Selected Podcast
Breast Cancer Prevention and Treatment
Dr. Ahsan Basha leads a discussion on breast cancer.
Featured Speaker:
Ahsan Basha, MD
Dr. Ahsan Basha is a medical oncologist and hematologist at the Riverside Cancer Institute. Transcription:
Breast Cancer Prevention and Treatment
Host: Welcome to the podcast. Today, we're talking to Dr. Ahsan Basha. Dr. Basha, thank you for joining us. And we're going to be talking about breast cancer today. And statistics say one in eight women will be diagnosed with breast cancer, general statistics that we've gotten. What's really the one thing you would say to someone who's diagnosed, the most helpful tip you can give them right off the bat?
Dr. Ahsan Basha: Don't panic. Even though one in eight people have been diagnosed with breast cancer, overall, the number of people who survive it is higher than it's ever been. Treatments are improving and the vast majority of people will survive and live on a relatively normal life.
Host: That's great news, encouraging news. And the other things I've heard are certainly as with all disease states, early detection is always best. So with that in mind, talk a little bit about what women should be thinking about and what ages should they really be thinking about their breast health?
Dr. Ahsan Basha: Sure. So there actually had been some variability in the guidelines more recently between different organizations. There is American Cancer Society. There's the United States Preventative Task Force. But I think the one consistent thing is, that for women generally between the ages of 50 to 75, they should get mammograms on a scheduled basis.
Host: Okay.
Dr. Ahsan Basha: My preference has generally to follow the ACS guidelines, which I think are more generous and more practical in many cases. The guidelines there are basically that once you start hitting the age of 45 as a woman, you should be getting initially yearly mammograms. And after a period, a decade or so, you can decrease that if you wish or you could continue that yearly mammograms and as long as you're healthy, actually.
So if with your general health, you and your physician believe you can live 10 more years, whatever, then keep on getting the mammograms. So as long as you feel healthy, you want to stay healthy. And that's really the basic underlying thing to get mammograms.
Now, there's variabilities if you have a family history of breast cancer, if you have other risk factors that may be associated with breast cancer and that may play a little part in it. But generally, 45 until whenever you stop being healthy.
Host: And I've heard 40, is that something that changed from 45, is the standard normal year that you would start getting...?
Dr. Ahsan Basha: So 40 is, again, it depends on the organization. In general, the set guidelines is 45. Between 40 and 45, they say basically you should have been informed talk with your physician, it would be a primary care physicia actually more than anything else and come to an informed decision.
Part of the reasoning behind that has been there's been concern about too many false positives and putting people through a lot of stress and anxiety. But again, if there is a reason why you should, you should talk with your physician in that case.
Host: So as they say to all of us, always be kind of aware of what your body's doing. Generally, people think no when something's different about their body in some way. So I think we probably want to tell women that if they notice something different in their breasts, that's the time to bring it up first, maybe to their primary care provider.
Dr. Ahsan Basha: You should know your body just as a general rule. That goes for men and women. In this case, obviously, women. There is actually no recommendations to self-breast exam anymore, but just have an idea of what your body normally feels like whether it's once in a while in the shower, once in a while whenever. And exactly, if you notice something that's different, you don't wait until your annual mammogram. You go to your doctor, communicate with the doctor and take them from there. You know, they may recommend it that time to go ahead and do a mammogram or they may reassure you everything's okay.
Host: You mentioned earlier upon first diagnosis, the first thing, don't panic. After that, what's the process that a woman would go through following a diagnosis? And what should be on her mind in terms of questions to ask and things to kind of look out for?
Dr. Ahsan Basha: Sure. So, the good news is most programs, including like Riverside Care, if you get diagnosed through the best breast cancer screening program, there is a navigator who helps you. So one will help you connect with the right doctors, whether that doctor would be a surgeon or a medical oncologist like myself. Eventually, there'll be a team, but they'll get you to the right people through a navigator.
In addition, you want to get information from good sources. And don't just randomly Google. Talk to people, but, you know, don't necessarily listen to what everybody says. A lot of people have different ideas about breast cancer, especially, you know, things used to be different, things have changed now. Trusted sources that I look to are the Susan G. Komen Breast Cancer Organization. They have great information and have people that are able to talk to you. The American Cancer Society is a great place too. But again, your physician is a good source of information. The cancer navigator programs like Riverside provide is a great source of information and guidance. So you don't have to panic.
Host: Sure. I would guess you'd also recommend, as for all of us, so many things as we're saying we like everyone to keep in mind, general health, you know, keep weight, diet, exercise, all those kinds of things are important, particularly if you've been diagnosed with the disease, I would guess.
Dr. Ahsan Basha: Yes. So both in terms of once you've been diagnosed, maintaining good health, maintaining activity, it helps you get through everything you're going to go through much better in terms of recovery, in terms of how you tolerate the treatment, everything like that. But there are quite a lot of suggestions that maintaining diet and exercise will reduce your risk of breast cancer in many ways. Specifically for breast cancer, theoretically, the leaner you are, the less estrogen your body makes. Increased estrogen exposure increases the risk of breast cancer. So both exercise and a good diet and being lean tend to reduce that risk somewhat.
And then, there's also suggestions, not a proven thing, but there are significant suggestions that healthy diet and exercise can improve the immune system, which helps reduce the risk for cancer.
Host: Positive things. When we talk about treatment, really the treatment journey can vary from patient to patient, radiation, chemo, surgery, all those things. Talk a little bit about what the possibilities might be for a patient.
Dr. Ahsan Basha: So one of the things I talked about is not panicking even though you mentioned that one in eight women will end up being diagnosed with breast cancer. By going through breast cancer screening and, general guidelines about being checked up on, overall more breast cancers are found in earlier stage when they're localized, before they become much more widespread.
So in many of those patients with early stage breast cancer, majority of time, what will happen is the cancer navigator or their primary care physician will direct them to surgeon to a deal with breast cancer very regularly, who will examine patients and decide what kind of surgery can we offer.
In the majority of women, we can offer breast conservation surgery, where they're able to keep their breasts and just have a lump taken out. In some cases, the surgeon may recommend mastectomy where they remove the entire breast, but oftentimes they will try to fight to get a lumpectomy. And that may involve at that point, getting a medical oncologist involved earlier on to do therapy that can shrink the tumor size down and make a lumpectomy more likely.
Overall, breast cancer team for most women will involve the surgeon, the medical oncologist who will provide what's called systemic therapy, meaning therapy that goes through the body whether it's in the form of hormones or anti-hormones, or sometimes chemotherapy, and oftentimes the radiation oncologist working together in a team fashion where they discuss your case and then come up with a plan overall for managing that patient.
Host: Yeah. Very good. As we wrap up, we kind of can end where we started. And that is your advice to a woman who's diagnosis again would be?
Dr. Ahsan Basha: Don't panic. Help is there. One of the reasons I got into oncology was my mom was diagnosed when I was in college. It was 1984. Actually, I was getting ready to take my medical school entrance exams, she was going through breast cancer treatment. And interestingly, eventually in my training, I ended up being trained under the doctor who treated her. I did not plan it that way. That's how it ended up happening. And, you know, looking back, that chemotherapy that my mom got, we never used any more at all, but she is still alive however many years ago now, 45 years ago.
Host: Wonderful. That's great to hear. Very good. Well, Dr. Basha, we appreciate your time. And thank you for the work you do.
Dr. Ahsan Basha: Thank you. Appreciate it.
Breast Cancer Prevention and Treatment
Host: Welcome to the podcast. Today, we're talking to Dr. Ahsan Basha. Dr. Basha, thank you for joining us. And we're going to be talking about breast cancer today. And statistics say one in eight women will be diagnosed with breast cancer, general statistics that we've gotten. What's really the one thing you would say to someone who's diagnosed, the most helpful tip you can give them right off the bat?
Dr. Ahsan Basha: Don't panic. Even though one in eight people have been diagnosed with breast cancer, overall, the number of people who survive it is higher than it's ever been. Treatments are improving and the vast majority of people will survive and live on a relatively normal life.
Host: That's great news, encouraging news. And the other things I've heard are certainly as with all disease states, early detection is always best. So with that in mind, talk a little bit about what women should be thinking about and what ages should they really be thinking about their breast health?
Dr. Ahsan Basha: Sure. So there actually had been some variability in the guidelines more recently between different organizations. There is American Cancer Society. There's the United States Preventative Task Force. But I think the one consistent thing is, that for women generally between the ages of 50 to 75, they should get mammograms on a scheduled basis.
Host: Okay.
Dr. Ahsan Basha: My preference has generally to follow the ACS guidelines, which I think are more generous and more practical in many cases. The guidelines there are basically that once you start hitting the age of 45 as a woman, you should be getting initially yearly mammograms. And after a period, a decade or so, you can decrease that if you wish or you could continue that yearly mammograms and as long as you're healthy, actually.
So if with your general health, you and your physician believe you can live 10 more years, whatever, then keep on getting the mammograms. So as long as you feel healthy, you want to stay healthy. And that's really the basic underlying thing to get mammograms.
Now, there's variabilities if you have a family history of breast cancer, if you have other risk factors that may be associated with breast cancer and that may play a little part in it. But generally, 45 until whenever you stop being healthy.
Host: And I've heard 40, is that something that changed from 45, is the standard normal year that you would start getting...?
Dr. Ahsan Basha: So 40 is, again, it depends on the organization. In general, the set guidelines is 45. Between 40 and 45, they say basically you should have been informed talk with your physician, it would be a primary care physicia actually more than anything else and come to an informed decision.
Part of the reasoning behind that has been there's been concern about too many false positives and putting people through a lot of stress and anxiety. But again, if there is a reason why you should, you should talk with your physician in that case.
Host: So as they say to all of us, always be kind of aware of what your body's doing. Generally, people think no when something's different about their body in some way. So I think we probably want to tell women that if they notice something different in their breasts, that's the time to bring it up first, maybe to their primary care provider.
Dr. Ahsan Basha: You should know your body just as a general rule. That goes for men and women. In this case, obviously, women. There is actually no recommendations to self-breast exam anymore, but just have an idea of what your body normally feels like whether it's once in a while in the shower, once in a while whenever. And exactly, if you notice something that's different, you don't wait until your annual mammogram. You go to your doctor, communicate with the doctor and take them from there. You know, they may recommend it that time to go ahead and do a mammogram or they may reassure you everything's okay.
Host: You mentioned earlier upon first diagnosis, the first thing, don't panic. After that, what's the process that a woman would go through following a diagnosis? And what should be on her mind in terms of questions to ask and things to kind of look out for?
Dr. Ahsan Basha: Sure. So, the good news is most programs, including like Riverside Care, if you get diagnosed through the best breast cancer screening program, there is a navigator who helps you. So one will help you connect with the right doctors, whether that doctor would be a surgeon or a medical oncologist like myself. Eventually, there'll be a team, but they'll get you to the right people through a navigator.
In addition, you want to get information from good sources. And don't just randomly Google. Talk to people, but, you know, don't necessarily listen to what everybody says. A lot of people have different ideas about breast cancer, especially, you know, things used to be different, things have changed now. Trusted sources that I look to are the Susan G. Komen Breast Cancer Organization. They have great information and have people that are able to talk to you. The American Cancer Society is a great place too. But again, your physician is a good source of information. The cancer navigator programs like Riverside provide is a great source of information and guidance. So you don't have to panic.
Host: Sure. I would guess you'd also recommend, as for all of us, so many things as we're saying we like everyone to keep in mind, general health, you know, keep weight, diet, exercise, all those kinds of things are important, particularly if you've been diagnosed with the disease, I would guess.
Dr. Ahsan Basha: Yes. So both in terms of once you've been diagnosed, maintaining good health, maintaining activity, it helps you get through everything you're going to go through much better in terms of recovery, in terms of how you tolerate the treatment, everything like that. But there are quite a lot of suggestions that maintaining diet and exercise will reduce your risk of breast cancer in many ways. Specifically for breast cancer, theoretically, the leaner you are, the less estrogen your body makes. Increased estrogen exposure increases the risk of breast cancer. So both exercise and a good diet and being lean tend to reduce that risk somewhat.
And then, there's also suggestions, not a proven thing, but there are significant suggestions that healthy diet and exercise can improve the immune system, which helps reduce the risk for cancer.
Host: Positive things. When we talk about treatment, really the treatment journey can vary from patient to patient, radiation, chemo, surgery, all those things. Talk a little bit about what the possibilities might be for a patient.
Dr. Ahsan Basha: So one of the things I talked about is not panicking even though you mentioned that one in eight women will end up being diagnosed with breast cancer. By going through breast cancer screening and, general guidelines about being checked up on, overall more breast cancers are found in earlier stage when they're localized, before they become much more widespread.
So in many of those patients with early stage breast cancer, majority of time, what will happen is the cancer navigator or their primary care physician will direct them to surgeon to a deal with breast cancer very regularly, who will examine patients and decide what kind of surgery can we offer.
In the majority of women, we can offer breast conservation surgery, where they're able to keep their breasts and just have a lump taken out. In some cases, the surgeon may recommend mastectomy where they remove the entire breast, but oftentimes they will try to fight to get a lumpectomy. And that may involve at that point, getting a medical oncologist involved earlier on to do therapy that can shrink the tumor size down and make a lumpectomy more likely.
Overall, breast cancer team for most women will involve the surgeon, the medical oncologist who will provide what's called systemic therapy, meaning therapy that goes through the body whether it's in the form of hormones or anti-hormones, or sometimes chemotherapy, and oftentimes the radiation oncologist working together in a team fashion where they discuss your case and then come up with a plan overall for managing that patient.
Host: Yeah. Very good. As we wrap up, we kind of can end where we started. And that is your advice to a woman who's diagnosis again would be?
Dr. Ahsan Basha: Don't panic. Help is there. One of the reasons I got into oncology was my mom was diagnosed when I was in college. It was 1984. Actually, I was getting ready to take my medical school entrance exams, she was going through breast cancer treatment. And interestingly, eventually in my training, I ended up being trained under the doctor who treated her. I did not plan it that way. That's how it ended up happening. And, you know, looking back, that chemotherapy that my mom got, we never used any more at all, but she is still alive however many years ago now, 45 years ago.
Host: Wonderful. That's great to hear. Very good. Well, Dr. Basha, we appreciate your time. And thank you for the work you do.
Dr. Ahsan Basha: Thank you. Appreciate it.