It's Where I Am with Zandra Polard

Unknown Speaker 0:18
Good morning, Las Vegas. This is onto a poll art. It's where I am today. My guests are the kita dove and Dr. Sandra morar of the oncology Institute in Henderson. So thank you both for being here today. You're welcome. Thank you. And we're gonna just jump right in. It is cancer breast cancer awareness month. And we wanted to bring some information to you all so that you know, how you can take care of yourself, do some preventive measures what to do how to do if you are diagnosed with breast cancer, and the such. So I invited Nikita here, because she is a breast cancer survivor. And I'd like for you to start by telling us your story. What happened when you first said, Oh, I think I better make an appointment to see the doctor because something doesn't seem right.

Unknown Speaker 1:14
My daughter is a massage therapist, and she would massage me and in my right arm, it will be pretty stiff, and a little sore, which was not a normal thing for me. And I kept telling her that mommy's really tied up in there. Why am I so tight? So she says maybe you should have it looked at. And so I thought I was okay. And I went to Africa. And when I went to Africa, I was there for a month. But I was moving around I was in apartments and in hotels and and I went from three suitcases to nine suitcases. And so I thought that maybe the suitcases were starting to make me feel even more sore. So I started a pressing on my breath. And when I started pressing, I started filling these little knots. And as the week went on, the knot started as if they calculated into each other because they got larger. So I asked my daughter, I said, Can you feel that? She says, Yeah, Mommy, I think you need to go and have that looked at. And again, I said, Oh, it's probably just the suitcases. You know, we're lifting

Unknown Speaker 2:18
you into your trip. When you notice the lumps or the nodules. I think I had probably about three days left. Okay, so you were pretty much on your way back home. Yes. Okay. And so then you get home and then what happens? Did you call the doctor right away? Or what was the process? That was

Unknown Speaker 2:35
my intention to do? But when I got home, you know, I started looking at my mail because I was gone a month in in the mail. I had a letter for my mammogram, which was going to be like a week later. So I said, Well, I'll just keep that appointment and I'll go then.

Unknown Speaker 2:49
Okay, so you had a mammogram coming up? Yes. Okay. So you go to your mammogram, and then what happens?

Unknown Speaker 2:57
She says, in the mammogram, it showed some abnormality in your breast. So we're going to do an ultrasound. And the ultrasound is something that I guess picks up a little bit more than what the mammogram does. It's always like, okay, but I got a little nervous, because I'm like, I went back to thinking about what I was feeling. And I'm like, well, that's probably all of that stuff I was filling earlier. So when she came back, and she says, There is something there, we're not sure what it is, and it seems to be something small. So we're going to take a biopsy, and in the biopsy, it will tell us more about what's going on. It was

Unknown Speaker 3:33
this all in the same day, it was all at the same day. Okay, so that had to be kind of frightening. That was very frightening. Yeah.

Unknown Speaker 3:39
And were you there alone? No, my husband usually goes with me, but he was in the other room.

Unknown Speaker 3:43
Okay. So they were just taking you from room to room right? And so what were you feeling?

Unknown Speaker 3:49
I just kept going back into that feeling of like, an earlier the month I was feeling tight, and I had told my daughter that mommy's tight there when I'm normally not, but

Unknown Speaker 3:59
you weren't thinking like, oh crap, this might be something serious.

Unknown Speaker 4:03
Oh, after I did the mammogram, I knew it was something serious.

Unknown Speaker 4:07
So Dr. morar, it is breast cancer awareness month. So a lot of ladies are out there getting, you know, their mammograms done for the year. Is it typical that you should get your mammogram every year? Is it different if you're older and what? What is it for men? What Should men do?

Unknown Speaker 4:25
The mammogram remains the standard screening tool that is recommended by American Cancer Society The National Comprehensive Cancer data and peaks the abnormalities in the breast one to two years earlier before any masses can be filled palpated in the breast or under the arm or in the axilla so mammogram, yes. As recommended that as standard of care. It's described it's once a year. And she started age of 40. There are some stipulations that after age 55 if everything had been okay, you can just continue to be evaluated every two years. But in the main site as the NCCN guidelines remain once a year follow up ultrasound. It is used when suspicious lesions which appears on a mammograms like microcalcifications, little induration, little thickening can appear for better view and the results of mammogram guide the next step, male breast cancer, we jumped to a different category. It is rare as for example, the in 2019 per 100,000 women, they were diagnosed about 260,000 breast cancers in females and 2600. In male, the male breast cancer evaluation and treatment kind of follow the female pathway of diagnosis and treatment. They have not been studied because they have this it is rare. It's more aggressive in male, the mammogram, see mail, it's not established as a way of evaluation. The point of interest is if if a lump mail fills in the breast area needs to be evaluated and removed.

Unknown Speaker 6:25
So men need to do that breast check as well. Yes,

Unknown Speaker 6:29
the breast check is a very important step for both male and female but MALE This is what they have to go for.

Unknown Speaker 6:35
Okay. Well, you know, Dr. miroir has been in this business for over 30 years. Is that correct? Yes, yes. Great. I would have no idea that you have been doing this for so long. Thank you for what you do. And please tell our viewers and listeners where you are located.

Unknown Speaker 6:53
I am representing the oncology Institute of hope and innovation. It is based in California, South California with offices they are about 55 oncologist in that area. That's the hub of our practice. So California would windier and San Bernardino I'm not very familiar with the with South California we have Nevada satellite and then Arizona satellite with five offices and in Nevada three offices in Nevada. We have office I wouldn't want office in North Las Vegas across Mountain View hospital on Cheyenne and canalway then in Spring Valley right by Spring Valley Hospital on Rainbow and Hacienda and in Henderson which is right by St. Rose Dominican in Del Webb medical Plaza in the on the Eastern Avenue.

Unknown Speaker 7:52
Okay, so you're practicing in California and in Nevada, not me, not you, but I am

Unknown Speaker 7:57
Yes, my my practice route is in California Dr. agajanian. It's the founder of the practice and his wife Hilda Virginians are the founders of the practice and is growing rapidly with good representation of good oncology care.

Unknown Speaker 8:13
Gotcha, gotcha. Okay, well, so now let's get into the types of cancer. First, I'll ask you Nikita, what type of cancer did they find it was a hormone to cancer. And doctor how many different types of breast cancer are there?

Unknown Speaker 8:29
So breast cancer can start in the ducts and of the ducts or the lobules of the breasts. So we have ductal carcinoma and lobular carcinoma, invasive ductal carcinoma, that means ductal cancer. It's about 85% of the cases the most common type of breast cancer, and then we have the lobular invasive carcinoma, so about 15 15% of breast cancers, the same type of treatment, some monatomic characteristics, ducts and lobules in the breast and some features as lobular carcinoma has a tendency to be bilateral one presenting in one breast you suspect that might be in the other breast that you haven't checked or you haven't noticed, and could be multifocal.

Unknown Speaker 9:18
Well, that's a lot you know, I the first time the first time I went and got my mammogram, I was pretty excited just because I had never done it before and it was my first time and there's so much advocacy for you know, getting your, your yearly mammogram. And so my older cousins, they will call me and say Hey, girl, you know, you've already it's time to get your mammogram. And so when I went down there I went. I was a little nervous just because it was the first time and then I got a letter in the mail. And it said it had a name. And I don't know what that name is, and I'm sure that you know, but it said that it just meant that my breast were dense. Yes. and from that I felt highly complimented. I felt like God to me, it meant that I needed to, what does it mean when it's when you're more dense,

Unknown Speaker 10:11
so dense breast, it's not very common. It's, of course in younger younger patients. That's why the mammogram starts at age 40. Yet, you can find dense breasts at age 55. And up and it's a little tricky as can hide the lesions. So the mammogram alone might not be enough. Mostly if you find some atypical some some abnormalities in the first mammogram that you wander even the biopsy that you complete it to be safe, it's benign. So non cancerous, you need to consider in dense breast younger patient, another form of surveillance, that is the MRI of the breast magnetic resonance imaging of the breast. So there is a condition that you need to attentively follow in spite of not having any form of cancer.

Unknown Speaker 11:05
So from what I find, when I'm thinking back on your story, Nikita, and you said that you were getting your mammograms every year. And nothing was detected until right before?

Unknown Speaker 11:17
Well know when I when I had it done on when I had a mammogram and on my left side, because she said my breasts were large and announced that Oh, yours will dance to me, you actually go. Anyways, so she said up, we wanted to go a little farther. And that was the imaging that you were talking about. And they found, I guess, a motto or whatever. And they removed my nipple and took it out. But but it was benign. But that was a couple of years before I actually had the breast cancer on this side. So so when I did get that call again, I was just before I got the call, I was like, oh, it's probably gonna be that like that one. And it'd be benign. Oh, but it wasn't.

Unknown Speaker 11:57
So take us back to when you found out that you indeed had breast cancer. And then it was time for treatment. What was that phone call? Like?

Unknown Speaker 12:08
She said, I would get the call between three and five days. So after the third day, I got really nervous. But then I started looking at it. And I said maybe the longer it is meaning it's nothing. And my daughter and I were in the kitchen. And the call came. And she says I'm so sorry that I have to say that the results came back as cancer. And I sat there for a minute and I said, Oh, okay, okay. Oh, okay, I can handle that. But I really couldn't. But that was just the first thing that came to my mind. The second thing came to my mind is my children, because I didn't know how I will present that to them. And then you know, when you hear cancer, you're like, What am I going to survive? I don't know much about it. But I've heard from other people, you know, there's certain types, like the doctor said, but I wasn't sure what type I had yet. And I know that my girlfriend who had triple negative was not a good one. So I was worried if I had that, then I was worried about what would I tell my children? And how would I tell them without them getting upset or whatever? And then I thought about, well, I need to tell my husband to and he wasn't there for the whole day. Oh, wow. So I held it. And because my daughter was in the kitchen with me, she consulted me. It was like Mommy, you're gonna be okay. It's gonna be okay.

Unknown Speaker 13:31
So sorry to hear about your experience. But you survived. Yes, I did. Thank you for sharing your story with us. But I also wanted to ask you both about support groups. Were you involved with the support group? Nikita,

Unknown Speaker 13:48
I looked for some, but I really didn't find what I was interested in. So I started researching myself. So I started interviewing women that had breast cancer, that had their breasts removed like me, what were their procedures? How did they deal with it? What did it feel like? Having someone to talk about it with and what if they felt that they didn't need it? With me interviewing the women, I got up to like 15 women, and in those 15 women, it gave me so much information that I wish I had at the beginning of my cancer, because it would have made me able to go that road which would have been a better suggestion, because I had that information as opposed to reactive because I'm afraid. I don't want to say the word die. But if I were to prevent from dying, what would I do? Or even with the After Effects know when they do the cosmetic Look, when I lost my breast it was not a nice look to me. So I'm like, What is my husband gonna think is you're going to still love me the same. And so I needed to hear that from other women. What does your husband feel like when you lost your breath? What was he like to you? What are your children going to think when they see you undress? And you know, longer have that look. So with me listening to the other women and talk, it made it better for me.

Unknown Speaker 15:04
So you had a good family and friends support? Yes. But what about those doctor more who don't who internalize things more who are not able to share and need to find a resource to help them?

Unknown Speaker 15:17
Yes, the main resource, the main site that you need to access is American Cancer Society. Not good representation of established Support Group in Las Vegas area I learned for the past two years that I'm here, the support group, you will be the womb, the patient will be advised through the American Cancer Society for different links that are more virtual than in presence. Unfortunately, I feel that I owe you more details as she was throwing in triple negative and sure hormonal positive. So we understand from Nikita that she has breast cancer that was fed by the estrogen production in her body. This is called estrogen receptor positive progesterone receptor positive. It's one of the nicest breast cancer if we can avoid nice and breast cancer together. Yes, mostly that another receptor her to its negative which I understood from Nikita with prior conversation that is the case. The immediate treatment after the biopsy establishes a diagnosis is surgery, which is lumpectomy, which is a part means a part of the breast is removed, that is followed by radiation to consolidate the local treatment or mastectomy. And if the tumor is less than two inches, or ancient, three quarters, no need for radiation is needed at the time of surgery for mastectomy, reconstruction can be initiated at that time, with expanders placed under the skin to stretch the skin for implants to come in later. Or you can have implants reconstruction completed six months later, gene testing on the breast tissue that had been removed that is cancer, disclose the benefit of chemotherapy or hormonal therapy alone or in combination. Nowadays, not everybody needs chemotherapy for breast cancer, Nikita didn't. She is taking hormonal treatment endocrine treatment, that means she is blocking the production of the estrogen in her body. And the genetic tests disclose the benefit of five years versus 10 years of one pill a day to control the cancer recurrence. For she mentioned triple negative other types of breast cancer, depending on the sell of the breast cancer evaluation are breast cancer that they don't the cell that does not represent any receptor through the analysis, no estrogen receptor no progesterone receptor not heard to this is the triple negative, more aggressive, or estrogen receptor positive but her to positive which will be determined for another type of treatment, no chemotherapy, immunotherapy, biological therapy nowadays, treatment that will extend to one year together with the pill that will block the estrogen blocker. So the pathologic analysis, the time when you meet with the oncologist after surgery is done, it's crucial, because based on the pathology report, evaluate the size of the tumor, the leaf nodes presence, positive of cancer or not. And the characteristic of these receptors of the breast cancer cell that will dictate based on the national guidelines of treatment, the best treatment for the specific patient. So the treatment is quite individualized.

Unknown Speaker 19:03
Yes, I'm sure and so I was hearing that you were talking to quite a few friends who had gone through this process, friends and referral. And but every situation is different. Yeah, right. So everyone's story is different, but there's always something you can pull from someone else's story to help strengthen yourself, right? Yes. So and what I've heard from you, Dr. Moore, is there is not a support group out here in Vegas that you refer to sights and so I want to let my listeners know, if you'd like to start a support group or if you know of a support group, please go to my website. It's where I am.com Let us know where people can find support groups for breast cancer or any type of support group because this program is designed to feed and give you the information so that you are knowledgeable and know how to move forward in your own life. And we all have shared experiences If you're not alone, so please go to the website. It's where I am.com and any information that will be helpful in regards to breast cancer or any type of support group. Please leave those comments there.

Unknown Speaker 20:12
Just want to add that Las Vegas area is developing a nurse navigator program okay Mountain View has a strong nurse navigator program, Sunrise Hospital so HCA system that I am aware with that and I work closer and the support group can be created at such with a nurse, nurse navigator being like the the follow up of the symptoms, the pooling Nikita into survivorship. Survivorship describes support group, what do you do after right What what are you going to do with your life what is going to happen? Five years later, we have to be mindful of bone health. Taking this estrogen blocker treatment, one in four patients will develop muscle aches, joint aches, we can switch the pills around no problem there. But 10% one in 10 women taking this type of medications will have a thinning of the bone. So we need to do a bone density test a DEXA scan once a year to see if the bones are going to be thinning out is thinning out at age 35. And up for any of us ladies.

Unknown Speaker 21:26
I think I feel that

Unknown Speaker 21:29
it's very easy to treat vitamin D calcium and then a pill a month or an infusion every six months or an infusion every year you probably you heard about reclassed or Prolia or Fosamax. That's the feel. So it's more to the patient, the treatment and the follow up from the oncologist endpoint doesn't end I'm done with the treatment goodbye. You see the patient once a month, you see the patient every two months every three months physical exam, and then it's bone health, cardiac health, okay. And bone marrow health as the counts hell. So you it's cancer patient breast cancer patients are complex patient, you see the patient as a whole individual. So you are going to have hot flashes, you are going to have dryness. So there are lots of things to take care of once you are in remission, and you have to follow up any evidence of recurrent disease. So

Unknown Speaker 22:28
can I say something? That's funny you said that because when I was having all of those symptoms, I was like, no, no more till I feel like that.

Unknown Speaker 22:38
Colleges. You tell everything on colleges.

Unknown Speaker 22:43
I wasn't sure if it was blending in with that. Because yes, like the dryness, it was like no, wow, I'm feeling like this. I didn't I didn't associate that

Unknown Speaker 22:53
weekend, fix it. Yeah, we can. We can make everybody happy.

Unknown Speaker 22:59
Sounds good. So Nikita, did you want to tell us about what you're doing now that you are in remission?

Unknown Speaker 23:06
Well, I started a journey with my cancer because like I said, I had so many questions, and I have an oncologist. But there are sometimes some things you're not sure if you're comfortable to tell your doctor about it. But you can tell your girlfriend. Yeah, you can say it to somebody that maybe gone through it, and they understand it. But then you have to find them. So what I've started doing is I've started interviewing women, and I'm going to compose that into a book. Of all the things in questions she want to know about cancer. Very nice. I thought because my oncologist is like 26. And I'm in my 60s. I was like she can feel bad.

Unknown Speaker 23:48
Yes, we know we see enough. We see enough patients every day that we feel that we have all the cancers that we didn't get off. So.

Unknown Speaker 23:55
So if you feel more comfortable telling your girlfriend or your husband, you still got to transfer that information to your oncologist because that is the person who is going to be able to help you right? If you feel good in the moment. And you need that sense of relief by telling a girlfriend, that's great. But yeah, please get that information over to your oncologist just

Unknown Speaker 24:15
write it down and push the push the paper until I have a good report

Unknown Speaker 24:19
with my oncologist. beginning I wasn't sure how to approach it because like I said, she was so much younger than me and I and my girlfriends that have gone through cancer. Sure, I felt more comfortable talking with them. But I'd still do talk to my oncologist.

Unknown Speaker 24:35
But that's important. I thank you for sharing that because you know everyone isn't so open right to talk to anyone. Sometimes we don't even have a friend that we want to confide in about our personal situations. And so that's why we're doing the show. This is why it's where I am brings this information to you want to thank all the listeners for tuning in to 91 point by jazz and more and just A little reminder, go to it's where I am.com You can go to it's where I am.com. You can see this show, you can see previous shows, and that will take you straight to the YouTube channel. And so you would need to subscribe there as well. We want everyone to be informed. We want people to comment, because our listeners are hearing what we're saying people are watching, and people are listening. And whether they do that today or tomorrow, that information is out there for you. And we want to be a source of information for you out there. So again, I want to thank my guests for being here today. Thank you kita dub and Dr. Marar. You can find the kita if anyone else wants to be interviewed, or find out about that book. She is at Katie dub on Instagram that's at KITTIEDO V. And this is Ontraport. Thanks again for listening. I'll see you the second Saturday of next month. I believe it's November 14. We'll see you then. Thanks for tuning in.

Transcribed by https://otter.ai