1 00:00:03,279 --> 00:00:07,320 Speaker 1: Welcome everyone to the Amy and TJ Podcast. It is 2 00:00:08,039 --> 00:00:10,840 Speaker 1: a very special month. It is October, and that means 3 00:00:10,840 --> 00:00:14,960 Speaker 1: it is Breast Cancer Awareness Month. And it's an important 4 00:00:14,960 --> 00:00:17,759 Speaker 1: month because, first of all, it's time to honor those 5 00:00:17,800 --> 00:00:21,160 Speaker 1: who have been treated for breast cancer. It's time to 6 00:00:21,239 --> 00:00:24,560 Speaker 1: honor those who are fighting cancer who have metastatic breast cancer. 7 00:00:25,160 --> 00:00:28,760 Speaker 1: And almost as important, it's time to raise awareness, to 8 00:00:28,800 --> 00:00:33,040 Speaker 1: continue to raise awareness about early detection, about reminding women 9 00:00:33,400 --> 00:00:37,200 Speaker 1: to make those appointments with their ogyns, to get those 10 00:00:37,240 --> 00:00:41,160 Speaker 1: mammograms scheduled, and to show up for the actual appointment. 11 00:00:41,880 --> 00:00:44,560 Speaker 1: And just to remind everyone, breast cancer is the most 12 00:00:44,600 --> 00:00:48,199 Speaker 1: commonly diagnosed cancer in women in the United States. A 13 00:00:48,280 --> 00:00:52,640 Speaker 1: woman in this country is diagnosed every two minutes, and 14 00:00:52,760 --> 00:00:57,000 Speaker 1: great strides have been made with breast cancer research and 15 00:00:57,040 --> 00:01:00,200 Speaker 1: certainly in treating women and men with this disease, but 16 00:01:00,240 --> 00:01:02,360 Speaker 1: there is still so much more to do because breast 17 00:01:02,360 --> 00:01:06,240 Speaker 1: cancer remains the leading cause of cancer death in American women. 18 00:01:06,360 --> 00:01:10,720 Speaker 1: And so to get all the latest information on where 19 00:01:10,720 --> 00:01:13,800 Speaker 1: we are with this disease, on the research being done, 20 00:01:14,000 --> 00:01:18,320 Speaker 1: and what you can do to prevent breast cancer, or 21 00:01:18,520 --> 00:01:20,840 Speaker 1: at the very least, if you've been a patient, or 22 00:01:20,880 --> 00:01:22,959 Speaker 1: you are currently fighting it or someone you know, is 23 00:01:23,360 --> 00:01:26,320 Speaker 1: what you can do to live a better life, a 24 00:01:26,319 --> 00:01:30,480 Speaker 1: healthier life, and prevent recurrence and for all of that 25 00:01:30,640 --> 00:01:33,520 Speaker 1: very important information. TJ and I are so excited to 26 00:01:33,680 --> 00:01:39,039 Speaker 1: welcome my personal oncologist. She's a star at NYU, doctor 27 00:01:39,120 --> 00:01:42,680 Speaker 1: Ruth Ratz. Thank you so much for being with us. 28 00:01:43,280 --> 00:01:46,959 Speaker 2: Amy and Tji am really really happy to be back 29 00:01:46,959 --> 00:01:49,480 Speaker 2: with you in the studio. I always love seeing you 30 00:01:49,640 --> 00:01:50,720 Speaker 2: and especially here. 31 00:01:51,680 --> 00:01:53,800 Speaker 1: Thank you Ruth and doctor Ratz. You know, I think 32 00:01:53,880 --> 00:01:57,320 Speaker 1: some people roll their eyes up Breast Cancer Awareness Month, 33 00:01:57,360 --> 00:02:00,680 Speaker 1: the pink ribbons. This is so much more than just 34 00:02:00,680 --> 00:02:03,920 Speaker 1: this month, But can you explain why this month is 35 00:02:04,040 --> 00:02:06,480 Speaker 1: actually truly important. 36 00:02:07,080 --> 00:02:13,320 Speaker 2: This month is really really important because it represents what 37 00:02:13,680 --> 00:02:17,240 Speaker 2: women did in the late nineteen seventies and in the 38 00:02:17,320 --> 00:02:22,320 Speaker 2: nineteen eighties to really speak out and say to the 39 00:02:22,360 --> 00:02:26,160 Speaker 2: medical profession and to all of the sort of public 40 00:02:26,200 --> 00:02:31,800 Speaker 2: health officials out there, breast cancer is the single most 41 00:02:31,840 --> 00:02:36,000 Speaker 2: important cancer that affects women. A lot of people get it, 42 00:02:36,520 --> 00:02:40,880 Speaker 2: and we want to have more information and we want 43 00:02:40,919 --> 00:02:43,919 Speaker 2: to have a say about what happens with our treatment. 44 00:02:45,000 --> 00:02:48,200 Speaker 2: So in the nineteen seventies, when My mother was diagnosed 45 00:02:48,200 --> 00:02:51,760 Speaker 2: with breast cancer in her forties because she felt a 46 00:02:51,800 --> 00:02:54,880 Speaker 2: little lump in her breast. No screening, mammogram or anything 47 00:02:54,919 --> 00:03:00,000 Speaker 2: like that. She went to her doctor. She was admitted 48 00:03:00,200 --> 00:03:04,440 Speaker 2: to the hospital and the surgeon came in and said, 49 00:03:05,840 --> 00:03:07,480 Speaker 2: missus aur so, I'm going to take you to the 50 00:03:07,480 --> 00:03:11,320 Speaker 2: operating room and we're going to remove the lump. If 51 00:03:11,360 --> 00:03:16,079 Speaker 2: it's cancerous, I have to do a mestectomy. If it's 52 00:03:16,120 --> 00:03:18,760 Speaker 2: not cancer, you'll wake up and everything will be great. 53 00:03:20,040 --> 00:03:23,360 Speaker 2: So she signed on the dotted line. They put it 54 00:03:23,360 --> 00:03:26,200 Speaker 2: her sleep in the operating room, and she woke up 55 00:03:26,320 --> 00:03:30,880 Speaker 2: alone in the recovery room, put her hand on her chest, 56 00:03:30,919 --> 00:03:34,960 Speaker 2: felt that huge bandage, and that's how she figured out 57 00:03:35,000 --> 00:03:40,360 Speaker 2: she had cancer. Wow, a lot has changed since then, 58 00:03:40,400 --> 00:03:44,000 Speaker 2: but that is a chilling, chilling story. Yeah. So you know, 59 00:03:44,200 --> 00:03:45,760 Speaker 2: a good friend of mine wrote a book called The 60 00:03:45,760 --> 00:03:49,040 Speaker 2: Breast Cancer Wars, doctor barn learn her same thing happened 61 00:03:49,080 --> 00:03:52,160 Speaker 2: to his mother, And the women's movement said, hey, wait 62 00:03:52,200 --> 00:03:54,080 Speaker 2: a second, no, no, no, no, you can't do this 63 00:03:54,160 --> 00:03:58,120 Speaker 2: to us anymore, and then the doctors and scientists started listening. 64 00:03:59,400 --> 00:04:03,400 Speaker 2: It was it is now illegal in New York State 65 00:04:03,480 --> 00:04:07,120 Speaker 2: and pretty much everywhere else to do surgery for cancer 66 00:04:07,160 --> 00:04:11,040 Speaker 2: without first doing a biopsy and having a conversation with 67 00:04:11,120 --> 00:04:14,000 Speaker 2: that woman. And this was only you know, this is 68 00:04:14,040 --> 00:04:17,120 Speaker 2: the nineteen seventies. It's not that long ago, and we 69 00:04:17,200 --> 00:04:19,720 Speaker 2: certainly have made great strides. And I didn't know that 70 00:04:19,839 --> 00:04:23,440 Speaker 2: story about your mom doctr Ratsky at all, and has 71 00:04:23,440 --> 00:04:25,839 Speaker 2: that motivated you in so many ways I can only 72 00:04:25,880 --> 00:04:30,000 Speaker 2: imagine as an oncologist. Yeah, of course. I mean I 73 00:04:30,120 --> 00:04:32,640 Speaker 2: was in college and I remember my dad calling me. 74 00:04:32,760 --> 00:04:34,359 Speaker 2: I was on my way home for spring break and 75 00:04:34,400 --> 00:04:37,760 Speaker 2: he called and said, okay, I'll pick you up at 76 00:04:37,760 --> 00:04:39,760 Speaker 2: the station. I came down from Boston to you know, 77 00:04:39,800 --> 00:04:41,720 Speaker 2: took the train to Penn station. He picked me up 78 00:04:41,720 --> 00:04:44,240 Speaker 2: and we're heading uptown. I thought he's taking me out 79 00:04:44,279 --> 00:04:47,200 Speaker 2: to dinner. Next thing, I know, like the taxi cab 80 00:04:47,279 --> 00:04:49,960 Speaker 2: pulls up in front of a hospital. I said, well, 81 00:04:50,000 --> 00:04:52,320 Speaker 2: wait a second, like what's going on here? And that's 82 00:04:52,320 --> 00:04:53,640 Speaker 2: when I went up and saw my mom in the 83 00:04:53,680 --> 00:04:54,920 Speaker 2: hospital after the surgery. 84 00:04:55,279 --> 00:04:55,880 Speaker 1: My goodness. 85 00:04:56,000 --> 00:04:58,880 Speaker 2: Yeah. So yes, of course I knew I wanted to 86 00:04:58,920 --> 00:05:00,920 Speaker 2: be a doctor, but I think that kind of sealed 87 00:05:01,000 --> 00:05:03,360 Speaker 2: where I was headed in my career. 88 00:05:03,560 --> 00:05:05,839 Speaker 1: That makes a lot of sense, a lot of sense. 89 00:05:05,880 --> 00:05:12,320 Speaker 1: So this month now some what fifty years later, do 90 00:05:12,440 --> 00:05:17,200 Speaker 1: you see a rise in breast cancer diagnoses this month 91 00:05:17,240 --> 00:05:20,280 Speaker 1: because women are reminded to come in and get their mammograms, 92 00:05:20,279 --> 00:05:22,719 Speaker 1: and so then more women are actually diagnosed this month 93 00:05:22,760 --> 00:05:23,240 Speaker 1: than others. 94 00:05:23,600 --> 00:05:26,480 Speaker 2: Yes, Actually we do see that variation during the course 95 00:05:26,520 --> 00:05:28,680 Speaker 2: of the year, and I think it's fantastic that we 96 00:05:28,760 --> 00:05:31,839 Speaker 2: have breast cancer Awareness Month. People do go in and 97 00:05:31,880 --> 00:05:34,840 Speaker 2: schedule their tests. We don't get that many diagnoses over 98 00:05:34,839 --> 00:05:38,520 Speaker 2: the summer, everyone's on vacation. But back to school, Breast 99 00:05:38,520 --> 00:05:42,599 Speaker 2: Cancer Awareness Month. Make your checkup appointments, go in, get tested, 100 00:05:42,640 --> 00:05:43,840 Speaker 2: and if you need us, we're here. 101 00:05:44,360 --> 00:05:46,320 Speaker 1: Yeah, you are there. You were there for me, and 102 00:05:46,360 --> 00:05:49,320 Speaker 1: you still are here for me. In terms of where 103 00:05:49,320 --> 00:05:52,680 Speaker 1: we are with getting the mammogram, there are different options. 104 00:05:52,680 --> 00:05:55,040 Speaker 1: Now we've talked about these before, but I'm seeing more 105 00:05:55,120 --> 00:05:59,280 Speaker 1: and more evidence that three D mammograms are the gold standard, 106 00:05:59,320 --> 00:06:01,680 Speaker 1: and yet they're not available to everyone. Tell us a 107 00:06:01,720 --> 00:06:04,560 Speaker 1: little bit about where we are on mammogram technology and 108 00:06:05,000 --> 00:06:07,279 Speaker 1: what women should be able to ask for. 109 00:06:08,320 --> 00:06:12,000 Speaker 2: You're right, Amy, the technology in imaging has really really 110 00:06:12,080 --> 00:06:15,760 Speaker 2: changed over the years, Even just the mammogram technology mammogram 111 00:06:15,800 --> 00:06:18,680 Speaker 2: is just an X ray of the breast, and as 112 00:06:18,760 --> 00:06:22,680 Speaker 2: anyone who's had it done knows, you get kind of 113 00:06:22,720 --> 00:06:26,120 Speaker 2: squished between these plates so that the X ray can 114 00:06:26,279 --> 00:06:29,279 Speaker 2: actually compress the tissue and give us an image of 115 00:06:29,320 --> 00:06:32,480 Speaker 2: what's going on in the breast tissue if the tissue 116 00:06:32,520 --> 00:06:36,599 Speaker 2: is very dense, and that's more common in younger women, 117 00:06:37,080 --> 00:06:39,960 Speaker 2: because as we get older that breast density, the breast 118 00:06:39,960 --> 00:06:43,800 Speaker 2: tissue itself becomes a little less active, and really the 119 00:06:43,800 --> 00:06:47,800 Speaker 2: breast is fundamentally made of fat, and that's easy to 120 00:06:47,839 --> 00:06:50,800 Speaker 2: see little spots and dotson, But when the breast tissue 121 00:06:50,839 --> 00:06:54,360 Speaker 2: is active in younger women, more proliferative, sometimes it's hard 122 00:06:54,360 --> 00:06:58,760 Speaker 2: to see stuff. So by improving our technology with two 123 00:06:58,880 --> 00:07:07,120 Speaker 2: D and then three imaging and adding computer assisted detection, 124 00:07:07,240 --> 00:07:09,920 Speaker 2: which we've had for a long time now, several years, 125 00:07:10,400 --> 00:07:15,160 Speaker 2: and layering on top of that even more intelligence, both 126 00:07:15,240 --> 00:07:19,720 Speaker 2: the doctor's intelligence but artificial intelligence, adding that in where 127 00:07:19,720 --> 00:07:24,240 Speaker 2: our computers can help us see through the background noise 128 00:07:24,360 --> 00:07:26,720 Speaker 2: and say here's something we really should pay attention to 129 00:07:26,760 --> 00:07:31,280 Speaker 2: on the mammogram, and then the radiologist might say we 130 00:07:31,280 --> 00:07:34,440 Speaker 2: should also add an ultrasound sonogram of the breast or 131 00:07:34,480 --> 00:07:39,320 Speaker 2: maybe this person also needs an MRI. So it's very individualized. 132 00:07:39,400 --> 00:07:40,720 Speaker 2: It's not one size fits all. 133 00:07:42,080 --> 00:07:45,520 Speaker 1: And you mentioned dense breast tissue. I was just reading 134 00:07:45,520 --> 00:07:49,280 Speaker 1: and I realized just this month a new regulation is 135 00:07:49,320 --> 00:07:54,960 Speaker 1: actually in place September tenth, they now have new regulations 136 00:07:55,440 --> 00:08:00,160 Speaker 1: which allow patients or empower patients, I should say, with 137 00:08:00,200 --> 00:08:02,400 Speaker 1: the information that they need to make an informed decision 138 00:08:02,440 --> 00:08:06,679 Speaker 1: about breast cancer screening based on their breast density. Now 139 00:08:06,800 --> 00:08:10,080 Speaker 1: it actually will show on your mimography report if you 140 00:08:10,280 --> 00:08:13,120 Speaker 1: have dense breast tissue, and a lot of women don't 141 00:08:13,120 --> 00:08:16,120 Speaker 1: realize that they have it. Why is that significant? 142 00:08:17,000 --> 00:08:20,360 Speaker 2: You're right Amy that that's now going to be regulated. 143 00:08:20,400 --> 00:08:22,840 Speaker 2: I think more and more across the country. We've been 144 00:08:22,840 --> 00:08:25,600 Speaker 2: doing it in New York State for a while. It's 145 00:08:25,720 --> 00:08:29,760 Speaker 2: very important because if the breast tissue is dense, we 146 00:08:29,840 --> 00:08:33,520 Speaker 2: may need to add that other modality, whether it's ultrasound 147 00:08:33,640 --> 00:08:38,119 Speaker 2: or MRI. And don't forget the clinical exam because sometimes 148 00:08:38,160 --> 00:08:41,440 Speaker 2: we see something or feel something that doesn't show up 149 00:08:41,440 --> 00:08:43,920 Speaker 2: on imaging. So we kind of need to do a 150 00:08:43,960 --> 00:08:44,840 Speaker 2: little bit of everything. 151 00:08:45,840 --> 00:08:48,360 Speaker 1: And how do you know as a patient what you 152 00:08:48,440 --> 00:08:51,040 Speaker 1: can ask for, what your insurance will cover. I mean, 153 00:08:51,120 --> 00:08:54,320 Speaker 1: so much of this has to do with accessibility. It's 154 00:08:54,320 --> 00:08:57,679 Speaker 1: about information and knowing your rights, but also knowing what 155 00:08:57,720 --> 00:08:59,720 Speaker 1: you have to pay for and what right your insurance 156 00:08:59,760 --> 00:09:01,560 Speaker 1: come we'll be willing to pay for. 157 00:09:02,160 --> 00:09:04,600 Speaker 2: I think the best thing is for each person to 158 00:09:04,640 --> 00:09:08,800 Speaker 2: have a dialogue with her doctor. If it's the obg 159 00:09:09,000 --> 00:09:12,120 Speaker 2: i N, they're usually pretty well informed and can talk 160 00:09:12,160 --> 00:09:15,280 Speaker 2: to the breast imaging center the radiologist about well, what's 161 00:09:15,320 --> 00:09:18,960 Speaker 2: going to be best for this patient. If it's a 162 00:09:18,960 --> 00:09:21,480 Speaker 2: primary care doctor and they may not be as well 163 00:09:21,600 --> 00:09:24,960 Speaker 2: informed about those options, then have your patient go for 164 00:09:25,000 --> 00:09:27,880 Speaker 2: a consultation and speak to the radiologist or speak to 165 00:09:27,920 --> 00:09:30,520 Speaker 2: the obg i N about what the best exam is. 166 00:09:31,160 --> 00:09:33,040 Speaker 1: Yeah, you have to know your rights and then use 167 00:09:33,040 --> 00:09:35,240 Speaker 1: your voice, right, Yeah, that's a huge part of it. 168 00:09:35,840 --> 00:09:38,959 Speaker 1: This has been a big troubling trend. Yes, we've had 169 00:09:39,040 --> 00:09:42,240 Speaker 1: great strides made in keeping women alive for those first 170 00:09:42,280 --> 00:09:46,560 Speaker 1: five years. It's ninety nine percent correct survivor survivor rate. 171 00:09:46,640 --> 00:09:50,640 Speaker 1: That's phenomenal, and yet we're seeing more and more, in 172 00:09:50,720 --> 00:09:55,880 Speaker 1: a fairly alarming rate, women under fifty getting breast cancer. 173 00:09:56,640 --> 00:10:01,840 Speaker 2: Do doctors know why? I'm really concerned about that. We 174 00:10:02,000 --> 00:10:06,200 Speaker 2: have seen a trend that more young women are getting diagnosed, 175 00:10:07,520 --> 00:10:09,400 Speaker 2: So we have to ask the question, is it because 176 00:10:09,440 --> 00:10:14,120 Speaker 2: more young women are getting screened. Maybe we're picking up 177 00:10:14,160 --> 00:10:16,480 Speaker 2: little things and people who are a little younger because 178 00:10:16,480 --> 00:10:19,559 Speaker 2: they're coming in in their early forties to get that screening. 179 00:10:19,960 --> 00:10:22,640 Speaker 2: But I'm seeing patients even in their thirties and sometimes 180 00:10:22,760 --> 00:10:27,240 Speaker 2: late twenties more than we used to see. One factor 181 00:10:27,600 --> 00:10:32,120 Speaker 2: is that the genetic mutations that can increase the risk 182 00:10:32,160 --> 00:10:35,559 Speaker 2: of getting breast cancer. People have heard of the BRCA mutations, 183 00:10:35,960 --> 00:10:40,160 Speaker 2: and there are other ones check two, rip one, a 184 00:10:40,200 --> 00:10:42,880 Speaker 2: whole bunch of new genes that we know about. But 185 00:10:42,960 --> 00:10:47,880 Speaker 2: what we're seeing is with each generation, the women getting 186 00:10:47,920 --> 00:10:51,080 Speaker 2: breast cancer are also getting younger and younger, and we're 187 00:10:51,080 --> 00:10:54,360 Speaker 2: not really sure what that's all about. May have to 188 00:10:54,400 --> 00:10:58,160 Speaker 2: do with our environment and may have to do you know, 189 00:10:58,200 --> 00:11:00,559 Speaker 2: what we're eating and drinking, what we're being exposed to, 190 00:11:01,320 --> 00:11:18,800 Speaker 2: not sure. 191 00:11:10,800 --> 00:11:13,320 Speaker 1: To what you're saying right there. To that point, big 192 00:11:13,800 --> 00:11:16,920 Speaker 1: headlines this week specifically, or at least the past couple 193 00:11:16,920 --> 00:11:20,959 Speaker 1: of weeks that there's a new study out that links 194 00:11:21,360 --> 00:11:24,240 Speaker 1: not just the food but the food packaging that we're 195 00:11:24,240 --> 00:11:28,920 Speaker 1: all using to transfer our food to eat, our food 196 00:11:29,000 --> 00:11:34,040 Speaker 1: with to breast cancer carcinogens. Those are scary headlines and 197 00:11:34,080 --> 00:11:37,160 Speaker 1: seemingly impossible to deal with because what am I supposed 198 00:11:37,200 --> 00:11:41,760 Speaker 1: to do about how we package our food as a country, 199 00:11:43,160 --> 00:11:46,120 Speaker 1: And what would you say to women? What are we 200 00:11:46,200 --> 00:11:49,000 Speaker 1: supposed to do with these headlines and this information. It 201 00:11:49,040 --> 00:11:51,760 Speaker 1: feels like everything could be causing cancer or at least 202 00:11:51,960 --> 00:11:55,760 Speaker 1: creating these types of carcinogens. Well, I certainly think that 203 00:11:55,920 --> 00:11:59,600 Speaker 1: over the past fifty years we've seen a really, really 204 00:12:00,400 --> 00:12:07,000 Speaker 1: enormous change in the whole chain of food production, packaging, 205 00:12:07,080 --> 00:12:12,160 Speaker 1: and distribution in America and the developed world. So, you know, 206 00:12:12,200 --> 00:12:15,079 Speaker 1: when my mother was a little girl, everything was fresh, right, 207 00:12:15,120 --> 00:12:17,080 Speaker 1: You just bought the food for the day that you 208 00:12:17,120 --> 00:12:19,920 Speaker 1: were going to eat. By the time I was growing up, 209 00:12:19,960 --> 00:12:22,680 Speaker 1: we had supermarkets, but yeah, we were still buying stuff 210 00:12:22,880 --> 00:12:25,640 Speaker 1: pretty much that was fresh, and we didn't have so 211 00:12:25,760 --> 00:12:31,680 Speaker 1: much in the way of plastic packaging. And now kind 212 00:12:31,679 --> 00:12:36,160 Speaker 1: of everything is packaged either in styrofoam or plastic, and 213 00:12:36,200 --> 00:12:38,960 Speaker 1: then we're using plastic utensils and we're keeping it in 214 00:12:39,000 --> 00:12:44,000 Speaker 1: our fridge for who knows how long. We don't know 215 00:12:44,160 --> 00:12:48,200 Speaker 1: for sure the absolute cause and effect of that, but 216 00:12:48,320 --> 00:12:52,800 Speaker 1: it's really problematic. We're hearing about these forever chemicals which 217 00:12:52,840 --> 00:12:55,920 Speaker 1: are related to some of these plastic compounds. They stick 218 00:12:55,960 --> 00:12:59,240 Speaker 1: around in our bodies, they're hanging out in our oceans 219 00:12:59,280 --> 00:13:02,360 Speaker 1: as we're throwing all this plastic garbage into the oceans, 220 00:13:02,360 --> 00:13:05,440 Speaker 1: and they're getting into the animals. We also know that 221 00:13:05,480 --> 00:13:08,920 Speaker 1: the food is processed way more than it was, you know, 222 00:13:08,920 --> 00:13:13,319 Speaker 1: a few decades ago, so especially the animal proteins. Animals 223 00:13:13,360 --> 00:13:17,360 Speaker 1: are being fed with growth hormones and antibiotics and all 224 00:13:17,440 --> 00:13:20,080 Speaker 1: kinds of stuff just to fatten them up and get 225 00:13:20,080 --> 00:13:20,760 Speaker 1: more production. 226 00:13:21,920 --> 00:13:24,680 Speaker 2: But then in turn, we're eating that stuff and we're 227 00:13:24,720 --> 00:13:28,360 Speaker 2: getting exposed to the same antibiotics and the same hormones, 228 00:13:28,360 --> 00:13:32,120 Speaker 2: and that changes what's going on in our bodies metabolically, 229 00:13:32,440 --> 00:13:36,280 Speaker 2: and the microbiome, which you know you probably have heard about. Also, 230 00:13:36,360 --> 00:13:39,559 Speaker 2: those healthy bacteria that live in our body, well, they 231 00:13:39,600 --> 00:13:42,680 Speaker 2: get altered when they're exposed to some of these chemicals. 232 00:13:43,240 --> 00:13:46,120 Speaker 2: So there's a big chain reaction going on here. 233 00:13:47,000 --> 00:13:49,480 Speaker 3: Doctors. I haven't hypothetical, and I hope you take it 234 00:13:49,480 --> 00:13:51,160 Speaker 3: in the spirit in which it's intended here. I know 235 00:13:51,200 --> 00:13:53,760 Speaker 3: it's kind of crazy to think this way, but a 236 00:13:53,840 --> 00:13:57,360 Speaker 3: child born today. You have a daughter today, and you say, 237 00:13:57,400 --> 00:14:00,240 Speaker 3: I want to give her the best chance of not 238 00:14:00,280 --> 00:14:03,320 Speaker 3: getting breast cancer at any point in her life. What 239 00:14:04,160 --> 00:14:07,880 Speaker 3: could you do with that child? Feed that child, expose 240 00:14:07,920 --> 00:14:11,160 Speaker 3: that child to to give yourself the best chance? And 241 00:14:11,200 --> 00:14:14,080 Speaker 3: no matter what you do, sometimes are you just going 242 00:14:14,120 --> 00:14:16,200 Speaker 3: to be unlucky and nothing you can do about it? 243 00:14:16,559 --> 00:14:18,800 Speaker 2: TJ, You're right, I mean, how do we take control 244 00:14:18,800 --> 00:14:22,240 Speaker 2: over this? And what do we do? I think, you know, 245 00:14:22,360 --> 00:14:24,640 Speaker 2: just on the personal level, we can pay attention to 246 00:14:25,520 --> 00:14:29,360 Speaker 2: the kinds of foods we buy. It is a little 247 00:14:29,360 --> 00:14:32,760 Speaker 2: bit crazy that it costs more money to buy healthier 248 00:14:32,800 --> 00:14:37,400 Speaker 2: food than to buy junk food. So we've got to 249 00:14:37,480 --> 00:14:39,920 Speaker 2: address that as a nation and say, how can we 250 00:14:39,960 --> 00:14:42,480 Speaker 2: get people to have a healthier diet, not just in 251 00:14:42,560 --> 00:14:46,280 Speaker 2: terms of cancer, but even cardiovascular health. Everything, More fresh 252 00:14:46,280 --> 00:14:49,800 Speaker 2: fruits and vegetables into the diet, more fiber, less fat, 253 00:14:50,680 --> 00:14:55,080 Speaker 2: less junk food of course, less processed food, especially the 254 00:14:55,120 --> 00:15:00,560 Speaker 2: stuff coming from animal products, so dairy products, milk, eggs, cheese, 255 00:15:01,560 --> 00:15:04,960 Speaker 2: and then all the meat products chicken and fish, and 256 00:15:05,760 --> 00:15:08,520 Speaker 2: you know, beef, which we eat a lot of in America, 257 00:15:09,000 --> 00:15:12,120 Speaker 2: much more than in other places. So if you can 258 00:15:12,160 --> 00:15:15,680 Speaker 2: buy organic food where the animals are not fed all 259 00:15:15,760 --> 00:15:19,800 Speaker 2: those antibiotics and hormones. That's probably healthier. Same with the 260 00:15:19,920 --> 00:15:25,280 Speaker 2: dairy products, the eggs and the cheese and milk. I 261 00:15:25,320 --> 00:15:28,640 Speaker 2: think that probably long term might make a difference, hard 262 00:15:28,680 --> 00:15:33,040 Speaker 2: to say for sure. The other thing is just being 263 00:15:33,080 --> 00:15:38,400 Speaker 2: healthy in terms of not being obese, doing physical exercise, 264 00:15:39,800 --> 00:15:44,280 Speaker 2: not smoking, and not drinking excessive amounts of alcohol because 265 00:15:44,320 --> 00:15:45,640 Speaker 2: all of those things make us sick. 266 00:15:45,480 --> 00:15:49,240 Speaker 3: Too, and we need to just grow our own leafy 267 00:15:49,280 --> 00:15:52,240 Speaker 3: drinks in the backyard, eat those the rest of our life. 268 00:15:52,280 --> 00:15:53,880 Speaker 3: Don't leave the house, I think, is what you're saying, 269 00:15:53,880 --> 00:15:54,600 Speaker 3: and we should be fine. 270 00:15:54,680 --> 00:15:58,880 Speaker 1: Yeah, you know. And I also just I know some 271 00:15:58,960 --> 00:16:02,320 Speaker 1: women are scared. They don't want to know. It's like 272 00:16:02,400 --> 00:16:05,120 Speaker 1: ignorance is bliss. And obviously that is not a good 273 00:16:05,200 --> 00:16:09,840 Speaker 1: way to deal with a potential cancer diagnosis. Because people 274 00:16:09,880 --> 00:16:13,200 Speaker 1: are afraid of getting one, they avoid perhaps the tests altogether. 275 00:16:13,280 --> 00:16:18,720 Speaker 1: But early detection is absolutely the way to save lives 276 00:16:18,720 --> 00:16:20,240 Speaker 1: when it comes to breast cancer. And I was hoping 277 00:16:20,280 --> 00:16:22,000 Speaker 1: you could expound on that because I think some people 278 00:16:22,040 --> 00:16:24,280 Speaker 1: just think, well, I'll just kick the can down the 279 00:16:24,320 --> 00:16:25,080 Speaker 1: road to next year. 280 00:16:25,760 --> 00:16:30,080 Speaker 2: Don't do that. Early detection is still key. It's a very, 281 00:16:30,200 --> 00:16:34,280 Speaker 2: very very powerful tool that each woman can have to 282 00:16:34,360 --> 00:16:38,360 Speaker 2: take control over her own health. And I always tell 283 00:16:38,400 --> 00:16:41,520 Speaker 2: people that, you know, going for the mammogram doesn't prevent cancer, 284 00:16:41,840 --> 00:16:45,400 Speaker 2: but it could prevent you from dying from cancer. So 285 00:16:45,560 --> 00:16:49,040 Speaker 2: it's really really important if we find a small tumor, 286 00:16:49,160 --> 00:16:51,800 Speaker 2: even if it's an aggressive subtype, because not all breast 287 00:16:51,840 --> 00:16:54,600 Speaker 2: cancers are the same, lots of different kinds of breast cancer, 288 00:16:55,440 --> 00:17:01,040 Speaker 2: but we know that size in this situation still counts, 289 00:17:01,360 --> 00:17:04,000 Speaker 2: and if it's small and if it hasn't spread too far, 290 00:17:04,760 --> 00:17:08,040 Speaker 2: we usually have a much better chance of eradicating it 291 00:17:08,080 --> 00:17:11,200 Speaker 2: completely and eliminating those problems down the road. 292 00:17:11,400 --> 00:17:13,280 Speaker 3: Can you give us a good news in trends? We 293 00:17:13,320 --> 00:17:15,639 Speaker 3: always talk about we see younger women, that's troubling, and 294 00:17:15,680 --> 00:17:18,280 Speaker 3: all these troubling things. What's the good news you're seeing 295 00:17:18,280 --> 00:17:18,800 Speaker 3: in trends. 296 00:17:18,880 --> 00:17:22,080 Speaker 2: Yeah, the good news is our treatment's way better, way 297 00:17:22,119 --> 00:17:26,320 Speaker 2: better than it was, so we understand much more about 298 00:17:26,320 --> 00:17:31,720 Speaker 2: the biology of breast cancer. Basic science research is critically 299 00:17:31,760 --> 00:17:35,280 Speaker 2: important to pushing this field forward, So we have to 300 00:17:35,359 --> 00:17:39,520 Speaker 2: keep funding research in the laboratory where the scientists are 301 00:17:39,600 --> 00:17:43,520 Speaker 2: digging into those molecular mechanisms of why is that cell 302 00:17:43,600 --> 00:17:46,920 Speaker 2: turning into a cancer cell, what's making it grow, what's 303 00:17:46,960 --> 00:17:49,880 Speaker 2: making it travel, what's making it spread? And now our 304 00:17:49,920 --> 00:17:53,600 Speaker 2: therapies are more and more targeted to the type of 305 00:17:53,640 --> 00:17:57,000 Speaker 2: breast cancer that someone has, and they work better. The 306 00:17:57,040 --> 00:17:59,920 Speaker 2: treatments are more effective. We can learn to turn on, 307 00:18:00,280 --> 00:18:02,760 Speaker 2: switch on, and off all those different pathways in the cell. 308 00:18:02,800 --> 00:18:06,280 Speaker 2: It's really really exciting. I've seen that change over the 309 00:18:06,280 --> 00:18:08,600 Speaker 2: course of my career, and I know there are people 310 00:18:08,640 --> 00:18:13,040 Speaker 2: alive and well who wouldn't have been when I first 311 00:18:13,080 --> 00:18:19,760 Speaker 2: went into practice, and that is the greatest, greatest joy 312 00:18:19,800 --> 00:18:20,760 Speaker 2: in my clinical work. 313 00:18:21,320 --> 00:18:22,960 Speaker 1: I would say that brings tears to my eyes just 314 00:18:23,000 --> 00:18:24,119 Speaker 1: to hear that, yeah, it's. 315 00:18:23,960 --> 00:18:28,480 Speaker 3: True, but to that, yes, the advancement's research, advancement's technology 316 00:18:28,480 --> 00:18:31,119 Speaker 3: advancements and treatment are is it going to be a 317 00:18:31,119 --> 00:18:34,800 Speaker 3: while though, before those advancements are going to show up 318 00:18:34,840 --> 00:18:37,480 Speaker 3: in those trends you talk about with Okay, not so 319 00:18:37,600 --> 00:18:40,240 Speaker 3: many young women are getting it anymore? Okay, not as many? 320 00:18:40,520 --> 00:18:41,600 Speaker 3: Is that showing up yet? 321 00:18:42,200 --> 00:18:46,120 Speaker 2: Well, I think we have reduced breast cancer mortality overall 322 00:18:46,720 --> 00:18:51,240 Speaker 2: in America, so we have seen that already in terms 323 00:18:51,320 --> 00:18:53,399 Speaker 2: of the causation thing. I think we have to do 324 00:18:53,440 --> 00:18:56,359 Speaker 2: a little more work there, but we're definitely doing better 325 00:18:56,400 --> 00:18:59,200 Speaker 2: on treatment for sure, Doctor Ortsa. 326 00:18:59,320 --> 00:19:02,720 Speaker 1: Anyone who's listening to this podcast, I'm sure is familiar 327 00:19:03,040 --> 00:19:07,320 Speaker 1: with our dear friend Morgan Mitchell, who is stage four metastatic. 328 00:19:07,640 --> 00:19:11,840 Speaker 1: She is going to be celebrating her seven year anniversary 329 00:19:12,320 --> 00:19:16,080 Speaker 1: come December. That also brings tears to my eyes and 330 00:19:16,119 --> 00:19:19,199 Speaker 1: gives me chills because that was unheard of not that 331 00:19:19,359 --> 00:19:22,200 Speaker 1: long ago, or at least in recent history. Where are 332 00:19:22,240 --> 00:19:25,480 Speaker 1: we in terms of women who are living with stage 333 00:19:25,480 --> 00:19:28,520 Speaker 1: four and how they're living and how long they're. 334 00:19:28,359 --> 00:19:31,960 Speaker 2: Living, right, And that's where a lot of our research 335 00:19:32,080 --> 00:19:36,120 Speaker 2: starts in that stage four setting with people who have 336 00:19:36,240 --> 00:19:40,040 Speaker 2: advanced cancer, because the cancer is right there, so we 337 00:19:40,080 --> 00:19:42,879 Speaker 2: can see how the treatments are working, and we start there. 338 00:19:44,840 --> 00:19:47,320 Speaker 2: I lost a patient last week who was very, very 339 00:19:47,320 --> 00:19:50,280 Speaker 2: dear to me, but I took care of her for 340 00:19:50,280 --> 00:19:55,560 Speaker 2: twenty seven years wow, and the last ten of those 341 00:19:55,640 --> 00:19:59,639 Speaker 2: years she had metastatic breast cancer. But she lived a 342 00:19:59,680 --> 00:20:03,479 Speaker 2: good life with a really good quality of life. She 343 00:20:03,560 --> 00:20:06,000 Speaker 2: was able to work and continue her career and be 344 00:20:06,119 --> 00:20:10,000 Speaker 2: with her family and travel and enjoy herself, and it 345 00:20:10,040 --> 00:20:12,280 Speaker 2: was only at the very end in the last few 346 00:20:12,320 --> 00:20:16,520 Speaker 2: months where it got really rough, But that would never 347 00:20:16,560 --> 00:20:19,320 Speaker 2: have happened in the past. And that's because of all 348 00:20:19,400 --> 00:20:22,679 Speaker 2: of these new targeted therapies. Not only are they more effective, 349 00:20:23,080 --> 00:20:26,360 Speaker 2: but we really, really really work on trying to help 350 00:20:26,400 --> 00:20:30,719 Speaker 2: people live well and have a good quality of life 351 00:20:30,760 --> 00:20:34,359 Speaker 2: and do whatever we can to minimize side effects and 352 00:20:34,480 --> 00:20:39,120 Speaker 2: minimize the toxicity of our treatments. We're moving away from 353 00:20:39,119 --> 00:20:40,600 Speaker 2: some of the things we used to do all the 354 00:20:40,640 --> 00:20:43,119 Speaker 2: time because they were just too rough on people, and 355 00:20:43,160 --> 00:20:45,280 Speaker 2: now we have things that are working better. Now. I 356 00:20:45,280 --> 00:20:47,920 Speaker 2: can't tell you it's one hundred percent perfect, and I'm 357 00:20:47,960 --> 00:20:50,000 Speaker 2: not going to tell you that every treatment comes and 358 00:20:50,640 --> 00:20:53,400 Speaker 2: people feel fantastic. There are some side effects, there are 359 00:20:53,400 --> 00:20:56,919 Speaker 2: some tough things we have to go through, but it 360 00:20:57,040 --> 00:20:59,440 Speaker 2: is our mission to make sure that we keep doing 361 00:20:59,480 --> 00:21:02,080 Speaker 2: research to get this right and to do it better 362 00:21:02,080 --> 00:21:02,880 Speaker 2: and better and better. 363 00:21:11,760 --> 00:21:13,520 Speaker 3: Can you put in context of how rare that is 364 00:21:13,560 --> 00:21:15,200 Speaker 3: You talk about your patient that you took care of 365 00:21:15,200 --> 00:21:17,320 Speaker 3: for all that time and then Morgan seven years with 366 00:21:17,480 --> 00:21:20,720 Speaker 3: metastatic is do I have it right? I'm not overstating it. 367 00:21:20,760 --> 00:21:25,080 Speaker 3: That's these days not so unheard of, but that's pretty 368 00:21:25,119 --> 00:21:26,320 Speaker 3: rare for seven years. 369 00:21:26,400 --> 00:21:28,679 Speaker 2: Depends on the subtype of breast cancer. So there are 370 00:21:28,720 --> 00:21:32,000 Speaker 2: some subtypes where I certainly have patients with stage four 371 00:21:32,040 --> 00:21:35,800 Speaker 2: disease five, six, seven, eight, nine, ten years. I mean, 372 00:21:35,840 --> 00:21:39,320 Speaker 2: we're getting that's that's really happening. There are some other 373 00:21:39,400 --> 00:21:42,200 Speaker 2: subtypes of breast cancer that are tougher to treat, a 374 00:21:42,240 --> 00:21:45,760 Speaker 2: little bit more aggressive, and you know we're focusing our 375 00:21:45,760 --> 00:21:46,560 Speaker 2: efforts on those. 376 00:21:47,200 --> 00:21:50,879 Speaker 3: Can mindset, can attitude? Can just how you approach your 377 00:21:50,920 --> 00:21:53,679 Speaker 3: life after a metastatic diagnosis like that. I say this 378 00:21:53,760 --> 00:21:57,400 Speaker 3: because Morgan is the like the bubbliest, happiest person I've 379 00:21:57,400 --> 00:22:00,280 Speaker 3: ever been around ever, And I think when I met 380 00:22:00,280 --> 00:22:03,120 Speaker 3: her she'd already been diagnosed. I've only known her as 381 00:22:03,160 --> 00:22:08,040 Speaker 3: stage four. She runs half marathons, marathons, She's just this bubbly, 382 00:22:08,520 --> 00:22:11,720 Speaker 3: this ball of life all the time. Can that have 383 00:22:11,880 --> 00:22:14,800 Speaker 3: an impact staying active? Can you still? Can you prolong 384 00:22:14,800 --> 00:22:19,480 Speaker 3: your life? I guess by changing some things after metastatic diagnosis. 385 00:22:19,760 --> 00:22:22,919 Speaker 2: This may not be a scientific answer, but yes, I 386 00:22:23,000 --> 00:22:27,800 Speaker 2: believe that our heads are connected to our bodies, and 387 00:22:27,840 --> 00:22:29,919 Speaker 2: when we use the word heart, we're here in this 388 00:22:29,960 --> 00:22:32,959 Speaker 2: iHeart Studio we use the word heart. Yes, it's that 389 00:22:33,119 --> 00:22:35,399 Speaker 2: pump that makes the blood go around your body, but 390 00:22:35,400 --> 00:22:39,320 Speaker 2: it's also the seat of our emotions. So I think 391 00:22:39,400 --> 00:22:44,320 Speaker 2: these are powerful connections. Our heads and our hearts, everything 392 00:22:44,359 --> 00:22:47,040 Speaker 2: in our body is interconnected how we feel, how we 393 00:22:47,080 --> 00:22:50,440 Speaker 2: live our lives. If we can fill our lives with joy, 394 00:22:50,480 --> 00:22:54,879 Speaker 2: with hope, with love, and with trying to live in 395 00:22:55,040 --> 00:22:57,840 Speaker 2: as healthy a way as possible, make the most of 396 00:22:57,880 --> 00:23:02,639 Speaker 2: each day, be optimistic, maybe have some faith and whatever 397 00:23:02,680 --> 00:23:05,000 Speaker 2: that is. Yeah, I think it helps. Yeah. 398 00:23:06,720 --> 00:23:10,080 Speaker 1: So yes, Morgan is actually via Sarah get expecting she 399 00:23:10,119 --> 00:23:13,239 Speaker 1: and her husband are expecting a baby in January, and 400 00:23:13,400 --> 00:23:15,919 Speaker 1: talking about having a reason to live, a reason to 401 00:23:15,960 --> 00:23:17,679 Speaker 1: have a reason to keep fighting. 402 00:23:17,800 --> 00:23:20,280 Speaker 2: Got it? Now? She just got a big one, she 403 00:23:20,400 --> 00:23:23,480 Speaker 2: sure did, and it's going to be a very powerful, 404 00:23:23,960 --> 00:23:25,359 Speaker 2: very powerful factor for her. 405 00:23:25,760 --> 00:23:28,240 Speaker 1: I wanted to ask you about that, because you are 406 00:23:28,480 --> 00:23:31,240 Speaker 1: there in the rooms with these women who are fighting 407 00:23:31,280 --> 00:23:34,159 Speaker 1: for their lives. How big of a deal is and 408 00:23:34,160 --> 00:23:36,920 Speaker 1: how often are you seeing women who think all hope 409 00:23:37,000 --> 00:23:39,320 Speaker 1: is lost for starting that family. I was diagnosed at 410 00:23:39,320 --> 00:23:41,080 Speaker 1: forty I already had two little girls. It was still 411 00:23:41,160 --> 00:23:43,679 Speaker 1: devastating for me. I remember you told me you're out 412 00:23:43,680 --> 00:23:47,200 Speaker 1: of the baby making business. You have two beautiful, healthy girls. 413 00:23:47,560 --> 00:23:49,560 Speaker 1: You're one of the lucky ones. But how many women 414 00:23:49,640 --> 00:23:53,720 Speaker 1: now are actually getting the option and seeking that opportunity 415 00:23:53,800 --> 00:23:58,080 Speaker 1: to have a family in maybe a less conventional way, 416 00:23:58,119 --> 00:23:59,880 Speaker 1: but still having the option to do so. 417 00:24:00,640 --> 00:24:04,080 Speaker 2: Well, Amy, again, you hit it right right on the head, 418 00:24:04,119 --> 00:24:08,440 Speaker 2: because that's changed too, especially now with all of our 419 00:24:08,920 --> 00:24:13,440 Speaker 2: young patients. So before we start treatment in our young patients, 420 00:24:14,440 --> 00:24:17,720 Speaker 2: we have that conversation about fertility, whether they already have 421 00:24:17,840 --> 00:24:20,719 Speaker 2: children or don't have children, if they have a partner, 422 00:24:20,760 --> 00:24:22,959 Speaker 2: don't have a partner, But if someone wants to do 423 00:24:23,000 --> 00:24:26,320 Speaker 2: fertility preservation where we do a round or two of 424 00:24:26,600 --> 00:24:31,120 Speaker 2: harvesting eggs and then we can freeze them or get embryos, 425 00:24:31,560 --> 00:24:33,840 Speaker 2: make sure that we have that in the bank before 426 00:24:33,880 --> 00:24:37,560 Speaker 2: we do something that might reduce a person's fertility or 427 00:24:37,680 --> 00:24:42,480 Speaker 2: may delay the time to when she would have children. 428 00:24:42,880 --> 00:24:46,280 Speaker 2: I've lots and lots of patients who've had babies after 429 00:24:46,280 --> 00:24:51,840 Speaker 2: treatment for breast cancer. Sometimes they've carried the pregnancies. Sometimes 430 00:24:51,880 --> 00:24:55,560 Speaker 2: they've gotten pregnant without the assistance of using an embryo 431 00:24:55,760 --> 00:24:59,040 Speaker 2: or IVF. Sometimes we have to use a little more technology, 432 00:24:59,240 --> 00:25:02,560 Speaker 2: but we have all of great new technologies now for 433 00:25:03,080 --> 00:25:08,879 Speaker 2: fertility preservation and for getting those babies. Some of my 434 00:25:08,960 --> 00:25:11,720 Speaker 2: patients also have you surrogates, you know, like Morgan, and 435 00:25:12,320 --> 00:25:15,760 Speaker 2: the babies are beautiful, they're healthy, and the families are 436 00:25:15,800 --> 00:25:17,040 Speaker 2: just fantastic to see. 437 00:25:17,440 --> 00:25:20,040 Speaker 1: So I know, I know, I can't are saying that 438 00:25:20,080 --> 00:25:23,639 Speaker 1: more and more. I can't wait for January. According to 439 00:25:23,680 --> 00:25:27,840 Speaker 1: the World Health Organization, the theme for this month's Breast 440 00:25:27,840 --> 00:25:32,400 Speaker 1: Cancer Awareness Month is no one should face breast cancer alone. 441 00:25:32,600 --> 00:25:36,160 Speaker 1: How important is community? As a physician, what you witness 442 00:25:36,200 --> 00:25:39,760 Speaker 1: when women are diagnosed, How important is it for them 443 00:25:40,280 --> 00:25:41,760 Speaker 1: to have that support? 444 00:25:42,040 --> 00:25:44,840 Speaker 2: Well, you know, support when we're facing any kind of 445 00:25:44,880 --> 00:25:50,080 Speaker 2: adversity in life is so important and so helpful. And 446 00:25:50,119 --> 00:25:54,000 Speaker 2: everyone defines that differently. For some people it's having a 447 00:25:54,040 --> 00:25:58,080 Speaker 2: loving partner. For some people it's their children, their parents. 448 00:25:59,000 --> 00:26:02,280 Speaker 2: Not everyone has a family that's nearby. You know, we 449 00:26:02,720 --> 00:26:04,600 Speaker 2: move all over the place. We have a lot of 450 00:26:04,960 --> 00:26:06,960 Speaker 2: young single people who are here. I have a lot 451 00:26:06,960 --> 00:26:10,520 Speaker 2: of older women who you know, are kind of on 452 00:26:10,560 --> 00:26:13,840 Speaker 2: their own, so we have to help them find that 453 00:26:13,960 --> 00:26:17,359 Speaker 2: community in where they are in their space. And there's 454 00:26:17,359 --> 00:26:21,280 Speaker 2: so much variability across the country. Some people are geographically 455 00:26:22,040 --> 00:26:25,399 Speaker 2: far away from their loved ones. Other people are living 456 00:26:25,440 --> 00:26:27,920 Speaker 2: in apartment buildings where they have a close, tight knit 457 00:26:27,960 --> 00:26:31,080 Speaker 2: group of friends who are supporting them. So I think 458 00:26:31,119 --> 00:26:33,120 Speaker 2: when we sit down and talk to a person, when 459 00:26:33,160 --> 00:26:35,800 Speaker 2: I do, I want to know, well, who is there 460 00:26:35,800 --> 00:26:40,159 Speaker 2: for you. Very often at that first meeting, that significant 461 00:26:40,200 --> 00:26:43,920 Speaker 2: other person you know will come in, and that's always 462 00:26:43,920 --> 00:26:46,480 Speaker 2: an important relationship. I told you about the woman who 463 00:26:46,560 --> 00:26:48,959 Speaker 2: passed away last week. I knew her husband as well 464 00:26:48,960 --> 00:26:52,080 Speaker 2: as I knew her well, you know, so that was 465 00:26:52,080 --> 00:26:55,720 Speaker 2: a long term relationship. But I think we have to 466 00:26:55,760 --> 00:26:59,040 Speaker 2: help our patients find those connections, even if they are 467 00:26:59,040 --> 00:27:02,800 Speaker 2: on their own. There's so many resources out there where 468 00:27:02,840 --> 00:27:07,160 Speaker 2: women can hook up online on the phone in breast 469 00:27:07,200 --> 00:27:10,880 Speaker 2: cancer support groups if that's appropriate for them. And at 470 00:27:10,880 --> 00:27:13,960 Speaker 2: our cancer center at NYU promar To Cancer Center, we 471 00:27:14,000 --> 00:27:17,960 Speaker 2: have social workers and a liaison psychiatry team who can 472 00:27:18,000 --> 00:27:20,400 Speaker 2: also help our patients with those aspects. 473 00:27:20,520 --> 00:27:22,359 Speaker 1: I don't know if you remember what I was alone 474 00:27:22,359 --> 00:27:26,120 Speaker 1: when I was diagnosed and the NYU psychiatry team actually 475 00:27:26,560 --> 00:27:29,119 Speaker 1: came in to help me because I was not well 476 00:27:29,440 --> 00:27:33,160 Speaker 1: mentally in that moment, and I was so grateful for 477 00:27:33,400 --> 00:27:36,680 Speaker 1: the staff you had and the people who were there 478 00:27:36,720 --> 00:27:38,879 Speaker 1: to help someone like me in that moment, who was 479 00:27:39,000 --> 00:27:44,679 Speaker 1: in fact alone and needed I genuinely needed assistance to 480 00:27:45,119 --> 00:27:47,959 Speaker 1: even get through that next hour, let alone the tests 481 00:27:47,960 --> 00:27:50,680 Speaker 1: I was facing throughout the day. So I was appreciative 482 00:27:50,720 --> 00:27:54,160 Speaker 1: of that eleven years ago, and I know that I'm 483 00:27:54,200 --> 00:27:56,199 Speaker 1: sure even more structure has been put in place for 484 00:27:56,280 --> 00:27:58,080 Speaker 1: women who find themselves in that situation. 485 00:27:59,600 --> 00:28:03,399 Speaker 2: And it's important that when the woman comes in to 486 00:28:03,480 --> 00:28:06,840 Speaker 2: talk to us, they kind of share those concerns with us, 487 00:28:06,880 --> 00:28:10,359 Speaker 2: because I may not always know what's going on, and 488 00:28:10,400 --> 00:28:13,800 Speaker 2: I try to ask, but speak up about everything because 489 00:28:13,840 --> 00:28:16,199 Speaker 2: really that we're here to We are here for you 490 00:28:16,280 --> 00:28:18,639 Speaker 2: to try to put that whole package together in the 491 00:28:18,640 --> 00:28:19,320 Speaker 2: treatment plan. 492 00:28:20,080 --> 00:28:22,439 Speaker 1: You are definitely there for me and continue to be 493 00:28:22,560 --> 00:28:26,720 Speaker 1: so I guess just I'm wrapping up here and TJ, 494 00:28:26,800 --> 00:28:27,800 Speaker 1: if you have anything else. 495 00:28:27,640 --> 00:28:28,639 Speaker 2: Please let me know. 496 00:28:29,240 --> 00:28:33,160 Speaker 1: But I guess I would love to leave our listeners 497 00:28:33,240 --> 00:28:37,679 Speaker 1: with what they can do during this month, what women 498 00:28:37,760 --> 00:28:39,600 Speaker 1: can do and what the people who love them can do. 499 00:28:39,640 --> 00:28:41,320 Speaker 1: I know men get breast cancer too. We always want 500 00:28:41,360 --> 00:28:44,000 Speaker 1: to point that out. Anyone who is breast issue can 501 00:28:44,440 --> 00:28:47,640 Speaker 1: actually get breast cancer. But what are the big takeaways? 502 00:28:47,640 --> 00:28:49,840 Speaker 1: And what do you want people to remember this month? 503 00:28:50,320 --> 00:28:53,280 Speaker 2: I would say for this month and then for every 504 00:28:53,320 --> 00:28:57,400 Speaker 2: month going forward, but we'll emphasize in this month. Take 505 00:28:57,440 --> 00:29:01,280 Speaker 2: a moment, do a quick self assessment. Am I trying 506 00:29:01,320 --> 00:29:04,400 Speaker 2: to live, you know, as healthy a life as I can? 507 00:29:04,720 --> 00:29:09,560 Speaker 2: Like those New Year's resolutions? What's my self assessment on that? 508 00:29:09,600 --> 00:29:11,880 Speaker 2: Can I eat a little more healthy? Can I exercise 509 00:29:11,880 --> 00:29:14,080 Speaker 2: a little bit more? Am I feeding my kids the 510 00:29:14,200 --> 00:29:18,040 Speaker 2: right stuff? Am I getting enough sleep? Am I drinking 511 00:29:18,120 --> 00:29:21,960 Speaker 2: too much alcohol? You know all that stuff. Oh, I'm 512 00:29:22,000 --> 00:29:24,520 Speaker 2: due for my mammogram. I better make my appointment, go 513 00:29:24,600 --> 00:29:27,360 Speaker 2: in for that checkup, and have a clinical breast exam, 514 00:29:28,080 --> 00:29:32,360 Speaker 2: because sometimes something subtle, a change in the skin or 515 00:29:32,400 --> 00:29:35,320 Speaker 2: the nipple or feeling under the arm, is just as 516 00:29:35,360 --> 00:29:38,040 Speaker 2: important as having the imaging. So do the clinical exam 517 00:29:38,120 --> 00:29:42,680 Speaker 2: as well. And then don't be afraid if you notice 518 00:29:42,720 --> 00:29:46,840 Speaker 2: something or if the mammogram shows an abnormality, don't hesitate 519 00:29:47,440 --> 00:29:50,480 Speaker 2: follow up on it. Make sure you check it out 520 00:29:51,520 --> 00:29:55,640 Speaker 2: if you have questions. There are resources all over the country. 521 00:29:55,840 --> 00:29:57,600 Speaker 2: I mean, we're here in New York City. We have 522 00:29:58,800 --> 00:30:01,720 Speaker 2: so many wonderful health care facilities and some patients, and 523 00:30:01,760 --> 00:30:04,160 Speaker 2: some women across the country don't have access to that. 524 00:30:04,280 --> 00:30:08,760 Speaker 2: But get on the telephone, go on the internet, reach 525 00:30:08,800 --> 00:30:11,680 Speaker 2: out and there will be someone who can help you. 526 00:30:12,440 --> 00:30:15,320 Speaker 2: If you are concerned about something that you know that 527 00:30:15,480 --> 00:30:18,360 Speaker 2: could be related to breast cancer. Don't let fear stop you, 528 00:30:18,480 --> 00:30:19,360 Speaker 2: don't let fear stuff. 529 00:30:19,480 --> 00:30:22,360 Speaker 3: Yeah, can you give the official recommendation? It seems like 530 00:30:22,400 --> 00:30:25,880 Speaker 3: they always change. But for a woman, what age, when 531 00:30:25,880 --> 00:30:28,360 Speaker 3: you should go? How often those things like what is 532 00:30:28,360 --> 00:30:30,360 Speaker 3: the official You can do a self exam every day 533 00:30:30,360 --> 00:30:34,440 Speaker 3: if you want to, but what are the official recommendations 534 00:30:34,440 --> 00:30:35,959 Speaker 3: for age and when you should be in there? 535 00:30:36,000 --> 00:30:39,480 Speaker 2: See the official recommendation? My official recommendation. But I think 536 00:30:39,480 --> 00:30:42,480 Speaker 2: the official recommendation would be for women who are not 537 00:30:42,680 --> 00:30:46,600 Speaker 2: at increased risk because of either a family history of 538 00:30:46,600 --> 00:30:51,040 Speaker 2: breast cancer or some other problem they've had, but average risk. 539 00:30:51,080 --> 00:30:53,040 Speaker 2: You know, you're a healthy person, nothing's been going on, 540 00:30:53,120 --> 00:30:55,880 Speaker 2: and no one in your family had cancer. Somewhere around 541 00:30:55,920 --> 00:31:00,160 Speaker 2: age forty, get that first baseline mammogram, as Amy said, 542 00:31:00,200 --> 00:31:03,640 Speaker 2: if it shows dense breast tissue, and now they have 543 00:31:03,680 --> 00:31:07,120 Speaker 2: to tell you that, follow up with your doctor or 544 00:31:07,160 --> 00:31:10,520 Speaker 2: the radiologist. Hey, this says my breast tissue is really dense. 545 00:31:10,560 --> 00:31:12,840 Speaker 2: Do I need an ultrasound? Do I need a MRI? 546 00:31:13,080 --> 00:31:18,160 Speaker 2: Do I need something else? That's Number one. The second 547 00:31:18,160 --> 00:31:22,600 Speaker 2: thing would be for women who are at increased risk 548 00:31:23,200 --> 00:31:26,720 Speaker 2: because there's a family history of breast cancer, or they 549 00:31:26,800 --> 00:31:30,560 Speaker 2: already know. Let's say they had genetic testing and they 550 00:31:30,600 --> 00:31:33,680 Speaker 2: know they have a gene mutation that increases the risk 551 00:31:33,760 --> 00:31:36,280 Speaker 2: of getting breast cancer. They start a little earlier on 552 00:31:36,320 --> 00:31:40,160 Speaker 2: their screening, so that would be starting around aage forty. 553 00:31:40,240 --> 00:31:46,120 Speaker 2: And you know when should women stop screening? Right? I 554 00:31:46,240 --> 00:31:49,000 Speaker 2: think if you're an older person, you're in your seventies, 555 00:31:49,040 --> 00:31:51,480 Speaker 2: you're in your eighties. I even have some patience in 556 00:31:51,520 --> 00:31:56,560 Speaker 2: their nineties if you are healthy and well and otherwise 557 00:31:56,560 --> 00:31:59,640 Speaker 2: in good shape and living a full act of life. 558 00:32:00,000 --> 00:32:04,440 Speaker 2: I don't ignore it because even older women get breast cancer. 559 00:32:05,240 --> 00:32:08,440 Speaker 2: And I do treat women who are in their eighties 560 00:32:08,480 --> 00:32:11,560 Speaker 2: and nineties as long as they don't have a lot 561 00:32:11,600 --> 00:32:14,520 Speaker 2: of other health issues that are interfering with that, they 562 00:32:14,560 --> 00:32:16,880 Speaker 2: can also do very very well and not have that 563 00:32:16,960 --> 00:32:18,960 Speaker 2: turn into a big problem for them. So I don't 564 00:32:18,960 --> 00:32:20,440 Speaker 2: want to neglect our older ladies either. 565 00:32:20,840 --> 00:32:24,200 Speaker 1: Yeah, that's very important because I think people probably at 566 00:32:24,240 --> 00:32:26,360 Speaker 1: some point say yeah, what does it matter anyway? But 567 00:32:26,400 --> 00:32:29,320 Speaker 1: it does matter, and treatment does help women of all ages. 568 00:32:29,520 --> 00:32:33,000 Speaker 1: Talk for rats. It is always a pleasure to see you. 569 00:32:33,200 --> 00:32:36,160 Speaker 1: Thank you so much. I know you're busy treating patients 570 00:32:36,200 --> 00:32:38,520 Speaker 1: and saving lives, so we appreciate you making the trip 571 00:32:38,680 --> 00:32:40,520 Speaker 1: here to the iHeart Studios to be with us on 572 00:32:40,560 --> 00:32:41,840 Speaker 1: this very important month. 573 00:32:42,120 --> 00:32:44,280 Speaker 2: Well. I love being here. Thank you for inviting me.