And welcome back to Family Health Matters I'm Shelly Irwin, with me today is Mary Westphal, the state executive director for Michigan and Ohio.

Hello to you, Mary, glad you're here.

- Hi Shelley.

- We appreciate you.

That's of course, Susan G. Komen Melissa Budzinsky, program staff with our Gilda's club grand rapids.

Hello to you, Melissa.

Thank you for your expertise.

Yes.

And there is a Dr. Erica Wrubel.

She was here to share her specialty.

Thank you for you with a breast surgeon at Spectrum Health Cancer Center.

So thank you for your talents for many.

I always begin consistently equal time for how you spend your days in the world of breast cancer.

May I start with you, Melissa?

- Sure.

So I am on program staff at Gilda's Club Grand Rapids.

We are a free cancer and grief support community.

And people like myself on staff who are licensed mental health professionals facilitate groups where we create a safe non-judgemental environment a safe non-judgemental environment where people can lean into the emotional side of their experience.

And breast cancer especially for women, is well, and men, is an emotional journey as well as a physical journey.

And so giving space for people to connect with one another, to share their experience, strength and hope and create some support for one another while they're going through this very life-changing experience.

- Mary West.

Yeah, thank you.

Mary Westphal.

Tell us about you and your organization.

- Hi Shelly.

Thanks so much for having me.

I am with Susan G. Komen and we are an organization committed to a vision of a world without breast cancer.

We are so very proud to be fighting breast cancer on all friends.

We are very dedicated to research to help find the cure for breast cancer, as well as support in local communities for uninsured and under-insured women and men who are battling breast cancer, as well as certainly working in that pop-up public policy space, whether that's at the local state or national level, just making sure that we are advocating for our breast cancer survivors and ensuring that they are getting the type of treatment and care that they need that will maximize their, their world and their lives.

And we are very committed to making sure that breast cancer is stamped out and we know that we've made great progress but as I'm sure we'll hear from other members of your panel, we know that every time we make a breakthrough in research, we roll back and add a layer of that onion.

We find out that there's another set of barriers that need to be resolved.

So we are all about saving lives in the fight against breast cancer.

- Thank you, Dr. Wruble, I imagine no day is the same in your world.

Tell us a little bit about you.

- So I work currently at, Spectrum Health Cancer Center, at the Lemmen-Holton Cancer Pavilion downtown, where we provide comprehensive breast care services, which a large portion of that is treating women with breast cancer.

So that's typically what we offer.

They're going through typically the breast surgeon is the person that meets the patient first when they received that diagnosis.

So we lay out a lot of the foundation for their care and the direction that that's going to go.

So we've formed pretty long relationships with our patients over the years.

I was just telling the other panel members that we typically follow them out for five years after diagnosis.

So it's a great way to build relationship with the patient and get them through all aspects of their treatment.

- Yes, let's be stay with you, Dr. Wrubel with your science hat on why breast cancer, why does the breast attract a cancer?

- So breast cancer is a very common cancer.

It's affects one in eight women throughout their lifetime.

So it's one of the more common ones that we treat.

We don't know exactly what causes it, but we are learning more about risk factors and risk reduction and ways that you can reduce that risk.

And most of that stuff is reducing alcohol intake, making sure you're having a normal, healthy diet, exercising, all the things that women should do regardless, but we have shown in some studies that they help reduce that risk as well.

- How about the, the, the DNA, the heredity, then that brings us to a whole different conversation.

I know, but should I be more aware if there's a close family member?

- So we certainly encourage patients to know their family history, especially when it comes to breast and ovarian cancer.

There are certainly other cancers that can be associated with genetic mutations with breast cancer as well.

And some of those would be pancreatic cancer or any males in your family with a young age at prostate cancer.

So knowing all that family history and the ages of when those were diagnosed is very important.

And always share that with your physicians when you're either, when you're undergoing your screening or just on your annual visits to your physician's office.

We do have a high risk program at Spectrum Health that we recommend women that have a strong family history or any high risk factors that they can make an appointment through either through self referral, or through referral through their doctor's office.

And we go through whether they need additional screening or genetic testing to help benefit from that as well.

- And as Melissa mentioned, men can get breast cancer as well?

- Yeah, certainly men can get breast cancer.

It's very rare, but it does happen.

So we always encourage men to be performing self-exams as well, either on a monthly basis or at least part of their physical exam annually with their provider, yet, just being aware if there's any skin changes or new lumps that come up.

- Thank you.

Mary, At what point do we turn to your foundation?

- So certainly if you're uninsured or under-insured and you need support, it is the perfect time to reach out to come.

And we are very committed to a 360 degree effort to make sure you can access all the services you need.

We have an 800 number that anyone can call and to that they can access a mammogram.

If they qualify based on their income levels, they can also access patient support and patient assistance, which can be anything from assisting you with paying your rent, to help you with transportation to your doctor's appointment, helping you with childcare, helping with food, a variety of other things, because we know those barriers, prevent women from getting their mammograms or making sure that they're addressing their breast health issues.

And then of course, we've remained very committed to ensuring that we follow those patients through ensuring that they do access their care and that they are able to then thrive going forward and find the path that's right for them.

We do always encourage anyone who has changes in their breasts to reach out to first their family physician, or medical professional.

And again, if they have no access to insurance or they are under-insured to please feel free to call our 800 line easy number 1-877-GOKOMEN 1-877-GOKOMEN and we will be happy to help.

- Thank you for that.

Same question to you, Melissa.

At what point do you ask those with breast cancer to reach out to Gilda's Club?

- Anywhere along the line.

We literally have had people that have come from the doctor when they've heard that they've had a diagnosis to a couple of years down the line after they're done with treatment and surgeries, and they're, they're just moving back into their life without all of all of that.

And so the emotional journey can really put pressure on you And so the emotional journey can really put pressure on you any time in there and that and support can happen and is available for any, any moment on that journey.

Or if you know someone who has diagnosed, like if I was diagnosed my children and my parents and my siblings, they're all eligible to come to Gilda's and get support to learn how to support a person that's on a journey also.

So anywhere along the line, it is okay to reach out for help and ask for that support.

The point of Gilda's is that we don't want anyone to feel like they have to do this journey alone.

That we are there to walk with them and to hold their hand and to, to support them as they move through.

- Yes.

We all know the answer to this next question.

I'll bring it to you, Dr. Wrubel.

Talk about the importance of early detection.

- Yeah.

So early detection is key in breast cancer treatment.

The earlier we find it typically the smaller the tumors are the more treatment that we can provide in order to obtain a cure.

And it's certainly early detection with mammogram screening is one of those key components.

So we typically recommend that starting at age 40 for average risk women and starting that annually afterwards and continuing that certain high risk patients might be recommended to start screening earlier.

But so we encourage you to talk to your provider about those recommendations.

- Yes.

And mammograms, what's digging a little deeper annually as we get older?

What's our, what's our obligation here?

- Yeah.

So in the United States, we recommend starting at age 40 and then continuing them annually thereafter, and certainly bringing up in between any concerns that you have on your own self exams, and we can obtain imaging sooner if needed.

- Super.

Mary, tell me more about support groups or other foundation strategies that you offer.

- Absolutely.

So certainly when you call our 1-877 number you absolutely can get connected to a helpline, but I would also share with you Shelley that one of the things we're quite focused on is the risk for African-American women.

We know that African-American women absolutely have additional risk.

They tend to be diagnosed at a 40% higher rate than white women.

Certainly one of the reasons that we believe that to be accurate, and the statistics indicate is that African-American women may not be accessing or may not even have access to their medical care.

So they're getting diagnosed at a later stage in their lives.

So one of the things we want to be very clear about is we can provide support to anyone experiencing challenges and changes with their breasts, but we really encourage our African-American partners to pay attention, to know that early detection does make all of the difference, no matter what your race is.

Making sure that you are, you know, know your risk, you're getting screened, you know what's normal for you and you are absolutely making healthy lifestyle choices.

- Thank you for that reminder.

Would you follow up on that, Dr. Wrubel?

- Yeah.

So again, - Yeah.

So again, making sure getting mammogram screenings on a timely basis, Spectrum Health actually offers a mobile mammography unit through our services with a cancer center.

So over the course of the month of October, they're actually going to some of those higher risk population areas in Grand Rapids and our surrounding communities to provide better access, to care to those patients.

So it's harder for some people to get downtown or different hospitals in order to obtain their mammogram.

So we're trying to bring it a little bit closer to some people that need it the most and more information on that can be found at spectrumhealth.org by searching the mobile mammography.

And the schedule was up there.

You do still have to make an appointment.

It's not a walk-in basis, but that's one way that we're trying to reach out to some of those Western areas of our community.

- Yes.

Melissa, how has Gilda's meandered the course of COVID presently and in the future, one still need your help.

- Yeah, so great question.

And we very soon after COVID and the lockdown And we very soon after COVID and the lockdown we launched our virtual clubhouse.

And so we've been now since, since then, running a virtual clubhouse, all of our groups on online through zoom, just like what we're doing right now.

And it's been very successful.

And in fact, we have found that people are coming to group from their hospital bed or from their, from their time, let's say they're on chemo and their immune system is low and they really can't get out of the house.

So they don't feel good.

They come to group from their, their, you know, living room when they might not have come to group otherwise, or from across the country.

We have people from all over Michigan, all over the country that are able now to access support in a way that they didn't, they weren't able to before.

It's really such a beautiful thing.

And so now we're just dipping our toes, just actually yesterday, dipping our toes back into coming back in person.

And, and we're going to keep this virtual marriage to our groups.

And so we're offering hybrid so people can choose how it feels for them, how safe they, they want to be.

Or I'm not saying that very well, but they get to choose how they come to group.

And if it feels better for them to come virtually, that's great.

And then if they want to come in person, they also can do that.

And so we have hybrid groups and that seems to be working really well.

In fact, our breast group, our first Hybris, our hybrid breast group at the GR Clubhouse.

I had 10 in person and seven online all at the same time.

And it's just so heartening to, and, And it's just so heartening to, and, and such an honor to help all of those women come together and support one another and talk about what's important to them.

So.

- Yeah.

Thank you for that.

Yes.

Turning you, back to you, Mary, and how you are meandering again with your clients in Michigan and Ohio?

- Well, you know, Shelly, I think that Melissa's remarks were actually spot on while we're all tired of virtual.

And we see some places where the virtual platform is no longer working.

The one place that we feel it is working well is with our breast cancer survivors who really can't get out of their home.

Now they've got a way to stay connected.

They've got a resource, they've got help.

So that has in many ways been a blessing for all of our breast cancer survivors.

And so I'm so glad Melissa mentioned that.

With all things COVID though we've seen many changes as clearly, not as many women are getting their mammograms.

We have seen a surge through our network of requests since about the beginning of February, since about the beginning of February, where we began to see women who hadn't had their mammograms and they began to need help.

And they've done them.

We've seen a surge of breast cancers and I'm sure Dr. Wrubel can speak to that.

That's been unsettling.

I'll be honest with you.

We know early detection makes a huge difference.

So it's unsettling to think that people put off their mammograms during COVID.

The other thing I would say is, you know, so many people are familiar with Susan G. Komen because of our race for the cure and more than the series.

And so if those platforms changed dramatically, they do so much to help with awareness.

So that's impacted people and certainly to help with fundraising so that we can deliver these very important services.

And we've certainly had a really very real impact there.

However, we are really fully believing that we, we'll be back in person and we will continue to be able to save lives and the fight against breast cancer, through our many services that they can access through our 800 number.

- Yes.

And Dr. Wrubel, have you seen a lessening have you seen a lessening of those who need early detection because of COVID?

- Oh, certainly for a while we were, you know, dialing back on the scheduling for screening mammograms just initially when COVID began, because we weren't sure how that was going to impact the hospital system, but now we're back up and running and back at full capacity with all of our mammography units.

So we're encouraging anyone that hasn't had a mammogram in the last year to make sure that you get that scheduled as early as possible and to still be paying attention to your home screening and making sure you're visiting your physician for a yearly breast exam as well.

- Yes.

Dr. Wrubel staying with you both Gilda's Club and Susan G. Komen both Gilda's Club and Susan G. Komen have fundraisers that involve exercise.

So why is exercise possibly correlated with a good preventative choice?

- So exercise is a component of the healthy lifestyle that we promote for any women, either going through breast cancer or to help try to prevent breast cancer in our high risk women.

So exercise has been shown.

I mean, it's not only good for your body.

It's good for your mind helps with stress relief.

So for any women that are going through a process where, you know, it's one of the most stressful experiences in their lifetime, going through a breast cancer diagnosis and allowing them to have that release, but also this, the physical benefits of exercise are always good.

There's also some information that low fat diets and certain types of fruits and vegetables in your diet with high, high vitamin K and other minerals that can help with breast cancer reduction and certainly avoiding obesity, especially weight gain after menopause seems to be linked with higher risks of breast cancer.

So we encourage everyone to have a healthy lifestyle to try to avoid any of that.

- Never too late to start?

- Never too late to start.

Same thing with smoking, never too late to stop.

So.

- Appreciate that.

Yes, Melissa stress has been mentioned.

Emotion has been mentioned, take me through this journey that is experienced at Gilda's Club when there's a physical obviously challenge, but how about the emotional challenges?

- Sure.

Yeah.

There's so, it depends on to where that person is in their life, but oftentimes there's a, but oftentimes there's a, an immediate response to that their body has a mistrust of their body has a mistrust of their body or their body has, you know, done something without their knowledge.

And so then there's this, this struggle with that is getting to know themselves and with breast cancer, especially that there's a physical change in their body.

And especially culturally that our breasts And especially culturally that our breasts are mean something to us, and they're a way to feed our children as well as one of the denotations often of, of how we feel about ourselves.

And so there's a great renovation almost, And so there's a great renovation almost, you'd say of identity for these women.

And so being able to just talk about that, because there's so many choices, do I have reconstruction?

Don't I have reconstruction?

How do I do this?

When am I going to do this?

There's the prescription.

And then there's, there's choice also in that.

Who do I tell?

Who don't I tell?

Just all kinds of things, and then there's the physical uncomfortability.

And so all of that hits on every level.

And if they have a genetic component, the impact to their family, their, if they have daughters or if they have sisters, you know, sisters and, and brothers, there's so many levels of emotional impact in this particular journey that just talking about those particular journey that just talking about those coming together, knowing you're not alone, giving, giving voice to fears, to triumphs, giving voice to fears, to triumphs, to, you know, going forward, to struggles, going forward, to struggles, anxiety, really release's a lot of that from the body.

So then it, it lowers their stress increases their dopamine, their serotonin.

It helps them to relax more into it, helps them to know that there, that there is a light at the end of the tunnel, that there is some hope and it can actually physically help a, their experience in the moment.

This moment think what the doctor was talking about is that it helps longevity exercise and that kind of thing helps longevity, but it also helps your experience in this moment, which is really important.

And, and then it helps moving forward in learning about your and then it helps moving forward in learning about your resiliency and learning that you can embrace that and you can embrace the new you, and that you're going to be able to figure this out and your life is gonna get back on track.

You're not going to be in treatment forever.

You're not going to have no hair forever that it's going to grow back.

I was telling everyone before the show is that we often measure our hair and in the breast group and, and the women who have no hair are looking at the women who are six months out and the women who are six months, say, "See, this is six months growth!".

And they're like, oh, that's so great.

So even that conversation, they can't really have with everybody.

And it's really important.

So anyway, I could go on.

- Your passion is evidence.

All of yours.

Mary, is Komen involved in research or funding research?

There's, expand here.

- Absolutely, So, that is one of our pillars, absolutely is to be funding research, because that is how we know we will find the cures for breast cancer.

And I don't think we've had the opportunity to speak today at all about metastatic breast cancer, stage four advanced breast cancer.

Certainly we know that women who are battling metastatic breast cancer will not ever completely recover, but one of the things that Komen is become very committed to is research in that metastatic breast cancer space, trying to find ways to extend life, trying to find new therapies through clinical trials and trying to ensure that we can maximize those opportunities for women who are battling at any stage in breast cancer, but really looking very, very carefully and very directly at how do we make a difference in the metastatic breast cancer patient?

How do we prevent metastatic breast cancer?

How do we extend the life of someone battling metastatic breast cancer?

And we know that while the good work we do in our local communities funding direct service, we also recognize that the research dollars are really the way forward in terms of really eradicating breast cancer and finding new cures that will save women at any stage in the spectrum.

- Thank you for that.

At what point Dr. Wrubel, do you play your role?

I introduce you as a surgeon.

Are you involved right away or if complications- Expand.

- Yeah.

So my role as a breast surgeon is usually meeting with the patient initially right after they received their biopsy results after their imaging abnormality.

So typically myself as a breast surgeon is actually one of the first people the patient meets.

So we kinda like to think ourselves as the quarterback, we kind of help them lay out their treatment plan and help guide them through that treatment and whatever consultations they'll need on the way and additional therapy after surgery, typically with early breast cancer surgeries the first step, but that's not always, everyone's a little bit different, but typically if that is the first step, then we're seeing that patient throughout their whole journey and meeting with them along the way and helping guide that.

- Yes, Dr. Wrubel, what's your take home message to us and how do we find out more information, please?

- So my take home message is just to be aware of your breast tissue.

We kinda, we teach women to do self breast exams monthly at the same time of the month to make sure their hormone fluctuations don't affect the feel of it.

But to make sure that you're getting early screening starting at age 40 and continuing that throughout your lifetime.

And also to be aware of your family history and know if you need additional screening by talking to your physicians and other providers.

We have more information at Spectrumhealth.org again, on our mobile mammograms and where you can schedule your regular screening mammograms.

They have multiple locations throughout west Michigan, and we also have more information on that website about our high risk program and who would qualify for that.

So that's a good resource for people as well.

- Great.

Thank you for you, your service.

Tell us your final comment, Mary.

- So Susan G. Komen is very committed to a comprehensive approach to breast care, and we're very committed to caring for people who are battling breast cancer to research, to fund a slight saving, cutting edge research, to save lives.

We're very committed to action to advocacy and public policy.

And then of course, we're very committed to delivering support right there in every community and throughout our whole state of Michigan.

Komen is very committed to a vision of a world without breast cancer.

Everything we do starts with the question of, will this make an impact?

Will this fuel impact?

I couldn't be more proud of the good work that Susan G. Komen is doing to save lives in the fight against breast cancer.

And I encourage anyone who has questions or needs help or support to call our 800 line.

1-877-GOKOMEN 1-877-GOKOMEN or certainly they can send an email to komen.org.

I definitely feel like it's been an honor and a privilege to join you today.

Shelley, thank you so much for bringing this very important topic to the forefront, especially during October, which is breast cancer awareness month.

It's really making an important difference.

- Yes.

Thank you.

And I can save 30 seconds for you, Mary.

Remind me of the Susan G. Komen, why the name?

Such a touching story.

- Oh my gosh.

It's a great story.

Absolutely.

Susan G. Komen the story of the launch of our organization was Susie Komen was diagnosed with breast cancer in her thirties and she was battling breast cancer.

And she realized that this disease was very much in the shadows.

This was in the late eighties, I'm sorry, the late seventies.

And it was very much in the shadows and people didn't know what breast cancer was.

And the more women she met, the more she said, we've got to start talking about this.

We've got to increase awareness and Susie did not win her battle, but on her death bed, she reached out to her sister, Nancy Brinker, who of course been with her through that whole journey.

And she said to Nancy, "Nancy, I have one question and "Nancy, I have one question and I need you to make a promise to me."

And she said, "Will you promise me that you will dedicate your life to finding a cure for breast cancer?".

And like any loving sister, Nancy Brinker said, you have my promise.

Susie passed in 1979.

And Nancy launched Komen in 1982.

And Nancy did go through her own battle with breast cancer.

However, she is still alive and well.

And I love whenever I have the opportunity to share that story because it is the promise of two sisters and it has made such a huge difference in the world.

- Thank you, Mary.

All right, Melissa.

Then there's Gilda Radner.

Share, how we find out more information about Gilda's?

- Sure.

Yeah.

All you have to do is give us a call at (616) 453-8300.

All you have to do is give us a call at (616) 453-8300.

And we'll answer the phone and answer any questions you have or reach out on our website Gildasclubgr.org.

And your emotional health is part of your health.

And we, we want to make sure no one goes through a diagnosis alone of cancer.

So reach out.

We'd love to get you connected.

- Great.

Thank you ladies.

For again, your service to women and men take care to you.

Yes.

And thank you for watching this edition of Family Health Matters.