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-October is recognized nationally as Breast Cancer Awareness Month.

According to the National Breast Cancer Foundation, about one in eight women will develop breast cancer in her lifetime.

and one in one thousand men are diagnosed.

We sat down with Doctor John Stevens Jr., an OB-GYN at St.

Luke's University Health Network, to talk about the importance of early detection, establishing relationship, and having trust with your physician to share your concerns.

Dr.

Stevens, thank you for sitting down with me today.

I want to start from the beginning and talk early detection.

What are the signs and symptoms that someone should look for when detecting breast cancer in themselves.

And starting at what age should they do this?

-They basically can start at any age.

Any time somebody comes in for educational we have foam breast models where you can feel what lumps are like.

So, for some people feel that self breast examination is not important.

I've been practicing a long time.

I still think it is.

And what you're looking for, make sure if they think they feel a lump, if they have pain just on one side, or if they have any kind of natural discharge from the nipple area, especially if it's blood.

But also, you're looking for signs of redness, any kind of heat changes, any discolorations of the breast, any flakiness around the nipple area in case they had a discharge during the night that may have dried.

That's very important.

Plus, if they have any kind of swelling, if they see a difference in the size of the breasts.

These are signs that can be learned at any time.

Our local cancer society has a water-proof placard to hang in the shower.

We give them out to our patients in the office here.

If it's just checking, the best time is one week after the menstrual period starts.

If they're in menopause, they try and pick the same time each month if they're checking themselves.

And early detection is so important for the survival.

People should not die of breast cancer, not in this day and age.

-Who is at risk the most?

-Who is at risk?

The ones who are at risk are ones who are excessively overweight.

People that are heavy smokers, heavy drinkers.

People taking certain medications.

In those who have a sedentary lifestyle, who are not active, they don't do anything, and they're very non-compliant about preventive exams from their primary care or their gynecologist.

Plus, if they know there's a family history.

With family histories, if they have had any genetic studies, two or three first-degree members, which includes fathers and mothers -- because men can get breast cancers also.

Those are the ones who are at risk and should be seen at a more frequent basis, and encourage their family members to seek an exam.

-Now, is it a common misconception that only women can get breast cancer?

-Last year there were three thousand reported cases of men with breast cancer, which is approximately about 1% of all the breast cancers diagnosed in the last of 2018-2019.

There has been an increasing change over the last five, ten years of men detecting breast cancer.

-Now, according to estimates from the US Census Bureau, cancer is the leading cause of death among Hispanics.

So when talking about breast cancer specifically, is there a higher rate for breast cancer among Hispanics?

-I haven't noticed anything in practice.

But we know it's the number one cancer other than non-skin cancers for all ethnicities and so forth.

But again, I haven't seen much difference with the culture changes in the Latin countries, from Dominican Republic, Panama, Brazil.

I haven't seen much difference.

-But I imagine cancer doesn't discriminate.

So, regardless of your nationality... -Exactly.

And again, there could be some genetic component that they're not aware of, too.

-Now, are breast cancer screenings or mammograms considered preventative care?

-Some people do not want to have it, they're afraid there's too much radiation, but it's been proven, it doesn't affect anything with the radiation.

But again, now the new type of screening cancer that is called 3D, because of density of the breast.

And women with especially dense breasts can be missed if they don't notice it.

So the technology and the resolutions have become so good in all of the area hospitals here, and in health care, doing early detecting with it.

And that should be followed up between that and the ultrasounds on the breast.

-Now, someone that's underinsured, should they be afraid of going to see the doctor, if they detect something in...?

-They should not.

This is National Breast Cancer Month, and all the hospitals, especially -- I know St.

Luke's allows to walk for free screenings for the patients.

If someone is a resident of Allentown, Pennsylvania.

I know the Allentown Health Bureau, they will do free screening with it.

-Now, let's talk about the cases where it's determined that someone does have breast cancer.

-Yes.

-What sorts of questions should you be asking your oncologist at that point?

-Well, when they go they're going to have to, depending on what the cell type is, which is very important, because the breast cancer staging is a little bit different than stagings of other cancers.

And those who are breast specialists in the area that treat benign and cancer breast conditions, they base on a tissue report, the size, and from all the different studies from the ultrasound.

They need to have an MRI of the breast besides the mammogram.

A lot of this is based on the tissue.

Once they have it, the have to determine, do they need radiation?

Do they need chemotherapy?

Do they need a type of medication, like an aromatose inhibitor, to have after the cancer for so many years to prevent further cancers?

Do I need to have my entire breast removed?

Lumpectomy is a certain choice with it, which is very important.

So just having the proper care makes a big difference.

-Right.

Now, there's a stigma surrounding cancer.

So I also want to talk about the support systems that exist after when it's diagnosed for mental health.

Is that something that someone can find easily?

And if so, what do you recommend?

-The Lehigh Valley has a cancer society, which has a very good support system for all cancers, but especially with the breast, including if they've had to have a mastectomy.

They have the devices to support and so forth.

There's a great support system here.

And many times patients who have had breast cancer have been volunteers to someone who is diagnosed, even going to the hospital and speaking to them.

These are patients who've had it, and they share their experiences.

And when I have a patient diagnosed with it -- When my mother-in-law was alive she would help, either talking to them, coming in to the office here, talking to them via conference call.

She would let them know the experience she had, the side effects she may have had, what to look for.

And it really does make a difference.

So there's support not just from the cancer side, but also spiritually.

I just had a post-graduate course -- The spiritual aspect of any cancer, groups together of somebody who cares about someone, to meet with them, to get them through the times, whether it's chemotherapy, radiation, et cetera, help them, take them to the hospital.

Our local cancer society has been good.

I've been a volunteer for them since when I was in pharmacy school.

I am still very active with them.

It's really a great system.

-That's wonderful... -We're very lucky, we really are.

-Now, you brought up your mother-in-law.

I understand you have a personal story because your mother-in-law battled three different types of cancer.

-Yeah, my mother-in-law was diagnosed at age 64.

She thought she had felt a lump one Sunday after church.

Took her to the hospital on Sunday, repeated a mammogram, we saw a difference.

And the radiologist saw her within less than two weeks.

She had the cancer removed as a lumpectomy.

And she was treated with chemotherapy.

After five years she said, "I guess I don't need mammograms".

We said no.

12 years after the first cancer, she got a second breast cancer.

This was a different cell type which required removal of one breast.

She had radiation and chemotherapy.

And she said, "Well, since I had two, I'm not going to have it anymore".

Eight years after that, she had the third one.

She was 84.

A different cell type.

That one, she had radiation inside her breast twice a day for five days.

And she lived to be 97, didn't die of breast cancer.

She basically died of natural causes.

But she fought me tooth and nail because she didn't want to do anything.

So I had to convince her that we care about her, we love her, and do everything.

And she did.

She had a good quality of life.

-The moral of that story is that early detection is key.

-I tell that to so many patients, that early detection -- If you notice something you're not sure, call.

We'll see you the same day, if not -- I had a situation last week where I was at a post-graduate course in Columbus.

The patient called me, I called the office.

I said, "You'll see one of my partners".

They got in right away.

So in a fast treatment, you pick up things right away.

That's the key with all of them.

-Thank you, Doctor Stevens, for the insightful conversation.

-And thank you for being here.

-Bueno, y ya estamos de regreso.

Gracias por acompañarnos.

Nuestra siguiente invitada fue diagnosticada con cáncer del seno el día después de su cumpleaños.

Después de muchas decisiones que cambiaron su vida, desde entonces se considera una mujer completamente diferente.

Y hoy, Carolina González, está aquí para compartir su historia con nosotros, y para que otras sean más conscientes de sus opciones cuando se trata de esta enfermedad tan peligrosa.

Gracias por acompañarnos.

-Muchas gracias por tenernos aquí con todos ustedes.

-Carolina, queremos hablar de su batalla contra el cáncer.

¿A qué edad fue diagnosticada, y cómo?

Mi cumpleaños es marzo 29, y el día 30 me dijeron que tenía cáncer de seno.

-Guau.

¿Cómo fue ese proceso?

-Fue bien difícil porque un año anteriormente a ese día yo hubiese ido al hospital para que me checaran, porque sentí un tumor y me dijeron que todo estaba bien, que no era maligno.

Yo fui ese día para que me hicieran un escaneo y una mamografía.

Y la doctora no quiso hacerme la mamografía porque yo tenía nada más que 34 años, faltaban varias semanas para mis 35.

Y tal parece que no lo vieron en el escaneo.

Pero yo seguí peleando que me hicieran la mamografía.

Pero ella en verdad yo no creo que tuvo, ¿cómo le digo?

No tuvo la dedicación para checar bien la mamografía y no lo vio.

-Guau.

-Después, sí, el dolor siguió persistente.

Hay mucha gente que dice que el cáncer no duele.

Para mí, en mi caso, no fue verdad.

Me dolía mucho, por una forma de que tenía que usar un sostén, y un sostén de deporte para poder mantenerme durante el día y poder hacer las cosas que tenía que hacer con el trabajo y... -En el caso de usted, usted tuvo unos síntomas, usted sintió un dolor, algo que no era normal, y por eso tomó iniciativa de ir al doctor.

-Sí.

Me levanté en la noche y sentí dolor y una -- un -- una pelota.

Una pelota grande en mi seno izquierdo.

Y llamé a mis doctores y mis doctores me mandaron hacer una -- como les dije -- una radiografía de mama y también un escaneo con un especialista.

-Mucho se habla de eso, de la prevención, de que las mujeres se "chequeen", se examinen ellas mismas, y de que si notan algo diferente en su cuerpo que reaccionen, que no esperen, que no lo dejen para después.

-En mi caso, no me hicieron caso porque yo nada más tenía 34 años.

Y que las estadísticas ahora dicen que un 98% de nuevos casos son entre las edades de 19 en adelante hasta los 34 años.

So, no pueden dejar que la opinión de una persona -- Los doctores saben lo que están...hacer.

Pero ellos no son dioses.

Se pueden equivocar.

En mi caso se equivocaron.

Y pasó un año antes de yo volver a checarme.

-¿Cómo usted pasó por ese proceso, primeramente como mujer pero después como madre?

-Fue bien difícil.

Ese es un día que uno nunca quiere recordar, pero nunca se te va a olvidar.

La doctora me dijo que tenía cáncer, y yo la miré y miré a mi mamá, y después miré a la señora de nuevo.

Y le dije a mi mamá: "Mis niñas.

Mis niñas".

Perdonen.

Eso es bien difícil.

Porque yo nunca pensé en mí.

Siempre pensé qué iba a pasar con mis hijas.

Y la verdad eso fue bien difícil.

De ahí en adelante todo fue bien rápido.

Tenía que hacer decisiones rápidas.

Nada más era en el seno izquierdo, pero yo decidí sacarme los dos senos porque yo no quería volver a pasar por esa experiencia.

Era difícil suficiente saber que mis niñas iban a tener que pasar por la experiencia una vez, pero dos veces iba a ser demasiado.

-Te veo emocionada.

I see you emotional.

What was that like going through that process with your mom?

-It was hard to see.

Like -- My mom looked so... broken, so useless.

She couldn't do anything about it.

And -- I lean on my mom a lot.

And so -- It's something that happened like that... In a way for me, it really did upset me.

-Yeah.

-It's okay.

-And you're the older sister, so did you feel some sort of -- kind of just like, "I need to take care of my youngest sister, I have to take care of this now"?

-I had to stay strong because -- I had to stay strong for mom so she was able to keep going.

And I had to stay strong for Leanne so that she could not worry about me and my mom.

Me dio mucha tristeza -Let me ask you guys a question.

Now that you know that this could be in your genes, as your mother found out, are you guys worried?

Are you guys --?

How has this changed your lives?

-I'm worried.

But if anything, I would just remove my breasts and my ovaries if I needed to.

If I do carry it in my genes.

My mom does give me a lot of reassurance.

And if I need to turn to her, she's there.

She went through it, so I think I'd be good.

-Well, thank you guys for coming.

-Our next guest has taken the valiant approach in the fight with breast cancer.

Having her children by her side in every step of the way has helped her overcome the fear factor and tackle everyday challenges full force, truly showing how important one's support team is in the fight.

We welcome Janene Rabenold and her family.

Welcome.

-Thank you, guys.

-Janene, walk us through that time when you were first diagnosed.

What was that like?

What age were you diagnosed?

And what was that process?

-I was 37.

37 and a half, to be exact.

It was January 10, to be exact.

It was my actual -- my diagnosis.

I was scared.

Scared.

I Was afraid for my kids.

I didn't want them to have to live this.

That was the biggest thing.

I didn't want them to have to live this.

-How many kids do you have?

-I have five.

-Five kids.

And they're all here with us.

-I have four that are with me.

This is my son-in-law.

But I have for of them that are with me, yes.

-So what was it like for you as family members and, you know, as children of Janene, going through that process with her?

-It was scary.

It was super scary.

First thing that came to mind was, "I'm going to lose my mom".

But my support system, like my family, my friends, and stuff like that, school, they just told me to keep a positive mind.

That's kinda how I got through it.

-How were you diagnosed?

Was this something that you went to the doctor for a routine check?

Did you...?

-No.

Actually, I do my own routine breast exams.

And I felt something that just felt different.

It didn't feel like a lump, it felt different.

And this was before Christmas.

But I wanted to wait til after Christmas because I didn't want to bring this in with Christmas.

And shortly after, I had seen my gynecologist.

He did an exam himself and said, "Oh, feels normal.

But I'll send you for an ultrasound just to be on the safe side".

Well, when I got to do the ultrasound, they wanted to do a mammogram and an ultrasound.

Together between the two, they found three lumps in my right breast.

-Something that you diagnosed by yourself.

Which is why early detection is key.

-It's absolutely key.

-Is that something that you teach to your daughters?

-Absolutely... now.

I mean, I never really was, you know, persistent about breast exams, but now, absolutely.

I encourage that with anybody.

If something doesn't feel right, just go.

It's better to go to the doctor and they say there's nothing wrong, than for you to go later on and let it go.

There's nothing wrong with going to the doctor and saying, "You know, it's nothing.

You were just imagining things."

I'd rather hear that.

-Talk to us about the importance of that reinforcement, that family union, to be able to communicate with someone, in this case your family, your kids.

And talk about the process of what you're going through.

-Well, that's the relief, and that's what makes the fight easier.

Because to get it out or be able to share it with somebody makes it much easier to get through.

The more you bottle it up, the harder it is on yourself, on your body, on your mind.

So I talk about it often.

-How did you notify, tell your kids, that now you have cancer?

How was that process?

How did you decide to make that decision?

How did you break the news?

-Well, the only reason they know is because I had to go through chemo.

So it was just a matter -- I just sat them down one Sunday morning.

And this was about... -The day after my 19th birthday.

-The day after her 19th birthday.

-She didn't tell us.

My godmother did.

-Yeah... -She couldn't get it out.

-My very best friend of years came.

And she's like, "We gotta tell them".

And I'm like, "Alright".

She was in college.

She was going back to college the day that I told her.

And I'm like, well, we gotta get it done.

Because I didn't want to tell her when she was at school.

There were just so many things to process at the time.

-Now, it sends a powerful statement that you're all in the same shirts.

So tell me about that message you guys have.

-Well, a friend of mine on Facebook was making -- She actually made them for a bunch of people.

And I'm like, "I need that shirt.

I need that shirt".

It was very important because it's not my fight, it's everybody's fight.

-Right.

So your shirt says, "I fight cancer.

What's your superpower?"

And your kids' shirts say, "Her fight is my fight".

You know, I think that's powerful.

What does that mean for you?

-Every milestone and road that she gets into, it's all me.

You know, I feel the same thing.

And that's why when she had first told me it was hard.

The first thing I said is I'm not going back to school, cause I went to school an hour away.

And I drove, I did commute, but I didn't want to go to school.

I didn't want to leave her.

I'm the oldest of all five of us.

So it was hard.

And eventually I came home.

I was like, "I can't do this back and forth".

I was like, "You need me here.

I can't do this".

And I came home, I took care of her, I took care of my siblings.

That helped.

And we got through it.

-Were you afraid --?

You know -- Talk to someone whose mom is going through this, from the child, from the daughter, the son's point of view.

-We can't fight each other.

We have to fight together to get rid of this monster.

All I can say is you're not promised tomorrow.

And that's for anybody.

Anybody -- And you need to take every day as if it's your last.

Because anybody can be gone tomorrow.

It doesn't have to do with cancer.

And you need to appreciate every thing that you have.

-For sure.

And, Janene, I understand you got good news today.

Do you want to tell us?

-I did get good news.

Ahm... I went today for a scan.

I had a scan done in June, and then I had one done yesterday.

And from my scan in June til now, my tumor has shrunk to almost nothing, pretty much nothing.

So my treatment is working.

-That's great.

-So what's next?

Now that you have these good news, what's next... -Keep fighting.

-...in the process?

-That's right, keep fighting.

We keep fighting.

There's no end to this fight.

-October is Breast Cancer Awareness Month.

So you're in a position to make a powerful statement to a lot of women who are watching and might be going through the same thing that you did.

What message would you like to relay?

-Be fearless.

That's the biggest thing.

Be fearless.

Get your mammograms.

Keep an eye on yourself.

And, you know... Be fearless is the biggest thing.

And go for it.

And never give up, cause miracles happen.

I'm living proof.

-There you go.

-Absolutely.

-Well, thank you, guys.

Thank you for sharing your story.

Thank you for letting other people, through you guys, learn.

Because, again, sometimes by watching others, now we can understand or learn what to expect in case of.

So thank you.

Thank you for being here with us.

-Thank you.

-Thank you for having us.

Thank you.