Oct. 30, 2024
Understanding Breast Cancer Awareness Month
The month of October is Breast Cancer Awareness, a time to raise awareness and encourage preventative mammograms for women and men. Brooke Mobley, DO, MBA, associate medical director of Post Acute Care Optum Care of Florida will provide insight into understanding breast cancer and why breast cancer awareness is important.
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Show transcript
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. Rajay Seudath and award winning veteran broadcaster Ron Aaron will share information to improve your health and well being. And now, here are Ron Aaron and Dr. Rajay Sudhath.
RON AARON
Well, thank you very much for joining us today on Docs in a Pod. Our podcast is an award winning podcast. We're on the radio as well in a number of markets in Texas and Florida. I'm Ron Aaron. Our cohost, Dr. Rajay Seudath is with us. He's board certified in family medicine, a Tampa native and a current lead physician for Optum. He's at the university location in Tampa, Florida. Dr. Seudath earned his medical degree from the University of South Florida's Morsani College of Medicine. He has a passion for primary care and guiding his patients to meet their health care goals while maintaining his patients values. Dr. Seudath, it is great to have you on again. How are you doing?
DR. RAJAY SEUDATH
Doing pretty good. We are drying out from all of the rain from Hurricane Milton. Things are starting to get back in order. So, happy to be on the air with you.
RON AARON
Yeah, Tampa got hit pretty badly. In fact, worse than with Helene, right?
DR. RAJAY SEUDATH
Yes, very much so. More flooding, more trees down. Kids were out of school for about a week.
RON AARON
So, it's good to have them back in school.
DR. RAJAY SEUDATH
Absolutely.
RON AARON
We're going to take up a very important topic, Breast Cancer Awareness Month, and Dr. Brooke Mobley is our guest. She said that she has had the honor of being a returning guest multiple times and we're delighted to have her back. Dr. Mobley earned her degree from Xavier University in Louisiana in 2003. She joined the illustrious Alpha Kappa Alpha sorority. She then went on to obtain her Master of Business Administration from St. Joseph's Hobbs School of Business and her Doctor in Osteopathy in a dual-degree program from Philadelphia College of Osteopathic Medicine. Her medical career in which she was very active in the Student National Medical Association, the only national minority association for pre-medical and medical students on the local and national level. After graduation, Dr. Mobley went on to an internal medicine residency in nephrology and fellowship at Christiana Care Health Services in Newark, Delaware. Dr. Mobley, it is great to have you back.
DR. BROOKE MOBLEY
Great to be back.
RON AARON
Talk to us about the importance of Breast Cancer Awareness Month because breast cancer is a 12-month-a-year issue. It's not just a month. Why one month to focus on breast cancer?
DR. BROOKE MOBLEY
Well, at any time we have a topic or a very important need to educate a community, it's important to isolate it to a particular month to be very heavy in education, to be very heavy in advocacy, and for donation. We all know with the generations that we live in now; they have very short attention spans. So, while they may not be engaged for an entire 12 months on a particular topic, they will definitely do TikToks and wear the colors of that month for a 30-day period with no problem. Breast cancer actually shares this month with domestic violence awareness month as well.
RON AARON
Domestic violence awareness is a purple color and breast cancer awareness is pink.
DR. BROOKE MOBLEY
Yes.
RON AARON
Talk to us about the incidence of breast cancer. It's obviously an equal opportunity disease that is affected. Does it affect minorities more than Anglos? Who's at higher risk?
DR. BROOKE MOBLEY
Breast cancer first and foremost is going to affect women in a much larger range than it will the general population. 1 in 8 women will be diagnosed with breast cancer or approximately 13 percent of the female population, and we are learning that it is being diagnosed at earlier and earlier ages. Once upon a time, mammograms started at an older age, but now we are anticipating and encouraging people to get mammograms at 40 years old if they are an average-risk person. Someone who is at a higher risk like myself, my sister unfortunately lost her life to a combination of breast cancer and colon cancer, I started receiving MRIs of the breast at the age of 30 and mammograms probably at the age of 35. MRIs Are done at younger ages just because of the density of the breast. The older we get, the change in the density of the tissue that the breast is made out of is easier to see on a mammogram versus younger breasts have a different consistency, and they're easier to see these tumors or abnormalities on MRIs and ultrasounds. So, it's important to know first and foremost what your risk is as a female in the general population. But it definitely affects minorities out of proportion than it does majority races.
RON AARON
Now hold that thought, we're going to get right back to you. I want to let folks know who may have just joined us, you're listening to award winning Docs in a Pod. I'm Ron Aaron, along with our co-host today, Dr. Rajay Seudath, who we're delighted to have with us and our guest, Dr. Brooke Mobley, talking about breast cancer in light of Breast Cancer Awareness Month. Dr. Seudath, as a WellMed/Optum physician, you deal generally with patients who are 65 and over. Is there still a worry about breast cancer in older females?
DR. RAJAY SEUDATH
Absolutely, yes. Typically, we don't stop doing mammograms if someone has a first degree relative, so mom, dad, brother, sister. If they've had breast cancer, that person will continue to do yearly breast screenings. Again, if we have seen abnormalities on past mammograms, that would give another reason for a person to continue to get those. When it comes down to diagnostics versus screening, if a person has just the regular risk for a mammogram, then that could be a discussion where we talk about, do you need to continue screening? Do you not need to continue screening? Versus a person who has pain. A person who has pain in their breast or changes in the skin. That's a diagnostic issue and that's something that we're going to do a little bit differently from a mobility. It's still going to be a mammogram, but a diagnostic versus screening is a little bit different and it's usually going to be linked to an ultrasound as well.
RON AARON
Dr. Mobley, I know that there have been all kinds of differing recommendations on when mammograms ought to be done, differing recommendations on self-examination. What is the standard of care today in trying to detect breast cancer?
DR. BROOKE MOBLEY
I will say that one of the things we tell females is when they get their period, they should start learning how to do self-exams. That is the same change that typically breast buds come, and being very aware of the consistency of your breasts from the beginning is going to help you detect things later in life. So, while we're not necessarily looking for breast cancer at that young age, we are teaching them how to become familiar with their breasts, to become familiar with the different densities and lumps and bumps that just come in average normal breasts as we grow up. But unfortunately, there are some very small incidents of breast cancer in younger women as well. So, it's not only just to educate, but it's going to be hopefully diagnostic in some people. We all know with any cancer, regardless of where the cancer is affecting, the earlier you get a diagnosis, the better your prognosis is. Unfortunately, in the minority communities, for a lot of different reasons, whether it's financial ability, whether it is educational level, whether it is access to care, whether it is unfortunate disparities and how minority patients are being addressed, treated and diagnosed. African American women are out of proportion being diagnosed at much later stages of cancer. 40 percent of black women who are diagnosed with breast cancer have a morbidity from it, which is out of proportion to the general population. They also have the lowest numbers of a five-year success rate after being treated for breast cancer. It is important to ensure that we have programs that can get screening mammograms for people who may not have insurance. It is important that we speak to our patients on a fourth grade reading level or less in order to ensure that they are grasping the concept and understanding what we are saying. We need advocates on the ground to advocate for these minority populations to ensure that they are getting the same chance at survival, treatment and diagnosis as their majority counterparts.
RON AARON
Well, I'm so glad to hear you talk about health literacy. Where I live in San Antonio, Texas, some of the patients that see doctors are Spanish only speaking, and there's a communication gap, so there is an outreach to try to emphasize health literacy so health care providers and medical assistants understand their patient may not understand what they're saying. There are a whole lot of folks, and Dr. Seudath, I'm sure you see this, who may literally not understand what you're saying, but they're active listening to make you think they know. So, you're talking, they're shaking their head yes. They don't understand a thing you've said, right?
DR. RAJAY SEUDATH
That's kind of on case by case with each provider, you know, how do you kind of test if this person is understanding what you're saying? That's kind of a teach back. You kind of talk to them about something and then you say, tell me exactly what you're going to do. What's this plan going to be? You kind of let them teach that back to you to show that they've got an understanding for that. For these kind of things, you can explain it to them, and they can understand what you want, and they can simply say, yeah, I understand that, and I'm going to go do it, and then six months goes by and they haven't got their mammogram.
RON AARON
There was a case in a case in San Antonio where a woman who was Spanish-speaking got a prescription for her daughter and the directions were once a day. She read that as once and gave the child 11 tablets a day. The child died.
DR. RAJAY SEUDATH
Oh, wow.
RON AARON
And that's health literacy.
DR. RAJAY SEUDATH
Absolutely.
RON AARON
Dr. Mobley, how do you overcome those kinds of hurdles? So, first of all, you have to know your market, right? We think about medicine in a silo. But at the end of the day, medicine is a business like anything else. You have to know your target audience. You have to know your market. If you are a provider in a community that is foreign to you, you have to learn the community. You have to know what religion is the majority of the patients are from. What culture are they from? If it's an Asian community, you have to understand that them not looking directly at you when you talk is not a sign of disrespect. It's actually a sign of respect for them. In a lot of different communities, they just trust what the physician says and feel it is disrespectful to question them when they don't understand anything. Hence why you get the head nodding and you get the yes. Sometimes you have to go a little deeper and a little more extensive with your patients who you have some cultural differences from, or who may not truly understand. You have to utilize your interpreters and your translation lines. I know for some people, it seems cumbersome, but it could definitely change someone's life in the instant that you gave in Texas. So, it's important to use those resources, and sometimes you have to go above and beyond. When I was a nephrologist, I knew that I had a patient who was totally illiterate. So, reading anything off of pill bottles was very difficult for him. Being a dialysis patient, taking medications at a particular time and frequency of the day was a very dire need. So, what I did was I would have him bring the medications, he would fill his prescriptions, he would bring them all into the office, me and the nurses would work, and we would fill out his pill bottle for him. We would put a stamp with the sun on it for medications in the morning and put a stamp with the moon on it for the medications at night. Yes, that may seem cumbersome to some, but I definitely ensured that my patient was hitting his phosphorus levels, that he was hitting his potassium levels, that he was taking the proper medication to ensure that he didn't have low blood pressure in between dialysis. For me, as a health care provider, it is our job to go above and beyond when necessary because people's lives are in our hands.
RON AARON
That's perfect. We're going to come back to both of you in just a moment. If you've just joined us, you're listening to the award winning Docs in a Pod. Our podcast available wherever you get your podcasts. We're also on the radio in a number of markets in Texas and Florida. I'm Ron Aaron, along with Dr. Rajay Seudath, our co-host, Dr. Brooke Mobley is our special guest today. We're focusing on Breast Cancer Awareness Month right here on Docs in a Pod.
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RON AARON
We are so pleased you are sticking with us right here on the award winning Docs in a Pod. I'm Ron Aaron. Our co-host, Dr. Rajay Seudath is with us, and Dr. Seudath is joined today by Dr. Brooke Mobley. Dr. Mobley is talking about Breast Cancer Awareness Month, and we were talking about health literacy a couple of moments ago, and Dr. Seudath, off the air, you were giving us a pretty good example of how a patient not really understanding what you're asking of them can be a real detriment.
DR. RAJAY SEUDATH
Absolutely. We had a patient where the family members were acting as interpreters and each time, they had been asked that by previous providers, they were actually not telling her about the mammogram. They would just simply say, oh, she doesn't want that. So, for that patient, we used the language line, and we actually had them communicate with that. And for the first time, she actually got a mammogram, and it was negative, but that was a way to utilize the resources available to make sure that patients are getting the information that is needed for them and for the provider to ensure that what we're talking about is being understood.
RON AARON
Now, what is the language line?
DR. RAJAY SEUDATH
Most large companies, or even if you're a small mom and pops, you can have a language line service that you pay for, but that's something that you call in, you select the language, and then they connect you to a licensed interpreter. They'll usually give you their interpreter number so that you can document it, and then you do the interpretation.
RON AARON
That's perfect. I appreciate that. Dr. Mobley, we've talked a bit about diagnosing breast cancer. The flip side of that is if it is found, what are the treatment options?
DR. BROOKE MOBLEY
Diagnosis goes in a complicated form. First you note that there is a tumor, whether it's one that you found during a self-examination, one that is an area that is painful or discoloration in your breast or found on a screening mammogram, which lots are found these days. You then have to get it staged. When I say stage, you have to figure out, are there any involvement of lymph nodes? Is there any involvement of any other organs? What type of tumor it is based on biopsy? Is it invasive or non-invasive? Does it affect different glands associated with the breast? So, once all of the diagnostic is done and you've found out what stage you're in, then it determines whether or not you need chemotherapy, whether you need surgery, whether you need radiation, or whether you need a combination of two or three of those things. For the majority of people, stage two or above typically get mastectomies and they get the entire breast removed and based on if it is positive to certain hormones, well determine if that patient should also get a preventative mastectomy of the other breast for risk of reoccurrence. Being able to test different estrogens and different receptors to see if the tumor is positive to those helps us pinpoint the exact chemotherapy, the exact surgery and the exact area of radiation needed and necessary in order to treat the breast cancer to completion. Even once you get into remission, there are a lot of people who have to continue doing certain chemotherapies, whether it is IV or orally, for a certain amount of years after eradicating that particular tumor, which helps decrease the risk of recurrence. Even once you get in beyond that and you've completed all form of treatment, surgery, radiation, chemo, oral IV, or otherwise, you have to be monitored very, very closely for up to 10 to 15 years after that breast cancer, depending on the age you were diagnosed, to hopefully find any particular chance of recurrence as early as possible. As we stated in the first hour, we are always going to have a better chance of eradicating the cancer, to treating it, to resolution to a better life prognosis the earlier we are able to diagnose the cancer.
RON AARON
Now you had mentioned, Dr. Mobley, when we started the tragedy of your sister, who had breast cancer and colon cancer. Were they related? Did the breast cancer trigger the colon cancer?
DR. BROOKE MOBLEY
Like a lot of her life, my sister was an enigma and a strength to this world. On our paternal side, because we have the same mother and father, breast cancer and cancer in general was very, very effluent in the family. A lot of our different female family members who had had cancer. So, when my sister was diagnosed with breast cancer when she was going through the staging process, she had a PET scan that showed she had thymic cancer. So, they treated the thymic cancer along with the breast cancer in which she had chemo, radiation and a double mastectomy. Unfortunately, all of this was occurring around the age of 50, and because they were so enthralled with the fact that she had two primary cancers, thymic and breast, that she missed a screen and colonoscopy. I'll say it was unfortunate and that I suspect she should have been screened for colon cancer at the age of 40 considering our mother had a colectomy for pre-cancerous cells in her colon when I was in medical school. My sister probably should have started getting colonoscopies at the age of 40 or 45 but did not. Unfortunately, she did not have the screen and colonoscopy done at 50, and at 51 she started having weight loss and GI problems and was diagnosed with stage four colon cancer. That is what eventually ended her life as she was on her last few Herceptin injections to have treated breast cancer to resolution.
RON AARON
I'm so sorry. Wow.
DR. RAJAY SEUDATH
Im so sorry to hear that.
DR. BROOKE MOBLEY
Thats a learning lesson for her doctors, for me as a physician and for our community as a whole. My sister was a VP of a fortune 500 company. She was college-educated, and even then, she wasn't necessarily getting the standard of care that she required. Whether or not it would've saved her life, we don't know, but it would've been better to know sooner rather than later all that was going on in her body.
RON AARON
Well, that leads me to a question about how a patient and family can be an advocate for their own healthcare. If you don't think you're getting the care and the diagnosis and the treatment you need, speak up.
DR. BROOKE MOBLEY
Absolutely. I think one of the things that is very powerful is taking family members with you. Oh, I'm just here for moral support. It's easy to say that. But really and truly it's kind of having two brains for that visit. The person that you bring can be an advocate for you. Doctor, I heard about colonoscopies. When should he have one? Oh, you're right, it's the time that you should have a colonoscopy. It can drive that conversation for more screenings for more things. So, I think that's certainly one of the ways that we can advocate for our patients to bring people to advocate for them. Encourage them to bring someone to their visit.
RON AARON
Dr. Mobley, before we go, I want to come to how far we've come in diagnosing and treating breast cancer. Are we doing a better job?
DR. BROOKE MOBLEY
Yes, we are definitely doing a better job than we once were, but the United States of America is too progressive as a country to be doing or being where we are in any particular cancer diagnosis and treatment. So, it's important to take this month of October to donate if you can, to any of the reputable breast cancer awareness funds that help to fund research, that help to fund screaming mammograms, that help to fund treatment processes, even if it is wigs for patients who are bald. due to complications of their treatment. This is the month that if you want to get involved, get involved. If you want to know more, research. If you want to donate, give money. And that is bringing it all the way back to your original question, why it is important for us to isolate a month period where we can highlight and truly focus on one very important diagnosis and need for our country.
RON AARON
Is there a day in your mind where we end breast cancer?
DR. BROOKE MOBLEY
There is a day in my mind that we end all cancer. I like to rely on not only the clinical expertise and research and technology we have, but I am a spiritual person and I also rely on my Lord. So, together I think with those two entities, yes, anything is possible. We just have to focus, and we need to put our focus on making people better and not necessarily the financial gains of treatment and different things of that nature. We need to really put people's lives before anything else.
RON AARON
Well, I'll give you an amen to that. Thank you so much. We're flat out of time. Thank you to Dr. Brooke Mobley. Always a delight having you on and to our co-host Dr. Rajay Seudath. What a great, informative program. Thank you. I'm Ron Aaron. We will talk with you again soon, right here 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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