Metro Center Outlook: Women’s Health


Music VO: We’ll talk with an
expert abiout how early detection of breast
cancer can save lives. – If you feel something, even
if you had a recent mammogram that is normal, please
don’t ignore it. VO: Then we’ll learn how one
organization is helping Central Floridians and their
families battle breast cancer. – Programs for breast
cancer patients have gotten a lot better.
We’ve put a lot more checks and balances in
them to make sure that patients have a smoother ride. VO: But first, one
local survivor shares her story of empowerment. – I just want to be here as
a beacon of like “Ok, this is what it’s like, this is
life after breast cancer.” VO: In honor of breast
cancer awareness month, we’ll talk with 3 Central
Floridians about women’s health. All that and more,
next on Metro Center Outlook. Music Music Diane: Hello I’m Diane Trees.
Breast cancer is the second leading cause of death among
women in the United States. Today we’ll talk about
detection, treatment and advocacy. First, Linda
Schulte, an 8 and a half year survivor of breast cancer, joins
me to talk about how she’s helping other women
battling the disease. Linda, welcome to the
show. Linda: Thank you. Diane: You are were 37 I
believe, when you were diagnosed with stage 2
breast cancer. How did you learn about your diagnosis? Linda: Well it was, um, very
interesting. I actually was 37, as you mentioned, and you’re
not supposed to have breast cancer under the age of
40, uh, let alone under the age of 50. Um, and I
had actually been in a very regimented, um, work
out and diet and I had dropped a lot of weight
and I was very lean. I actually found it getting
out of the shower and I could see it actually
protruding out of my left breast. Um, one of the
scariest things that I did, which I don’t
recommend anybody doing is going, “Oh, I’m only 37,
don’t worry about it.” Cause I did wait and that
was about October of 2004. I waited until December to
go to the doctor. And um, almost didn’t even go get
a mammogram because again I was 37. So, when I
finally went in January, I went on a Monday. They
told to come back on a Wednesday for a biopsy. On
Friday, so from Monday to Friday I was diagnosed
with breast cancer with, as you mentioned, stage 4.
And I was a triple positive. Diane: So you were
in basically good health and had an exercise
regime and took care of
yourself. Linda: I was actually
in the best health of my life at that
moment, so it was kind of shocking to actually have a
diagnosis of breast cancer. Diane: That probably
stood you in, in, a good thing for you at that
point for you because Linda: I was actually
very lucky I was in as good a health as I was
in because that’s how I found it so quickly.
Again, being as lean as I was, um, it showed up.
Some women with the type of breast cancer I had,
very aggressive, very fast. They usually don’t
find out about it until they’re stage 4 and it’s
already metastasized. So I was again, very lucky that
I did find it and being so lean like I was and very
healthy, and they were able to pretty well douse me
pretty good with chemotherapy. Diane: How, how was
your treatment? What was it like for you? Linda: Um, it was uh, an
adventure. Um, the first one, I’ll tell you, it wasn’t that
bad. It wasn’t pleasant, but uh, I held everything together.
Doing the, I had to go through 8 rounds of chemotherapy, 8
sessions of it. The second one was really what I
would refer to as the most hellacious out of all of
them. That’s where your hair falls out. That’s
when the, it’s called adriamycin cytoxan, that’s
when it starts really affecting your hormone
levels. And, you get a
little emotional– Diane: The ramifications of so
many areas in your health. Linda: Yes, it just all comes to a head right
then. It’s like ok I’ve lost my hair, this is
real. So the four cycles of adriamycin cytoxan and
then I went on to Taxol for another four. Went to
that every two weeks and the last four were not as
bad, just really tiring is actually what it was. Diane: How did you find that encouragement to
persevere through this kind of experience? Linda: Well when I
was first diagnosed there was nobody out
there that was my age. That was the most
difficult part, I’ll be very honest with you. I
actually met with a social worker, the oncology
social worker at Florida Hospital, and I asked him,
you know I said “Well, where are all the young
breast cancer survivors?” He said “They’re not
around.” I immediately said “They’re all dead?”
And his answer, he chuckled back at me, he
said “No, no, no. What happens is young women
they go through it, they get better, and they move
on with their lives.” And his comment back to me was
“And that’s a darn shame.” And at that moment I kind
of realized my purpose is that I knew I had to one
fight it, beat it, be here, but also to be
available for women, all women diagnosed with
breast cancer, but mainly those that were diagnosed
at a younger age. Diane: Well that’s what I
wanted to know – Why is it so important for you to share
your story with other people? Linda: I don’t feel
like there was a “Linda” around when I was
diagnosed. Uh, I wish I had me to talk to. I
probably would have made some different choices,
and so I want to make sure I’m here for other women
to talk to. I’ve been there, done that. I can
tell you why I did what I did at that moment and I
can tell you what I would have done differently. I
just want to be here as a beacon of like “Ok, this
is what it’s like. This is life after breast cancer.”
I don’t live it and breathe it every single
day of m life anymore. But it’s still there and you
can have a successful life afterward. You can, I got
promotion while I was going through
chemotherapy, I’ve moved on to a new career since
I’ve been going through treatment. So it’s, I just
want to be here as a beacon for these other women
who may be diagnosed and facing it and scared, wondering,
“Am I going to see tomorrow?” Diane: What’s next, yeah.
Linda: And what’s next. Diane: How can
friends and family best support somebody that they
love that’s going through this? Linda: You know,
that’s a very good question because
everybody’s different. Some people want to have a
lot of people around them, they want to be surrounded
by friends and with family. Some people, they
only want one or two or three people, and they’re
very closed to it. So it’s really, it’s an individual
type of a thing. And really what you have to do
is just say to the person, “I’m here for you. Is there
something I can do for you?” Diane: So ask them how
you can be of help. Linda: “How can I support
you?” One thing I will tell you that was
very valuable to me is that I would get cards.
Almost, there’s one person in particular that
actually sent me a cartoon every single day in the
mail for the entire 8 treatments that I went through. Diane: Well that’s wonderful.
Linda: And just little things like that. And just
knowing what someone’s personality is like. And
I’m generally very jovial, very laughing all the
time. You know, just asking the people what
would they like what do they need. Sometimes they
don’t even know what they need. And one day it’ll be
like “I don’t need anything” and then click
“Oh you know what, I need somebody to take me to
treatment,” or something like
that. Diane: What would
be your words of advice, any words of
encouragement for women who are battling breast
cancer right now? Linda: This too shall pass.
Just keep on putting on your pink gloves. Fighting.
Doing your treatments. It’s difficult. I’m
dealing with one of my friends right now going
through it for the second time and you know every
single day she wants to know “Why her?” When you
sit down and you think about that and you’re woe
is me, “Why me?” there’s one thing I always said to
myself at that point is “Why not me?” So that’s
what you do, you have to put on those gloves, you
have to have a positive attitude. Have your days
where you’re going to be sad and upset cause you
gotta have those. Get through them, don’t let
them hold you back. Move forward and just know it’s
going to be something in your past, something
you’re gonna talk about 8 and a half years later. Diane: Thank you Linda, so
much for sharing. Linda: Oh, thank you very
much, appreciate it. Diane: When we come
back, we’ll learn how early detection can
make all the different for women with breast cancer. Music Diane: Dr. Nikita Shah is a
medical oncologist at Orlando Health who specializes in breast
cancer. Dr. Shaw, welcome. Nikita: Thank you
for having me. Diane: What is the top tip if
you had to choose, what would be your top tip for
early detection? Nikita: Don’t ignore anything
that does not feel right. We see that over and over again,
patients will say I just had a mammogram, how could
I now have breast cancer? If you feel something even
if you had a recent mammogram that is normal,
please don’t ignore it. Diane: So be accustomed to
what’s a baseline for you and let that be the
trigger for when you need to have attention. Nikita: That’s correct.
And that’s where we talk about the self
breast exam because until you know what your
breast feels like you won’t know when there’s
something different. And that’s why that monthly
breast exam kind of gets you to know what your
breast is like normally so then if you feel a lump,
you’ll say oh my gosh that’s new or different for me. Diane: What does early detection
do for survival rates? Nikita: We know that with
early detection the survival rate is over ninety-five
percent. So that’s why early detection is the key
because we know that if we can catch breast cancer
early we can cure it, we can never have it
come back again. Diane: That’s a huge statistic.
Ninety-five percent? Nikita: That is right.
Diane: There are risk factors associated with
breast cancer. Can you talk a little bit about
what some of those are? Nikita: So there are a lot
of risk factors but there’s not one which is
you know, causally known to be the one risk factor.
So some of the risk factors are you start
getting your periods early, you going into
menopause later, women who don’t have any children,
obesity, these are all risk factors. One of the
other risk factors is if you have a family history
of breast cancer. So sometimes we see clusters
where there are three or four family members with
breast cancer. That’s where we think of genetic
testing to BRC mutations. But remember only eight
percent of all breast cancers are genetic,
meaning about ninety-two percent of the time, there
is no reason why a women gets breast cancer. Diane: I didn’t realize
that, I thought that was much more of
a prominent factor. What about age, how does that
factor in with breast cancer? Nikita: So typically the
incidents of breast cancer increases with
age. So we hear all about the younger women
with breast cancer, but actually incidents
increases with age. So about age thirty, a
woman’s risk of developing breast cancer is one in
two thousands. By the time that woman is eighty, it’s
about one in nine. So your risk increases with age
and that’s why it’s very important that once a
woman hits the age of sixty or sixty-five, they
should not stop doing mammograms. Cause that’s
when you actually really need those screening mammograms
to pick up that early cancer so you can have that
ninety-five percent cure rate. Diane: And I think that’s a perception out there that
a lot of women when they reach a certain age feel
that it’s not necessary any longer, when actually
they’re more at risk than
others. Nikita: That’s correct.
Diane: When a lump is detected, what
would you advise, what’s the next step that a
woman should take? Nikita: So remember about eighty
to eighty-five percent of lumps are not cancerous.
So just because you feel a lump does not mean it is
cancer. But that also does not mean that you ignore
it. So if it is something new please have it looked
it. It’s very likely that if a woman feels a lump,
she’ll be sent for a mammogram, usually a
diagnostic mammogram. That’s the one where
they’ll do an additional view, they’ll do an
ultrasound. If something looks abnormally, the
calcification or the ultrasound looks abnormal,
then a biopsy will be recommended. And then the
biopsy will say whether this is cancerous or not.
Diane: Dr. Shah, we’ve talked, a lump is not
necessarily the defining factor. What are some of
the other ways, and you were saying a baseline for
a breast, what are some of the other things that can
show that there’s a problem? Nikita: So as part
of the breast exam, what a woman should be
doing is not just feeling for lumps but looking at
the breast. So if you’re right handed and you’re
looking at yourself in the mirror. Your right breast
will look a little bit bigger than the other. But
if you’ve never seen that, that may look abnormal. So
a change in the color of the skin, a change in the
nipple, the nipple suddenly gets eroded, if
you have nipple discharge, which may be clear, it may
be bloody, it may be milky, but that’s not a
normal occurrence for most women. So if you have
sudden nipple discharge, if you have puckering of the
skin, the skin looks like an orange peel, these are all signs
that there may be a problem. Diane: What about for men? And that’s not often
discussed, but men do get incidences of breast cancer. Nikita: That’s correct. One
percent of all breast cancers are in men. And they are treated
the same way, they behave the same way. Obviously
when I say they are treated the same way, they
obviously have to have surgery, but it’s always a
mastectomy because there’s not enough breast tissue.
In men, the most common presenting symptom is a
lump. Occasionally nipple discharge, but because
there’s not much breast tissue, it’s a lump that
is felt prominently. And when we see men with
breast cancer, it raises a red flag that it could be
associated with a BRCA2 mutation, classically male
breast cancer is associated with the
BRCA2 mutation. Diane: How does early detection
in patients, how does treatment differ for that patient if
you can catch it that soon? Nikita: So when you
catch it early and you do surgery, the
cancer is gone. Everything you are doing beyond that
is preventive therapy. Versus if it is caught
late, meaning it may have already spread somewhere
else, you’re always one step behind. So you’re
never going to be able to cure the disease, so now
you’re looking at something that has a
ninety-five percent cure rate down to the chances
of making it cured are almost zero. So the
treatment is very different so we do
aggressive therapy up front, we do chemotherapy,
radiation, endocrine manipulation, and surgery,
maybe some patients may need all of the above in
an effort to prevent the cancer from coming back.
Diane: There’s been an increased push I think, or
awareness for breast cancer both for education
and other ways. Are you seeing less women now
presenting with stage 3 or stage 4 than before? Nikita: Yes and no. I think we
are seeing a lot more early stage, especially what we
call stage 0 breast cancer which is a DCIS. Because
we are picking up more with screening mammograms.
But I think it’s probably also a combination of
sometimes a little bit of I don’t want to know, also
the economy, not having adequate access to
healthcare is that patients are not going for
their mammograms in time or they’re not going every
year or they go every two to three years, so by the
time breast cancer is diagnosed it is often
later stage. So the ones that are going regularly,
we are picking up early cancers, yes. But we are
seeing a lot of patients not going annually. Diane: Are there any
myths that you would like to dispel about breast
cancer? Misconceptions or? Nikita: Probably
the big few ones are: I don’t have a family
history of breast cancer so how could I get breast
cancer? And I tell patients, somebody has to
start your family history and you are the one to
start the family history. The other one is in the
women who do have the BRCA mutation. They think oh
it’s just a question of time before I get it,
there’s nothing I can do. No, there are a lot of
things you can do preventive. Removing the
breast before you develop breast cancer. Removing
the ovaries before you get ovarian cancer. So there
are preventive things that you can do. The other
common myth is antiperspirants, deodorants,
again no data on any of that. Diane: What about
diet or exercise? Does that factor in at
all? Nikita: Well we know that obesity is
associated with a higher estrogen level that
potentially can increase the risk of breast cancer.
So we know that overall exercise and a healthy diet
are good for you and that continues as far as reducing
your risk for breast cancer. Diane: What would be
your top number 1 piece of advice for women or
men regarding breast cancer? Nikita: It is very
treatable if caught early and we recommend a three
prong approach. So 1, is annual mammograms starting
at age forty. And like I mentioned earlier, no
upper limit, as long as a woman is in good health
she needs to continue annual mammograms, every
single year, no skipping at all. Number 2, monthly
self breast exams. Do your breast exam so you know
what your breast feels like. So for women who are
menstruating the best time to do a breast exam is
about seven or eight days after your period has
ended that’s when your breasts are least lumpy so
you get a good feel for that. For women who are
post-menopausal, it doesn’t matter, pick a day
of the month and do your breast exam every month.
Even for women who are nursing, we recommend that
they should do a breast exam, maybe right after a
feed. And the third approach, is an annual
breast exam by a health care provider. So with
these three approaches, you can really catch breast
cancer very early and cure it. Diane: Thank you
Dr. Shah, so very much. After the break,
we’ll talk with a local leader of an organization
dedicating to breast cancer outreach and
advocacy. Music Diane: Stefanie Steele is
the executive director of Susan G. Komen for the
Cure’s Orlando affiliate, which has raised more than
four million dollars to support breast cancer
research, education and treatment. Stefanie,
welcome to the show. Stefanie: Hi, thank
you for having me. Diane: What is the mission
for Susan G. Komen? Stefanie: Really our mission is
to end breast cancer forever. And locally we’re doing that
through our local grant programs and research. Diane: How is the organization
making an impact across Central Florida? Stephanie: Well
we are the largest nongovernment funder of
breast cancer programs in Central Florida, as well
as the largest research funder for breast cancer. Diane: How did you get
involved with this? Stefanie: I started as a
volunteer. It was just something I was really
passionate about, and slowly kept coming back more and more
and when the opportunity became available to work for the
affiliate, I jumped on it and here I am today. Diane: You have worked then
for a number of years for the organization. Have you seen
some changes along the way? Stefanie: Absolutely. There’s
been a lot of changes. Specifically in where we
are with our programs. Our programs for breast cancer
patients have gotten a lot better. We’ve put a lot
more checks and balances in them to make sure that
patients have a smoother ride. Diane: How do you work
with families and the patients involved? Stefanie: We strive to be a
support system for people here in the local community. Of
course we offer these resources but we often get to know them
on a one-on-one basis to where they’ll call me up
and let me know how they’re doing. I mean, I
get invited to birthday parties and things like
that for the families of breast cancer survivors.
And we really enjoy that. We want to be there for people. Diane: Stefanie, what are some
of the educational efforts that go into promoting
early detection? Stefanie: Absolutely. Well one
of the things that we are really promoting is to
just know what’s normal for you. A lump in my
breast might be different than a lump in someone
else’s breast. So it’s just important to pay
attention to changes that are happening to your body
specifically. So we really just promote people paying
attention to what’s happening to their
body and any changes. Diane: So almost saying, you
know your own baseline and what deviates from that might
be an idea that you need to get it checked. Stefanie: Absolutely. Everyone
knows about the lump and they associate that with breast
cancer. But there are actually a lot of other symptoms that
can indicate a risk of breast cancer. Even
itching in your breast. That can indicate
potential breast cancer, potential risk. But people
don’t pay attention to those things because for
so long we talked about the lump. But it’s
important to know about rashes, skin dimpling,
your nipple turning inwards, there’s a lot of
different changes. So we sort of changed our messages
to look at the breast as a whole and pay attention
to all things that happen. Diane: Again I think
you’re right. People aren’t aware of the
other risk factors or evidence of a problem occurring.
Stefanie: Absolutely. Diane: Now you mentioned
some resources for the patient and the
families. What are some of the resources that you offer? Stefanie: Sure, so what we do
as a local affiliate is up to seventy-five percent of
everything we raise we keep it here in Central
Florida. And we put it out into different programs in
the community so that patients can have access
to things such as breast health screening,
diagnostics, testing, education and also
financial assistance when going through breast
cancer. We also have a lot of resources in support
groups as well as linking breast cancer patients to
one another to lean on. Diane: How critical is it
for a patient to have the support of an
organization like yours? Stefanie: It’s huge. Every
patient that I have ever met has just been so thankful to
know that there’s a place to go for information but also
for a relationship of some type of support to meet
other people, to know that we’re doing something to
impact and make a difference in the breast
cancer community. Diane: How much does it help
with the families? I would think that that’s such an
emotional time watching a love one battle breast cancer. Stefanie: Absolutely. And a lot
of people don’t realize, when your loved one is going
through breast cancer, simple things like
vacuuming, doing laundry, cooking, those types of
things family needs to pitch in because women
can’t often move their arms after surgery for a
certain amount of time. So we always try to educate
family. Just be there. Do normal things. Every day
things make a difference. But also participating in
some of our events and just getting behind our
cause it also empowers them to know that they
are making a different. Diane: People don’t realize
all those aspects. Now you talk about an educational
aspect for the family. Do you have classes or just
is it a formal kind of thing that they can
sign up for or? Stefanie: Absolutely. We’ve got
all sorts of different things. Every year really varies
based on what our community wants and what
they ask for. We’re often putting out surveys saying
“Would you like to come to an educational event?” So
we do a lot of breast cancer symposiums, as well
as individual classes or education tents at events,
or we have a lot of people come in to the office to
learn things and they often end up staying
as a volunteer. Diane: So you do a lot of
presentations as well as just the informal here’s a table
and some information. Stefanie: Absolutely. Diane:
I didn’t realize that. Stefanie: Oh, we try to
be everywhere. We are always open to go and
speak wherever we can because we realize that’s
the basis, that’s where it starts. Just having people
familiar with what Komen does and also about
breast cancer. Diane: Now I know that the Susan
G. Komen chapter spans a nine county area. How are you keeping
up with demand for services? Stefanie: Well, what
we do is every few years is we do a community
profile. And basically what that is is a deep
dive into Central Florida where we’re looking at
statistics and what’s happening to patients so
we can see what are the gaps in the breast cancer
here in Central Florida and what do we need to do
to make a bigger impact? Because what we need to do
here in Central Florida might be different from
what Miami or New York needs to do. So we keep up
with it up every few years by looking at these
numbers and just talking to our patients and providers
to see what they need and then we change our granting
priorities based on that. Diane: What about partnerships?
Does Susan G. Komen partner with local groups? Stefanie: Oh absolutely.
We’re partnering with people in different ways.
So we do a lot of educational partnerships
as well as sponsorships where we partner with
bigger companies. They’ll often donate but we also
go out there and we speak to their employees and
tell them about breast cancer. We do screening
events, partnering with all of our grantees, which
is everything from health departments to homeless
clinics to hospitals. Diane: Sounds like you
have a wonderful outreach. Now you talked a little
bit about your volunteer role to start with. How do
people get involved with the volunteer aspect
of Susan G. Komen? Stefanie: I mean often it’s just
a phone call to our office or an email saying I want
to be involved. You want to help, we’ve got things
for people to help us with. Because there’s so
much going on. Our Race for the Cure that just
happened. We had about 400 volunteers out there. So
that’s our largest event. But all throughout the
year, we always need volunteers to help us with
different things, so it’s just a matter of getting
in touch with us and letting us know
you want to help. Diane: Where can people
go to learn more about the organization?
Stefanie: Sure. They go to
our website which is just komen. K-O-M-E-N Central
Florida dot O-R-G or we actually have a help line.
It’s free. It’s 1-877-GO-KOMEN. It can help
point you to resources but they can also talk to you
about breast health as well. Diane: Stefanie,
thank you so much. Stefanie: Thank you.
Diane: That’s all for our show today. Visit
wucftv dot org slash metro for interactive features,
special content and more. Thanks for tuning in. Until
next time, I’m Diane Trees.

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