breast cancer. Number Two,

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Speaker 1: a mammogram alone can't necessarily tell if you have any

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Speaker 1: kind of abnormality. So I have all at and like

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Speaker 1: people feel their breasts and they're kind of lumpy and

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Speaker 1: big or they're whatever, and they think.

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Speaker 2: Oh, I have dense press.

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Speaker 1: You can only find out through a mammogram if you

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Speaker 1: actually have dense press and as I said, nearly half

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Speaker 1: of women over the age of forty fall into this category.

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Speaker 1: And so you really need additional screening and we're going to.

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Speaker 2: Talk about that.

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Speaker 1: Well, why don't we just talk about that now, because Lisa,

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Speaker 1: it's very upsetting to me A that so many women

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Speaker 1: don't know that. And the FDA changed their rule requiring

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Speaker 1: women to be notified that they have dense press and

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Speaker 1: it all has to be done in the same language now, right,

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Speaker 1: that was I think done in the spring of last year,

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Speaker 1: put into effect maybe in September.

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Speaker 2: Actually it became icial rules. Thank you. I've got all

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Speaker 2: these experts in audience. I should just have asked you all.

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Speaker 1: But anyway, you know, Sharon knew this already, but so

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Speaker 1: many women don't. How can we spread the word A

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Speaker 1: that you need to find out if you have dense

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Speaker 1: breasts and be about additional screening and see insurance companies

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Speaker 1: need to pay for additional screening.

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Speaker 2: It's so unfair and so wrong.

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Speaker 5: Yeah, so you stated the main issues perfectly as you

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Speaker 5: always do, Katie.

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Speaker 2: Oh, thank you, Lisa, but.

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Speaker 4: It's so true. But yeah, you're right.

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Speaker 5: The Foot and Drug Administration of enacted policies such that

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Speaker 5: all mimography units have to now report on breast density

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Speaker 5: to patients that are undergoing mamographic evaluation, and it became

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Speaker 5: official for all states just a couple of weeks ago,

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Speaker 5: So that.

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Speaker 4: Is a wonderful advance.

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Speaker 5: However, women are then left with having to sort out

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Speaker 5: what do I do next now that I've been told

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Speaker 5: that my mammogram shows breast density. I would recommend that

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Speaker 5: you speak to your radiologist, Sharon did. Speak to your

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Speaker 5: healthcare provider, because there are options in terms of addition

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Speaker 5: enhanced breast imaging, such as breast ultrasound.

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Speaker 4: Some women will need breast MRI.

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Speaker 5: There are innovative ways of performing mammograms, such as contrast

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Speaker 5: enhanced mimography, and these modalities can sometimes help improve the

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Speaker 5: ability to evaluate the mammogram. As you also correctly stated,

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Speaker 5: having that breast density not only makes a regular routine

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Speaker 5: mammogram more difficult to interpret, but it's a risk factor

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Speaker 5: indicating that you're att more likely to develop breast cancer

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Speaker 5: in the future. So speak with your healthcare provider if

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Speaker 5: you are told that you have dense breast find out

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Speaker 5: what your options are and make sure that these options

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Speaker 5: and issues are documented, because the way that they're documented

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Speaker 5: can influence whether or not your insurance plan will reimburse

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Speaker 5: will pay for the additional testing business.

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Speaker 1: I know that in some states it's required that they

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Speaker 1: pay insurance for additional screening. I interviewed somebody in Ohio

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Speaker 1: I think you were on the podcast with her actually,

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Speaker 1: who really fought to have insurance pay for additional screening

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Speaker 1: because she was diagnosed with stage four breast cancer. They

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Speaker 1: kept missing it on the mammogram. So I really admire

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Speaker 1: her and the women in other states have worked to

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Speaker 1: make this happen.

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Speaker 3: I'll also say that even though I got the mammogram

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Speaker 3: and the ultrasound, the MRI showed more. Yeah, So if

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Speaker 3: we had just left it to the mammogram and the ultrasound,

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Speaker 3: it would have only shown a very small portion. The

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Speaker 3: MRI showed that there was a lot more than they

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Speaker 3: initially thought. So that's additionally why it's important.

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Speaker 1: Yeah, but I think wouldn't a standard of care be

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Speaker 1: if someone like Sharon presented with something suspicious on both

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Speaker 1: the mammogram and the breast ultrasound, she would almost automatically

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Speaker 1: be given an MRI to kind of validate the findings.

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Speaker 2: Or am I crazy?

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Speaker 5: Now, that is often the strategy, But the decision about

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Speaker 5: MRIs in the base of a breast cancer diagnosis is

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Speaker 5: definitely a nuanced, challenging decision to make, but often it

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Speaker 5: is very, very helpful. Breast MRI is absolutely valuable in

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Speaker 5: women that have known breast cancer predisposition such as a

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Speaker 5: strong family history, a known genetic susceptibility, mutation carriers such

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Speaker 5: as a BRCA mutation, women that have had prior therapeutic

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Speaker 5: radiation to the chest wall.

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Speaker 4: These are all markers.

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Speaker 5: Of women that will benefit from MRI in addition to

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Speaker 5: MAMMOGRAHAM to early detect a new breast cancer.

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Speaker 1: You know, I know that women, white women, and black

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Speaker 1: women are diagnosed at the same rate with breast cancer,

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Speaker 1: but black women have a forty percent higher mortality rate.

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Speaker 1: I discovered this when you were treating me for my

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Speaker 1: breast cancer, and it was so disconcerting. Can you explain

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Speaker 1: why this is the case.

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Speaker 5: Yeah, well, there are a lot of reasons at which

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Speaker 5: I am happy to discuss, But first of all, I

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Speaker 5: just have to say I was so struck in getting

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Speaker 5: to know you through your treatment experience, how passionate you

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Speaker 5: became about addressing breast cancer disparities and learning about breast

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Speaker 5: cancer disparities. This woman, as she's getting ready to start

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Speaker 5: her breast cancer surgery, she's talking about how she wants

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Speaker 5: to use her experience to advocate for women so that

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Speaker 5: all women have access to the treatment options that she

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Speaker 5: was able to avail herself of.

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Speaker 4: It's still mind volve them.

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Speaker 5: To me, how gracious you are, how you think of everybody?

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Speaker 1: Were getting me to sleep, you know, making me count

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Speaker 1: for ten backwards, and I was like, you guys, it's terrible.

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Speaker 2: So many women.

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Speaker 1: Well, you know, I felt so lucky that I had

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Speaker 1: the good fortune and honestly the financial wherewithal an insurance

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Speaker 1: coverage to get the very best treatment available. And I

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Speaker 1: couldn't stop thinking what would I have done if I

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Speaker 1: had had to wait to get my lump back to me,

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Speaker 1: if I had to wait to get my mammogram, if

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Speaker 1: my doctor didn't automatically give me a breast ultrasound every

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Speaker 1: time I was checked. And you know, your health should

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Speaker 1: not be determined by your zip code or your bank account,

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Speaker 1: and it so often is. And that's why I am

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Speaker 1: so passionate about not only giving the people the information

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Speaker 1: they need, but supporting them because it's just unfair that

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Speaker 1: a person of means is a survivor and a person

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Speaker 1: who doesn't have means is often not. And it's just

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Speaker 1: the inequities are maddening to me. Well, and I'm going

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Speaker 1: to talk about your research in a second, but let's

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Speaker 1: talk about the reasons that Black women have a forty

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Speaker 1: percent higher mortality. Some of it has to do with

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Speaker 1: their breast density, right, and some of it has to

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Speaker 1: do with access.

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Speaker 2: Can you just talk about that, Lisa.

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Speaker 5: There are many complex reasons explaining these breast cancer disparities

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Speaker 5: that you described, and indeed, breast cancer mortality rates death

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Speaker 5: rates are forty percent higher in African American women compared

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Speaker 5: to White American women. Now, the incidents rates actually used

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Speaker 5: to be lower for breast cancer and Black women compared

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Speaker 5: to white women, but there's been a disproportion so interesting incidence,

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Speaker 5: so that now the rates are equal. But we've had

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Speaker 5: this widening of the mortality gap, and it's because of

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Speaker 5: a lot of different factors. The disproportionately high prevalence of

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Speaker 5: socioeconomic disadvantages in the African American community, higher poverty rates,

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Speaker 5: higher rates of being uninsured or under insured, all of

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Speaker 5: these factors definitely contribute to delays and breast cancer diagnosis,

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Speaker 5: delays in completing treatment, and this will result in higher

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Speaker 5: mortality rates.

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Speaker 1: So poverty, but it's also these social determinants of going on.

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Speaker 5: Yes, yeah, so we still unfortunately continue to see discriminatory

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Speaker 5: patterns in the healthcare system. African American women are less

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Speaker 5: likely to be offered genetic testing, African American women are

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Speaker 5: less likely to have mimmography in the highest quality centers,

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Speaker 5: and African American women are less likely to be offered

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Speaker 5: cutting edge breast cancer treatments, such as in the setting

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Speaker 5: of clinical trials and clinical research. So we definitely have

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Speaker 5: to address all of those inequities in the healthcare system,

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Speaker 5: number one, if we're going to achieve.

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Speaker 4: Breast health equity.

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Speaker 5: But there are other factors, and there are several characteristics

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Speaker 5: that describe the breast cancer burden of the African American community,

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Speaker 5: indicating that there are tumor biology factors that we need

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Speaker 5: to understand through research. African American women are more likely

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Speaker 5: to be diagnosed with breast cancer at younger ages. We

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Speaker 5: are more likely to have biologically aggressive tumors called triple

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Speaker 5: negative breast cancers and male breast cancer is actually more

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Speaker 5: common in the African American community. So my own research

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Speaker 5: actually looks at studying the breast cancer burden of women

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Speaker 5: in different regions of the continent of Africa, and we've

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Speaker 5: learned that women from West Africa, which is the homeland

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Speaker 5: for the ancestors of most African Americans, the triple negative

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Speaker 5: breast cancers are most common in that part of the continent,

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Speaker 5: and it's because of specific genetic variants that developed in

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Speaker 5: the ancestors of West Africans related to having to develop

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Speaker 5: resistance to infectious.

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Speaker 4: Diseases like malaria.

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Speaker 5: But these variants have downstream consequences on the breast tissue

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Speaker 5: immune landscape such that it predisposes to the breast to

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Speaker 5: developing these triple negative breast cancers. So these international research

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Speaker 5: programs will actually teach us about the genetic root cause

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Speaker 5: of aggressive tumors like triple negative breast cancer, and it'll

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Speaker 5: teach us how to prevent and treat these tumors better.

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Speaker 1: The research you're doing is so interesting, So are you

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Speaker 1: taking different populations globally and looking at sort of there

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Speaker 1: or are you focus mostly on the continent of Africa.

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Speaker 5: We are definitely expanding more globally. We have several partners

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Speaker 5: now in different regions of Africa, because Africa is a

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Speaker 5: huge continent, tremendous diversity in terms of lifestyle, culture and genetics,

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Speaker 5: because it's the founder homeland for all of human kind.

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Speaker 5: Of course, so we do study breast cancer in East Africa,

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Speaker 5: West Africa, Central Africa, but we are also expanding to

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Speaker 5: study the breast cancer burden in Mexico and in South America.

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Speaker 5: These genetics of ancestry definitely play a role in susceptibility

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Speaker 5: for different patterns of the disease, and we have to

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Speaker 5: look at all of these internationally dis patient populations to

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Speaker 5: truly understand the root causes of cancer comprehensibly.

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Speaker 2: So basically, all breasts are not created equal.

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Speaker 4: I mean very true.

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Speaker 2: It's true, and I'm talking at.

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Speaker 1: A cellular level right and at a genetic level. At

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Speaker 1: why this Breast Cancer Awareness Month, I'm proud to support

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Speaker 1: their Move for Pink initiative, helping to drive real change

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Speaker 4: For the third year in a row.

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Speaker 1: Easy Spirit has been giving back, donating a portion of

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Speaker 1: Newman's groundbreaking breast cancer research. I know firsthand how important

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Speaker 1: this work is. I've actually had my own journey with

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Speaker 1: breast cancer, and doctor Newman was my doctor. Easy Spirit

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Speaker 1: easy spirit, you're taking a step in the right direction

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Speaker 1: for breast cancer research too. Another thing, I was curious

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Speaker 1: if some of the social determinants of health, you know,

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Speaker 1: like higher smoking rates or obesity rates, or the fact

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Speaker 1: that there are so many food deserts and the intersection

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Speaker 1: sadly of poverty and race, if that is also contributing

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Speaker 1: to not only access to healthcare and to preventative screening,

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Speaker 1: but also is that having an impact on the specific

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Speaker 1: cellular activity in breasts.

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Speaker 2: Does that make sense?

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Speaker 5: Oh, you stated it perfectly. It is so true. That's

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Speaker 5: absolutely correct. Environment definitely plays a role in breast cancer.

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Speaker 5: And there is a very large, exciting, growing body of

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Speaker 5: research looking at how certain neighborhood characteristics related to poverty

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Speaker 5: related to nutritional insecurity and food deserts. These characteristics are

439
00:27:13,280 --> 00:27:16,360
Speaker 5: not only associated with obesity rates, which is another risk

440
00:27:16,400 --> 00:27:21,400
Speaker 5: factor for getting breast cancer, but these neighborhood characteristics are

441
00:27:21,440 --> 00:27:25,880
Speaker 5: also inherently related to likelihood of developing certain breast cancer patterns.

442
00:27:26,280 --> 00:27:29,919
Speaker 1: And also another problem I know is getting women of

443
00:27:29,960 --> 00:27:33,440
Speaker 1: color in clinical trials, right, I mean, it's hard enough

444
00:27:33,480 --> 00:27:37,960
Speaker 1: to get anyone in clinical trials, but particularly challenging for

445
00:27:38,320 --> 00:27:45,359
Speaker 1: the black community to participate. Why has that been so challenging, Lisa.

446
00:27:46,280 --> 00:27:51,000
Speaker 5: Again, Katie, for so many complex reasons. They're destinately the

447
00:27:51,040 --> 00:27:53,080
Speaker 5: medical communityificant distrust.

448
00:27:53,240 --> 00:27:55,440
Speaker 4: Yes, and for appropriate reasons.

449
00:27:55,440 --> 00:27:59,280
Speaker 5: In the past, there have been horrific abuses in clinical

450
00:27:59,400 --> 00:28:06,040
Speaker 5: research tex Tuskegee, the Tuskegee experience, and so rightfully, many individuals,

451
00:28:06,119 --> 00:28:10,280
Speaker 5: especially from communities of color, are suspicious of clinical research.

452
00:28:10,840 --> 00:28:16,439
Speaker 5: But we can absolve the medical professional community from responsibility either.

453
00:28:16,800 --> 00:28:20,159
Speaker 5: There are actually many studies showing that one of the

454
00:28:20,200 --> 00:28:25,600
Speaker 5: biggest barriers to an African American cancer patient participating in

455
00:28:25,640 --> 00:28:31,359
Speaker 5: the clinical trial is the absence of the physician offering

456
00:28:31,480 --> 00:28:35,480
Speaker 5: a clinical trial to that patient. Some physicians just don't

457
00:28:35,520 --> 00:28:38,320
Speaker 5: want to take the time to explain the clinical trial.

458
00:28:38,840 --> 00:28:42,080
Speaker 5: Some physicians are fearful that bringing up a clinical trial

459
00:28:42,120 --> 00:28:46,320
Speaker 5: will somehow alienate the patient and generate more is distrust.

460
00:28:46,680 --> 00:28:47,720
Speaker 4: But we have to get over that.

461
00:28:48,160 --> 00:28:51,600
Speaker 5: Clinical trials are part of standard of care and we

462
00:28:51,720 --> 00:28:53,760
Speaker 5: have to offer them to everybody.

463
00:28:54,160 --> 00:28:56,760
Speaker 1: The other thing I know that you care deeply about

464
00:28:57,040 --> 00:29:01,920
Speaker 1: is to have more black doctors, because I think people

465
00:29:02,080 --> 00:29:08,640
Speaker 1: feel often more comfortable when their doctor has a similar

466
00:29:08,680 --> 00:29:12,479
Speaker 1: experience than they do, and that is actually increasing, but

467
00:29:12,680 --> 00:29:14,640
Speaker 1: not at a fast enough rate, is it.

468
00:29:14,840 --> 00:29:16,320
Speaker 4: Yeah, that is so true.

469
00:29:16,800 --> 00:29:20,680
Speaker 5: Just as we need better gender balances in the healthcare

470
00:29:20,880 --> 00:29:26,040
Speaker 5: professional community, we also need more diversity in the healthcare workforce.

471
00:29:26,440 --> 00:29:28,840
Speaker 4: And I do think that it's true that many.

472
00:29:28,800 --> 00:29:32,240
Speaker 5: Patients want to have a match in terms of not

473
00:29:32,320 --> 00:29:34,800
Speaker 5: only the gender, but often the race, ethnicity of their

474
00:29:34,840 --> 00:29:38,280
Speaker 5: position to their own experiences and identity.

475
00:29:38,800 --> 00:29:41,240
Speaker 4: But the patient population.

476
00:29:40,880 --> 00:29:43,760
Speaker 5: Overall, I think will have greater trust in the healthcare

477
00:29:43,800 --> 00:29:46,720
Speaker 5: system if they see a healthcare system that reflects their

478
00:29:46,800 --> 00:29:48,720
Speaker 5: neighborhoods and their communities.

479
00:29:49,080 --> 00:29:51,720
Speaker 1: Sharon, is that one of the reasons that going to

480
00:29:51,840 --> 00:29:55,320
Speaker 1: doctor Newman appealed to you? Did you feel more of

481
00:29:55,360 --> 00:29:58,880
Speaker 1: a connection with a woman of color as your surgeon?

482
00:30:00,360 --> 00:30:03,600
Speaker 1: She's okay, no, I'm curious.

483
00:30:03,800 --> 00:30:06,400
Speaker 2: I mean, did that enter into it at all?

484
00:30:08,520 --> 00:30:11,240
Speaker 3: Yes? But more importantly what entered into and she didn't know,

485
00:30:11,360 --> 00:30:15,520
Speaker 3: was that I did research on her. I went online,

486
00:30:15,760 --> 00:30:18,600
Speaker 3: and when I saw that her study what she was doing,

487
00:30:19,160 --> 00:30:22,160
Speaker 3: I thought, wow, not only is she a woman of color,

488
00:30:22,680 --> 00:30:25,560
Speaker 3: but also, you know, let's be honest, she is the

489
00:30:25,640 --> 00:30:29,800
Speaker 3: lead person in her field at her hospital, so her

490
00:30:29,840 --> 00:30:32,600
Speaker 3: expertise was important to me. The fact that she was

491
00:30:32,600 --> 00:30:35,240
Speaker 3: doing research around this was important to me. But that

492
00:30:35,280 --> 00:30:38,360
Speaker 3: wasn't enough for me. So I went to some other

493
00:30:38,440 --> 00:30:44,040
Speaker 3: doctors at other hospitals. And then, funny enough, gender is

494
00:30:44,040 --> 00:30:46,320
Speaker 3: important because when I went to the male doctor at

495
00:30:46,320 --> 00:30:49,360
Speaker 3: a very nice hospital, instead of telling me I had

496
00:30:49,400 --> 00:30:51,360
Speaker 3: dense bruss, he kept telling you, I had complex br us.

497
00:30:51,440 --> 00:30:53,440
Speaker 3: And a woman doesn't want to know she has complex

498
00:30:53,480 --> 00:30:54,520
Speaker 3: for us.

499
00:30:54,560 --> 00:30:59,080
Speaker 1: Okay, I don't know, nice and a little nicer than

500
00:30:59,280 --> 00:31:02,920
Speaker 1: I was as a woman who gets called complicated.

501
00:31:03,000 --> 00:31:05,920
Speaker 3: I was like, okay, now my breast complicated too, So

502
00:31:06,080 --> 00:31:09,080
Speaker 3: I was kind of taking that issue. But he didn't

503
00:31:09,120 --> 00:31:12,600
Speaker 3: handle me with the same care that doctor Newman handled me.

504
00:31:13,200 --> 00:31:15,680
Speaker 3: And then what was interesting was that he also was

505
00:31:15,720 --> 00:31:19,000
Speaker 3: specializing in the same type of research, but for Jewish women,

506
00:31:19,600 --> 00:31:23,720
Speaker 3: and I thought, wow, that's amazing, and I really appreciated

507
00:31:23,760 --> 00:31:25,840
Speaker 3: that he was doing that. But I was like, well,

508
00:31:25,880 --> 00:31:28,880
Speaker 3: he's specializing in Jewish women, and I've just talked to

509
00:31:28,880 --> 00:31:31,840
Speaker 3: a woman who's a woman who's handling me with a

510
00:31:31,840 --> 00:31:36,120
Speaker 3: lot of care and compassion. She has the expertise, and

511
00:31:36,200 --> 00:31:39,600
Speaker 3: more importantly, she is doing research about women like myself.

512
00:31:40,160 --> 00:31:44,440
Speaker 4: So where do I go? It seems easy enough, and

513
00:31:44,480 --> 00:31:45,120
Speaker 4: I already.

514
00:31:44,920 --> 00:31:46,680
Speaker 3: Knew I was going to her, but I just wanted

515
00:31:46,720 --> 00:31:51,160
Speaker 3: a second opinion. And then her peers in the industry

516
00:31:51,240 --> 00:31:54,200
Speaker 3: kept telling me she was amazing, so she didn't even

517
00:31:54,240 --> 00:31:56,920
Speaker 3: have to tell me she was amazing. Her peers in

518
00:31:56,960 --> 00:31:59,160
Speaker 3: the industry at the other hospitals were like, well, if

519
00:31:59,160 --> 00:32:00,400
Speaker 3: you're not going to go with us, she is one

520
00:32:00,440 --> 00:32:02,280
Speaker 3: of the best in the industry.

521
00:32:02,400 --> 00:32:06,480
Speaker 1: So I'm curious, Lisa, and why you decided. I mean,

522
00:32:06,560 --> 00:32:08,960
Speaker 1: first of all, you're a brilliant person. You could study

523
00:32:09,160 --> 00:32:13,120
Speaker 1: whatever you wanted. I'm sure, why did you decide to

524
00:32:13,920 --> 00:32:19,960
Speaker 1: really investigate the disparities in white women and women of

525
00:32:20,000 --> 00:32:21,800
Speaker 1: color when it came to breast cancer.

526
00:32:21,920 --> 00:32:22,720
Speaker 2: What was it?

527
00:32:23,280 --> 00:32:26,400
Speaker 1: Did you have an aha moment? Did you treat somebody,

528
00:32:26,520 --> 00:32:29,720
Speaker 1: did you read the statistics? What made you think I

529
00:32:29,880 --> 00:32:31,640
Speaker 1: need to dig deeper into this.

530
00:32:32,880 --> 00:32:35,480
Speaker 5: It was actually a little bit of everything you just described.

531
00:32:35,480 --> 00:32:37,600
Speaker 5: But before I get into that, I just want to

532
00:32:37,600 --> 00:32:40,040
Speaker 5: thank both of you for your comments, and I also

533
00:32:40,120 --> 00:32:42,600
Speaker 5: want to specifically give a shout out to Sharon for

534
00:32:42,640 --> 00:32:44,680
Speaker 5: the way she kept it so real with me. She

535
00:32:44,800 --> 00:32:47,600
Speaker 5: did her homework and investigated other centers and then she

536
00:32:47,720 --> 00:32:49,960
Speaker 5: came back and told me what she liked about my

537
00:32:50,080 --> 00:32:52,840
Speaker 5: program and what she didn't like about my program.

538
00:32:53,920 --> 00:32:56,280
Speaker 4: She was very honest about things that we needed to

539
00:32:56,960 --> 00:32:57,320
Speaker 4: work on.

540
00:32:57,720 --> 00:32:59,160
Speaker 5: Well, I'm not even going to say what they were,

541
00:32:59,200 --> 00:33:02,160
Speaker 5: because I've correct to everything that she told me about it.

542
00:33:04,640 --> 00:33:08,480
Speaker 5: But for me, it was a long journey to coming

543
00:33:08,560 --> 00:33:12,120
Speaker 5: to where my career is today and back. I won't

544
00:33:12,120 --> 00:33:13,840
Speaker 5: say how long ago, but it was more than twenty

545
00:33:13,960 --> 00:33:16,680
Speaker 5: years ago. When I was first starting on my career,

546
00:33:16,800 --> 00:33:19,400
Speaker 5: I was a general surgeon taking care of a lot

547
00:33:19,440 --> 00:33:24,160
Speaker 5: of different types of surgical problems, and back then we

548
00:33:24,280 --> 00:33:27,719
Speaker 5: didn't have an appreciation for the types of race related

549
00:33:27,760 --> 00:33:31,680
Speaker 5: differences in breast cancer burden that you described today, and

550
00:33:31,720 --> 00:33:35,239
Speaker 5: those are very well documented today, but that back then

551
00:33:35,280 --> 00:33:38,360
Speaker 5: we didn't understand them very well. We didn't understand the

552
00:33:38,360 --> 00:33:40,920
Speaker 5: fact that breast cancer is actually comprised of a whole

553
00:33:41,000 --> 00:33:45,240
Speaker 5: spectrum of different subtypes, and we just didn't understand why

554
00:33:45,280 --> 00:33:49,280
Speaker 5: some breast cancers were more poorly controlled than others. And

555
00:33:49,480 --> 00:33:52,840
Speaker 5: my general surgery practice was based in Brooklyn, New York, where,

556
00:33:52,880 --> 00:33:56,880
Speaker 5: of course we have a beautiful and robustly diverse patient population,

557
00:33:57,560 --> 00:34:02,240
Speaker 5: and every day I was struck in my own practice

558
00:34:02,400 --> 00:34:05,480
Speaker 5: by how my black breast cancer patients were being diagnosed

559
00:34:05,480 --> 00:34:09,480
Speaker 5: at younger ages. They were often diagnosed with bulkier tumors,

560
00:34:09,920 --> 00:34:13,200
Speaker 5: and they were developing recurrences of their breast cancer more frequently.

561
00:34:14,040 --> 00:34:16,960
Speaker 5: And so I decided to pursue additional training and research

562
00:34:17,280 --> 00:34:21,520
Speaker 5: so that I could have a dedicated career studying breast

563
00:34:21,520 --> 00:34:26,839
Speaker 5: cancer and dedicated to surgical management of the disease. So

564
00:34:26,920 --> 00:34:31,960
Speaker 5: that twenty year journey twenty plus your journey actually has

565
00:34:32,000 --> 00:34:34,960
Speaker 5: evolved into this international breast cancer research and a lot

566
00:34:35,000 --> 00:34:37,120
Speaker 5: of research looking at the genetics of the disease.

567
00:34:37,880 --> 00:34:41,320
Speaker 1: I know that it's true in the case of calling cancer,

568
00:34:41,480 --> 00:34:45,480
Speaker 1: that younger and younger people are being diagnosed, which is

569
00:34:45,600 --> 00:34:50,680
Speaker 1: really upsetting people in their twenties and thirties and forties.

570
00:34:51,040 --> 00:34:53,440
Speaker 1: You know, you have to get a screening, colonoscopy or

571
00:34:53,600 --> 00:34:58,400
Speaker 1: some kind of calling screening at age forty five because

572
00:34:58,400 --> 00:35:02,200
Speaker 1: of these numbers, they lowered the age for your first screening.

573
00:35:03,040 --> 00:35:07,120
Speaker 1: And I'm curious if this is true for breast cancer,

574
00:35:08,280 --> 00:35:12,800
Speaker 1: and if you have any idea why younger and younger

575
00:35:12,800 --> 00:35:16,560
Speaker 1: people seem to be getting diagnosed with these diseases.

576
00:35:17,200 --> 00:35:19,280
Speaker 4: Well, you are again correct.

577
00:35:19,680 --> 00:35:22,880
Speaker 5: We are seeing a similar pattern in breast cancer as

578
00:35:22,920 --> 00:35:26,520
Speaker 5: what you described in colon cancer, with higher and increasing

579
00:35:27,000 --> 00:35:30,720
Speaker 5: population based incidence rates of breast cancer in younger women,

580
00:35:31,120 --> 00:35:34,040
Speaker 5: women that are still in the pre menopausal age ranges.

581
00:35:34,400 --> 00:35:39,200
Speaker 5: We don't completely understand the explanations, but we are assuming

582
00:35:39,280 --> 00:35:42,200
Speaker 5: at this point in time that it's related to a

583
00:35:42,239 --> 00:35:49,120
Speaker 5: constellation of factors. Diet, lifestyle, environmental exposures, obesity rates are

584
00:35:49,200 --> 00:35:52,040
Speaker 5: unfortunately on the rise in the United States, and all

585
00:35:52,080 --> 00:35:55,400
Speaker 5: of these factors, in addition to our genetics, we'll be

586
00:35:55,440 --> 00:35:56,239
Speaker 5: playing a role in.

587
00:35:56,360 --> 00:35:59,520
Speaker 1: I wonder when you say environmental factors, I feel like it.

588
00:36:00,280 --> 00:36:02,640
Speaker 1: You know, it's frustrating to me because we've seen these

589
00:36:02,719 --> 00:36:05,360
Speaker 1: numbers for a few years now, and I've talked to

590
00:36:05,440 --> 00:36:08,280
Speaker 1: a lot of scientists because of stand Up to Cancer

591
00:36:08,400 --> 00:36:14,200
Speaker 1: and my own cancer activism, and some say it might

592
00:36:14,280 --> 00:36:21,000
Speaker 1: be the over prescription of antibiotics. Other people say maybe

593
00:36:21,040 --> 00:36:27,720
Speaker 1: process foods. We're hearing a lot about alcohol consumption and cancer.

594
00:36:27,760 --> 00:36:30,359
Speaker 1: I think a big study just came out about that

595
00:36:30,480 --> 00:36:33,719
Speaker 1: and how closely linked they are. When do you think

596
00:36:33,760 --> 00:36:37,000
Speaker 1: we're going to And I wonder about pesticides, and I

597
00:36:37,040 --> 00:36:40,800
Speaker 1: wonder about these forever chemicals. What are they called p fasts?

598
00:36:40,880 --> 00:36:45,520
Speaker 1: Is that what they're called? Anybody, come on audience, P

599
00:36:45,719 --> 00:36:50,800
Speaker 1: fast right, pfas I guess, And everything from leggings to

600
00:36:51,440 --> 00:36:56,759
Speaker 1: you know, rubber mats and all kinds of household products.

601
00:36:57,160 --> 00:36:58,600
Speaker 2: When do you think, I know, it's.

602
00:36:58,480 --> 00:37:02,040
Speaker 1: Really hard at semiologists struggle with this, But when do

603
00:37:02,080 --> 00:37:05,440
Speaker 1: you think we'll have a better idea about why this

604
00:37:05,520 --> 00:37:08,960
Speaker 1: is happening because it has such a huge impact on

605
00:37:09,120 --> 00:37:14,319
Speaker 1: screening recommendations and overall awareness for a younger population.

606
00:37:15,040 --> 00:37:20,839
Speaker 5: Yeah, these are incredibly difficult questions to address, and yes,

607
00:37:21,000 --> 00:37:25,160
Speaker 5: epidemiologists are continuing to struggle with them. It is correct

608
00:37:25,239 --> 00:37:29,680
Speaker 5: that excessive and increasing rates of alcohol consumption on a

609
00:37:29,719 --> 00:37:35,200
Speaker 5: daily basis will increase breast cancer risk. Obesity increases breast

610
00:37:35,200 --> 00:37:39,120
Speaker 5: cancer risk. Leading a sedentary lifestyle with the lack of

611
00:37:39,160 --> 00:37:42,920
Speaker 5: adequate exercise on a daily basis, All of those patterns

612
00:37:42,920 --> 00:37:45,759
Speaker 5: will increase breast cancer risk. The things that do not

613
00:37:46,120 --> 00:37:49,680
Speaker 5: seem to affect breast cancer risk would be wearing a

614
00:37:49,680 --> 00:37:52,840
Speaker 5: brazier or not wearing a brazier, or different types of

615
00:37:53,040 --> 00:37:53,759
Speaker 5: brazil If.

616
00:37:53,719 --> 00:37:55,640
Speaker 2: People think that really has an impact.

617
00:37:56,040 --> 00:37:59,239
Speaker 5: It seems to cycle like every couple of years. There

618
00:37:59,239 --> 00:38:03,200
Speaker 5: are these yet on the internet about risk of braziers

619
00:38:03,239 --> 00:38:06,040
Speaker 5: and breast cancer risk, but yet non association.

620
00:38:06,280 --> 00:38:07,800
Speaker 2: Yeah, but sometimes when.

621
00:38:07,680 --> 00:38:10,120
Speaker 1: I used to take walks, I would stick my iPhone

622
00:38:10,160 --> 00:38:13,160
Speaker 1: and my bra and then I kind of wondered, Oh,

623
00:38:13,200 --> 00:38:16,640
Speaker 1: I wondered if that actually had an impact on my

624
00:38:16,760 --> 00:38:17,480
Speaker 1: breast cancer.

625
00:38:17,880 --> 00:38:18,640
Speaker 2: Do you think it did?

626
00:38:19,440 --> 00:38:20,000
Speaker 4: I don't think so.

627
00:38:20,719 --> 00:38:22,880
Speaker 3: I do not think so. But I asked you about

628
00:38:22,880 --> 00:38:25,480
Speaker 3: the diet. Ho I think I asked you about my dietoke.

629
00:38:26,040 --> 00:38:27,880
Speaker 3: I was like, drinking twenty years of di coke? Did

630
00:38:27,880 --> 00:38:29,000
Speaker 3: that lead to my breast cancer?

631
00:38:29,320 --> 00:38:29,919
Speaker 2: But you never?

632
00:38:30,320 --> 00:38:33,160
Speaker 1: I mean, I think what's what the problem is. There's

633
00:38:33,400 --> 00:38:37,040
Speaker 1: you know, people fill in the lack of knowledge with

634
00:38:37,040 --> 00:38:42,600
Speaker 1: with uh, you know, ideas and speculation, and I think

635
00:38:42,800 --> 00:38:44,719
Speaker 1: we really need to focus on that.

636
00:38:45,280 --> 00:38:46,680
Speaker 2: Are people studying this.

637
00:38:47,360 --> 00:38:51,960
Speaker 5: They are very aggressively, but it's so difficult to get

638
00:38:52,040 --> 00:38:56,239
Speaker 5: a consistent and definitive handle on the answers because so

639
00:38:56,320 --> 00:39:00,799
Speaker 5: many of these factors are poorly recalled by individuals. They're

640
00:39:00,840 --> 00:39:06,160
Speaker 5: poorly documented, so it's difficult to accurately assess the quantity

641
00:39:06,239 --> 00:39:14,839
Speaker 5: of different dietary components, the exposures to different pesticides, right,

642
00:39:14,960 --> 00:39:16,160
Speaker 5: things that are in the environment.

643
00:39:16,200 --> 00:39:19,640
Speaker 1: You believe in breast cancer clusters, you know, where you

644
00:39:19,760 --> 00:39:22,520
Speaker 1: see a lot of breast cancer like Long Island by

645
00:39:22,560 --> 00:39:27,000
Speaker 1: the way. Yes, that is that there have been reported

646
00:39:27,239 --> 00:39:32,600
Speaker 1: a lot of cases in certain geographic areas or in neighborhoods,

647
00:39:32,719 --> 00:39:36,799
Speaker 1: and you know, but it's never quite proven. And is

648
00:39:36,840 --> 00:39:40,960
Speaker 1: that something that you think warrants more study.

649
00:39:41,320 --> 00:39:45,480
Speaker 5: Yeah, absolutely warrants more study. And the clusters are very real.

650
00:39:46,080 --> 00:39:49,200
Speaker 5: It becomes difficult to tease out though why those clusters

651
00:39:49,239 --> 00:39:53,479
Speaker 5: occur because neighborhoods exist with people living in the same

652
00:39:53,600 --> 00:39:57,839
Speaker 5: environment for so many different reasons. Families like to live

653
00:39:57,920 --> 00:40:02,120
Speaker 5: together if they have certain lifestyles in common, or cultures

654
00:40:02,160 --> 00:40:05,600
Speaker 5: in common, race ethnicities often want to be in the

655
00:40:05,640 --> 00:40:08,360
Speaker 5: same neighborhood with each other. So there are just so

656
00:40:08,560 --> 00:40:12,400
Speaker 5: many factors that go behind the reasons why a neighborhood

657
00:40:12,520 --> 00:40:17,040
Speaker 5: is characterized by one pattern versus a different pattern.

658
00:40:17,040 --> 00:40:18,799
Speaker 1: But it does make you wonder, like is there an

659
00:40:18,880 --> 00:40:22,520
Speaker 1: environmental fact as way here? Is it like a certain

660
00:40:22,600 --> 00:40:27,719
Speaker 1: kind of plant maybe nearby that or pesticides anyway, It's

661
00:40:28,040 --> 00:40:31,040
Speaker 1: as I said, it's a lot of speculation. Let's focus

662
00:40:31,160 --> 00:40:35,640
Speaker 1: on for the remaining time we have on the best

663
00:40:35,680 --> 00:40:39,600
Speaker 1: way to prevent breast cancer and the best way to

664
00:40:39,680 --> 00:40:44,640
Speaker 1: prevent a recurrence of breast cancer, because I think both

665
00:40:44,680 --> 00:40:48,719
Speaker 1: of those are so important. We're all wearing our nice, comfortable,

666
00:40:48,880 --> 00:40:52,919
Speaker 1: easy spirit shoes, and that makes me want to ask

667
00:40:53,000 --> 00:40:57,560
Speaker 1: you about exercise and the role of being a physical

668
00:40:57,640 --> 00:41:01,040
Speaker 1: activity in terms of not only breast cancer, but a

669
00:41:01,040 --> 00:41:02,600
Speaker 1: whole host of diseases.

670
00:41:03,360 --> 00:41:03,960
Speaker 4: Yeah.

671
00:41:04,280 --> 00:41:08,479
Speaker 5: Yeah, exercise and continuing to move, being on the move

672
00:41:08,760 --> 00:41:11,799
Speaker 5: is good for the mind, body, and soul, and it

673
00:41:12,080 --> 00:41:17,440
Speaker 5: very definitely is valuable in preventing breast cancer and in

674
00:41:17,800 --> 00:41:20,520
Speaker 5: having a better outcome if you have been diagnosed with

675
00:41:20,560 --> 00:41:25,200
Speaker 5: breast cancer. Now, I don't want women and breast cancer

676
00:41:25,280 --> 00:41:29,120
Speaker 5: survivors to feel that everything is on their shoulders and

677
00:41:29,360 --> 00:41:32,160
Speaker 5: in terms of preventing a recurrence of a breast cancer

678
00:41:32,239 --> 00:41:35,799
Speaker 5: or preventing it from being diagnosed altogether, because some things

679
00:41:35,840 --> 00:41:39,560
Speaker 5: are simply out of our control. But absolutely we can

680
00:41:39,960 --> 00:41:44,960
Speaker 5: provide ourselves some protection against a breast cancer diagnosis with

681
00:41:45,200 --> 00:41:51,360
Speaker 5: a healthy lifestyle, balanced diet, and continuing to be screened.

682
00:41:51,600 --> 00:41:54,400
Speaker 5: Because there is no doubt about it that early detection

683
00:41:54,520 --> 00:41:58,320
Speaker 5: of a breast cancer, regardless of the breast cancer subtype,

684
00:41:58,400 --> 00:42:01,880
Speaker 5: early detection of that breast cancer is a huge factor

685
00:42:02,080 --> 00:42:05,760
Speaker 5: in likelihood of successful treatment, and if a breast cancer

686
00:42:05,840 --> 00:42:09,520
Speaker 5: has been diagnosed, a woman has to be vigilant about

687
00:42:09,560 --> 00:42:13,400
Speaker 5: her breast evaluation for both breasts for the rest of

688
00:42:13,440 --> 00:42:16,080
Speaker 5: her life. She not only could develop a recurrence of

689
00:42:16,120 --> 00:42:18,680
Speaker 5: the breast cancer in that breast or in other parts

690
00:42:18,680 --> 00:42:19,759
Speaker 5: of the body, but.

691
00:42:19,680 --> 00:42:21,880
Speaker 4: She can develop a whole new breast cancer. And it

692
00:42:21,960 --> 00:42:23,680
Speaker 4: always breaks my heart when.

693
00:42:23,840 --> 00:42:26,760
Speaker 5: I hear breast cancer patients say that they just didn't

694
00:42:26,840 --> 00:42:29,359
Speaker 5: realize that they have to be on the lookout for

695
00:42:29,480 --> 00:42:31,239
Speaker 5: a new cancer developing.

696
00:42:32,200 --> 00:42:33,319
Speaker 4: There's a Lenser's key.

697
00:42:33,560 --> 00:42:39,160
Speaker 1: Yeah, there's exercise, and there's exercise, like for me taking

698
00:42:39,239 --> 00:42:42,960
Speaker 1: a nice walk around Central Park and looking at all

699
00:42:43,040 --> 00:42:46,920
Speaker 1: the people and the squirrels and the birds. But how

700
00:42:47,239 --> 00:42:52,440
Speaker 1: like how intense should your exercise be? Because I think

701
00:42:52,480 --> 00:42:57,480
Speaker 1: there's a big spectrum right from lazy to intense. Right,

702
00:42:57,800 --> 00:43:00,719
Speaker 1: So do you have to really get your heart rate up?

703
00:43:00,920 --> 00:43:04,120
Speaker 1: And can you give us some advice on that, Lisa,

704
00:43:05,040 --> 00:43:07,400
Speaker 1: or is it kind of out of your well.

705
00:43:08,200 --> 00:43:11,360
Speaker 5: I don't think that you have to be manic about

706
00:43:11,400 --> 00:43:18,400
Speaker 5: your exercise regimen, but making sure that you walk regularly

707
00:43:18,480 --> 00:43:23,960
Speaker 5: throughout the day, take a flight, or two upstairs every day.

708
00:43:25,280 --> 00:43:26,040
Speaker 4: That will help.

709
00:43:26,640 --> 00:43:29,239
Speaker 1: And if you break a sweat, it's a good thing, right.

710
00:43:29,719 --> 00:43:34,160
Speaker 1: I don't like very sweat straightforward parameter. Okay, let's just

711
00:43:34,200 --> 00:43:37,480
Speaker 1: talk quickly about diet and alcohol and sort of what

712
00:43:37,520 --> 00:43:40,759
Speaker 1: you recommend. Should I not be eating bacon because it

713
00:43:40,840 --> 00:43:44,640
Speaker 1: is my favorite food, it is my very favorite food.

714
00:43:45,640 --> 00:43:49,280
Speaker 2: Well, it's all about balance, because I don't.

715
00:43:49,120 --> 00:43:52,440
Speaker 3: Want to hear the answer to that one. I love bacon. Oh,

716
00:43:52,440 --> 00:43:54,000
Speaker 3: but I'm good. I took off both of us, so

717
00:43:54,040 --> 00:43:54,439
Speaker 3: I'm good.

718
00:43:55,719 --> 00:43:58,680
Speaker 1: Bacon is probably not good for a lot of different things.

719
00:43:58,760 --> 00:44:02,600
Speaker 5: But yeah, it's all about balance in life and not

720
00:44:02,760 --> 00:44:06,880
Speaker 5: overdoing it with any type of food on a daily basis,

721
00:44:07,400 --> 00:44:10,320
Speaker 5: but especially fried foods, things like and fatty foods.

722
00:44:10,320 --> 00:44:12,360
Speaker 4: You don't want to overdo those on a daily basis.

723
00:44:12,760 --> 00:44:13,680
Speaker 4: Same with alcohol.

724
00:44:13,719 --> 00:44:18,680
Speaker 5: There are some cardiovascular benefits to some alcohol intake, but

725
00:44:19,520 --> 00:44:22,240
Speaker 5: more than a couple of glasses on a daily basis

726
00:44:22,280 --> 00:44:24,960
Speaker 5: is going to be bad for a number of different

727
00:44:25,360 --> 00:44:30,640
Speaker 5: health issues, including breast cancer. Risk of diet that has

728
00:44:30,719 --> 00:44:33,239
Speaker 5: a lot of fresh fruits and vegetables in it is

729
00:44:33,520 --> 00:44:39,440
Speaker 5: excellent fiber. Fiber isn't a fiber? Yeah, yeah, And in general,

730
00:44:39,680 --> 00:44:43,160
Speaker 5: all of the dietary patterns that are good for cardiovascular

731
00:44:43,239 --> 00:44:44,760
Speaker 5: health are good for breast health.

732
00:44:45,360 --> 00:44:48,840
Speaker 1: Let me ask you about genetic testing because I feel

733
00:44:48,880 --> 00:44:51,399
Speaker 1: like a lot of people don't get genetic testing. They

734
00:44:51,400 --> 00:44:55,560
Speaker 1: think it's too expensive or they think, you know, honestly,

735
00:44:55,719 --> 00:44:59,480
Speaker 1: they sort of don't want to know. So who is

736
00:44:59,560 --> 00:45:04,359
Speaker 1: genetic testing right for? And what would you tell your

737
00:45:04,400 --> 00:45:09,120
Speaker 1: patients or anyone listening to our conversation about genetic testing.

738
00:45:10,400 --> 00:45:15,279
Speaker 5: Well, fortunately, the costs of genetic testing have plummeted since

739
00:45:15,320 --> 00:45:19,400
Speaker 5: the Supreme Court ruling in twenty thirteen opening up genetic

740
00:45:19,480 --> 00:45:22,920
Speaker 5: testing to be performed by a number of different companies.

741
00:45:23,080 --> 00:45:26,879
Speaker 5: The prices have plummeted, and we have large scale panels

742
00:45:27,080 --> 00:45:29,920
Speaker 5: for genes that can be evaluated to look for hereditary

743
00:45:29,960 --> 00:45:34,040
Speaker 5: susceptibility for a variety of different cancers, not only breast cancer,

744
00:45:34,080 --> 00:45:40,960
Speaker 5: but we can identify hereditary predisposition for ovarian cancer, colon cancer, melanoma. Now,

745
00:45:40,960 --> 00:45:45,480
Speaker 5: there are some people who believe that everybody should be

746
00:45:45,560 --> 00:45:49,279
Speaker 5: genetically tested, at least for certain genes when they reach

747
00:45:49,400 --> 00:45:53,279
Speaker 5: adult life. We haven't quite gotten to the point where

748
00:45:53,320 --> 00:45:57,520
Speaker 5: that is broadly available to the general population. At this

749
00:45:57,640 --> 00:46:01,560
Speaker 5: point in time, the United States and Services Task Force

750
00:46:01,640 --> 00:46:06,200
Speaker 5: does recommend that anybody with Oshkenazi Jewish background should consider

751
00:46:06,239 --> 00:46:11,120
Speaker 5: getting tested for specific BRCA mutations once they reach age thirty,

752
00:46:11,160 --> 00:46:13,400
Speaker 5: because there's a very high risk.

753
00:46:13,480 --> 00:46:16,200
Speaker 1: For your risk of breast and ovarian goes up to

754
00:46:16,280 --> 00:46:18,960
Speaker 1: eighty percent if you'r BRACK a positive right.

755
00:46:18,840 --> 00:46:22,200
Speaker 5: Exactly, That is so true if you do have a

756
00:46:22,280 --> 00:46:27,000
Speaker 5: strong family history of breast cancer ovarian cancer, I mean

757
00:46:27,120 --> 00:46:30,239
Speaker 5: multiple relatives with either of those cancers. If there are

758
00:46:30,239 --> 00:46:33,600
Speaker 5: any men in your family with breast cancer, if you

759
00:46:33,719 --> 00:46:38,440
Speaker 5: have in your extended family tree many individuals diagnosed with

760
00:46:38,480 --> 00:46:42,160
Speaker 5: even other cancers such as coerectol or melanoma, those would

761
00:46:42,160 --> 00:46:45,120
Speaker 5: all be features indicating that you should consider getting genetic

762
00:46:45,160 --> 00:46:49,200
Speaker 5: testing done. If there's a bilateral breast cancer in the family,

763
00:46:49,560 --> 00:46:53,440
Speaker 5: breast cancer being diagnosed at younger ages, for women that

764
00:46:53,640 --> 00:46:57,200
Speaker 5: are themselves diagnosed with breast cancer at young ages, or

765
00:46:57,320 --> 00:47:01,400
Speaker 5: triple negative breast cancers, these are all so features indicating

766
00:47:01,440 --> 00:47:04,960
Speaker 5: that you might be more likely to have hereditary predisposition.

767
00:47:05,680 --> 00:47:08,480
Speaker 5: Now I am a breast surgeon, The American Society of

768
00:47:08,520 --> 00:47:11,640
Speaker 5: Breast Surgeons advocates in favor of all women who've been

769
00:47:11,680 --> 00:47:16,160
Speaker 5: diagnosed with breast cancer, regardless of age, racial ethnic background,

770
00:47:16,320 --> 00:47:19,440
Speaker 5: regardless of their pattern of breast cancer. If they are

771
00:47:19,440 --> 00:47:22,080
Speaker 5: diagnosed with breast cancer, they should be offered genetic testing.

772
00:47:22,160 --> 00:47:24,239
Speaker 5: And so I do offer genetic testing to all of

773
00:47:24,239 --> 00:47:24,920
Speaker 5: my patients.

774
00:47:25,160 --> 00:47:28,480
Speaker 1: I would like to make another argument for genetic testing though,

775
00:47:28,640 --> 00:47:34,319
Speaker 1: if I may, I do you know I think what

776
00:47:34,360 --> 00:47:38,680
Speaker 1: people don't understand is the vast majority of cancers involve

777
00:47:38,800 --> 00:47:44,279
Speaker 1: no family history. I think it's something like seventy eight

778
00:47:44,440 --> 00:47:47,520
Speaker 1: or eighty percent of calling cancer cases. And I know

779
00:47:47,560 --> 00:47:52,600
Speaker 1: a lot about this because my husband have no family history. Similarly,

780
00:47:52,880 --> 00:47:56,960
Speaker 1: the majority of breast cancer cases have no family history.

781
00:47:57,440 --> 00:48:02,160
Speaker 1: So isn't it smart before you get diagnosed to see

782
00:48:02,200 --> 00:48:05,719
Speaker 1: if you have any genetic mutations that may make you

783
00:48:06,400 --> 00:48:10,759
Speaker 1: at greater risk for any of these cancers so you

784
00:48:11,000 --> 00:48:16,160
Speaker 1: can schedule your screenings accordingly, So you might have to

785
00:48:16,200 --> 00:48:19,520
Speaker 1: be more vigilant. For example, I had genetic testing, I

786
00:48:19,640 --> 00:48:21,880
Speaker 1: believe it or not, have a higher risk of colling

787
00:48:21,920 --> 00:48:25,719
Speaker 1: cancer slightly because I have some genetic mutation and new

788
00:48:25,800 --> 00:48:28,640
Speaker 1: mutations are being discovered all the time.

789
00:48:29,040 --> 00:48:30,279
Speaker 2: So to me, it's kind of.

790
00:48:30,239 --> 00:48:33,399
Speaker 1: A no brainer to say, well, boy, I better not

791
00:48:33,560 --> 00:48:37,080
Speaker 1: forget to get my colling cancer, screening my colonoscopy or

792
00:48:37,080 --> 00:48:39,160
Speaker 1: my colon guard, whatever I choose to do.

793
00:48:40,000 --> 00:48:42,040
Speaker 2: So isn't that a good argument?

794
00:48:42,040 --> 00:48:44,000
Speaker 1: I remember, by the way, my parents were late for

795
00:48:44,040 --> 00:48:46,720
Speaker 1: their colonoscopies or whatever, and I was like, you guys

796
00:48:46,760 --> 00:48:49,759
Speaker 1: know how embarrassing it would be for me if you've

797
00:48:49,760 --> 00:48:51,600
Speaker 1: got diagnosed with calling cancer.

798
00:48:51,680 --> 00:48:54,600
Speaker 2: Come on, anyway, it's all about me.

799
00:48:56,239 --> 00:49:01,640
Speaker 1: So why wouldn't people recommend screening before they get diagnosed

800
00:49:01,719 --> 00:49:05,319
Speaker 1: with something so they can be armed with better information

801
00:49:05,520 --> 00:49:07,840
Speaker 1: that could potentially save their lives.

802
00:49:08,000 --> 00:49:13,120
Speaker 5: Ye, you are correct again, genetic testing a way.

803
00:49:12,600 --> 00:49:18,320
Speaker 4: Yes you are. In my book, you already are, but correct.

804
00:49:18,560 --> 00:49:22,000
Speaker 5: Genetic testing can save lives, and it does save lives

805
00:49:22,160 --> 00:49:25,400
Speaker 5: as we learn more about it. People who have hereditary

806
00:49:25,400 --> 00:49:29,440
Speaker 5: predisposition for different cancers can detect those cancers earlier with

807
00:49:29,600 --> 00:49:34,320
Speaker 5: enhanced screening. Some of these genetic markers serve as markers

808
00:49:34,320 --> 00:49:38,000
Speaker 5: for specific treatments that will be necessary if a cancer

809
00:49:38,040 --> 00:49:42,239
Speaker 5: is diagnosed, and we have good ways of preventing different cancers.

810
00:49:42,800 --> 00:49:45,879
Speaker 5: Individuals that are at higher risk for ovarian cancer if

811
00:49:45,920 --> 00:49:48,560
Speaker 5: they remove their ovaries, that is a wonderful way to

812
00:49:48,800 --> 00:49:53,160
Speaker 5: prevent ovarian cancer. And it's been shown to have survival advantages.

813
00:49:54,360 --> 00:49:56,800
Speaker 5: People that are at high risk for breast cancer are

814
00:49:56,840 --> 00:50:01,760
Speaker 5: candidates often to take special medication that can prevent breast cancer.

815
00:50:01,719 --> 00:50:04,799
Speaker 1: Or you know, to even make lifestyle changes, right. You know,

816
00:50:04,880 --> 00:50:07,040
Speaker 1: if you know that, you can say I'm going to

817
00:50:07,080 --> 00:50:10,319
Speaker 1: make sure I'm really vigilant about my diet and exercise.

818
00:50:11,000 --> 00:50:13,359
Speaker 3: But I will say as someone who I did the test,

819
00:50:13,520 --> 00:50:15,920
Speaker 3: I did the genetic testing and came back negative the

820
00:50:15,960 --> 00:50:19,000
Speaker 3: first time, So I don't want people to get comfortable

821
00:50:19,360 --> 00:50:21,920
Speaker 3: to take it and it comes back negative.

822
00:50:21,640 --> 00:50:24,240
Speaker 2: Like I do a false sense gave me a false.

823
00:50:23,760 --> 00:50:27,000
Speaker 3: It did, and then I took it again once I

824
00:50:27,040 --> 00:50:30,560
Speaker 3: did find out, but this time I took a full panel, right,

825
00:50:30,640 --> 00:50:33,520
Speaker 3: So when you take it, take the full panel. And

826
00:50:33,560 --> 00:50:35,239
Speaker 3: I did it the second time not for me, but

827
00:50:35,440 --> 00:50:38,440
Speaker 3: my daughter, right because I needed to know and make

828
00:50:38,480 --> 00:50:41,160
Speaker 3: sure my daughter had as much family history as she

829
00:50:41,239 --> 00:50:44,279
Speaker 3: could possibly have. So I would definitely encourage everyone to

830
00:50:44,320 --> 00:50:46,760
Speaker 3: have it. And when you have it, take the full panel,

831
00:50:46,800 --> 00:50:50,920
Speaker 3: because now we've discovered that I have some unknown genetic

832
00:50:51,520 --> 00:50:53,640
Speaker 3: and that we're going to need more people to do

833
00:50:53,800 --> 00:50:56,000
Speaker 3: genetic testing so we can figure out what my own

834
00:50:56,080 --> 00:50:58,200
Speaker 3: known and I'm at risk for right.

835
00:50:58,680 --> 00:51:02,520
Speaker 1: You know, you mentioned Sharon so beautifully at the beginning

836
00:51:02,560 --> 00:51:05,640
Speaker 1: of this conversation that you're trying to serve others and

837
00:51:06,400 --> 00:51:11,839
Speaker 1: help your community understand the importance of early detection about

838
00:51:11,920 --> 00:51:15,480
Speaker 1: getting screened. And I'm curious, how are you doing that,

839
00:51:15,800 --> 00:51:21,440
Speaker 1: because it's so important that women of color that we

840
00:51:21,600 --> 00:51:24,560
Speaker 1: reach out to them and make sure they know where

841
00:51:24,560 --> 00:51:27,200
Speaker 1: to go to get screened, make sure they know where

842
00:51:27,200 --> 00:51:32,040
Speaker 1: to go if they're uninsured or underinsured or insured, you know,

843
00:51:32,520 --> 00:51:36,759
Speaker 1: And I'm curious what you think are the most effective

844
00:51:36,840 --> 00:51:38,120
Speaker 1: ways to reach women.

845
00:51:38,640 --> 00:51:41,160
Speaker 3: Well, I mean, first, it starts with the conversation. So

846
00:51:41,480 --> 00:51:44,759
Speaker 3: like my mother, I was also very very private, and

847
00:51:44,960 --> 00:51:47,360
Speaker 3: when I discovered I had breast cancer, I actually, for

848
00:51:47,400 --> 00:51:50,120
Speaker 3: the first time my life decided to be public and

849
00:51:50,239 --> 00:51:53,240
Speaker 3: so I started sharing with everyone. Then I had breast

850
00:51:53,280 --> 00:51:57,040
Speaker 3: cancer and well, my doctor was my treatment. My daughter

851
00:51:57,200 --> 00:52:00,400
Speaker 3: created a WhatsApp communication because I didn't how to do

852
00:52:00,440 --> 00:52:05,000
Speaker 3: it with all my friends and telling them to get mammograms.

853
00:52:05,280 --> 00:52:07,880
Speaker 3: Before my surgery, I had a bye bye Boobs party

854
00:52:08,520 --> 00:52:11,319
Speaker 3: and I invited men and women to come to say

855
00:52:11,360 --> 00:52:15,279
Speaker 3: bye bye to my twins, but also to once again

856
00:52:15,360 --> 00:52:17,480
Speaker 3: talk about the importance of early detection.

857
00:52:17,840 --> 00:52:20,240
Speaker 4: And making it less.

858
00:52:20,040 --> 00:52:23,120
Speaker 3: Scary for folks. And everyone knew that my mom had

859
00:52:23,360 --> 00:52:27,160
Speaker 3: allowed hers to metastasize and what it caused me, and

860
00:52:27,200 --> 00:52:30,160
Speaker 3: so what they felt was like Wow. I had people

861
00:52:30,239 --> 00:52:33,759
Speaker 3: go get their mammograms and make appointments. I also run

862
00:52:33,800 --> 00:52:36,160
Speaker 3: a boys and girls club, so I have lots of

863
00:52:36,200 --> 00:52:39,480
Speaker 3: thousands of families there. So we are now having community

864
00:52:39,560 --> 00:52:43,719
Speaker 3: days where we're bringing in health professionals to talk about diabetes,

865
00:52:44,080 --> 00:52:47,560
Speaker 3: breast cancer, asking the American Cancer to bring the van

866
00:52:47,760 --> 00:52:49,920
Speaker 3: so we can do free screenings because a lot of

867
00:52:49,920 --> 00:52:52,920
Speaker 3: our parents are living the poverty line. And I know

868
00:52:53,040 --> 00:52:55,920
Speaker 3: for a fact that my father also died from cancer,

869
00:52:56,320 --> 00:52:59,759
Speaker 3: and both my mother and my father did not necessarily

870
00:52:59,840 --> 00:53:02,720
Speaker 3: go to the best places and didn't get the best device,

871
00:53:03,320 --> 00:53:06,719
Speaker 3: and they listened only to one doctor who wasn't necessarily

872
00:53:06,719 --> 00:53:10,280
Speaker 3: giving them the best device. And so I think sometimes

873
00:53:10,320 --> 00:53:13,360
Speaker 3: as African Americans were scared and we live by fear.

874
00:53:14,000 --> 00:53:16,359
Speaker 3: And so I also am a minister in a church,

875
00:53:16,719 --> 00:53:18,520
Speaker 3: and so I talk about it in the church.

876
00:53:18,680 --> 00:53:21,680
Speaker 1: I was going to say, Black churches to me, would

877
00:53:21,680 --> 00:53:23,839
Speaker 1: be a great place to spread the word.

878
00:53:23,920 --> 00:53:26,200
Speaker 2: Maybe you could travel around to a bunch of.

879
00:53:26,880 --> 00:53:31,160
Speaker 3: So I've been motivational speaking on this topic, and it's

880
00:53:31,200 --> 00:53:33,319
Speaker 3: really about the fact that and when I said it

881
00:53:33,320 --> 00:53:36,279
Speaker 3: at church, all these older women came up to me, go,

882
00:53:36,480 --> 00:53:39,960
Speaker 3: I had breast cancer, And I'm like, I've been sent

883
00:53:40,080 --> 00:53:43,600
Speaker 3: up here, y'all to tell me, Like I was trying

884
00:53:43,600 --> 00:53:45,320
Speaker 3: to figure out if I get a tattoo, no nipples,

885
00:53:45,320 --> 00:53:47,359
Speaker 3: all these things I had questions about, and y'all sitting

886
00:53:47,360 --> 00:53:49,480
Speaker 3: here and y'all knew I was having a double mis actomy.

887
00:53:49,480 --> 00:53:50,239
Speaker 2: You don't want to tell me.

888
00:53:51,360 --> 00:53:54,799
Speaker 3: But I think that the more I've been comfortable with

889
00:53:54,840 --> 00:53:57,319
Speaker 3: it and I've been sharing, I had surgery yesterday, by

890
00:53:57,360 --> 00:54:02,040
Speaker 3: the way, but I'm telling every I'm on the ones app.

891
00:54:02,200 --> 00:54:02,880
Speaker 2: I'm not only.

892
00:54:02,880 --> 00:54:05,400
Speaker 3: Instagram because I don't know how to do social media,

893
00:54:05,640 --> 00:54:08,839
Speaker 3: but I'm sharing, And I think taking the stigma out

894
00:54:08,880 --> 00:54:12,719
Speaker 3: of it, taking the fear out of it not being.

895
00:54:12,920 --> 00:54:17,799
Speaker 1: And also having a sense of humor clean breaks I

896
00:54:17,840 --> 00:54:19,800
Speaker 1: think that breaks the ice for people.

897
00:54:19,960 --> 00:54:21,719
Speaker 3: It really does, because I told everyone I had to

898
00:54:21,719 --> 00:54:24,799
Speaker 3: have emergency surgery yesterday, and I told everyone's because I

899
00:54:24,800 --> 00:54:27,000
Speaker 3: only had cancer in my right breast and my left

900
00:54:27,000 --> 00:54:28,920
Speaker 3: breast was fine, So my left breast got mad at

901
00:54:28,960 --> 00:54:31,000
Speaker 3: me for cutting it off. And then I wound up

902
00:54:31,000 --> 00:54:34,160
Speaker 3: getting an affection, so I had to take take care

903
00:54:34,160 --> 00:54:38,000
Speaker 3: of it yesterday. So but I have decided that I'm

904
00:54:38,040 --> 00:54:40,560
Speaker 3: going to laugh and I am going to enjoy it,

905
00:54:40,560 --> 00:54:42,279
Speaker 3: but I'm going to share, and I'm going to ask

906
00:54:42,320 --> 00:54:44,480
Speaker 3: people to go get their mammograms. I'm going to ask

907
00:54:44,560 --> 00:54:48,160
Speaker 3: them to have opinions, to do the research, do their homework,

908
00:54:48,320 --> 00:54:51,520
Speaker 3: get the genetic testing. And also, don't be afraid to

909
00:54:51,640 --> 00:54:55,239
Speaker 3: share with your children. They've got a note too, You've

910
00:54:55,360 --> 00:54:57,040
Speaker 3: you know, like I think sometimes with parents we want

911
00:54:57,040 --> 00:54:59,280
Speaker 3: to love them and protect them and keep it to ourselves,

912
00:54:59,360 --> 00:55:02,600
Speaker 3: but we owe them to talk to them and to

913
00:55:02,719 --> 00:55:04,080
Speaker 3: share in our journey.

914
00:55:05,200 --> 00:55:05,960
Speaker 2: Before we go.

915
00:55:06,040 --> 00:55:08,760
Speaker 1: I want to ask you one question, Lisa, about the future,

916
00:55:08,880 --> 00:55:12,839
Speaker 1: because I've been reading obviously a lot about AI. Who

917
00:55:12,960 --> 00:55:16,960
Speaker 1: hasn't and now with the expanded use of AI when

918
00:55:17,040 --> 00:55:20,120
Speaker 1: it comes to things like screening and pathology, etc.

919
00:55:21,400 --> 00:55:23,279
Speaker 2: It's very exciting.

920
00:55:23,680 --> 00:55:28,520
Speaker 1: I know that I read that AI can make early

921
00:55:28,600 --> 00:55:33,480
Speaker 1: detection easier and that it can even be used to

922
00:55:33,680 --> 00:55:39,120
Speaker 1: predict who might actually be diagnosed with breast cancer before

923
00:55:39,200 --> 00:55:43,360
Speaker 1: they even exhibit any symptoms, which is mind boggling to me.

924
00:55:43,800 --> 00:55:46,160
Speaker 1: Can you talk a little bit about how you see

925
00:55:46,200 --> 00:55:48,760
Speaker 1: the role of AI changing your field.

926
00:55:49,120 --> 00:55:51,920
Speaker 4: Oh, it's the enormous, Katie.

927
00:55:52,200 --> 00:55:55,920
Speaker 5: Yes, AI holds great promise in being able to improve

928
00:55:56,200 --> 00:56:00,239
Speaker 5: breast cancer outcomes. And as you mentioned with mammograms for example,

929
00:56:00,800 --> 00:56:05,040
Speaker 5: wouldn't it be incredible if, based upon a screening mammogram

930
00:56:05,080 --> 00:56:08,120
Speaker 5: and a woman that's totally healthy, if we could predict

931
00:56:08,200 --> 00:56:10,640
Speaker 5: the thirteen percent of the women in this country that

932
00:56:10,719 --> 00:56:14,640
Speaker 5: are destined to develop breast cancer and then prevent.

933
00:56:14,480 --> 00:56:16,080
Speaker 4: The cancer from developing in them.

934
00:56:16,640 --> 00:56:21,680
Speaker 5: And this is the promise of the artificial intelligence algorithms.

935
00:56:21,680 --> 00:56:23,840
Speaker 5: Now we're not quite there yet, but that is the

936
00:56:23,920 --> 00:56:28,720
Speaker 5: direction that we're going in. And artificial intelligence big data

937
00:56:28,800 --> 00:56:32,200
Speaker 5: algorithms are very useful in being able to evaluate and

938
00:56:32,239 --> 00:56:38,360
Speaker 5: read pathology biopsy specimens. But just as AI holds incredible promise,

939
00:56:38,920 --> 00:56:43,680
Speaker 5: it also holds great risks and if we don't do

940
00:56:43,760 --> 00:56:47,880
Speaker 5: it right, we're going to worsen the disparities that already exist.

941
00:56:48,400 --> 00:56:52,600
Speaker 5: If we develop these AI algorithms based upon data from

942
00:56:52,920 --> 00:56:58,440
Speaker 5: limited populations skinny women, women that are more affluent, women

943
00:56:58,480 --> 00:57:03,320
Speaker 5: with only European ancest we're going to be very limited

944
00:57:03,360 --> 00:57:05,799
Speaker 5: in what we can learn from these algorithms and we're

945
00:57:05,800 --> 00:57:08,360
Speaker 5: going to worsen some of the disparities that already exist.

946
00:57:08,440 --> 00:57:09,880
Speaker 2: That's such an important point.

947
00:57:09,960 --> 00:57:13,680
Speaker 1: Do you think that the tech world is mindful of

948
00:57:13,760 --> 00:57:18,160
Speaker 1: that as they start developing these tools, because I feel

949
00:57:18,160 --> 00:57:22,400
Speaker 1: like the word is out that these disparities exist and

950
00:57:22,440 --> 00:57:26,400
Speaker 1: that the large language models, whatever you call them, really

951
00:57:26,480 --> 00:57:28,480
Speaker 1: have to include a diverse population.

952
00:57:29,120 --> 00:57:29,960
Speaker 4: Yeah.

953
00:57:30,240 --> 00:57:35,800
Speaker 5: I hope that they are robustly aware of these risks,

954
00:57:36,160 --> 00:57:40,200
Speaker 5: but I'm not too sure because unfortunately, they often end

955
00:57:40,280 --> 00:57:44,000
Speaker 5: up relying upon data sets that already exist, and these

956
00:57:44,080 --> 00:57:48,400
Speaker 5: pre existing data sets are frequently very limited in the

957
00:57:48,400 --> 00:57:51,400
Speaker 5: individuals that have contributed data. So we have to be

958
00:57:51,440 --> 00:57:54,560
Speaker 5: working together to generate new data sets that are more

959
00:57:54,600 --> 00:57:58,240
Speaker 5: broadly inclusive of women that live in different environments, the

960
00:57:58,440 --> 00:58:01,400
Speaker 5: women that consume different types of diets, women that have

961
00:58:01,480 --> 00:58:03,200
Speaker 5: different ancestral backgrounds.

962
00:58:04,520 --> 00:58:06,800
Speaker 4: These data sets have to be generated de novo.

963
00:58:07,240 --> 00:58:08,640
Speaker 2: Yeah, such a good point.

964
00:58:08,920 --> 00:58:12,680
Speaker 1: Well, Sharon Joseph and doctor Lisa Newman, you both are

965
00:58:12,760 --> 00:58:16,040
Speaker 1: such rock stars. Thank you so much for such an

966
00:58:16,080 --> 00:58:22,000
Speaker 1: important informative conversation about breast cancer for Breast Cancer Awareness Month.

967
00:58:22,040 --> 00:58:25,320
Speaker 1: Thank you for the research you're doing, Sharon, thank you

968
00:58:25,400 --> 00:58:29,439
Speaker 1: for your advocacy, and everyone here. Thank you for being

969
00:58:29,480 --> 00:58:32,160
Speaker 1: a part of this conversation. I hope you'll go out

970
00:58:32,200 --> 00:58:34,880
Speaker 1: and spread the word to all of your friends and

971
00:58:34,960 --> 00:58:35,880
Speaker 1: family members.

972
00:58:35,960 --> 00:58:39,120
Speaker 2: So thank you, thank you, and thank.

973
00:58:38,920 --> 00:58:43,560
Speaker 4: You for being so fabulous. Your sake so many lives.

974
00:58:43,240 --> 00:58:47,080
Speaker 5: Katie, just by being who you are.

975
00:58:56,160 --> 00:58:59,360
Speaker 1: Thanks for listening everyone. If you have a question for me,

976
00:59:00,040 --> 00:59:02,320
Speaker 1: object you want us to cover, or you want to

977
00:59:02,360 --> 00:59:05,640
Speaker 1: share your thoughts about how you navigate this crazy world

978
00:59:06,000 --> 00:59:08,920
Speaker 1: reach out. You can leave a short message at six

979
00:59:09,040 --> 00:59:12,600
Speaker 1: oh nine five P one two five five five, or

980
00:59:12,640 --> 00:59:15,240
Speaker 1: you can send me a DM on Instagram. I would

981
00:59:15,280 --> 00:59:18,320
Speaker 1: love to hear from you. Next Question is a production

982
00:59:18,440 --> 00:59:22,920
Speaker 1: of iHeartMedia and Katie Couric Media. The executive producers are Me,

983
00:59:23,240 --> 00:59:27,880
Speaker 1: Katie Kuric, and Courtney Ltz. Our supervising producer is Ryan Martz,

984
00:59:28,400 --> 00:59:33,240
Speaker 1: and our producers are Adriana Fazzio and Meredith Barnes. Julian

985
00:59:33,280 --> 00:59:38,400
Speaker 1: Weller composed our theme music. For more information about today's episode,

986
00:59:38,600 --> 00:59:40,959
Speaker 1: or to sign up for my newsletter wake Up Call,

987
00:59:41,440 --> 00:59:44,280
Speaker 1: go to the description in the podcast app or visit

988
00:59:44,440 --> 00:59:47,600
Speaker 1: us at Katiecuric dot com. You can also find me

989
00:59:47,680 --> 00:59:51,400
Speaker 1: on Instagram and all my social media channels. For more

990
00:59:51,480 --> 00:59:56,800
Speaker 1: podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or

991
00:59:56,840 --> 01:00:02,040
Speaker 1: wherever you listen to your favorite shows. Hi everyone, it's

992
01:00:02,120 --> 01:00:04,400
Speaker 1: Katie Couric. I'd like to talk to you for a

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