Speaker 1: Welcome everyone to the Amy and TJ Podcast. It is
Speaker 1: a very special month. It is October, and that means
Speaker 1: it is Breast Cancer Awareness Month. And it's an important
Speaker 1: month because, first of all, it's time to honor those
Speaker 1: who have been treated for breast cancer. It's time to
Speaker 1: honor those who are fighting cancer who have metastatic breast cancer.
Speaker 1: And almost as important, it's time to raise awareness, to
Speaker 1: continue to raise awareness about early detection, about reminding women
Speaker 1: to make those appointments with their ogyns, to get those
Speaker 1: mammograms scheduled, and to show up for the actual appointment.
Speaker 1: And just to remind everyone, breast cancer is the most
Speaker 1: commonly diagnosed cancer in women in the United States. A
Speaker 1: woman in this country is diagnosed every two minutes, and
Speaker 1: great strides have been made with breast cancer research and
Speaker 1: certainly in treating women and men with this disease, but
Speaker 1: there is still so much more to do because breast
Speaker 1: cancer remains the leading cause of cancer death in American women.
Speaker 1: And so to get all the latest information on where
Speaker 1: we are with this disease, on the research being done,
Speaker 1: and what you can do to prevent breast cancer, or
Speaker 1: at the very least, if you've been a patient, or
Speaker 1: you are currently fighting it or someone you know, is
Speaker 1: what you can do to live a better life, a
Speaker 1: healthier life, and prevent recurrence and for all of that
Speaker 1: very important information. TJ and I are so excited to
Speaker 1: welcome my personal oncologist. She's a star at NYU, doctor
Speaker 1: Ruth Ratz. Thank you so much for being with us.
Speaker 2: Amy and Tji am really really happy to be back
Speaker 2: with you in the studio. I always love seeing you
Speaker 2: and especially here.
Speaker 1: Thank you Ruth and doctor Ratz. You know, I think
Speaker 1: some people roll their eyes up Breast Cancer Awareness Month,
Speaker 1: the pink ribbons. This is so much more than just
Speaker 1: this month, But can you explain why this month is
Speaker 1: actually truly important.
Speaker 2: This month is really really important because it represents what
Speaker 2: women did in the late nineteen seventies and in the
Speaker 2: nineteen eighties to really speak out and say to the
Speaker 2: medical profession and to all of the sort of public
Speaker 2: health officials out there, breast cancer is the single most
Speaker 2: important cancer that affects women. A lot of people get it,
Speaker 2: and we want to have more information and we want
Speaker 2: to have a say about what happens with our treatment.
Speaker 2: So in the nineteen seventies, when My mother was diagnosed
Speaker 2: with breast cancer in her forties because she felt a
Speaker 2: little lump in her breast. No screening, mammogram or anything
Speaker 2: like that. She went to her doctor. She was admitted
Speaker 2: to the hospital and the surgeon came in and said,
Speaker 2: missus aur so, I'm going to take you to the
Speaker 2: operating room and we're going to remove the lump. If
Speaker 2: it's cancerous, I have to do a mestectomy. If it's
Speaker 2: not cancer, you'll wake up and everything will be great.
Speaker 2: So she signed on the dotted line. They put it
Speaker 2: her sleep in the operating room, and she woke up
Speaker 2: alone in the recovery room, put her hand on her chest,
Speaker 2: felt that huge bandage, and that's how she figured out
Speaker 2: she had cancer. Wow, a lot has changed since then,
Speaker 2: but that is a chilling, chilling story. Yeah. So you know,
Speaker 2: a good friend of mine wrote a book called The
Speaker 2: Breast Cancer Wars, doctor barn learn her same thing happened
Speaker 2: to his mother, And the women's movement said, hey, wait
Speaker 2: a second, no, no, no, no, you can't do this
Speaker 2: to us anymore, and then the doctors and scientists started listening.
Speaker 2: It was it is now illegal in New York State
Speaker 2: and pretty much everywhere else to do surgery for cancer
Speaker 2: without first doing a biopsy and having a conversation with
Speaker 2: that woman. And this was only you know, this is
Speaker 2: the nineteen seventies. It's not that long ago, and we
Speaker 2: certainly have made great strides. And I didn't know that
Speaker 2: story about your mom doctr Ratsky at all, and has
Speaker 2: that motivated you in so many ways I can only
Speaker 2: imagine as an oncologist. Yeah, of course. I mean I
Speaker 2: was in college and I remember my dad calling me.
Speaker 2: I was on my way home for spring break and
Speaker 2: he called and said, okay, I'll pick you up at
Speaker 2: the station. I came down from Boston to you know,
Speaker 2: took the train to Penn station. He picked me up
Speaker 2: and we're heading uptown. I thought he's taking me out
Speaker 2: to dinner. Next thing, I know, like the taxi cab
Speaker 2: pulls up in front of a hospital. I said, well,
Speaker 2: wait a second, like what's going on here? And that's
Speaker 2: when I went up and saw my mom in the
Speaker 2: hospital after the surgery.
Speaker 1: My goodness.
Speaker 2: Yeah. So yes, of course I knew I wanted to
Speaker 2: be a doctor, but I think that kind of sealed
Speaker 2: where I was headed in my career.
Speaker 1: That makes a lot of sense, a lot of sense.
Speaker 1: So this month now some what fifty years later, do
Speaker 1: you see a rise in breast cancer diagnoses this month
Speaker 1: because women are reminded to come in and get their mammograms,
Speaker 1: and so then more women are actually diagnosed this month
Speaker 1: than others.
Speaker 2: Yes, Actually we do see that variation during the course
Speaker 2: of the year, and I think it's fantastic that we
Speaker 2: have breast cancer Awareness Month. People do go in and
Speaker 2: schedule their tests. We don't get that many diagnoses over
Speaker 2: the summer, everyone's on vacation. But back to school, Breast
Speaker 2: Cancer Awareness Month. Make your checkup appointments, go in, get tested,
Speaker 2: and if you need us, we're here.
Speaker 1: Yeah, you are there. You were there for me, and
Speaker 1: you still are here for me. In terms of where
Speaker 1: we are with getting the mammogram, there are different options.
Speaker 1: Now we've talked about these before, but I'm seeing more
Speaker 1: and more evidence that three D mammograms are the gold standard,
Speaker 1: and yet they're not available to everyone. Tell us a
Speaker 1: little bit about where we are on mammogram technology and
Speaker 1: what women should be able to ask for.
Speaker 2: You're right, Amy, the technology in imaging has really really
Speaker 2: changed over the years, Even just the mammogram technology mammogram
Speaker 2: is just an X ray of the breast, and as
Speaker 2: anyone who's had it done knows, you get kind of
Speaker 2: squished between these plates so that the X ray can
Speaker 2: actually compress the tissue and give us an image of
Speaker 2: what's going on in the breast tissue if the tissue
Speaker 2: is very dense, and that's more common in younger women,
Speaker 2: because as we get older that breast density, the breast
Speaker 2: tissue itself becomes a little less active, and really the
Speaker 2: breast is fundamentally made of fat, and that's easy to
Speaker 2: see little spots and dotson, But when the breast tissue
Speaker 2: is active in younger women, more proliferative, sometimes it's hard
Speaker 2: to see stuff. So by improving our technology with two
Speaker 2: D and then three imaging and adding computer assisted detection,
Speaker 2: which we've had for a long time now, several years,
Speaker 2: and layering on top of that even more intelligence, both
Speaker 2: the doctor's intelligence but artificial intelligence, adding that in where
Speaker 2: our computers can help us see through the background noise
Speaker 2: and say here's something we really should pay attention to
Speaker 2: on the mammogram, and then the radiologist might say we
Speaker 2: should also add an ultrasound sonogram of the breast or
Speaker 2: maybe this person also needs an MRI. So it's very individualized.
Speaker 2: It's not one size fits all.
Speaker 1: And you mentioned dense breast tissue. I was just reading
Speaker 1: and I realized just this month a new regulation is
Speaker 1: actually in place September tenth, they now have new regulations
Speaker 1: which allow patients or empower patients, I should say, with
Speaker 1: the information that they need to make an informed decision
Speaker 1: about breast cancer screening based on their breast density. Now
Speaker 1: it actually will show on your mimography report if you
Speaker 1: have dense breast tissue, and a lot of women don't
Speaker 1: realize that they have it. Why is that significant?
Speaker 2: You're right Amy that that's now going to be regulated.
Speaker 2: I think more and more across the country. We've been
Speaker 2: doing it in New York State for a while. It's
Speaker 2: very important because if the breast tissue is dense, we
Speaker 2: may need to add that other modality, whether it's ultrasound
Speaker 2: or MRI. And don't forget the clinical exam because sometimes
Speaker 2: we see something or feel something that doesn't show up
Speaker 2: on imaging. So we kind of need to do a
Speaker 2: little bit of everything.
Speaker 1: And how do you know as a patient what you
Speaker 1: can ask for, what your insurance will cover. I mean,
Speaker 1: so much of this has to do with accessibility. It's
Speaker 1: about information and knowing your rights, but also knowing what
Speaker 1: you have to pay for and what right your insurance
Speaker 1: come we'll be willing to pay for.
Speaker 2: I think the best thing is for each person to
Speaker 2: have a dialogue with her doctor. If it's the obg
Speaker 2: i N, they're usually pretty well informed and can talk
Speaker 2: to the breast imaging center the radiologist about well, what's
Speaker 2: going to be best for this patient. If it's a
Speaker 2: primary care doctor and they may not be as well
Speaker 2: informed about those options, then have your patient go for
Speaker 2: a consultation and speak to the radiologist or speak to
Speaker 2: the obg i N about what the best exam is.
Speaker 1: Yeah, you have to know your rights and then use
Speaker 1: your voice, right, Yeah, that's a huge part of it.
Speaker 1: This has been a big troubling trend. Yes, we've had
Speaker 1: great strides made in keeping women alive for those first
Speaker 1: five years. It's ninety nine percent correct survivor survivor rate.
Speaker 1: That's phenomenal, and yet we're seeing more and more, in
Speaker 1: a fairly alarming rate, women under fifty getting breast cancer.
Speaker 2: Do doctors know why? I'm really concerned about that. We
Speaker 2: have seen a trend that more young women are getting diagnosed,
Speaker 2: So we have to ask the question, is it because
Speaker 2: more young women are getting screened. Maybe we're picking up
Speaker 2: little things and people who are a little younger because
Speaker 2: they're coming in in their early forties to get that screening.
Speaker 2: But I'm seeing patients even in their thirties and sometimes
Speaker 2: late twenties more than we used to see. One factor
Speaker 2: is that the genetic mutations that can increase the risk
Speaker 2: of getting breast cancer. People have heard of the BRCA mutations,
Speaker 2: and there are other ones check two, rip one, a
Speaker 2: whole bunch of new genes that we know about. But
Speaker 2: what we're seeing is with each generation, the women getting
Speaker 2: breast cancer are also getting younger and younger, and we're
Speaker 2: not really sure what that's all about. May have to
Speaker 2: do with our environment and may have to do you know,
Speaker 2: what we're eating and drinking, what we're being exposed to,
Speaker 2: not sure.
Speaker 1: To what you're saying right there. To that point, big
Speaker 1: headlines this week specifically, or at least the past couple
Speaker 1: of weeks that there's a new study out that links
Speaker 1: not just the food but the food packaging that we're
Speaker 1: all using to transfer our food to eat, our food
Speaker 1: with to breast cancer carcinogens. Those are scary headlines and
Speaker 1: seemingly impossible to deal with because what am I supposed
Speaker 1: to do about how we package our food as a country,
Speaker 1: And what would you say to women? What are we
Speaker 1: supposed to do with these headlines and this information. It
Speaker 1: feels like everything could be causing cancer or at least
Speaker 1: creating these types of carcinogens. Well, I certainly think that
Speaker 1: over the past fifty years we've seen a really, really
Speaker 1: enormous change in the whole chain of food production, packaging,
Speaker 1: and distribution in America and the developed world. So, you know,
Speaker 1: when my mother was a little girl, everything was fresh, right,
Speaker 1: You just bought the food for the day that you
Speaker 1: were going to eat. By the time I was growing up,
Speaker 1: we had supermarkets, but yeah, we were still buying stuff
Speaker 1: pretty much that was fresh, and we didn't have so
Speaker 1: much in the way of plastic packaging. And now kind
Speaker 1: of everything is packaged either in styrofoam or plastic, and
Speaker 1: then we're using plastic utensils and we're keeping it in
Speaker 1: our fridge for who knows how long. We don't know
Speaker 1: for sure the absolute cause and effect of that, but
Speaker 1: it's really problematic. We're hearing about these forever chemicals which
Speaker 1: are related to some of these plastic compounds. They stick
Speaker 1: around in our bodies, they're hanging out in our oceans
Speaker 1: as we're throwing all this plastic garbage into the oceans,
Speaker 1: and they're getting into the animals. We also know that
Speaker 1: the food is processed way more than it was, you know,
Speaker 1: a few decades ago, so especially the animal proteins. Animals
Speaker 1: are being fed with growth hormones and antibiotics and all
Speaker 1: kinds of stuff just to fatten them up and get
Speaker 1: more production.
Speaker 2: But then in turn, we're eating that stuff and we're
Speaker 2: getting exposed to the same antibiotics and the same hormones,
Speaker 2: and that changes what's going on in our bodies metabolically,
Speaker 2: and the microbiome, which you know you probably have heard about. Also,
Speaker 2: those healthy bacteria that live in our body, well, they
Speaker 2: get altered when they're exposed to some of these chemicals.
Speaker 2: So there's a big chain reaction going on here.
Speaker 3: Doctors. I haven't hypothetical, and I hope you take it
Speaker 3: in the spirit in which it's intended here. I know
Speaker 3: it's kind of crazy to think this way, but a
Speaker 3: child born today. You have a daughter today, and you say,
Speaker 3: I want to give her the best chance of not
Speaker 3: getting breast cancer at any point in her life. What
Speaker 3: could you do with that child? Feed that child, expose
Speaker 3: that child to to give yourself the best chance? And
Speaker 3: no matter what you do, sometimes are you just going
Speaker 3: to be unlucky and nothing you can do about it?
Speaker 2: TJ, You're right, I mean, how do we take control
Speaker 2: over this? And what do we do? I think, you know,
Speaker 2: just on the personal level, we can pay attention to
Speaker 2: the kinds of foods we buy. It is a little
Speaker 2: bit crazy that it costs more money to buy healthier
Speaker 2: food than to buy junk food. So we've got to
Speaker 2: address that as a nation and say, how can we
Speaker 2: get people to have a healthier diet, not just in
Speaker 2: terms of cancer, but even cardiovascular health. Everything, More fresh
Speaker 2: fruits and vegetables into the diet, more fiber, less fat,
Speaker 2: less junk food of course, less processed food, especially the
Speaker 2: stuff coming from animal products, so dairy products, milk, eggs, cheese,
Speaker 2: and then all the meat products chicken and fish, and
Speaker 2: you know, beef, which we eat a lot of in America,
Speaker 2: much more than in other places. So if you can
Speaker 2: buy organic food where the animals are not fed all
Speaker 2: those antibiotics and hormones. That's probably healthier. Same with the
Speaker 2: dairy products, the eggs and the cheese and milk. I
Speaker 2: think that probably long term might make a difference, hard
Speaker 2: to say for sure. The other thing is just being
Speaker 2: healthy in terms of not being obese, doing physical exercise,
Speaker 2: not smoking, and not drinking excessive amounts of alcohol because
Speaker 2: all of those things make us sick.
Speaker 3: Too, and we need to just grow our own leafy
Speaker 3: drinks in the backyard, eat those the rest of our life.
Speaker 3: Don't leave the house, I think, is what you're saying,
Speaker 3: and we should be fine.
Speaker 1: Yeah, you know. And I also just I know some
Speaker 1: women are scared. They don't want to know. It's like
Speaker 1: ignorance is bliss. And obviously that is not a good
Speaker 1: way to deal with a potential cancer diagnosis. Because people
Speaker 1: are afraid of getting one, they avoid perhaps the tests altogether.
Speaker 1: But early detection is absolutely the way to save lives
Speaker 1: when it comes to breast cancer. And I was hoping
Speaker 1: you could expound on that because I think some people
Speaker 1: just think, well, I'll just kick the can down the
Speaker 1: road to next year.
Speaker 2: Don't do that. Early detection is still key. It's a very,
Speaker 2: very very powerful tool that each woman can have to
Speaker 2: take control over her own health. And I always tell
Speaker 2: people that, you know, going for the mammogram doesn't prevent cancer,
Speaker 2: but it could prevent you from dying from cancer. So
Speaker 2: it's really really important if we find a small tumor,
Speaker 2: even if it's an aggressive subtype, because not all breast
Speaker 2: cancers are the same, lots of different kinds of breast cancer,
Speaker 2: but we know that size in this situation still counts,
Speaker 2: and if it's small and if it hasn't spread too far,
Speaker 2: we usually have a much better chance of eradicating it
Speaker 2: completely and eliminating those problems down the road.
Speaker 3: Can you give us a good news in trends? We
Speaker 3: always talk about we see younger women, that's troubling, and
Speaker 3: all these troubling things. What's the good news you're seeing
Speaker 3: in trends.
Speaker 2: Yeah, the good news is our treatment's way better, way
Speaker 2: better than it was, so we understand much more about
Speaker 2: the biology of breast cancer. Basic science research is critically
Speaker 2: important to pushing this field forward, So we have to
Speaker 2: keep funding research in the laboratory where the scientists are
Speaker 2: digging into those molecular mechanisms of why is that cell
Speaker 2: turning into a cancer cell, what's making it grow, what's
Speaker 2: making it travel, what's making it spread? And now our
Speaker 2: therapies are more and more targeted to the type of
Speaker 2: breast cancer that someone has, and they work better. The
Speaker 2: treatments are more effective. We can learn to turn on,
Speaker 2: switch on, and off all those different pathways in the cell.
Speaker 2: It's really really exciting. I've seen that change over the
Speaker 2: course of my career, and I know there are people
Speaker 2: alive and well who wouldn't have been when I first
Speaker 2: went into practice, and that is the greatest, greatest joy
Speaker 2: in my clinical work.
Speaker 1: I would say that brings tears to my eyes just
Speaker 1: to hear that, yeah, it's.
Speaker 3: True, but to that, yes, the advancement's research, advancement's technology
Speaker 3: advancements and treatment are is it going to be a
Speaker 3: while though, before those advancements are going to show up
Speaker 3: in those trends you talk about with Okay, not so
Speaker 3: many young women are getting it anymore? Okay, not as many?
Speaker 3: Is that showing up yet?
Speaker 2: Well, I think we have reduced breast cancer mortality overall
Speaker 2: in America, so we have seen that already in terms
Speaker 2: of the causation thing. I think we have to do
Speaker 2: a little more work there, but we're definitely doing better
Speaker 2: on treatment for sure, Doctor Ortsa.
Speaker 1: Anyone who's listening to this podcast, I'm sure is familiar
Speaker 1: with our dear friend Morgan Mitchell, who is stage four metastatic.
Speaker 1: She is going to be celebrating her seven year anniversary
Speaker 1: come December. That also brings tears to my eyes and
Speaker 1: gives me chills because that was unheard of not that
Speaker 1: long ago, or at least in recent history. Where are
Speaker 1: we in terms of women who are living with stage
Speaker 1: four and how they're living and how long they're.
Speaker 2: Living, right, And that's where a lot of our research
Speaker 2: starts in that stage four setting with people who have
Speaker 2: advanced cancer, because the cancer is right there, so we
Speaker 2: can see how the treatments are working, and we start there.
Speaker 2: I lost a patient last week who was very, very
Speaker 2: dear to me, but I took care of her for
Speaker 2: twenty seven years wow, and the last ten of those
Speaker 2: years she had metastatic breast cancer. But she lived a
Speaker 2: good life with a really good quality of life. She
Speaker 2: was able to work and continue her career and be
Speaker 2: with her family and travel and enjoy herself, and it
Speaker 2: was only at the very end in the last few
Speaker 2: months where it got really rough, But that would never
Speaker 2: have happened in the past. And that's because of all
Speaker 2: of these new targeted therapies. Not only are they more effective,
Speaker 2: but we really, really really work on trying to help
Speaker 2: people live well and have a good quality of life
Speaker 2: and do whatever we can to minimize side effects and
Speaker 2: minimize the toxicity of our treatments. We're moving away from
Speaker 2: some of the things we used to do all the
Speaker 2: time because they were just too rough on people, and
Speaker 2: now we have things that are working better. Now. I
Speaker 2: can't tell you it's one hundred percent perfect, and I'm
Speaker 2: not going to tell you that every treatment comes and
Speaker 2: people feel fantastic. There are some side effects, there are
Speaker 2: some tough things we have to go through, but it
Speaker 2: is our mission to make sure that we keep doing
Speaker 2: research to get this right and to do it better
Speaker 2: and better and better.
Speaker 3: Can you put in context of how rare that is
Speaker 3: You talk about your patient that you took care of
Speaker 3: for all that time and then Morgan seven years with
Speaker 3: metastatic is do I have it right? I'm not overstating it.
Speaker 3: That's these days not so unheard of, but that's pretty
Speaker 3: rare for seven years.
Speaker 2: Depends on the subtype of breast cancer. So there are
Speaker 2: some subtypes where I certainly have patients with stage four
Speaker 2: disease five, six, seven, eight, nine, ten years. I mean,
Speaker 2: we're getting that's that's really happening. There are some other
Speaker 2: subtypes of breast cancer that are tougher to treat, a
Speaker 2: little bit more aggressive, and you know we're focusing our
Speaker 2: efforts on those.
Speaker 3: Can mindset, can attitude? Can just how you approach your
Speaker 3: life after a metastatic diagnosis like that. I say this
Speaker 3: because Morgan is the like the bubbliest, happiest person I've
Speaker 3: ever been around ever, And I think when I met
Speaker 3: her she'd already been diagnosed. I've only known her as
Speaker 3: stage four. She runs half marathons, marathons, She's just this bubbly,
Speaker 3: this ball of life all the time. Can that have
Speaker 3: an impact staying active? Can you still? Can you prolong
Speaker 3: your life? I guess by changing some things after metastatic diagnosis.
Speaker 2: This may not be a scientific answer, but yes, I
Speaker 2: believe that our heads are connected to our bodies, and
Speaker 2: when we use the word heart, we're here in this
Speaker 2: iHeart Studio we use the word heart. Yes, it's that
Speaker 2: pump that makes the blood go around your body, but
Speaker 2: it's also the seat of our emotions. So I think
Speaker 2: these are powerful connections. Our heads and our hearts, everything
Speaker 2: in our body is interconnected how we feel, how we
Speaker 2: live our lives. If we can fill our lives with joy,
Speaker 2: with hope, with love, and with trying to live in
Speaker 2: as healthy a way as possible, make the most of
Speaker 2: each day, be optimistic, maybe have some faith and whatever
Speaker 2: that is. Yeah, I think it helps. Yeah.
Speaker 1: So yes, Morgan is actually via Sarah get expecting she
Speaker 1: and her husband are expecting a baby in January, and
Speaker 1: talking about having a reason to live, a reason to
Speaker 1: have a reason to keep fighting.
Speaker 2: Got it? Now? She just got a big one, she
Speaker 2: sure did, and it's going to be a very powerful,
Speaker 2: very powerful factor for her.
Speaker 1: I wanted to ask you about that, because you are
Speaker 1: there in the rooms with these women who are fighting
Speaker 1: for their lives. How big of a deal is and
Speaker 1: how often are you seeing women who think all hope
Speaker 1: is lost for starting that family. I was diagnosed at
Speaker 1: forty I already had two little girls. It was still
Speaker 1: devastating for me. I remember you told me you're out
Speaker 1: of the baby making business. You have two beautiful, healthy girls.
Speaker 1: You're one of the lucky ones. But how many women
Speaker 1: now are actually getting the option and seeking that opportunity
Speaker 1: to have a family in maybe a less conventional way,
Speaker 1: but still having the option to do so.
Speaker 2: Well, Amy, again, you hit it right right on the head,
Speaker 2: because that's changed too, especially now with all of our
Speaker 2: young patients. So before we start treatment in our young patients,
Speaker 2: we have that conversation about fertility, whether they already have
Speaker 2: children or don't have children, if they have a partner,
Speaker 2: don't have a partner, But if someone wants to do
Speaker 2: fertility preservation where we do a round or two of
Speaker 2: harvesting eggs and then we can freeze them or get embryos,
Speaker 2: make sure that we have that in the bank before
Speaker 2: we do something that might reduce a person's fertility or
Speaker 2: may delay the time to when she would have children.
Speaker 2: I've lots and lots of patients who've had babies after
Speaker 2: treatment for breast cancer. Sometimes they've carried the pregnancies. Sometimes
Speaker 2: they've gotten pregnant without the assistance of using an embryo
Speaker 2: or IVF. Sometimes we have to use a little more technology,
Speaker 2: but we have all of great new technologies now for
Speaker 2: fertility preservation and for getting those babies. Some of my
Speaker 2: patients also have you surrogates, you know, like Morgan, and
Speaker 2: the babies are beautiful, they're healthy, and the families are
Speaker 2: just fantastic to see.
Speaker 1: So I know, I know, I can't are saying that
Speaker 1: more and more. I can't wait for January. According to
Speaker 1: the World Health Organization, the theme for this month's Breast
Speaker 1: Cancer Awareness Month is no one should face breast cancer alone.
Speaker 1: How important is community? As a physician, what you witness
Speaker 1: when women are diagnosed, How important is it for them
Speaker 1: to have that support?
Speaker 2: Well, you know, support when we're facing any kind of
Speaker 2: adversity in life is so important and so helpful. And
Speaker 2: everyone defines that differently. For some people it's having a
Speaker 2: loving partner. For some people it's their children, their parents.
Speaker 2: Not everyone has a family that's nearby. You know, we
Speaker 2: move all over the place. We have a lot of
Speaker 2: young single people who are here. I have a lot
Speaker 2: of older women who you know, are kind of on
Speaker 2: their own, so we have to help them find that
Speaker 2: community in where they are in their space. And there's
Speaker 2: so much variability across the country. Some people are geographically
Speaker 2: far away from their loved ones. Other people are living
Speaker 2: in apartment buildings where they have a close, tight knit
Speaker 2: group of friends who are supporting them. So I think
Speaker 2: when we sit down and talk to a person, when
Speaker 2: I do, I want to know, well, who is there
Speaker 2: for you. Very often at that first meeting, that significant
Speaker 2: other person you know will come in, and that's always
Speaker 2: an important relationship. I told you about the woman who
Speaker 2: passed away last week. I knew her husband as well
Speaker 2: as I knew her well, you know, so that was
Speaker 2: a long term relationship. But I think we have to
Speaker 2: help our patients find those connections, even if they are
Speaker 2: on their own. There's so many resources out there where
Speaker 2: women can hook up online on the phone in breast
Speaker 2: cancer support groups if that's appropriate for them. And at
Speaker 2: our cancer center at NYU promar To Cancer Center, we
Speaker 2: have social workers and a liaison psychiatry team who can
Speaker 2: also help our patients with those aspects.
Speaker 1: I don't know if you remember what I was alone
Speaker 1: when I was diagnosed and the NYU psychiatry team actually
Speaker 1: came in to help me because I was not well
Speaker 1: mentally in that moment, and I was so grateful for
Speaker 1: the staff you had and the people who were there
Speaker 1: to help someone like me in that moment, who was
Speaker 1: in fact alone and needed I genuinely needed assistance to
Speaker 1: even get through that next hour, let alone the tests
Speaker 1: I was facing throughout the day. So I was appreciative
Speaker 1: of that eleven years ago, and I know that I'm
Speaker 1: sure even more structure has been put in place for
Speaker 1: women who find themselves in that situation.
Speaker 2: And it's important that when the woman comes in to
Speaker 2: talk to us, they kind of share those concerns with us,
Speaker 2: because I may not always know what's going on, and
Speaker 2: I try to ask, but speak up about everything because
Speaker 2: really that we're here to We are here for you
Speaker 2: to try to put that whole package together in the
Speaker 2: treatment plan.
Speaker 1: You are definitely there for me and continue to be
Speaker 1: so I guess just I'm wrapping up here and TJ,
Speaker 1: if you have anything else.
Speaker 2: Please let me know.
Speaker 1: But I guess I would love to leave our listeners
Speaker 1: with what they can do during this month, what women
Speaker 1: can do and what the people who love them can do.
Speaker 1: I know men get breast cancer too. We always want
Speaker 1: to point that out. Anyone who is breast issue can
Speaker 1: actually get breast cancer. But what are the big takeaways?
Speaker 1: And what do you want people to remember this month?
Speaker 2: I would say for this month and then for every
Speaker 2: month going forward, but we'll emphasize in this month. Take
Speaker 2: a moment, do a quick self assessment. Am I trying
Speaker 2: to live, you know, as healthy a life as I can?
Speaker 2: Like those New Year's resolutions? What's my self assessment on that?
Speaker 2: Can I eat a little more healthy? Can I exercise
Speaker 2: a little bit more? Am I feeding my kids the
Speaker 2: right stuff? Am I getting enough sleep? Am I drinking
Speaker 2: too much alcohol? You know all that stuff. Oh, I'm
Speaker 2: due for my mammogram. I better make my appointment, go
Speaker 2: in for that checkup, and have a clinical breast exam,
Speaker 2: because sometimes something subtle, a change in the skin or
Speaker 2: the nipple or feeling under the arm, is just as
Speaker 2: important as having the imaging. So do the clinical exam
Speaker 2: as well. And then don't be afraid if you notice
Speaker 2: something or if the mammogram shows an abnormality, don't hesitate
Speaker 2: follow up on it. Make sure you check it out
Speaker 2: if you have questions. There are resources all over the country.
Speaker 2: I mean, we're here in New York City. We have
Speaker 2: so many wonderful health care facilities and some patients, and
Speaker 2: some women across the country don't have access to that.
Speaker 2: But get on the telephone, go on the internet, reach
Speaker 2: out and there will be someone who can help you.
Speaker 2: If you are concerned about something that you know that
Speaker 2: could be related to breast cancer. Don't let fear stop you,
Speaker 2: don't let fear stuff.
Speaker 3: Yeah, can you give the official recommendation? It seems like
Speaker 3: they always change. But for a woman, what age, when
Speaker 3: you should go? How often those things like what is
Speaker 3: the official You can do a self exam every day
Speaker 3: if you want to, but what are the official recommendations
Speaker 3: for age and when you should be in there?
Speaker 2: See the official recommendation? My official recommendation. But I think
Speaker 2: the official recommendation would be for women who are not
Speaker 2: at increased risk because of either a family history of
Speaker 2: breast cancer or some other problem they've had, but average risk.
Speaker 2: You know, you're a healthy person, nothing's been going on,
Speaker 2: and no one in your family had cancer. Somewhere around
Speaker 2: age forty, get that first baseline mammogram, as Amy said,
Speaker 2: if it shows dense breast tissue, and now they have
Speaker 2: to tell you that, follow up with your doctor or
Speaker 2: the radiologist. Hey, this says my breast tissue is really dense.
Speaker 2: Do I need an ultrasound? Do I need a MRI?
Speaker 2: Do I need something else? That's Number one. The second
Speaker 2: thing would be for women who are at increased risk
Speaker 2: because there's a family history of breast cancer, or they
Speaker 2: already know. Let's say they had genetic testing and they
Speaker 2: know they have a gene mutation that increases the risk
Speaker 2: of getting breast cancer. They start a little earlier on
Speaker 2: their screening, so that would be starting around aage forty.
Speaker 2: And you know when should women stop screening? Right? I
Speaker 2: think if you're an older person, you're in your seventies,
Speaker 2: you're in your eighties. I even have some patience in
Speaker 2: their nineties if you are healthy and well and otherwise
Speaker 2: in good shape and living a full act of life.
Speaker 2: I don't ignore it because even older women get breast cancer.
Speaker 2: And I do treat women who are in their eighties
Speaker 2: and nineties as long as they don't have a lot
Speaker 2: of other health issues that are interfering with that, they
Speaker 2: can also do very very well and not have that
Speaker 2: turn into a big problem for them. So I don't
Speaker 2: want to neglect our older ladies either.
Speaker 1: Yeah, that's very important because I think people probably at
Speaker 1: some point say yeah, what does it matter anyway? But
Speaker 1: it does matter, and treatment does help women of all ages.
Speaker 1: Talk for rats. It is always a pleasure to see you.
Speaker 1: Thank you so much. I know you're busy treating patients
Speaker 1: and saving lives, so we appreciate you making the trip
Speaker 1: here to the iHeart Studios to be with us on
Speaker 1: this very important month.
Speaker 2: Well. I love being here. Thank you for inviting me.