Hello, welcome to
"Wonderfully Made"
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My name is Stoy Proctor
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and today, we're going
to be discussing the topic
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"Breast Cancer"
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I'd like to welcome as
our guest Dr. Allan Handysides
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and he'll be answering questions
today for us on this topic.
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Thank you, Stoy, it's a pleasure
to be with you here today.
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Allan, what are some of
the risks of breast cancer?
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Supposed you're
diagnosed with breast cancer,
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what happens?
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Well, I think perhaps what the
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question that you
have in mind is...
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Are there predisposing factors
that give rise to breast cancer?
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The risk of breast cancer,
of course, is of dying...
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and that's why it's very
important to diagnose it early
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But, people who take an
intelligent look at themselves
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and their families, they
may know whether they are
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at increased risk or not.
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There are many, many
factors, for instance...
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As women get older,
and as men get older,
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because we should remember
that this is a disease that
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can affect both men and women...
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Although maybe 99%, 99.5
or more percent are in women.
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A small number of men
also get breast cancer.
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And men who find a
lump in their breast
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should take
particular care about it because
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it can be very
serious for men too.
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Basically, as women or men
age, they are more predisposed.
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Women over the age of 60 are
the group that are more likely
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to have breast cancer.
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In addition to this,
younger women have to be
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aware of their genetic history
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because there are certain
families in which breast cancer
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is much more common.
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For instance, if a mother,
and her sisters, and maybe
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a couple of your
siblings have breast cancer,
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they you really need
to take special care,
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because you may be
carrying a GENE that predisposes
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to breast cancer.
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There are other
factors... environmental factors
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For instance, a
person that becomes obese...
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Obesity has a very distinct
relationship to breast cancer.
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Dietary factors have been
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difficult to tie into
breast cancer.. as you know.
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But it's also important if there
has been a history of radiation
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...excessive radiation. Exposure
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Exposure, you know that
can also be associated with
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increased risk of breast cancer.
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Now suppose a woman is being
told that she has a tumor...
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is this synonymous with cancer?
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I think this is
something that we should really
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say at the outset of our program
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A tumor means an
overgrowth of cells.
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A growth of cells
that are probably in excess
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to those that are
required for the function
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of that particular tissue.
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Now if those are
relatively normal cells...
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their growth is not
wild, but is somewhat regulated
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just that there
tends to be overgrowth,
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that may be a benign tumor.
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So you can think
of a tumor as a lump.
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...9 out of 10 lumps
that women are going to find
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are going to be benign.
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So, if there are
women watching this program,
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you need to understand
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that if you find a lump in
your breast, don't panic because
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...90% of the time,
it's just a benign tumor.
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And so, really, the
detection of breast cancer
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is what's most important.
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So now, could you tell us
more about self-detection...
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self-examination?
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The diagnosis
from a physician... Yes
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Self-examination has been
studied and some people have
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said... that regular
and routine self-examination
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does not result in fewer
deaths from breast cancer.
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On the other hand, we must
acknowledge that the MAJORITY
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In fact, the VAST
majority of breast cancers
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are detected by
women themselves.
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And so it would seem
that regular vigilance
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and an awareness
of one's own body
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is very important.
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I often say, that one
should get up and first thing
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in the morning and look at
yourself in the mirror and say..
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"Hello beautiful!" Lift up
your arms like this, you know,
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and see how your
breasts ride on the chest...
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to be sure that there's
not any puckering, or pulling
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of the skin... to be
sure that the breasts
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are looking well and fine.
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In fact, at this point, I
would like us to bring to us for
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an interview, Mollie...
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Mollie has a very interesting
story that I would like
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her to share
with us at this time.
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Mollie, I'm so pleased that
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you could be with us
today... Well thank you!
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You have a wonderful
story to tell, and I think that
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our viewers
will love to hear it.
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You actually had
breast cancer. Yes, I did...
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Would you like to
tell us how you found that?
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Well, I had gone for my
yearly checkup in April,
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and they didn't find a thing.
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And, in June though, as
I was doing a self exam,
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I found what I thought was
a lump, but it didn't really
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ALARM me... but I thought,
you know, probably I should
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go have a mammogram.
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And so, I called the
local lab, and they took me in
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and sure enough,
they found a lump as well.
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And they referred me
then to a surgeon in Marion,
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and they sent my
lab work over to him...
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and he did a biopsy...
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He's the one that, after
the needle biopsy, I think is
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what he did initially...
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He said, "You know,
you do have something that
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looks quite cancerous. "
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How did you feel at that moment?
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It just STUNNED me!
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It just absolutely
did not occur to me that I
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could have cancer.
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I was the
HEALTHY one in my family.
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I was the one
that ate healthy...
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and was NEVER sick!
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Actually, I can
tell people now...
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I've rarely ever been sick...
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OH! Except that
time I had cancer!
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So what happened after that?
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Well, he took me in,
first of all, for a lumpectomy
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and came back and told me,
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"You know, we're going
to have to go even further
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than this. "We're
going to have to do
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a mastectomy because the
lumpectomy, there was still
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1 little tentacle that
ran a little too far. "
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And I didn't want to
have such major surgery...
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to me, it was major...
without a second opinion.
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So we sent the results, all of
the lab reports and everything
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off to Chicago
to someone there...
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A very, very smart thing to do.
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And they conferred that
what I REALLY needed to do
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was have a mastectomy.
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And so, you know, I
went into the doctor's office
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Dr. Voss, and he told me...
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"You know, we've got to
schedule you for a mastectomy...
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this is definitely cancer, and
the other doctor has confirmed
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my initial diagnosis that you
needed to have a mastectomy. "
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And I said, "Well, you
know, probably I could work this
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into my schedule...
maybe the middle of February. "
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Now this was October...
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And he said, "No,
you don't understand,
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we need to do this next week. "
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THAT just floored me!
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I wasn't psychologically
prepared to do it that quickly.
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I needed time, but
you know those doctors
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just won't let you wait...
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Not when you've got
a problem like cancer!
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And so, we went ahead
and had the surgery done...
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And, you know, that
was quite a while ago.
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How long ago was all this?
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I was just thinking about
that, 8 years and 3 months ago
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And what I have to
do, of course, every year
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is go have all
of my lab work done,
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my blood work
done, and so forth...
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And once a year, I can walk
away from my doctor's office
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after he looks over all
the results, and he tells me...
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"You're ABSOLUTELY cancer-free!"
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So once a year, I can walk
away from that doctor's office
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and say... "I'm
cancer-free and I can prove it"
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It DOES feel good!
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Wonderful, it
really is wonderful!
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Did you have any reconstructive
surgery afterwards?
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Yes, as a matter of
fact, I felt like I was
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young at the time, and I thought
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"You know, it's not so
much vanity-sake, other than
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"I just want to look
normal in my clothes. "
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Besides that, the
insurance covered it.
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And I thought,
"Why not?" Go for it!
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And so, I did have
reconstruction done.
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But, you know, that was more
painful than the actual surgery
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itself... the
reconstruction, it takes a while
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and they actually
go UNDER the muscle,
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and then they
s-t-r-e-t-c-h it out,
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and that can be quite painful.
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On this side of it, I'm glad
that I did, just simply because
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my clothes look normal.
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I just wanted to look normal.
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I didn't want to look
abnormal... and God blessed me.
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Well, you couldn't look
more normal today than that...
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And, of course, 8
years and 3 months,
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or nearly going on 9 years...
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We can DEFINITELY say
you're cured... Absolutely!
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But you know, I think
that the essential element
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that I would like our viewers
to take away from this is
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that YOU found
the lump. Yes, I did
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And that actually is the common
way that breast cancer is found
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And it was a small
lump, but what I didn't do was
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say... "Oh,
that's nothing. " Exactly
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Even though I
didn't want to believe
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that it could be anything...
there was still that possibility
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And so, I did go ahead
and have further testing done.
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Now Mollie, we have a
model of breasts, and this model
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of breasts has, within
the left breast, some lumps...
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And I would like it if
you would, for our viewers,
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show how we examine the
breasts... Okay, be glad to
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Here's the model, and what
you're doing right there, Mollie
00:10:17.14\00:10:21.34
is NOT the way to
examine the breast...
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and I'm sure
that's what you know...
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We don't stab the
breast with our fingertips...
00:10:25.25\00:10:27.50
Instead, we use the
flat portion of our fingers,
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the palps of our
fingers, and we want to be
00:10:31.43\00:10:34.00
very methodical and cover
the whole of the breast area.
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So that means, we must
start up at the clavicle,
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which is the collarbone, and
we can go in a radial fashion
00:10:41.70\00:10:45.07
in circles, or as we're
doing here, go up and down
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methodically
crisscrossing the breast.
00:10:47.98\00:10:51.17
Now, I think you found
something right there...
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That must give
you a funny feeling...
00:10:53.38\00:10:55.10
Yes, there's a lump.
00:10:55.13\00:10:56.23
But this breast here, as
we do it, has several lumps.
00:10:56.26\00:11:00.02
As we come over the
nipple area, it's important
00:11:00.05\00:11:02.83
NOT to be afraid to
examine beneath the nipple...
00:11:02.86\00:11:06.93
And, indeed, in this
model, there is, as you're going
00:11:06.96\00:11:10.32
back to it there, a
lump underneath the nipple.
00:11:10.33\00:11:14.23
Also, just to show that
breast lumps can occur ANYWHERE,
00:11:14.26\00:11:18.20
they have placed another lump,
00:11:18.23\00:11:19.48
and you're
feeling it right there.
00:11:19.51\00:11:21.82
Now, a breast examination is
not complete without examining
00:11:21.85\00:11:25.35
under the
armpit, as you are doing
00:11:25.38\00:11:26.97
with your fingers right there.
00:11:27.01\00:11:28.21
And I believe...
there you found something.
00:11:28.24\00:11:30.67
You have found a lymph node.
00:11:30.70\00:11:32.72
We would hope that people
would not find a lymph node
00:11:32.75\00:11:36.15
in the axilla.
00:11:36.18\00:11:38.91
So Mollie, you've
shown our patients how to
00:11:38.94\00:11:42.64
examine a breast, and
you have also shown them
00:11:42.67\00:11:45.76
that regular
examination, being alert,
00:11:45.79\00:11:49.01
and taking care of yourself
00:11:49.04\00:11:50.60
results in you
looking so well today...
00:11:50.63\00:11:52.80
Well, thank you very much.
00:11:52.83\00:11:53.92
Mollie, thank you so
much... You're very welcome
00:11:53.96\00:11:57.17
It's been a pleasure
having you here... thank you.
00:11:57.21\00:12:00.39
Some of you who watched this
last segment may be wondering...
00:12:00.42\00:12:03.71
"What happens if I
find a lump in my breast?"
00:12:03.74\00:12:08.32
Let's ask Dr. Handysides...
00:12:08.35\00:12:10.60
Dr. Handysides,
what is the next step?
00:12:10.63\00:12:13.29
Well, the next step is to go and
visit your health professional.
00:12:13.32\00:12:16.53
You really want to
get a professional opinion
00:12:16.56\00:12:18.89
on this lump.
00:12:18.92\00:12:20.71
And the lump needs to
be examined clinically,
00:12:20.74\00:12:23.56
because there are certain
consistencies, mobilities,
00:12:23.59\00:12:27.40
attachments and
features about a lump that a
00:12:27.43\00:12:30.17
health professional will
be able to identify as being
00:12:30.18\00:12:34.37
reassuring, or possibly
suggestive that things need
00:12:34.40\00:12:37.95
to be further investigated.
00:12:37.98\00:12:40.43
It may be that an ultrasound
would show whether this
00:12:40.46\00:12:43.38
was a cyst or not, because
it might show fluid in there.
00:12:43.41\00:12:46.43
Depending on your
age, and depending on your
00:12:46.46\00:12:50.11
predisposing factors, he
may want to do mammography.
00:12:50.14\00:12:55.86
Even CT and MRI of the
breast have been shown to be
00:12:55.87\00:13:01.47
very, very good.
00:13:01.50\00:13:03.13
But in a situation
where there is a lump...
00:13:03.16\00:13:06.53
that cannot be
positively identified,
00:13:06.56\00:13:09.50
I can't stress how important
it is that there should be
00:13:09.53\00:13:14.25
a definitive diagnosis, and
that is usually made by biopsy.
00:13:14.28\00:13:18.88
One can't just say...
00:13:18.91\00:13:20.82
"Well, let's watch
it and see... or PERHAPS
00:13:20.85\00:13:24.99
it's this or perhaps... "
00:13:25.02\00:13:26.18
You REALLY NEED to
make a definitive diagnosis.
00:13:26.19\00:13:28.82
And as Mollie said, her
doctor was not prepared to wait
00:13:28.85\00:13:31.82
until next February from October
00:13:31.85\00:13:34.29
They wanted to
move ahead. Next week...
00:13:34.32\00:13:35.94
It doesn't make a
difference of a week...
00:13:35.97\00:13:38.37
but certainly
months begin to count.
00:13:38.40\00:13:41.25
So, a biopsy is the first step.
00:13:41.28\00:13:44.25
Now what about mammograms?
When do they come in?
00:13:44.28\00:13:47.15
Well, mammography has
been used, and is being used
00:13:47.18\00:13:50.51
as a screening device.
00:13:50.54\00:13:52.26
There's been a lot of
controversy about mammography
00:13:52.27\00:13:54.56
because, first of all,
the studies have sometimes
00:13:54.59\00:13:58.72
differed as to its effectiveness
as a screening tool.
00:13:58.75\00:14:02.75
It does not detect all cancers.
00:14:02.78\00:14:05.15
It maybe will give very
positive results in 90%.
00:14:05.18\00:14:09.64
That's very good...
and you couple that with
00:14:09.67\00:14:12.73
self-examination,
clinical examination,
00:14:12.74\00:14:15.50
ultrasound and so forth...
00:14:15.53\00:14:17.31
And the detectible
cancers rise even more.
00:14:17.34\00:14:21.88
So vigilance is very important,
00:14:21.91\00:14:24.04
and mammography
today has a very, very low
00:14:24.05\00:14:26.83
amount of radiation.
00:14:26.84\00:14:28.55
The modern technology has
reduced the amount of radiation
00:14:28.58\00:14:31.93
Probably the most
uncomfortable thing about it is
00:14:31.96\00:14:34.60
that the breast has to be
squeezed between 2 plates,
00:14:34.61\00:14:37.73
and so we usually advise
younger women who are still
00:14:37.76\00:14:40.61
menstruating that they
go AFTER the menstrual cycle
00:14:40.64\00:14:43.58
so that their breasts
are not sensitive and tender.
00:14:43.61\00:14:46.90
Don't they have some
new machines now that make
00:14:46.91\00:14:50.65
that less comfortable... Oh yes!
00:14:50.68\00:14:52.30
All the time,
techniques are improving...
00:14:52.33\00:14:55.08
so it's becoming
less of a problem...
00:14:55.11\00:14:57.33
And it's certainly
nothing excruciating that women
00:14:57.36\00:15:00.24
couldn't have a mammogram.
00:15:00.27\00:15:02.69
I can hear some of
our viewers saying...
00:15:02.72\00:15:04.60
"Oh... it's good for him to say,
he's never had to have one. "
00:15:04.61\00:15:07.35
But it is true that good
technique in the hands of a
00:15:07.38\00:15:10.77
very supportive staff can
be done very, very nicely.
00:15:10.80\00:15:15.59
You know, every year over
200,000 women hear these words
00:15:15.62\00:15:20.76
"I don't like the looks of
that, we need to do a biopsy. "
00:15:20.77\00:15:24.78
And after they've done
that, the doctor may say...
00:15:24.81\00:15:27.67
"I believe you might have an
aggressive, or you might have
00:15:27.70\00:15:30.36
a cancerous tumor. "
00:15:30.39\00:15:31.84
What kind of
treatment do you recommend?
00:15:31.87\00:15:35.17
There is not the
slightest doubt in my mind...
00:15:35.20\00:15:39.07
and I don't believe
that there's any doubt in the
00:15:39.10\00:15:42.36
literature either...
that a cancer in the breast
00:15:42.39\00:15:46.76
caught early
should be removed...
00:15:46.79\00:15:48.94
because it can usually
be removed in its entirety.
00:15:48.97\00:15:52.84
Are you talking about a
total mastectomy or... No
00:15:52.87\00:15:56.50
You know that again,
there's been a lot of change...
00:15:56.53\00:16:00.34
Forty years ago, when
I was a medical student,
00:16:00.37\00:16:04.53
they were doing
radical mastectomies...
00:16:04.56\00:16:08.51
dissecting glands
out behind the sternum,
00:16:08.54\00:16:12.62
really defacing the people.
00:16:12.63\00:16:16.40
Today with early detection...
00:16:16.41\00:16:18.18
and this is one of the beauties
of doing routine mammography
00:16:18.19\00:16:21.17
with early detection,
oftentimes a simple lumpectomy
00:16:21.20\00:16:25.17
In fact, there are people
who have had an excision biopsy
00:16:25.20\00:16:29.87
that has been wide
enough that it excised
00:16:29.90\00:16:32.34
the whole of the tumor...
00:16:32.37\00:16:34.39
and when that takes
place, they may be cured!
00:16:34.40\00:16:37.84
And so, a lumpectomy
may be all that's required.
00:16:37.85\00:16:41.37
Of course, the treatment
has to be matched to the stage.
00:16:41.38\00:16:45.60
And you haven't
talked about staging...
00:16:45.63\00:16:47.50
I haven't talked about staging,
maybe we should talk about that
00:16:47.53\00:16:50.59
Cancer begins usually
in a duct of the breast...
00:16:50.62\00:16:57.46
The breast is a gland, so
in one of the gland ducts,
00:16:57.49\00:17:01.02
or in the acinar
portion that makes the milk...
00:17:01.05\00:17:04.47
we start to get these
abnormal cells that divide...
00:17:04.50\00:17:06.77
When they progress BEYOND
the actual basement membrane,
00:17:06.80\00:17:13.08
they go from stage 0,
which is just the abnormal cells
00:17:13.09\00:17:16.98
or in situ, to an
invasive cancer...
00:17:17.01\00:17:21.57
But if it's a very small
cancer, less than a centimeter,
00:17:21.60\00:17:24.85
it's just a stage I cancer...
00:17:24.88\00:17:27.99
and at that stage, very seldom
has it spread to lymph nodes.
00:17:28.02\00:17:32.13
Now USALLY, in the biopsy or
lumpectomy, they will examine
00:17:32.16\00:17:38.32
for lymph nodes in the axilla.
00:17:38.35\00:17:40.20
This is a test, as much as
anything else, to see whether
00:17:40.23\00:17:43.24
it has spread to the axilla.
00:17:43.27\00:17:45.26
They currently are still
removing, maybe 10-15 nodes
00:17:45.29\00:17:49.97
from the axilla...
lymph glands from the axilla.
00:17:50.00\00:17:53.34
However, it has become
increasingly obvious that the
00:17:53.37\00:17:56.84
sentinel node... that is the
first node in the drainage area
00:17:56.87\00:18:02.46
can be biopsied, and
it's looking very promising
00:18:02.49\00:18:06.21
in the studies
that are being done...
00:18:06.24\00:18:07.55
that sentinel node biopsy,
which would be simpler than
00:18:07.58\00:18:11.91
a total dissection of the axilla
00:18:11.94\00:18:14.83
will be sufficient
to say whether or not
00:18:14.86\00:18:17.06
it has spread or not
spread to the axilla.
00:18:17.09\00:18:19.20
If the sentinel
node is NOT involved,
00:18:19.23\00:18:21.66
then the likelihood is 97-98%
that no other nodes are involved
00:18:21.69\00:18:27.22
Of course, people,
women or men, can ALWAYS have
00:18:27.25\00:18:30.23
the right to choose
if they want a complete
00:18:30.26\00:18:32.90
dissection or otherwise.
00:18:32.93\00:18:35.04
Today, a simple
mastectomy maybe required for a
00:18:35.07\00:18:39.60
more extensive cancer...
00:18:39.63\00:18:41.87
And then, of course, if
the cancer is beginning to grow
00:18:41.90\00:18:45.31
through to the fibrous
overlying the pectoralis muscle
00:18:45.34\00:18:49.19
on the chest wall,
or is becoming more...
00:18:49.22\00:18:51.50
then a more radical procedure
may require to be done.
00:18:51.51\00:18:55.92
But, by and large, we are seeing
VERY FEW radical mastectomies
00:18:55.95\00:19:01.50
and, with early detection,
far more is lumpectomy
00:19:01.53\00:19:05.21
followed in many
cases by irradiation because
00:19:05.24\00:19:09.75
irradiation will mop up
any localized cancer cells,
00:19:10.75\00:19:15.66
or cells that might
be beginning to migrate
00:19:15.69\00:19:18.58
and the success rate
with a local irradiation
00:19:18.61\00:19:21.08
has been just excellent.
00:19:21.11\00:19:22.66
What about systemic therapy
that goes beyond radiation maybe
00:19:22.69\00:19:27.14
Somebody who has
disease confined to the breast,
00:19:27.17\00:19:31.74
probably does not
require very heavy chemotherapy.
00:19:31.77\00:19:36.54
Chemotherapy is
reserved for people in whom
00:19:36.57\00:19:39.64
distant spread, or dissemination
throughout the body...
00:19:39.67\00:19:43.65
stage III, stage
IV, has taken place.
00:19:43.68\00:19:47.60
I should mention "tamoxifen"
00:19:47.63\00:19:50.04
because tamoxifen or these
estrogen-blocking substances
00:19:50.07\00:19:53.99
...These are substances which
plug the estrogen receptors
00:19:54.02\00:19:57.49
And the idea there
is that if you can plug
00:19:57.52\00:19:59.65
an estrogen
receptor with tamoxifen,
00:19:59.68\00:20:02.38
then estrogen won't work on it.
00:20:02.41\00:20:05.14
The tamoxifen doesn't
stimulate cellular division
00:20:05.17\00:20:07.69
it just blocks the receptor.
00:20:07.72\00:20:09.15
So that is sometimes recommended
for a period of 4 to 5 years
00:20:09.19\00:20:12.90
AFTER there has been a
treatment such as a lumpectomy,
00:20:12.94\00:20:19.16
followed by radiation.
00:20:19.19\00:20:20.78
Now, who makes the
choice on whether the simple,
00:20:20.81\00:20:26.16
or more complicated, or
more radical things are done
00:20:26.19\00:20:33.85
to the woman's
breast? The patient.
00:20:33.88\00:20:37.50
Always the patient? The
patient makes the choice.
00:20:37.53\00:20:40.08
We are responsible
for our own bodies.
00:20:40.11\00:20:43.33
Now an intelligent
patient, listens to good advice,
00:20:43.36\00:20:48.91
and weighs it,
seeks out all kinds of
00:20:48.94\00:20:52.92
information, and then
makes her or his choice
00:20:52.95\00:20:56.41
based on that information...
00:20:56.44\00:20:58.43
And that's why second
opinions are VERY important.
00:20:58.46\00:21:01.37
Any of you who are watching
this program... who may HAVE
00:21:01.40\00:21:05.64
a lump at this time, I
would advise you STRONGLY
00:21:05.67\00:21:10.24
that you get as MUCH
information as you possibly can.
00:21:10.27\00:21:14.65
One of the things that I
sometimes feel we need to stress
00:21:14.68\00:21:18.73
particularly from this station,
because we do an awful lot
00:21:18.76\00:21:23.44
of talk about lifestyle,
and disease prevention...
00:21:23.45\00:21:27.98
we need to understand
that there is a DIFFERENCE
00:21:28.01\00:21:30.72
between PREVENTING a
disease, and CURING a disease.
00:21:30.75\00:21:35.36
I sometimes say that if you have
a child who is wanting to put
00:21:35.39\00:21:38.54
his hand on a hot stove,
and you pull the hand away,
00:21:38.57\00:21:41.80
you have prevented a burn!
00:21:41.83\00:21:43.99
But once the burn has taken
place, it doesn't really help
00:21:44.02\00:21:47.79
to pull the hand away
once the burn has taken place.
00:21:47.80\00:21:51.63
In the same way, our lifestyle
is very, very important
00:21:51.66\00:21:56.47
for giving us the BEST chance
possible to AVOID these diseases
00:21:56.50\00:22:01.33
But if we GET the disease
through no fault of our own,
00:22:01.36\00:22:03.93
perhaps through genetics...
00:22:03.96\00:22:07.18
The fact is that we
don't understand, nor know,
00:22:07.21\00:22:09.91
THEN, yes, those good lifestyle
measures are still important
00:22:09.94\00:22:14.89
to help us FIGHT the disease,
00:22:14.90\00:22:17.17
but we really should get
rid of it because we have no
00:22:17.20\00:22:20.22
evidence whatsoever that
they will CURE the disease
00:22:20.25\00:22:24.42
unless we actually
surgically remove or irradiate
00:22:24.45\00:22:27.72
somehow KILL those cancer cells.
00:22:27.75\00:22:30.30
And then, of course, the
preventive measures are to
00:22:30.33\00:22:32.51
help us prevent getting
cancerous change in tissues.
00:22:32.54\00:22:36.80
Do we really know some of
the causes of breast cancer?
00:22:36.81\00:22:40.57
This has been
looked at a great deal.
00:22:40.60\00:22:42.80
I've talked about the
predisposing factors...
00:22:42.83\00:22:44.75
For instance, it may be
estrogen exposure is important.
00:22:44.78\00:22:47.75
We know that young women who
begin menstruating very early
00:22:47.78\00:22:50.71
...maybe 9 years old,
and then menstruate through
00:22:50.74\00:22:52.95
until they're 55 years of
age, exposed to endogenous
00:22:52.98\00:22:56.55
body-made
estrogen for a long time,
00:22:56.58\00:22:59.50
we know that they
have an increased risk...
00:22:59.53\00:23:02.74
So the earlier age of menarche,
and the long period of time
00:23:02.77\00:23:09.03
is the risk
factor... IS a risk factor!
00:23:09.06\00:23:10.17
But does a woman have a choice?
00:23:11.13\00:23:12.71
She doesn't have
a choice! Okay...
00:23:12.74\00:23:14.29
But there ARE some
choices For instance...
00:23:14.32\00:23:16.66
AFTER the menopause, we
also know that taking hormonal
00:23:17.38\00:23:21.90
replacement therapy,
which can be justified in
00:23:21.93\00:23:25.63
certain situations, but
we know that there is an
00:23:25.66\00:23:28.50
increased risk of breast cancer
in the woman who continues
00:23:28.53\00:23:32.82
taking estrogens
after the menopause...
00:23:32.85\00:23:36.05
because she is
lengthening that exposure.
00:23:36.06\00:23:38.35
There is a little
bit of evidence that
00:23:38.38\00:23:39.99
birth control pills MAY
be related to breast cancer,
00:23:40.02\00:23:44.99
but it's not strong evidence.
00:23:45.02\00:23:46.72
It's just a little suggestion.
00:23:46.73\00:23:47.99
OBESITY is a VERY,
VERY STRONG correlate.
00:23:48.02\00:23:52.26
ALCOHOL... the drinking of
alcohol has been associated
00:23:52.29\00:23:56.09
with increased
risks of breast cancer.
00:23:56.12\00:23:58.91
Now, what if the
cancer reoccurs...
00:23:58.94\00:24:02.35
and how likely is it
to reoccur after 5 years?
00:24:02.38\00:24:06.82
Is there any Stats on that?
00:24:06.83\00:24:08.38
Well, we can't ALWAYS say that
somebody that survives 5 years
00:24:08.41\00:24:13.91
would not have a recurrence...
00:24:13.94\00:24:15.06
But the VAST
majority who reach 5 years,
00:24:15.09\00:24:18.85
can clinically say
that they are cured
00:24:18.89\00:24:21.33
That's good news! GOOD NEWS! Yes
00:24:21.36\00:24:23.76
Now, some women are concerned
about the side effects of some
00:24:23.77\00:24:26.79
of these treatments.
00:24:26.82\00:24:28.15
Could you say just a
little bit about that
00:24:28.18\00:24:29.65
in the next couple of minutes?
00:24:29.68\00:24:31.35
Well, I don't think it's a
bad thing to be concerned about.
00:24:31.38\00:24:35.75
If you have dissection of
the lymph glands, for instance,
00:24:35.78\00:24:38.97
in the axilla, which are
very necessary if there is
00:24:39.00\00:24:40.98
cancer there, you may
find that there is a swelling,
00:24:41.01\00:24:44.27
or what we call
"lymphedema" of that arm.
00:24:44.28\00:24:47.91
...Now you need to be
very careful if that happens
00:24:47.94\00:24:50.58
because the skin will
be particularly prone to
00:24:50.61\00:24:53.90
little cuts and
scratches that can get infected
00:24:53.93\00:24:57.45
because the
drainage is not good...
00:24:57.48\00:24:59.30
So that's an
important thing to be aware of.
00:24:59.33\00:25:02.64
Of course, radiation
leaves an area that is reddened,
00:25:02.65\00:25:07.17
and burned somewhat.
00:25:07.20\00:25:09.41
And people who have
a reddening, you know,
00:25:09.44\00:25:13.22
later goes a little bronze, they
may be self-conscious about that
00:25:13.25\00:25:17.57
Some numbness and tingling
beneath an area of surgery
00:25:17.60\00:25:21.12
is not uncommon.
00:25:21.15\00:25:22.83
If you're on medications,
the medications themselves
00:25:22.86\00:25:25.54
may have side effects.
00:25:25.57\00:25:26.83
Tamoxifen sometimes
causes people to feel nauseated
00:25:26.86\00:25:30.68
It sometimes is
upsetting to the stomach.
00:25:30.71\00:25:33.08
It can even irritate
the lining of the uterus
00:25:33.11\00:25:36.64
and cause little cystic changes
within the lining of the uterus.
00:25:36.67\00:25:39.49
So, yes, you have to be
aware of these side effects.
00:25:39.52\00:25:42.76
What about losing their hair?
00:25:42.79\00:25:45.10
No, they're not going to
lose hair with tamoxiphen. Okay
00:25:45.13\00:25:47.90
They are going to lose
hair if they are put on other
00:25:47.93\00:25:51.08
chemotherapeutic agents
that are, "cidal" to the cell
00:25:51.11\00:25:55.66
they are killing the cells,
and they may lose their hair.
00:25:55.69\00:25:58.57
But the good thing about that
is that hair usually re-grows.
00:25:58.60\00:26:02.35
What about
reconstructive surgery?
00:26:02.38\00:26:04.78
Is that something
you would recommend?
00:26:04.81\00:26:06.77
Reconstructive surgery
is something that is really
00:26:06.80\00:26:11.13
a woman's choice.
00:26:11.16\00:26:12.40
It depends on
how old they are...
00:26:12.43\00:26:15.26
It may depend on how
they perceive their body...
00:26:15.29\00:26:18.31
the sense of body
image that they have.
00:26:18.34\00:26:20.94
Some women feel a
loss of femininity
00:26:20.97\00:26:23.22
when they lose the breast.
00:26:23.25\00:26:24.64
And certainly, reconstructive
surgery can be done
00:26:24.67\00:26:26.75
beautifully...
Plastic surgeons are excellent
00:26:26.78\00:26:28.97
at this, and they can do an
excellent job using one's own
00:26:29.00\00:26:33.18
tissue, fat... moving it around,
mobilizing their own flaps.
00:26:33.21\00:26:36.44
Sometimes putting in an
implant which are very realistic
00:26:36.47\00:26:40.21
the implants of today.
00:26:40.24\00:26:41.74
And, by the way, implants
have been cleared of some of the
00:26:41.77\00:26:45.23
shadow that was
over them in times past.
00:26:45.26\00:26:51.99
So, this sounds a
little encouraging...
00:26:52.02\00:26:55.17
that really, breast
cancer diagnosis is not
00:26:55.20\00:26:59.28
necessarily a death sentence...
00:26:59.31\00:27:00.76
Oh no... breast cancer diagnosis
is not a death sentence
00:27:00.79\00:27:03.81
by ANY MEANS! So it's
not like the old days?
00:27:03.84\00:27:05.49
NOT like it used
to be in the old days
00:27:05.52\00:27:07.54
And to this, we really owe,
I believe, improved technology,
00:27:07.57\00:27:12.38
but very, very much
so... EARLY diagnosis
00:27:12.41\00:27:16.55
and getting on with
a specific treatment
00:27:16.58\00:27:19.05
at the time of early diagnosis
00:27:19.09\00:27:20.81
And just one other quick
question about 15 seconds...
00:27:20.85\00:27:23.44
Should women consider
alternative therapy in this case
00:27:23.47\00:27:29.27
Well, when you've had something
studied as breast cancer
00:27:29.30\00:27:34.07
has been studied...
with thousands upon THOUSANDS
00:27:34.10\00:27:36.83
of thousands of cases, there
really is not an alternative
00:27:36.86\00:27:40.32
because they KNOW
what is the best therapy...
00:27:40.35\00:27:43.05
and that's what's
currently being used.
00:27:43.08\00:27:44.70
SO, we're GLAD TODAY,
Dr. Handysides, for the
00:27:44.73\00:27:47.47
GOOD NEWS that you've
given us about breast cancer.
00:27:47.50\00:27:49.84
We are happy that...
what our viewers have,
00:27:49.87\00:27:53.10
hopefully, learned
something more than they
00:27:53.13\00:27:55.82
knew about breast cancer.
00:27:55.85\00:27:57.24
It is not a death sentence.
00:27:57.27\00:27:59.74
There is great
hope out there for you.
00:27:59.77\00:28:02.23
But, be sure to get checked
up and be sure if you are
00:28:02.26\00:28:06.38
diagnosed... to believe the Lord
can help you get through this
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and you will, in
the end, be good!
00:28:10.65\00:28:13.23