The Scoop with Tanya Flanagan

Unknown Speaker 0:00
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Unknown Speaker 0:26
Good morning and thank you for joining me for the scoop with Tanya flat again. I'm so happy you decided to wake up and start your day with me. Here on the scoop, where we talk about life, joy, funny moments, trending topics, and so much more. We promise to keep you in the know and find out what you know. So let's get started.

Unknown Speaker 0:53
Good morning, and welcome to another episode of the scoop with me. Tanya Flanagan here on K u and v 91.5. We are in the month of October. And you've heard me mention quietly a couple of times on the show just quick references to breast cancer and breast cancer being a part of my life journey. Well, this month is breast cancer awareness month. And I am dedicating four of the shows this month to a discussion on breast cancer and so I'm excited to kick this series of conversations off this morning. I have on the line in the studio with me and on the line we have Dr. Stephanie Christiansen from comprehensive cancer centers of Nevada. I'd like to welcome her. Good morning. Thank you for joining me. And we also have my dear friend back with me today and we mentioned it before she was here in the past. Ava's brown Riley, who is a professional golfer and we were here before talking about golf. Well, while we didn't tell you then that Avis is also a breast cancer survivor. And so, Avis Good morning, and welcome. Thank you for being here.

Unknown Speaker 2:00
Good morning. Thanks so much for having me on the show.

Unknown Speaker 2:02
I am so glad that we are here together and that we have Dr. Christensen to give that medical perspective. So we're going to kick off the conversation as I mentioned about breast cancer. A little bit of my story, I'm a three time breast cancer survivor. So throughout the month, we're going to dig into what we noticed when we were diagnosed, how we respond to it, what the medical journey was like how it affects your family, how it affects you. And the different courses of treatment and where it can take you in terms of lumpectomies we'll talk about technical terms, mastectomy is reconstruction, plastic surgery. So there's just a lot that goes into facing this journey and dealing with this fight. So without further ado, Eva thumb. Tell us a little bit about yours because I want to make sure I want I want to have Dr. Dr. Christiansen talk about where we are with medical advances. So I had two cases of ductal carcinoma insight two, and then one case of adenoma. at no moment and Carr's insight to carcinoma adenocarcinoma is what it was at that point. So in regular terms I had in regular terms, I had two that were isolated spaces like they were confined to a milk duck and my breast and then a third one that had spread and it was no longer contained. So I had stage zero and then stage two way cancers. But your cancer was stage

Unknown Speaker 3:35
four, stage four breast cancer. And

Unknown Speaker 3:39
for anyone who knows was four stages. So what what kind of to have and then I want to

Unknown Speaker 3:43
I had invasive ductal carcinoma. So in 2010, I went in for my yearly mammogram. And I received a notice three days later stating that it appeared that something was abnormal. So I returned back. And then the final notice was everything was normal. But in reality, everything wasn't normal. So they should have diagnosed me with stage one, January 2010. So a few months after that, I started feeling very fatigued, very tired. One for wearing many hats. As at the time I was an operation manager at FedEx Express, raising two young kids making sure that they got to their events after school on time and I've also coaching golf at Lincoln High School in San Diego, that's where I'm from. And so around March or April, I really started feeling extremely tired. And then come May I was bathing myself and underneath my right armpit. I found and felt two lumps. So I immediately called my doctor, Dr. Patricia Pittenger. And so she says Avis come in tomorrow morning. So I went in the next day, and they pulled tissue. And three days later, I found out that I was diagnosed with invasive ductal carcinoma, stage four breast cancer

Unknown Speaker 5:21
oil. Dr. Christiansen I want to bring you into the conversation because we're talking about diagnosis. Avis and I are both African American women. So I know it's different by race. Can you talk to us about what types of things women hear when they are diagnosed? And what it even means? Because a lot of times you don't understand?

Unknown Speaker 5:45
Yeah, I think take a step back. Tanya, when you were talking about the two different types of cancer you were diagnosed with? You know, I always, I always you know that we kind of go from stage zero to stage four. And when it's stage zero or ductal carcinoma in sight two, that means there are some abnormal cells, but those cells are confined within the milk ducts, like you said, and I always tell people, you know, no one's ever died of DCIS. And because by nature, it hasn't invaded the tissue, it hasn't spread, it can't metastasize. But once it invades through that ductal wall, that's when you start getting into invasive ductal carcinoma, which is what Adas is talking about. And that's when cells get out of the ducts. And they have potential to spread to the lymph nodes, which it sounds like, you know, you had when you're helping, you know, bumps into the armpits, and it can spread to other parts of the body, like the bone, the liver, the lungs. And so that's the biggest differentiation between the two different types of cancer.

Unknown Speaker 6:42
You mentioned the areas that it metastasizes to that it spreads to I had heard at one point that the brain had been included in that is there anything

Unknown Speaker 6:53
is certainly Yeah, certainly breast cancer can go to the brain, all types of breast cancer can go to the brain, there are particular breast cancers that are more likely to go to the brain. So we separate breast cancer by their hormonal receptor status, and by something called a her two receptor. And we're going to have overexpression of the her two receptor, or something called triple negative, meaning they don't have expression, if any of these receptors are more likely to have metastatic disease to the brain. But certainly any woman can have metastatic disease to the brain. I

Unknown Speaker 7:23
like that you brought up you mentioned the triple, triple negative, triple positive, and we've talked about that often. I was a triple positive diagnosis, which was, it was it was crazy, because as I was talking to professionals in the medical field, and we were discussing my diagnosis, I remember talking with a doctor who was kind of a friend happened to be a plastic surgeon. And he said to me, we were walking down the street downtown, and he said to me, not that it's a good thing. But it's a good thing. You're kind of lucky. You have triple positive breast cancer. And of course, I'm looking at him with this expression, like how can any part of it be luck or good thing? I'm, I'm third, I'm in my 30s and I'm dealing with breast cancer. And he began to talk to me more about women and having the triple negative versus triple positive. So can you talk with us a little bit about that? I don't know. Eva's were you triple negative triple?

Unknown Speaker 8:22
I was triple negative.

Unknown Speaker 8:24
Okay, so we are one of each right? I'm positive. She's negative. Can you can talk about that with us?

Unknown Speaker 8:29
Yeah, yeah. So as it stands right now, once you get the diagnosis of breast cancer, the pathologist goes back and looks at the individual tumor cells. And there's certain stands that the pathologist can do to determine what type of breast cancer you have. So there's an estrogen receptor and a progesterone receptor. These are receptors for female hormones. And these these receptors basically are fed by the production of estrogen. Most common type of breast cancer is some form of estrogen receptor positive. And then as I said, there's another receptor we checked for which is called a her to new pathway. And you can get overexpression of this her too. And so it's very important when you get to diagnosis of breast cancer to know which of your receptors were positive and negative. And your oncologist is going to care because that's how we dictate what treatment options are available for you. So Tanya, to go back to you when when when the your friend told you, you know, that's good news. I always kind of use the caveat that there's no good cancer so none of it's good news. It's all bad news. It's all cancer. But but but there is some promising news meaning when we have receptors we have more options for treatment. Unfortunately, with triple negative we don't we were just stuck with chemotherapy and now in the last year or two immunotherapy, but we don't have directed therapy whereas if you're hormone receptor positive, we can attack the hormones or if you're her two receptor positive we can attack the herd to receptors that gives us just more options for treatment.

Unknown Speaker 9:52
Okay, I think that that is probably the best explanation I've ever had in terms of the breakdown between all of them because I know I was hard to new positive, right? And that I knew that it meant the truth of course of treatment work for me. What I didn't understand I, my misunderstanding I should say was, I thought that people who were triple negative were getting the same course of treatment as me. But the doctors weren't sure there was no proof that it was working. Not that it was kind of different courses of treatment as an option, because I have these receptors on the top of my sales ever going to receive and respond, I didn't realize the differentiation, or the advantage, I guess, that I had.

Unknown Speaker 10:35
We do totally different chemotherapy for her to positive than a triple negative.

Unknown Speaker 10:40
Now with my treatment, in order to save my life, I was treated with aggressive chemo. And then later, after the six doses, I was treated with radiation.

Unknown Speaker 10:53
And I didn't do radiation, I didn't do radiation, because at the time it was presented. So it was actually presented with my very first diagnosis, I was 32. And once the I did a lumpectomy, I took some of the breast tissue clear at the margins, took the took the area that included the milk duck that was affected, that clear margins, and the conversation of radiation came up looking at the statistical data to support why one would choose to use to do radiation. The percentages weren't outweighing the enough on the positive side versus the other cases of whoever did or didn't. It was like two to one. And it just wasn't strong enough. And it just in my conviction in my spirit, something in my spirit just said, I really don't ever want to do. I don't ever want to do radiation like Dear God, I just don't want it, I can't see it. And so I didn't ever do radiation. And I remember my third diagnosis when it came back the third time, or I had the third case. That's another story we'll get into. Radiation wasn't on the table. But I remember going in to see Dr. Allison Mary and Kay Allison, who was also with comprehensive cancer centers of Nevada. And every time I would come into it saying your radiation. And finally I said Dr. Allison, I'm not going for radiation, but you keep bringing up radiation. So is this a Freudian slip? Do I need radiation that tracked all the way off to the Mayo Clinic in Arizona to get a second opinion? Because she was like, well, let's just get some opinions. But I didn't do it. Dr. Christiansen? What are women looking at when they do radiation? And how does that affect you? And then Eva's? How did it affect you? That's kind of

Unknown Speaker 12:35
yes, I'll go first. How to chemo and radiation affects me. Well, it's almost like if you were to stick your finger in the outlet, and it just shocks and destroys and it kills the good and the bad cells. But with radiation radiation was very devastating in the sense that the laser is just shooting directly at that particular area. But by doing that, that was not good for my body as well. So I live with peripheral neuropathy. I'm still somewhat confused on what really caused me to have peripheral neuropathy. Some doctor says it was the chemo, but then some doctors say it was the radiation. So I wrote the book, building up a champion, how became a champion in life, and I talked about it in my book, chapter seven, my battle with the big C. And I believe I mentioned that it was the chemo that caused peripheral neuropathy. If you can just tune in on that, Dr. Stephanie, because I just really love to know which one is the truth.

Unknown Speaker 13:41
My strong suspicion is it probably was the chemotherapy more than the radiation. You know, I don't have your record to know exactly what drugs you got. But but generally chemo can be toxic to nerves. It's one of the one of the long term side effects of chemotherapy.

Unknown Speaker 13:58
Radiation while we're talking about it, kind of give us more how it works, because there are women out there right now who are evaluating what to do. They've been diagnosed with breast cancer. And they have this this all this stuff in front of them and it's overwhelming. I honestly have a friend right now who just the other day had a double mastectomy. She did a double mastectomy and she's at home expanders. The 800 pound gorilla is on her chest right now. It is the worst feeling you can't even sit up without feeling like it feels like a ton of bricks is just on your chest and you're trying to get up and every move literally takes your breath away. But there's someone there trying to figure out do I Couple this with radiation? What are they facing? What is it doing for them so that they don't understand Dr. Christiansen? What what is it? Yeah, so

Unknown Speaker 14:57
to take a step back, you know not all women need chemotherapy. Not all women need radiation. But some women need all of the above. And generally what chemotherapy does is I talk about, it's trying to control cancer cells that may have spread distantly in the body. So cells that have escaped the breast escape the lymph nodes, and maybe in the bloodstream, which have the potential to land on the liver, the bones, the lungs, the brain, what you want is chemotherapy to kill off those cells. What radiation does is it's trying to kill additional cancer cells that may have been left behind in the breast or the lymph nodes. And so we talk radiation is more local control. Whereas chemotherapy is distinct control, trying to get the cells that have spread radiation is a local control, trying to make sure that cancer doesn't come back into the breast. And there's a number of factors that go into who needs what, in large part, we think that women who don't have mastectomy is that only have lumpectomies need radiation? There are, of course, some exceptions. But in general, if you've had a lumpectomy, you need radiation, I was defiant.

Unknown Speaker 16:03
But no. I did. I did breast conservation. So I preserved the breasts, which is

Unknown Speaker 16:12
why radiation was recommended. Exactly. And and then women who women who have lymph node positive disease need radiation as well. Very often women who have very large tumors need radiation. So there are guidelines to dictate who needs what. And so after you know, you have your surgery, you'll always meet not always, but if your medical oncologist or the surgeon thinks it's necessary, we'll have you see a radiation oncologist who have gotta go to your case and figure out you know, how much you benefit from it, and what are the risks and versus the benefits? Want

Unknown Speaker 16:44
me to go into this field? Because I mean, it's so it's a relationship. And I will say, for me, I know with my doctor when I got the letter, and she's retired now, but honestly say, even when I think about it, anytime I think about it, it's an emotional space for me, because you become so connected to the person who treats you that you don't think you can make it. If your oncologist isn't there, it's like when you're gonna retire, what am I gonna do. And her goal is that you never have to face it again, that she gets you to the other side, and you're just helping you have all these years. But you're just sitting there thinking, but what am I gonna do? You're not gonna be here, how do I? How do I function? So it's, it's such a personal space, why this field of medicine for you?

Unknown Speaker 17:37
I was very fortunate to get into it, did you have an oncologist and now with a focus in breast cancer, I love the fact that I have these long term relationships with patients. And I love the fact that my cure rates are very good, unfortunately, not perfect, but they're very good. You get to see patients who you treated who were nervous and clung to you, and you're in your office in tears, you know, over and over again, who've now gone through their journey and on the other side, and they're living life and thriving. And they come to you, you know, once or twice a year and and you get to have these long term wonderful relationships with people. And it's really been a blessing and a wonderful career.

Unknown Speaker 18:13
Well, I want to say thank you, for you weren't my doctor personally, but thank you for being in this field. I had Dr. Joseph spots, who was the breast specialist, who by the end of her career was part of the comprehensive cancer centers of Nevada family as well. And then I had Marianne K. Allison, who really took me through my journey before I was transferred to another doctor because she retired. But your care is so important. And women advocating for their care and Avis, maybe you could talk about this too, because you did kind of in your initial introduction, but even more. I remember when I was first diagnosed and I'm, I go through three different doctors to get an opinion to make sure what they're telling me is true. And at that age, I was working for the casino was the Public Relations Manager with MGM Mirage resorts. And I'm busy, you know, I'm moving, I'm growing, but I'm coming out the big green monster every night thinking wow, I work at MGM Grand cobranded is it's just so Vegas, right? And whoop hears this nuts. To me, it's a hiccup. It's a speed bump. So I'm like, just fix it so I can keep going. And my first thought was, find a doctor, get it fixed, whatever they say. I don't think I really checked all the way in until the third time. The second time I was angry, but we'll get there. But I You know what I'm saying? So I guess what I'm saying is women have to advocate and what do you say to that and Dr. Christiansen what some advice you can give that maybe even goes beyond the self breast exam that they tell us to do. Every month you know

Unknown Speaker 20:00
Well, even though even the guidelines for self breast exams have sort of fallen out of favor where most the most experts actually don't think they work and so so I don't even think that's as important as just making sure you know if you're of age getting your annual mammogram, you know, keeping up with a primary care physician so you're otherwise in good health. And then if you notice any changes in the breast you know, dimpling, you know, redness, lumps, bumps, nipple discharge, nipple bleeding, you get in right away to see that primary care, Doctor OBGYN who can who can get the process going.

Unknown Speaker 20:34
So it was for you, what was your space of? What do you say to women about being aware and empowered to?

Unknown Speaker 20:42
Well, I was diagnosed at the age of 36. And I was very fortunate to have Dr. Julie and Dr. Jennifer, as my doctor and my oncologist, so they too had breast cancer. So they treated me as if they treated themselves. So I just like the audience to know that continue doing your yearly mammogram. And the body speaks to to you, it talks to you really, really does, it shows you signs of something that's feeling right. Or, you know, you start to develop lumps, you can feel those lumps in your breasts, I felt them under my, my armpit. And they were deep behind the tissue tissue. So I just highly recommend that women not think of going in for a mammogram as a fear factor, but a greater appreciation of going in to detect early detention.

Unknown Speaker 21:42
I want to I want to add to that, because you mentioned filling the lump. I was 32. In my case, I had a milk duck that was involved. So I didn't feel anything. I actually had three suspicious areas in the same breast. When I started on this journey, I had a seven o'clock and nine o'clock and 11 o'clock area on my breast that were of concern. And I want to say to people, Take someone with you to the doctor, take a friend, someone that can help you here. And I say this because it wasn't until I was further along on the journey that I realized what they had been saying to me was if two out of the three areas came back as positive for cancer, I was facing a mastectomy at 32 years old. And I was like, I didn't hear that. Because I just was, I think all I heard was cancer. And everything else that went with it. I was going to the doctor's by myself. I wasn't taking anyone with me. I was gonna notice I can do this. I got this I can go I didn't hear. I didn't hear half of what was said to me. But I want to say in the vein of not feeling any lumps. I was having headaches. So to your point Avis, you do know your body changes, things are different. I don't know headaches, not sleeping well tire, just something that is very off. Take it seriously. I'm not saying that it's breast cancer. I'm not saying that at all. I'm just saying you know your body better than anyone else knows your body. So if something is seems like it's not right, do the due diligence to determine what may be the cause of what's making you feel. You know that you're not right. In my case, I happen to have breast cancer doesn't mean that's everyone, you know the situation, but

Unknown Speaker 23:39
I like to chime in on that when you just ate it. When I walked in the door to the doctor's office, I was with my husband and my parents. I'm still fairly young at the age of 36, like yourself, 32. And I sat down. And when I looked at the oncologist, Dr. Jennifer, I could have sworn Her eyes were about as big as a bullfrog. When she's talking to me. I just zoomed in and zoomed out. You hear but you don't hear. So always Take someone with you to take notes to take notes, Kobe's Yes, absolutely. Because you're sitting there and you're in shock. And you're just not quite sure how to react. It's almost like you're stuck in that moment. And it was a very interesting moment at that time just sitting there saying, Okay, I hear what she's saying. But I couldn't receive it like I want it to and so I got in the car. My husband was like, were you not paying attention? I was like, Yes, I did. But that seemed like everything was just going over my head. And that's the space that Tony had talked about. Were you not quite sure. And you're not ready to accept the fact that you have been diagnosed with breast cancer

Unknown Speaker 24:51
because everything is going through your mind what you're being told. Is this the right doctor for me? Is Is he right? Is she right? It Is this really the best course? Do they really know what they're talking about? Do I get Second? Third? I mean, there's a million things and you cannot focus but in the medical space, Dr. Stephanie, anything else that before because we're, the morning goes so quickly, we're down to our last five minutes to talk. But I'm glad we're able to lay the foundation from a medical standpoint of what to look for, I want to let you bring us full circle on things that you would share with patients or women about breast cancer in and being mindful?

Unknown Speaker 25:37
Well, I think because it's October, and it is breast cancer awareness month, I think making sure you get your mammogram scheduled. Fortunately, in Las Vegas, it takes a long time to schedule so call ahead and make the appointment because the radiology centers are assumed to be pre booked out for a couple months. So making sure you get that. And and I think to reiterate, if you start to feel abreast change, especially that persists more than you know, a few days and it's not going away, then absolutely get in early don't wait. There are types of types of breast cancers that tend to grow really fast. Unfortunately, African American women are more at risk for some of these triple negative more aggressive breast cancers, antennae present later. So they're not sitting on breast changes, you know, asking for help if you detect something new or different.

Unknown Speaker 26:23
And anything on nutrition that we can share with them that you would say to them. There's so much here that we we could unpack just about how your diets affected in chemo and just how you're feeling but from a preventative standpoint, or just to Healthy Living standpoint, is there anything that is widely recommended or that you'd like to stress to your patients?

Unknown Speaker 26:46
Well, what I say is, it's, it's all the stuff we know we're supposed to be doing that's so hard to do. So we know that women that exercise multiple times, you better try to get your heart rate up, you know, four to five times a week for 30 to 45 minutes, trying to stay healthy bodyweight. In the medical field, we find that as a body mass index less than 25 to a healthy body weight, you know, less processed foods, more vegetables, more lean proteins, you know, less red meat, all that stuff is is is valuable. Certainly less alcohol is valuable. I always tell my patients, you don't have to completely abstain from alcohol, but you shouldn't be a heavy drinker. So for women, that means what I call it beverage or less per night. And those are the main things.

Unknown Speaker 27:30
I think those are good standards in new healthy and I just like to we know them but like to bring them back to top of mind. It's important to hear them because then you're reminded in it, it may be helps you reset, and now we're about to put another new year's resolution but sometimes in the middle of the year just over the hump, you need to reset and have a strong finish. So that means we can get on track what exercise and diet that may contribute to us saving our lives during this Breast Cancer Awareness Month. We want to stress that as much as possible. I want to thank both of you for being on the show this morning. Avis is going to continue to go forward with me this month. Dr. Christiansen Thank you. I appreciate you more than I can express. Thank you for your for your work and your service. And thank you for your time with Coleman when we were together there as well.

Unknown Speaker 28:26
Well, thank you, Tanya, and thanks for all you've done to give back to the breast cancer community. I know it's been really valuable, locally and and beyond.

Unknown Speaker 28:32
Thank you. Have a wonderful week everybody. Thank you for tuning in to the scoop. I hope you have learned something. Remember, schedule your mammograms and check on your buddy. We'll see you next week. I want to thank you for tuning into the scoop with me Tony Flanagan and I want to invite you to get social with me I'm on Facebook and Twitter. My name is my handle ta n YAFLA na GA N You can also find me on Instagram at Tanya almond eyes Flanagan and if you have a thought and opinion or a suggestion, don't hesitate to shoot me an email to tanya.flanagan@unlv.edu Thanks again for joining in. Stay safe and have a great week.

Transcribed by https://otter.ai