Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Tamika Perry and award winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. Now, here are Ron Aaron and Dr. Tamika Perry.

RON AARON
Hello everybody, and welcome to the award winning Docs in a Pod. I'm Ron Aaron. Along with us today is our co-host, Dr. Tamika Perry. We're going to talk in honor of Breast Cancer Awareness Month about breast cancer. Before we do that, let me introduce Dr. Perry. She is associate medical director for WellMed. As associate medical director, Dr. Perry's goal is to support providers at a number of well-matched clinics, helping them deliver quality care and a compassionate patient experience. She's been with WellMed for a little over 10 years, and we're delighted to have her with us. She earned her undergraduate degree from Prairie View A&M University. She then went on to graduate from Philadelphia College of Osteopathic Medicine, where she was National Health Service Corps Scholar. Next, she completed her family medicine residency at Methodist Charlton Medical Center, where she served as Chief Resident. Dr. Perry is board certified by the American Osteopathic Board of Family Physicians. She also earned a masterÕs in public health, with an emphasis on health management and policy, at the University of North Texas Health Science Center. In addition, Dr. Perry is a diplomat of the American Board of Obesity Medicine. She also serves the various needs of her local community through membership in the Delta Sigma Theta sorority. Dr. Perry lives in Dallas with her daughter, and in their free time, they love to travel the world.

DR. TAMIKA PERRY
We do.

RON AARON
Dr. Perry, it is great to have you on again.

DR. TAMIKA PERRY
Thanks, Ron. Every time you read that introduction, I'm like, who is that person? Because it seems like my whole life focuses around the one I have in college. I'm Taylor's mom.

RON AARON
You spent time in college yourself.

DR. TAMIKA PERRY
I did. I spent a lot of time in school. I actually like school. I hoped my daughter would have taken on that same passion of loving school, but she does not. I realize as a mom, she's an individual so. She does well in school. She just doesn't have a passion for it like I do.

RON AARON
What does she do at Prairie View?

DR. TAMIKA PERRY
She is a psychology major, and I've reiterated to her over and over again, please don't write any papers about me.

RON AARON
Yeah. Analyzing my mom.

DR. TAMIKA PERRY
Right. Why I am like I am because of my mom.

RON AARON
We're going to pick up the topic of breast cancer in honor of Breast Cancer Awareness Month. We're delighted to welcome Kimberly Channels. She's a physician's assistant and dedicated at WellMed at New Tampa, where she brings compassionate care and clinical expertise to her patients. Kimberly earned a Master of Science in physician assistant medical science and a Bachelor of Science in physician assistant studies from Alderson Broaddus College in Philippi, West Virginia. Kimberly also earned an Associate of Arts degree from the University of South Florida in Tampa. Outside of health care, she enjoys embracing life's adventures and recently ticked off that bucket list item. She went for a ride in a hot air balloon. 80 days around the world, right Kimberly?

KIMBERLY CHANNELS, PA
Yes, it was quite exciting. My husband had no interest in going up in the hot air balloon, but I went with my friend, and we had a great time in Las Vegas across the desert. Got to see the sunrise several times across the mountains, so that was kind of cool. A couple minutes later, there's another sunrise. It was super smooth. I'm thinking I need to find another hot air balloon ride somewhere. Not in Tampa, because we do have this area close to us, but IÕm not really a fan of looking down at traffic, so I will look for some place that has a little bit more scenery for me to try it again.

RON AARON
You donÕt have the goal of jumping out of an airplane yet, right? Skydiving.

KIMBERLY CHANNELS, PA
IÕve never jumped out of an airplane.

DR. TAMIKA PERRY
I've done that one. I've jumped out of an airplane.

RON AARON
You skydived?

DR. TAMIKA PERRY
Yes, for my 34th birthday. It was the 34th birthday present. I thought we were on our way to Chili's or something to go out to eat, and I kept going, why are we driving so far? We went out to a rural area, and he was like, surprise, this is your birthday present. So, we did tandem jump out of an airplane. It was interesting.

RON AARON
What was that like for you?

DR. TAMIKA PERRY
I was really nervous. I called my mom and my grandma. My grandma started singing spirituals on the phone, and she was like, see, you went to all those fancy schools now you have these fancy ideas. We don't do that. She thought that was totally the end. It was actually really peaceful. When we did the jump. Now, first of all, let me tell you, Ron, and we're going to get into breast cancer. I went out there, and you're supposed to have like a 4 or 5-hour class. So, as we're putting on the equipment, I raised my hand. I said, sir, when does the class start? He said, oh heck, baby girl, let me tell you how it's going to go. My class was 32 seconds, so I was like, oh my God, why am I doing this? I feel like the person who took me was like, you got this off a Groupon, didn't you? When we got up there, you jump and you freefall for about 10, 15 seconds, maybe up to 30 seconds. And I'm thinking, why did I do this? And then he opens the canopy and you just kind of float down and everything looks so peaceful and so beautiful. As we were getting towards the bottom, there was a body of water, and I kept trying to make my legs go over the water. And he said, what are you doing? I said, I don't swim very well, but I feel like if something happens, we're going to fare better if we fall in the water. He said, we're going to be fine. It's a cool experience, actually.

RON AARON
Is it something you'll do again?

DR. TAMIKA PERRY
No, sir. I'm good. I'll go up in the air balloon, but I donÕt need to jump out of a plane.

RON AARON
WeÕre talking about the topic of breast cancer. As I mentioned, it is Breast Cancer Awareness Month. Breast cancer is pretty common. It's the most common cancer in women, except for skin cancers, and accounts for 30%, or 1 in 3 of all new female cancers each year, according to the American Cancer Society. Kimberly talked to us a bit about not only identifying and diagnosing and treating breast cancer, but what is something with every patient, male or female, you pay attention to?

KIMBERLY CHANNELS, PA
Breast cancer is, like you said, the number one cancer for females. We have to be aware. And you screen for breast cancer. We have to remind the patient to get their screening, get their mammogram, do their breast exams. Men should also check their breasts to make sure they don't feel any lumps in there because men can also get breast cancer as well. October persists Breast Cancer Awareness Month, so we think pink to remind us that we need to take that extra look at the breast during that time and all through the year, actually.

RON AARON
Hold that thought. We're going to get right back to you. I want to let folks who may have just joined us know you're listening to the award winning Docs in a Pod. Dr. Tamika, our co-host, is with us, and we're talking with Kimberly Channels. She's at WellMed at New Tampa in Tampa, Florida, and we're talking about Breast Cancer Awareness Month. Kimberly, I read in doing some research for today's show that it turns out older women are at higher risk for breast cancer than younger women.

KIMBERLY CHANNELS, PA
Yes. That's true. The average age for females is around 62 or 63. It's still important to screen patients and screen women, even as they're getting older. It's a discussion that you need to have with your medical provider to find out if you are a candidate for breast cancer screening. What is your current health situation? What are we going to do regards to breast cancer treatment if you were to be diagnosed with breast cancer?

RON AARON
I also read somewhere that despite what most people believe, you have to have a family member who has had breast cancer, it's not true. You don't necessarily have a genetic connection.

KIMBERLY CHANNELS, PA
That's true. Most of the patients actually don't even have that genetic predisposition. They did their mammogram, and they did detect the breast cancer. We hope that they were able to detect the cancer early, so they'll have the best treatment available and best outcome available.

RON AARON
Dr. Perry, it's confusing for folks because the suggested use of mammograms keeps changing in terms of when the first one should be given and how often they should be given. What's the best advice now?

DR. TAMIKA PERRY
Some of it is patient dependent, but generally around the age of 40 we're going to start and it's every 1 or 2 years. It depends on what governing body you're looking at, and each one has a little bit different focus. So, if you're looking at the US Preventive Task Force, they're going to suggest every two years is sufficient for breast cancer screening. The American Cancer Society says every year. If you have a family history, a strong family history, most certainly the screening will start before the age of 40. Kim touched on something that was really important earlier. She alluded to, when should you stop having cancer screenings or breast cancer screenings? There's a method for the madness there. 75 generally is whatÕs recommend for women to stop having breast cancer screening, but that's because, like Kim said, you have to look at other comorbid conditions. What else is going on with the patient? For example, my grandmother at 78 had a lump on her breast which she never wanted me to biopsy or touch, and that's something that's totally up to her because it's her body. So, she moved from Dallas to back to our hometown, and somebody convinced her to let her biopsy it. Of course, it was cancer. My grandma opted not to have anything done because she was a long-time smoker with peripheral vascular disease. She had moderately controlled congestive heart failure and said, I don't want anything. I don't want any aggressive treatment. I don't want anything done. What I want to do is I want to sit on my porch, drink my beer, eat my pecans, and talk about the people who walk by. The highlight of her life. So, for 10 years, that's what she did without any treatment. Now, in the last year, she did succumb to metastatic cancer, but she's 88 at this point. For ten years, she lived life on her own terms, and that last year it was a little bit rough on her. But not all those years were good years. At some point we have to say, is this treatment going to cause more harm than good? Has she had major surgeries? Has she had chemotherapy, radiation? Would she have lived 11 bad years, or do we take the ten good years? Do you know what I mean?

RON AARON
ThatÕs a really good question.

DR. TAMIKA PERRY
Yeah. I just wanted people to be aware of that because Kim touched on something really, really good. Some people may be wondering, why would we stop screening at some point? Because at some point, are we going to outlive the natural progression of the disease? And at some point, do we say the treatment is harsher on our bodies than the actual disease state itself?

RON AARON
Kimberly, are some breast cancers more aggressive than others? Can you have a mild form of breast cancer and just drink beer and eat pecans and you'll be fine?

KIMBERLY CHANNELS, PA
That's where the biopsy will determine what type of breast cancer you have. What type of receptor sites play into your particular cancer? The oncology world has so many advances that they can predict with your type of cancer, what the best treatment is, and what your percentage recovery survival rate that would come based on your particular type of cancer where it's stage that. So, that's very important when you're looking at what type of treatment you are having and the conversation that you have with your oncologist so that you can make an educated decision about how to treat your particular type of breast cancer.

RON AARON
We'll talk about self-exam diagnosis and the kind of treatments that are available in just a moment. ItÕs Breast Cancer Awareness Month, and we're giving you a preview on the award winning Docs in a Pod.

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RON AARON
We are learning a lot about breast cancer. It's Breast Cancer Awareness Month. I'm Ron Aaron, and you're listening to the award winning Docs in a Pod. Our podcast is available wherever you get your podcasts. We're also on the radio in several cities in Texas and Florida as well. Kimberly Channels, a physician's assistant, is with us. She's at WellMed at New Tampa in Tampa, Florida. Our co-host, as always, delighted to have her, Dr. Tamika Perry. ItÕs Breast Cancer Awareness Month, but shouldn't you be aware of it every month?

DR. TAMIKA PERRY
Most certainly. Kim can tell us about self-breast exams. Think about it like this. This is what I've always been taught in learned. With breast exams, theoretically, we ask a woman to do them once a month. So, you examine your breast 12 times a year. We do the mammogram once a year. Even though the mammograms are a sensitive device in which we look through the breast tissue using radiation picture, you know your body. If you get to know your body well, and know how to do the exam well, you're going to detect that really, really early.

RON AARON
Early gives a greater chance for cure.

DR. TAMIKA PERRY
Absolutely. The most common breast cancer in the US is something called an Invasive Ductal Carcinoma In Situ. It's about 70 to 80% of all breast cancers. If you're at stage zero, the survival rate is like 99%. Stage one, it's like 90%. I mean, Campton Hill has the stats on the on the rest of it, but the earlier the better.

RON AARON
Kimberly, how do you teach self-exam?

KIMBERLY CHANNELS, PA
I usually tell my women that checking their breast once a month in the shower, actually, is probably one of the easiest ways. Getting familiar with the breast so that if they do feel something that's changed and feel a lump, then they can come in and have an examination. I remind some of my thinner women, your ribs are hard, so know where your ribs are and be able to know that when you feel something different, like a lump not movable or even a lump that you feel that is movable, you feel something thatÕs changed, and you would want to have it checked out. If you're seeing any skin changes and nipple discharge, any bleeding from the nipple. If you're having any dimpling, in your breast, that's always been a concern. When you get out of the shower, you want to kind of bend down forward looking in the mirror and seeing if you see any dimples. That's another way to look for changes in your breasts. Always check underneath the armpits as well. You don't want to have, lumps under your armpits that shouldn't be there. The most important thing is to get familiar with your breasts so you know that there is a change if there is a change that develops that you would be able to feel.

RON AARON
Now, is that something that you should do every day?

KIMBERLY CHANNELS, PA
You usually do it once a month. You certainty can always do it more frequently. I usually tell my patients if theyÕre still menstruating to do it a week after the menstrual cycle. That's when the hormone levels are best and less tender for the breast. For my menopausal ladies, I recommend to put a spot on your calendar, do it the first day of the month or the 15th of the month. Some time you can remember that you did it that month. So, using that calendar to remind you. Sometimes there's some shower details that some people have that they hang in the shower to remind them as well.

RON AARON
Dr. Perry, is it something that if you're used to doing this, you can detect changes in your breast?

DR. TAMIKA PERRY
Almost certainly. You should always be in tune with your body. This is what I tell my ladies. Anytime you feel something is abnormal, even if you can't discern whether it's pathologic or not, and that's for us to discern, me and Kim, you need to let us know. Then we will let you know, hey, this is this is really just a pimple on your skin, or this is something that we need to check out, but then you'll know what's normal for you and what's not normal for you. I encourage people to know your bodies and know your bodies well. Same goes to a diabetic. Always look at the bottom of your feet. Know what the bottom of your feet look like. Women, know what your breasts feel like. So, you want to know what changes are supposed to be and not supposed to be. Kim made a great point when talking about the size of the breast and tissue texture changes. I always tell my girls to bend over and if one of your breasts is stuck to your chest wall, but the other one goes to your knees, that is not normal. If it wasn't like that last month, you need to let me know. Let me know so we can check that out. We look for something called a Peau d'orange surface change where the surface of your breast may look like an orange peel, and it may actually be an orange color. That's a special type of breast cancer. If that change happens, let us know. It's not just a rash or cellulitis. These are things that we should know. You should always be in tune with your body.

RON AARON
What's interesting is denial. A lot of folks don't want to know, right?

DR. TAMIKA PERRY
They donÕt. I had a colleague when I was early in my training and her mom unfortunately died of breast cancer, but her mom wound up saying, well, I knew one breast was bigger than the other for a while and it was a little tight, I just thought maybe I had a mild infection or something, but she had breast cancer and she didn't say anything. I know a lot of women who don't want to get mammograms because they say, well, the mammogram hurts. My counter-argument is always that cancer hurts a lot.

RON AARON
And cancer kills.

DR. TAMIKA PERRY
Yeah, cancer kills. That mammogram is uncomfortable for every bit of 10 minutes and then it's over with. Maybe less than that and it's over with. So, the screening is so important.

RON AARON
Kim, for those who are resistant to a mammogram, is it not one of the best ways to detect a potential problem?

KIMBERLY CHANNELS, PA
Your mammogram is really, in terms of the gold standard, in terms of detection for breast cancer. If we do detect that there's something abnormal or there's a lump or there's other changes in the imaging, then sometimes they will recommend other studies to be done. Ultrasound images can sometimes be done. Of course, if the radiologists are seeing something suspicious or they're just not sure, they're going to recommend a biopsy or sometimes they recommend short term follow up. But again, that's something that you need to follow the recommendation of your medical provider or the person who is actually ordering a test, whether it be your primary, your gynecologist, that type of provider so you can follow the best guidance.

RON AARON
For a biopsy, can that be done with just a syringe drawing out some fluid, or do they need to cut it out?

KIMBERLY CHANNELS, PA
They usually start with what they call a biopsy, and there's several different types of biopsies depending on what type of imaging finding that they see. There are breast centers and providers centers where they do basically a biopsy with a syringe. They pull out these towels and then they put a little marker inside, so you know where they've been. Then they're tested for cancer. Then if it's cancerous, usually at that point, the treatment plan would then be some removal if that is in their treatment plan. Some people have lumpectomy, some people have mastectomies, which is where they remove the entire breast. But again, at that point, that's where you would have a discussion with the breast surgeon or the ecologist in terms of treatment plan.

RON AARON
My wife and I have a good friend who was diagnosed with breast cancer in one breast and chose to have a double mastectomy as a preventive measure so she couldn't get it in the other breast. How common is that?

KIMBERLY CHANNELS, PA
It is common. It depends. If you have a certain type of breast cancer or certain genetic type of breast cancer, sometimes they will recommend a bilateral mastectomy. It comes down to partially what your medical professional is recommending, but also sometimes patient choice as well. I had breast cancer, but my oncologist recommended a lumpectomy for my particular type. There's really no added life or benefit of having a double mastectomy or single mastectomy. I chose the to do what they call breast-preserving type of surgery, a lumpectomy.

RON AARON
You're talking about yourself?

KIMBERLY CHANNELS, PA
Yes.

RON AARON
How scary was that when you got the diagnosis?

KIMBERLY CHANNELS, PA
It was pretty darn scary. It's very humbling when you're on the other side of the table, literally as a patient. You have your mammogram and they say, it looks like it's a little suspicious, and then they're like, you have to biopsy and then you're waiting for the results. It's scary because then you worry about your family when you have a diagnosis. You sometimes worry not as much about yourself, but you worry about how everybody else can respond because you had that diagnosis.

RON AARON
In my friendÕs case, the physician's office called her on a Friday and said, we've got some results back. Can you come in Monday? She said, why do I have to wait?

DR. TAMIKA PERRY
Yeah. Why do you have to wait? I agree with that. That probably wasn't the best customer service.

RON AARON
Made for a long weekend.

DR. TAMIKA PERRY
Yeah. Very long weekend. Kim brought up a great point. She said she had an abnormal mammogram. Then she had to go back for an additional study and then a biopsy. This is the point that I think that she brought up that was really good. Go back if they tell you your mammogram is abnormal and get the additional study and or biopsy that's recommended. I say that because one, a mammogram uses radiation to look through breast tissue to find abnormal lumps. The radiation now with the 3D mammograms are really, really good studies. I mean, a toddler could look at a mammogram and say, that's not supposed to be there because it's usually really obvious. It looks best through postmenopausal breast tissue, where the tissue deducts and glands have turned mainly to fat because the assumption is, at this point in your life, the bodily assumption, you're not going to have any babies anymore, so the breast architecture changes. But if you're a young woman or you or you're a fortunate older woman with young breasts, you still may have very dense breasts. Sometimes it's difficult for that radiation to look through those dense breasts to see masses. So, what the radiologist may say is we need you to do a diagnostic or a mammogram, or we need you to do an ultrasound, or we have a little area that we'd like you to biopsy. I want to let the public know, please, please, please know they're not just trying to get extra money from you. This really needs to be done. In my entire career, including myself, I've had probably a thousand women who have had to go back for a second look. Of those women, probably about 100 of them had cancer in that second look. So, it's not that they're just trying to milk you for another copay or anything like that. We really need you to get it done.

RON AARON
We're going to have to move on. We we're out of time. But very quickly, Kimberly, you're okay now?

KIMBERLY CHANNELS, PA
I'm fine now. Just continuing to get my mammograms and imaging as instructed, so I'm blessed that I was able to get early detection and I did it when I was supposed to. So, thank you.

RON AARON
Gotta stop you right there. Kimberly Channels, thank you so much. SheÕs a physician's assistant in Tampa, Florida, and our co-host was Dr. Tamika Perry. I'm on Aaron. Thanks for joining us on the award winning Docs in a Pod.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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