♪ >> October is national b***** Cancer Awareness Month.

As we close out on the honor and tell the stories of survivors and talk to experts about the importance of early detection and more that's now on connections.

♪ ♪ ♪ Thank you for joining us for connections today.

I'm Renee Shaw.

As we close out b***** Cancer Awareness Month.

We want to empower women and men to understand the importance of early detection treatment options and lift up the stories of survivors.

We begin the conversation with Doctor Rachel Saunders, an OBGYN at UK Health Care.

>> It seems like we're seeing more and more women being diagnosed with b***** cancer.

Can you kind of tell us, though, the rate of incidents and is it really trending younger and younger ages?

>> Thank So right now, the incidence of b***** cancer for women as about one in 8 women, we estimate that one in 8 women will be diagnosed with b***** cancer in their lifetime.

When we look at the incidents for men, it's about one to 833.

Well, it's actually a little higher than I was thinking because about 99% of new cases of b***** cancer are diagnosed in women.

Right?

So the the one percent right.

And we'll meet a gentleman a little later on who falls into that unfortunate one percent category.

>> What do we know about a young women in particular who either anecdotally are people that we know who have even aggressive forms of cancer and their in their 30's are early 40's.

>> So again, a lot of that is anecdotal evidence.

So as of right now, we have not changed our screening guidelines, but it is very interesting because we've also noticed that the age of puberty and the age of first having your period is getting younger and women and one of the risk factors for developing b***** cancer is prolonged exposure to estrogen, which is a hormone that gives us our them in futures.

Right.

And so to me, it's curious because I wonder if there's not even an environmental factor that is contributing to some of this and why we're seeing, you know, earlier incidents of b***** cancer, more aggressive and also that kind, of course, ponds with younger women starting their periods.

You know, around the ages 8 or 9 versus 12 to 13 when we were, it's 8 or 9.

They're starting their first menstrual cycle.

Yeah.

So you think a lot of that is environmental or >> foods we eat are what explains that?

Yeah.

I mean, this is just kind of personal theory, but I do think that kind of starts to explain some of the changes we're seeing.

>> Right?

Wow.

And so that increases their risk.

That's a risk factor.

You're starting your period at 8 and then you don't go through menopause or you don't stop having periods until your mid 50's.

And that's all along window in which are being exposed to estrogen, which then can increase your risk for developing b***** cancer.

And so for the one percent of men who get b***** cancer.

>> Is it because they have levels of estrogen?

How how is that happening with men?

all men have some small levels of estrogen, just like all women have some small levels of What we see in men that are diagnosed with b***** cancer, it's usually due to a genetic abnormality.

>> You may have heard of the BRC a jeans, The RCA specifically associated with male b***** cancer.

So more often than not, when we see a man with b***** cancer, he actually has that a genetic mutation, right?

And so men don't typically get screened for b***** cancer.

So I assume that many men find it when they are showering and we'll talk to a gentleman.

That's how he found it through just something just wasn't right.

And it wasn't that he was doing an intentional exam.

It was just kind of happenstance.

Yes, exactly.

Yeah.

And so what do you advise all men, I guess to do, too, be aware and to check their bodies.

Yeah, I mean, I all people should be checking their buddies regularly and kind of knowing what your baseline so that when you talk to your doctor, you can have a nice conversation about this is my normal.

And this is changed.

And that helps us as providers be able to give you the best recommendations right?

The treatments for b***** cancer have a come a long way.

They kind of the most hot off the press right now.

Thing right now is Where we actually take your immune cells and train them to attack your cancer cells.

And then we put that therapy in your body to kind of help direct that, right.

So is that a stand-alone type of treatment or is that used in combination with either radiation or chemotherapy that's usually used in radiation with combination with other things, And is there a certain stage of of the disease progression, which that's all that's an option or preferred usually immunotherapies used in patients who have what we would consider to be triple negative b***** cancer.

So those are b***** cancers that don't have any harm interceptors right.

And this is really prevalent with African-American women, right?

So talk to us about this prevalence with them.

And then also the mortality rates that affect us because of this.

Yes.

So when we kind of break down the incident to b***** cancer based on racial groups, we find that African-American women.

We are the second most common group to get get b***** cancer outside of white women.

However, when were diagnosed is usually a more aggressive form of cancer like the triple negative.

We just And it usually diagnosed at a later stage so that there's usually distant that metastasis when you're diagnosed right?

So just not getting screened when we should are one of the reasons why it is so advanced.

>> So the triple negative b***** cancer portion is likely probably due to some form of genetics that we're still exploring.

But there is a large portion of the social determinants of health that effect.

>> Our health care.

And a large per population of African American people don't have easy access to doctors don't have easy access to insurance.

There's also health care discrimination that's been kind of in the forefront of the news and all of those things play a role and make entry to healthcare later.

And so when you are diagnosed, it's usually later events.

>> I do want to talk about advocacy is what I like to call it foreign.

We hear this across the spectrum regardless of of racial or socioeconomic lines that you always need to be your best advocate.

But you we do hear anecdotally, I hear from my circle of friends about how sometimes they feel like they're being dismissed when they say that they're experiencing pain.

Are they know something is wrong and it's kind of shrugged off.

Can you talk to us about how physicians or maybe being trying to to recognize their racial bias and to make sure that they're treating their patients equally.

So as I we have really been at the forefront in medical education.

>> And changing a lot of that unconscious bias that lead to medicine not being helpful to, you know, minority populations.

And one of the things I personally do because of the correction director for the OBGYN course at University taking that school.

As I talk to my students about experience as a minority women and how important it is to listen to patients and to really take what they're saying into consideration right?

>> There seems to make some confusing messaging about when to get screened for what can you help sort it out for us, particularly when it comes to b***** cancer?

so kind of the 2 governing bodies that help tell us how to manage patients is the 9th United States Preventative Services Task force.

And then there's the American College of Obstetricians and Gynecologists.

So I follow with Aycock because they're a little more conservative with their screening.

And I like to be conservative with my patients.

So the recommendation is starting screening at the age of 40 and after the age of 40 screening, every one to 2 years until the age of 50, and then they recommend annual screening The United States Preventative Services Task Force recommends screening starting at the age of 50 and screening every one to 2 years thereafter.

Right?

Why the discrepancy?

Why aren't they aligned?

I think that discrepancy, as we kind of mentioned earlier, is due to when the United States is looking at recommendations for health.

We're trying to find that intersection of not missing any malignancies and also being conservative with our health care dollars and not overburdening the health care system, right.

And so that's why some of those screening guidelines differ.

What I recommend to patients, however, is to talk to your doctor and talk about, you know, your personal genetics, your personal history and come up with the screening plan that makes you feel and that makes a point said to talk to your family about what's in your family lineage.

I mean, what you could have a genetic predisposition to and it's really important to have those conversations.

>> I do always liked in these conversations on hopeful notes about how far we've advance in the treatment of b***** cancer.

And if you get a b***** cancer diagnosis, that doesn't mean a fatality.

But there's a lot.

There's a lot of optimistic messaging that can be conveyed.

That's realistic, right?

Doctor Saunders?

So if you have a diagnosis of b***** cancer, you're 90% in the year.

5 year survival rate is where as in 1975 it was only 75%.

>> So we've actually made huge in the management of b***** cancer due in large part to early detection and better advancements in treatment right?

>> And so there is a still optimism for a cure, right?

And we hold on to that.

Well, I thank you so much for your time helping us sort through all of it.

Thank you.

Thank you.

>> The CDC says most cases are diagnosed after the age of 50, but we're about to hear from Courtney line of Hart County.

>> A young woman in her early 30's who found a lot during a self exam.

>> Good to get a go.

Go go.

I was 31 years old.

When I was diagnosed with b***** cancer, one more.

I was shocked.

>> To say the least many patients coming in to see me and say how could I have had b***** cancer?

Never had a family member with b***** cancer?

Well, interestingly, that numbers about 80 85% of patients with b***** cancer do not have a mother or sister that have had b***** a kind of shocks.

The public.

>> I was diagnosed stage invasive ductal carcinoma.

>> Starting in about 1990, there has been a significant fall before mortality from b***** cancer in United States, which has been a very, very important point.

>> That's probably a combination of awareness, a combination of screening and equally important is a very good treatment we have now.

>> My original plan was surgery and radiation and then it was after surgery when they found the lymph node involvement.

And I did it.

I ended up.

I had 3 tenors.

>> We were willing to accept the challenge and we KET we were going to get through it no matter and we just want the war.

Our chance.

>> I ended up having to do 8 doses of chemotherapy and I would do every other week.

And then after that, I did.

25 rounds of radiation.

>> Technically she went into remission.

The day of surgery when they removed it all.

But all of the following things that took place chemo and radiation.

Both of those had their own challenges.

Both of those are really tough.

>> Throughout the journey, there were times when I was, you know, had to sleep rest and she didn't understand that you there.

But Justin did a great job of this meets arrest.

I think Jansen understood it more.

I think it took them a while to understand it.

>> But he KET that mommy was.

We had it saying the words sick, but mommy just needed to rest and get better and get healthy.

Please, please, please do yourself.

B***** exams.

I know it's one of those things that you rush through it or you think I don't really need to do this.

>> But you do.

It's important for young women to know is.

Just general body awareness.

Actually, it's kind of relevant to all of We need to.

But we're just a thing when we're taking care of ourselves.

Putin, clothing on if something's different.

And it doesn't get better over the course of a couple weeks.

We need to use your doctor.

Whew.

>> I am currently on 2 different One is an oral chemotherapy that will be taking for the next 2 years.

I also I'm going to be taking a hormone medication that kind of shuts down all my hormones because my b***** cancer was hormone driven.

>> And that's been probably one of most important parts of all the b***** cancer research over the last 20 plus years.

This so-called out of a treatment, which is how to customized to each individual patient, what they need to really up the mindset that likelihood of the cancer.

>> Dot crime.

>> She and I are marching through that process to just reduce the risk of the likelihood of this cancer coming back again.

And most likely it won't.

With with the plan we have in place.

She >> Our best to her Courtney November will Mark one year since Courtney learned she had cancer.

She says since then she's become much more diligent about healthy eating and exercise and that her faith, family, friends and community have helped her stay strong throughout her treatment and recovery.

October, as you know, is the busiest month of the year for the Kentucky Cancer program.

In addition to hosting screening events across the state.

>> They're also raising awareness with a walk, a car tour and even a rodeo.

Kelsey Starks, our Kentucky Edition contributor tells us what they're hoping to accomplish.

>> Well, Renee b***** cancer is the most common cancer among women worldwide.

And in Kentucky, we consistently ranked as having one of the highest death rates in the country.

Well, the Kentucky Cancer programs mission is to change that.

And that Pan Temple Jennings is here with the Kentucky Cancer programs.

Thank you so much for being Tell us what the Kentucky Cancer program is.

What you do.

And you all have a ton of events coming up for b***** Cancer Awareness Month.

We do October's one of our biggest months.

Obviously, but the Kentucky Cancer program.

We are a state funded program through a state legislature and the allocate.

The money is down to the University of Louisville and University of Kentucky.

So it comes through the Brown Cancer Center, which is part of U of L and the Marquee Cancer Center, which is part of UK so statewide, we do efforts in trying to raise awareness about cancer screening early detection prevention.

And then of course, we like to focus on at times, too.

Sure.

And that's one of the things that, you know it because why Kentucky consistently ranks.

>> With this high death rate and it's because of the lack of screening.

It is.

It is.

We see across the board that people are not going in to get screened >> weather be for their mammograms.

The Pap smears now lung cancer screening caller, r***** cancer screening.

All of these are things that individuals can do on a routine basis to reduce the risks of having an advanced cancer.

So that's why it's so important.

>> I'm in it.

So a lot of people say, oh, it's b***** cancer awareness month.

And you know, so we do walks and we get together.

And what does it actually do?

And you've seen some real change come out of these awareness efforts.

So tell us about that.

We have, you know, b***** cancer is something that everybody hears about pink.

And some people say pink isn't pretty.

>> But it's what people identify with is what women identify with.

You know that, hey, its peak months, let's go get a mammogram that's helped a lot of people to think lot.

Ladies remember It also is just a special time to recognize those ladies who have fought so hard and who are thriving.

so it's a time for them to come.

Celebrate to get with their sisters, although b***** cancer survivors, they celebrate every day because, you know, each day is a triumph.

When you're dealing with any type of cancer.

So we really October as to celebrate with survivors.

Another time to emphasize for those women, if you've not been screened, especially during COVID, so many people stop getting screened by.

And so we really are still emphasizing to ladies.

It's time to get out there and get screened if you haven't done it yet.

Yeah, it's not something to put off.

>> Is what it what is your biggest challenge?

Is it the uninsured population?

Is it getting screened?

Is it helping people before during after treatment.

What's the biggest challenge will face?

The biggest challenge is getting people screened and you know, for ladies it, there's opportunities out there everywhere.

There's programs in the state if they're uninsured.

And that's what we really try to emphasize across the state with Kentucky Cancer program and even going to provider offices.

So if they have patients who are uninsured, there's a program out there called the Kentucky Women's Cancer screening program and it's through the state Health Department, which is funded through CDC.

And it's an opportunity if women do not have insurance for their under ensure that they have this really high deductible, that they can actually get a mammogram or Pap smear for free.

And then if something is found, it will still pay for diagnostic screening and then it can help pay for treatment options or any sort of surgery.

Chemotherapy, radiation.

So there's opportunities and resources out there.

So we try to get out there and let the women know that just didn't take advantage of what's already out So how do people get involved and do you have a lot screening opportunities around the state?

>> We There's several different opportunities for women to get screened.

They can always go to the Kentucky Cancer program website and there's our Pathfinder.

That will list all the different It's sites that they can go to in Jefferson County.

We have the mobile mammography unit that goes out from the Brown Cancer Center and we have screenings for rest of the year.

You're out the where we're going into what week sometimes called the hard to reach areas where people may not transportation to get to screenings.

They work every day.

So we do a lot of Saturday screenings.

Yeah.

And churches are really good and inviting us to come in and do a screening at their site and make it their members there and they help promote it.

So we're really trying to focus, especially this month and next month on getting out and letting women know that this opportunities here for them.

Thank you, Cal say women account for 99% of b***** cancer cases.

So >> that means there's room for the disease to impact men.

And that's exactly what happened to Andrew Skipper, Martin, known by many as just skipper.

He spent decades serving the commonwealth and state and local government and was a key adviser to former Kentucky Governor Paul Patton.

And he's also a b***** cancer survivor.

>> For those that think, man, don't get b***** cancer.

Well, give me a call because men do get b***** cancer.

Now the odds are tremendously small compared to a woman.

But when I got this 10 years it was about 100,000 to one where the odds of a man getting b***** cancer.

So I'm anoushah are a dish.

You want to know we do?

Washington also like to but Cisse and under my right n***** was a little piece as Well, I KET for some reason that man don't get b***** cancer.

So don't worry about it.

And so when I went to the doctor, he looked a story about 100,000 want.

OK, next time out when he let's get look at.

So I got sent to the doctors to the hospital to have a mammogram.

And it was interesting because I went into the room with 5 women and I'm the only man sitting there.

One lady said, sir, you in the right Hall.

Yeah, yeah.

So I took it.

I got my mammogram that was interesting.

so it came out that it was cancers I have a great doctor.

Beth Riley is with that.

Cancer center in Louisville and a Brown Cancer Center.

Louisville, which is you, Bill and she is a researcher at cancer doctors.

She sent a little small thing California to be analyzed and it sturgeon produced.

Now a lot of Evan estrogen, have estrogen produced tumors right?

So I'm taking the same pill as a woman.

because and here's what not and you're still taking it.

I'm taking it.

Yeah, I think I'm coming to the end of taken its of taking it for almost 9 years.

Right.

And here's what Beth, his to Doctor Riley, Beth Riley sheet.

She says, Skipper, if you're you have we all have estrogen and testosterone.

But if sturgeon wants more testosterone, it will reach into a man's testosterone and converted.

I think it's called there's another work, then convert them.

But don't take testosterone.

My daughter was over and Humana and she when she found, she says stop taken us.

She said it's a women's problems or harm homes, stop it.

So idea.

Then when the doctor asked me, Beth, Ask me said was stopped taking.

She said because I would think maybe it wanted more testosterone, right?

Converted it.

And I have.

And and they sent that off to California for research because not many men have this, but it proved it was sturgeon produced.

And I take.

I think that's the name.

I'm sure a bit butcher in the name.

That's not land.

but that's the pill at take.

Which a lot of women take that pill right?

>> So what was the other part of your treatment plan or is it just been an oral medication?

Did you have to go to oral medication?

I was blessed to head to the There was not in my lymph node good.

>> And the and with it not I didn't have to take anything else.

So I was very blessed came out of that.

Now.

>> Do they call it stage one or did they give it a particular stage?

You know?

>> was so I was just blessed to have it.

And I have been I got to say this that when Jeanie Patton Paul were leaving office, Judy had a big b***** cancer survivors launch after the Derby.

And then when she left office, Jane per share came in and started harsh isn't And because the people had a backside of the track really didn't have services right.

NJ has started that.

So I've been fortunate to get to these events at Churchill Downs because they want one man to come they in in that room at Millionaire's Row Churchill Downs.

1000 women that are b***** cancer survivors and they motivated me because I was scared.

But when I got on the operating table, it hit me, skipper.

Look at all the women you sane.

That had that are b***** cancer survivors.

And for some reason it put me to rest said if they can do it, I can pull up my big boy pants and I can deal with it.

Yeah.

And that was a motivating factor for me to see all the women but men can get b***** cancer.

>> All right.

You like you said it's a small chance.

One percent.

Yeah.

you know, things are so much.

Did you feel like you had adequate support?

Because all of the research and all the resources are really female women directed, but from and kind is gone.

The research.

Yeah.

Beth Riley says that there's probably more and getting it now.

I don't know what that means, It's up.

Something man ought to watch.

>> And they ought look for any bumps, anything else and then go to a doctor and say, what is it?

You don't dismiss it on ICE.

MS in Salem can't get it.

That's not true.

>> But you took action.

I mean, when you recognize that something was wrong, you >> sought medical know, and got good doctors and so that's my story.

I don't know that there's any more to it or what there's a lot to it because, you know, you actually sharing it because some men would feel some sense of embarrassment, maybe about it.

But you are.

You're coming out about it because, you know, I mean, sometimes being at the odd one in the bunch was Lice.

Am an odd one in the bond would say, other And after we got through the shock, there was humor.

>> Yeah.

Here in our family, there's a lot of humor.

>> my granddaughter Haleigh Rodman.

She gave me a brawl with one Cup.

My grandson.

>> He gave me know he did.

He and boots.

>> So they they're found humor in it, right?

so it it's humor is a wonderful.

Remedy for thanks.

>> So do you talk about it with your male friends and said, yeah, it's like those.

If it taken testosterone, think about it because there's a lot of push to take testosterone.

And that is a horrible crime.

And though no one's talking about, don't take testosterone.

Is it worth it right then?

Probably the odds are you can take it and not bother you right?

So you've been taking this medication for 99 years of take it slow stop this month or next month.

>> And so do you get annual mammograms know, OK, so how do you how are you ensuring that you don't have a week?

>> Price a year.

They punch in feel and ask me And that's the extent of what I do.

Yeah.

Blessing was nothing in the no 10, right?

It's catching early.

Catch it early.

Catch it early.

Whatever.

You got to catch it early, right, making a lot of progress in cancer, but you got to catch it early.

>> Power due to do early detection.

Stay on top of your health and thank you for joining us to for connections today.

I'm Renee Shaw.

Take really good care and we'll see you soon.