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.
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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.
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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.
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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.