Nov 4, 2012|
The Roswell team takes calls on breast cancer.
The Roswell team discusses women in research; mentoring the next generation.
A Roswell physician discusses Melanoma and Immunotherapies.
March is colorectal cancer awareness month. The Roswell team discusses screening options.
The Roswell Park Team and a family member discuss "The Healing Touch" Pilot Program
Automatically Generated Transcript (may not be 100% accurate)
-- this is Roswell. Rookie by Roswell Park Cancer Institute. Your team opinion or your total options. Your host him Wenger -- welcome back to Roswell this a comprehensive look at all aspects of cancer care treatment diagnosis and research. From a comprehensive source of Roswell Park Cancer Institute. Here in Buffalo, New York. I'm Tim Wenger in this time on the program we dipped into our two hour breast cancer special that aired during Breast Cancer Awareness Month. And on the program I was joined by doctor air Melinda the not geo director of the Roswell mammography center. Doctor Stephen had a breast cancer medical director and chief of breast surgery at Roswell. Doctor James Marshall senior vice president for cancer prevention and population sciences. And doctor Killian may assistant professor of oncology in Roswell us department of radiation medicine and five here on WB yen with ask the experts. -- -- Just have a question about breast cancer in males. O'Sullivan if they did that doctors could discuss that little bit I'm a prostate cancer survivor it's yours and thanks to Roswell about the Moeller and but. What I got from my annual physicals -- doctor I mean he doesn't. Question me about breast cancer doesn't even think she checks these forward I mean isn't something males should be concerned about. Well first of all congratulations on being an eight year survivor that's the number of cancer survivors in this country is climbing rapidly with over twelve million. It's a wonderful and congratulations. Breast cancer in men is that occurs. It's quite uncommon. There are probably just -- and men who get breast cancer in western new Yorker -- compared to 14100 women who -- breast cancer. For someone who is. I'm not particularly. High risk because of a very strong family history or genetic mutation which can be related to male breast cancer in fact. Streaming for male breast cancer is really not warranted. Actually doing name breast examination directing of screening for breast cancer -- probably not warranted in your primary care office. Given all the other things that you should be doing so I wouldn't culture doctor him in that regard. However if you or your doctor fuel companies to be evaluated. When that happens and -- office found. You have to be reassured that in -- the large large majority of once -- the -- the men are not breast cancer. -- thanks for the call of any else Bob. -- OK appreciate that you know you mentioned that in in in men most of the lumps that are detected are not cancerous same for for women. Well it just depends on the -- of the woman in the nature of the -- but. Along for the woman has to be particular woman average 3540. Has to be very concerning has to be fully value with both imaging physical examination and then based on that biopsy meaning putting in the middle and to lump. And getting a piece of -- to put on the microscope doctor vernacular so many women undergo that annual man mammogram as they they should we hope they do. And they go through anxiety you know leading up to it and they go through anxiety if something abnormal is found doesn't mean it cancer. That's absolutely correct about 10% of women who have a mammogram in this country. Well at least need additional imaging meaning. Additional demographic views or possibly an ultrasound. Most of those women will not need a biopsy and even among those women who need a biopsy. Most of the biopsies. Are benign somewhere between twenty to 40% cancer. But obviously that's a very high percentage so there is an abnormal mammogram it is important to follow up and get the additional work. All right let's go up to Williams will Richard in Williams though you're on WB yen with ask the experts from Roswell park are you doing. Pretty good thank you thank you technical. I had my mother in her younger sister by about two years lived into their mid nineties. And -- in her name usually were quote. Found to have fresh -- You know wondered if -- or something about. Captured hoping that you belong to. Very good question because chemistry is one of the important risk factors. For having breast cancer breast cancer is primarily a disease of older women. I said earlier that women over age 35 or forty need to be concerned. Unfortunately breast cancer once in awhile occurs in very young women but in fact the majority of women with breast cancer in their 50s60s or older. And the fact that two sister's got breast cancer in their ninety's really does not. Portend for an obvious inherited change with a family that -- just to be tested for but in fact many women do get breast cancer when they're. Or more. Somewhat older. And can usually be treated quite readily and drive sometimes particularly if there infirm. We simply treat them with an anti estrogen hormone drug without any surgery or any other treatment. And follow two without having to do more aggressive treatment but -- breast cancer does occur when women -- -- older. That risks stays up when they get older and people can get breast cancer in their nineties. Which I don't know if they had any treatment for it. But -- neither of them died from breast cancer. That's another important point that most women in that age group who get breast cancer won't -- from a especially now that most of them are sensitive to the anti estrogen pills. Those pills that have very minimal side effects of that age group. And are very effective at stopping and of the growth of the cancer potentially shrinking it. And as again I said earlier potentially even avoiding any other treatment including surgery. Barry Richard thanks for the call and before we go to the bottom of the hour here doctor Marshall wanna bring you and we know on the biography obviously helps us. At least detect breast cancer is here but you you mentioned prevention you know that we can you hope to make advances we hope to make advances in prevention. What do we know now as far as what women can do. To help stave off breast cancer. Well there are couple of risk factors we know they have to do is behavior. One is obesity and the others are core values. And there's pretty good evidence that both of those are associated with increased risk. And so. Obesity is linked to so many. Of the chronic diseases in our society so it. It makes it certainly makes sense for people to keep an eye on that. Alcohol use is something that -- study after study has come and it's not a huge risk factor but it does -- -- associated with increased risk. So were. Keeping a close eye on alcohol usage -- makes the most sense. Come the the other issue is family history and clearly if -- person has a history of breast cancer. He and especially early breast cancer and that person needs to be watch very carefully what you do about that he has -- trying to catch anything. Develops early. Hasn't -- what is your question. Smoking itself is not. Particularly at risk factor for breast cancer but I know one of the scientists arousal part of some very compelling evidence about. Smoking in women who have breast cancer I think our audience might wanna hear about this very very important information that's -- -- -- -- Warren and his college. Well we've looked at we looked at in a very large data set with over 5000 people in it. And a smaller number of breast cancer patients that we looked at how they did as a result of treatment. And two women who smoked even women who had recently. Group within the past year did much better than women who -- still smoking and this is really compelling information and I think something that the public really needs to know about. And it's not just breast cancer isn't. No it's not it's a number catchers in in fact it's. Although this is Breast Cancer Awareness Month and we should focus on breast cancer its record that took actually to win the number of women in Western New York who died of lung cancer is higher. In the number and tired of breast cancer and that's totally preventable disease. But. A colleague of mine who's on the faculty Dana Farber. It's sad when she sees -- woman with early breast cancer who smokes should say look you're gonna dive you're smoking not your breast cancer. So hard it's very important that there was -- because they can get lung cancer and it because it makes the treatment of their breast cancer that's less effective I think that's. Of the most of them compelling and important information I've seen in this field in the last ten years -- lot more on that doctor -- and you wanted to remember and take a break here for news but when we come back I know I -- tobacco would come up and it should. That's a very important. Aspect of cancer not just a breast cancer is is. Doctorate -- pointed out here we will continue with that and your phone calls 8030930. -- 930 if you -- chime in. Today ask the experts from Roswell park and Tim later this is news radio 9:30 AM and 107 point seven FM. WB -- Welcome back to Saturday afternoon -- rainy one at that so what better to do then really kind of sit back and listen to the information we're presenting to you today -- -- linger. Normally hosting Roswell this on the radio and online at Roswell park dot org. Today though we are doing breast cancer Q&A session with the experts from Roswell Park Cancer Institute kind enough these forward and spend a Saturday afternoon for a couple of hours and asked -- questions mine as well 88030930. And -- 930 and also on that Twitter we're getting couple of those hash tag Roswell park. We've got doctor Stephen edge with us in studio doctor -- may doctor James Marshall and doctor. Air Melinda did not feel all. Different areas of expertise within the Roswell community in the area of breast cancer -- can shoot right back to the phones now if you will. And Donna out in -- failure on WB and hi Donna. I say thank you for taking my com. You're welcome glad. I'm 74 year old. We may not LB. And probably -- my whole life. Not productive maybe six times but not in 2005. I I would had a mammogram. Every year since the seventies. And in 2005. I had. State Warren. Negative but it -- -- problems so why I chose to have a mastectomy rather than a lumpectomy and does. Got along fine in. This April went in local and my physical as well as they -- a column ask reseller found that I had colon cancer. So that it has an abdominal -- and -- saddling my chest. Law. -- then did -- and and found something with my red. They did a -- and and I -- Bogut has seen everywhere and the base let these golf vertebrae. There is made from really act press. And everybody is like baffled by that. And I was wondering if any of the doctors. -- explained that to people. How. -- can't itself in remembrance. So that without going into the lymph system. It's softer edge I. And I'm very certain here what's happened to you. It is it's unbelievable. And I mean I I thought I had arthritis. He you know was Gardner singled me out working at keeping going and just thinking I had arthritis -- Motrin before or did -- My body was like fabric that's. Your -- what you're describing is just happens far to frequently. In the United States and around the world. Unfortunately we do not fully understand. What drives breast cancers to spread. Any invasive breast cancer and most breast cancers are what are called invasive because we have the potential to spread. -- may spread before there ever diagnosed to other parts of the body. And those cells may be only a microscopic amounts that we don't detect for many years. Women who have stage one breast cancer with negative lymph nodes have a much lower chance of having that happen. But unfortunately. One out of twenty or one out of ten of those women will eventually develop spread of the breast cancer as you have now. Had the lymph nodes than positive that chance might be one in 41 in three or if many of them loans were involved one and two. It can spread around the body by invading into blood vessels in the breast. And not going to vote don't completely -- Paris and movements. The month posting negative does not guarantee spread. What you have described whoever underscores what I said in my opening remarks for this show. We do not know everything we need to know about breast cancer. We have to support research. Breast cancer is not look good feel better. You have demonstrated that that's the case and our heart goes out to you and your family for what you're going through. I don't care and thank you might need to support breast cancer research to understand this so we can prevent this from happening. To your children and your children's children and their children. And though that there's there's there's no answer for -- event that it is no answer for why that at. We had to -- -- that we do not understand -- where one of breast cancer well enough to answer the question. And they don't -- -- and. You know old brand name more on hold -- Still besides golf. And they don't feel weird about they used to bone scans that they don't don't always get anymore at practice so that's sort of -- -- say they. Well the reason we don't just because the bone scans might not detect -- thing for many years. And it kept very careful research shows -- showed that they don't really prevent anything from happening by detecting it early if it spread. Oklahoma the discussion which I've even be happy to have with the offline if you call ask art piece here I'd be willing to continue this discussion with you off once -- Thank you very much I just thought maybe it was. It was something that was -- usual and maybe there's people out bad bad bad I you know I could help by telling my door. And you have because it's all too common story and it's breast cancers not look good it's not feel better -- Donna what I'm gonna do I'm putting you on hold right now and that. And again our best to you and tiger care as you move forward here. With what you're dealing with -- -- Twitter now hash tag Roswell park we've got a question folks here that says how does my negative bracket test impact risk for future breast cancer. Diagnosis. Doctors. -- -- Sure so the bracket tested an important test also referred to as the -- CAA testing. There are two genes that are known on that are associated with familial breast cancers as well as other breast cancers. Typically the testing is done based on risk. So your age at diagnosis or family members -- diagnosis. Or constellation of other cancers that run in the family. We can test for these teens and testing has improved. But the absence of being positive just does not mean that there isn't a familial association for that breast cancer. It just means that that tested negative. For my risk reduction strategy it really depends on your own personal circumstances in your family history what would be -- further with that. When we do genetic testing. A very large part of the importance or what needs to be done to do genetic testing very well. Is actually that counseling session in the review of family history. Review. Which types of cancers are in the family. It is not just -- -- CH. Mutations that are associated with breast cancer there are other familial syndrome. And genetic counselors will be able to discuss that individually with. And with the patient as Willis family members there may -- other tasks that may be more appropriate to do. And can also helped lead ten to further treatment strategies and risk reduction strategy. Harry if you do have a question on Twitter today you can just include and it hash tag Roswell park hash tag Roswell park protecting for those. And as a doctor may just answered one of those we'll get to those as they come in another phone call right now this is Fran. -- friend here with the experts from Roswell park on WBBM can we do. I'm high thanks for taking my call actually two questions. What is the treatment for a triple negative precept here. Common connected and that went counter negative. And then how accurate is that it can be gene testing in California. So two questions are related to. Triple negative breast cancer triple negative refers to a cancer route that. Is not responsive to the anti estrogen hormone drugs by virtue of being negative for one to estrogen -- sector and to the progesterone receptor. And is also negative for H. Marker on breast cancer is called the human effort promote growth for interceptor or hurt too. So it's negative for ER. PR and her true. Those cancers. Are treated generally by. Appropriate surgery and radiation. And then by chemotherapy chemotherapy reduces the chance that they will. That those cancers. May development has to -- as Donna has. At this point. -- The treatment is not as effective as it is for women who have estrogen receptor negative cancers that are positive for that her two protein. Because there is a drug that directly attacks -- her two protein and improves the benefit of chemotherapy. That is not effective in women with the triple negative cancers. As it used to be that we thought the effort to cancers her two positive cancers through the most aggressive cancers but now we flip that around because of the development of this anti her through drug called. -- to amend the trade name for that is perceptive. We so we flipped it around so the more aggressive cancers are the hurt too negative or too negative ER negative cancers. So called triple negatives that does not mean that everybody develops metastasis chemotherapy is effective at reducing. The chance of developing spread of cancer in women with triple negative breast cancers. -- Be attending a test is a test that. Can look at multiple. The genes that are seen in breast cancer. To help predict whether the chance of there. Developing spread in the futures higher or lower. And in particular with woman with very small breast cancers. It may help select those people who need chemotherapy were otherwise they would not be functioning chemotherapy with a triple negative breast cancer her over. Most of those will have the so called -- high score book the higher chances over and spread and would be given chemotherapy with that test it's probably most useful with. Cancer is thought to be quote less aggressive on quote. Who might be considered the not to receive -- up here. -- hope that help at all. OK Fran thank you for the call I appreciate it today and that leaves one line for unity 030930. And -- 930. Here at WB and we are asking the experts today from Roswell park we're talking about breast cancer. And we'll continue to take your phone calls right up until 2 PM this afternoon. With these folks and doctor Marshall before we take a break as a -- force. It may be worth pointing out that it wasn't that long ago that we didn't understand how to deal with feature -- positive tumors. And you know gradually as sweet as we study these and we look at two different characteristics that were peeling them off. And chipping away at this at this problem so we do better with those now. I'm much better than we used to have to Lancaster we go live in Lancaster -- on WB yen with the folks from Roswell. High on my question is I have I was diagnosed with breast cancer February of 2011. Can have a strong family history in my father's side his mother had breast cancer his father my father had breast cancer. Her feet her sister's ski and college female cousins of anti cancer. And I'm 53 and a 33 year old daughter I try to connect had to connect test for the press she wanted to be able negative. And -- she actually positive. I'm wondering if any other genetic testing that can be done. To find out my daughter has something -- routers or any other you know what kept them from testing should she be doing now it. You know to find out if there's anything in our families that since -- she wanted to didn't -- anything without this. Start with doctor -- doctor -- -- you. I'm glad to hear earlier -- from your breast cancer so congratulations. Think I would -- captain and I feel great. Now. The the fact is is that PRC -- -- two are not the only genes responsible for breast cancer inheritance. -- it it's that sounds that your father her breast cancers says. Yes yes I can't and then it ended up going to the ball. Right so and could go to the opponent men just like you can with Donna who called a little earlier. So. Most calm on those are some issues we receive mutations when -- men men in the family with breast cancer. But that we do not understand all genetic inheritance is with breast cancer you know there -- other types of cancer in the family. Well in my head I'm getting hit perfect call minor lake. And -- hamstring. But -- your father sort of -- -- Okay. There are a number roads in terms available there's a gene called 53. Doctor may is signaling that yes about sarcoma some 53 but that's on your father's that's on your mother's side of the campaign probably wouldn't be related. There're a number of other symptoms. Very likely none of -- proved to be positive so what you and your daughter need to do is recognize this high risk. And she needs to hearts start having breast cancer screening and an early age and and after I finished talking to second -- an aspect of Abacha and make comments about what imaging might be appropriate for your daughter. But. What is most important for you is to sit down with a certified genetic counselor. And spend an hour talking with them they'll take that that counselor were taken very -- -- family history. And we'll talk to you about the other genetics engines and the potential for other testing for other genes that might be appropriate based on security to a family history analysis. We have a world class generics such clinical genetics service with a certified medical geneticists and three genetic counselors arousal part who would be. Delighted this economy with you to go through the details of what might or might not be available. If there's nothing about a five so you would you did your daughter should do aggressive screening and and I think after financial -- on accompaniment. -- he. Yet along with the geneticists that we -- that Grassley also have a high risk screening program that might be very appropriate for your daughter it's for women. Who'd do not -- who have not been diagnosed with breast cancer but have a history like yours and your family. That suggesting high risk for breast cancer or actually do you have. Are known carries and BG. In addition she knew -- yearly mammogram. We also typically in these women who are very high risk for breast cancer while also do a yearly breast MRI. Preston rise another way of looking at the breast tissue and looking for breast cancer at some more involved -- -- a mammogram and actually involves. An injection of dye and it takes longer between thirty and 45 minutes. But it is very sensitive for breast cancer in women for high risk of breast cancer we do this in addition to the mammogram it doesn't replace the mammogram via I'm but it's an additional study that might be. Appropriate for your daughter. Doctor -- thoughts here before we go to the top of the hour. I think doctor to doctor cannot show really stressed the two things I was thinking strongly about and that is the importance of genetic counseling. The way the BR CAA testing is done is also important as well and that's something to discuss with the genetic counselor. Depending on other family members are our specific genes and specific changes that can be looked at and the way that the test can be run itself. Is is this whole genetic testing exploding I mean I'm hearing a lot more about it today than I did you know. Just a few years ago more women are really considering it if they're appropriate well I think we use as part of an important point. It's. Be -- appropriately many women and it's become. Well no no what the circumstances are were also seen it done inappropriately and some people who. -- who have a very weak -- district or family members and unfortunately. Use of the -- and appropriately can be misleading and cause some problems which is why anyone who's considering genetic testing. Should first meet with a certified genetics professional professional either a medical geneticists or -- certified genetic counselor. Prior to doing testing. Is very important. And another. A quick question. The type of genetic testing I had my attack other people on they have the blood test I had the one that was done with the mouthwash for. No problems same thing that. The only questions for the you have something called art testing PA RT check with your person does it. Okay I'm doctor vernacular you tell -- when you mentioned there. I just wanted to add a comment that it's important to remember though that most breast cancer occurs in women who do not have a strong family history of breast cancer so don't be lulled into comfort. If you don't have a family -- you should still be. I'll I'll Wear and having an annual mammogram that interior the most important respect for getting breast cancers being a woman over age forty. Get your annual mammogram. The doctors from Roswell park doctor air Melinda did not geo director of the Roswell mammography center doctor Stephen -- Breast cancer medical director and chief of breast surgery at Roswell doctor James Marshall senior vice president for cancer prevention and population sciences. And doctor Killian may assistant professor of oncology in Roswell -- department of radiation medicine part of our two hour breast cancer special with the experts. From Roswell park that is Roswell this if you'd like to call Roswell anytime -- free. It's 877. Ask our PCI that's 877275. 7724. Or visit their website at Roswell park dot. -- Listen to Roswell this Sunday mornings at 630 young WB EN. -- by Roswell Park Cancer Institute your team opinion for your total options online at Roswell this god of war. You -- And hanging do you. Then.