The Ben Mulroney Show - Cancer Screening & Perimenopause: What Women Need to Know

Episode Date: August 27, 2026

When should you start screening for cancer, and which symptoms should never be ignored? Ben Mulroney speaks with family physician Dr. Rachelle Grossman of Yorkville Medical Clinic about early cancer detection, changing screening recommendations, and understanding the physical and emotional changes that can come with perimenopause. If you enjoyed the podcast, tell a friend! For more of the Ben Mulroney Show, subscribe to the podcast! ⁠⁠⁠⁠⁠⁠⁠⁠https://link.chtbl.com/bms⁠⁠⁠⁠⁠⁠⁠⁠ Also, on youtube -- ⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/@BenMulroneyShow⁠⁠⁠⁠⁠⁠⁠⁠ Follow Ben on Twitter/X at https://x.com/BenMulroney Insta: ⁠⁠⁠@benmulroneyshow⁠⁠⁠ Twitter: ⁠⁠⁠@benmulroneyshow⁠⁠⁠ TikTok: ⁠⁠⁠@benmulroneyshow⁠⁠⁠ Executive Producer: Mike Drolet Reach out to Mike with story ideas or tips at [e-mail] Enjoy Learn more about your ad choices. Visit megaphone.fm/adchoices

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Surround yourself with signature Buick. Refinement from an available massaging driver's seat to an expansive panoramic moonroof and a stunning ultra-wide 30-inch diagonal screen. Don't miss Buick's employee pricing for you event. Visit buick.ca for more details. As parents get ready to send their kids back to school, one of the things that we do every year is we make sure the kids get their annual checkup and make sure everything's okay under the hood. And I think today is the perfect time to remind parents that, yeah, you should get yourself checked too. because there's all sorts of new screening ages for all sorts of issues that we get. And you can't chalk everything up to just getting older. And screening saves lives.

My next guest was misdiagnosed at 37 for a lump she felt at 36. We've talked about that in the past with Dr. Rochelle Grossman. I thank you very much for joining us in person. You're advocating for everybody to learn more and everybody to get tested. Yes. Yes. And the right way. Yeah. Okay, so there are certain ages for certain diseases and issues that we've lowered the age. Why?

And which ones? We've lowered and hired the age, right? So for PAPS meers, for example, it used to be we'd start every girl at 21. Now we start at 25 because we have better tools. Okay. For breast cancer, we've lowered. For colon cancer, we lowered. And I don't know if everyone knows the colon cancer because that's the most recent one,

that now we start screening average risk people at 45 instead of 50. Yeah. Is it just because we've learned more and we know more about the diseases and we have different ways to test? Yeah, I think we've learned more. I think we're seeing that younger people are dying from colon cancer. And so that's the reason for lowering that. And again, it's not just that everyone's going for a colonoscopy at 45.

We're also using better measures to screen. So instead of using the fecal occult blood test or the FOPBT kits that you used to put your poop in the mail every two years, now we're using something a little bit better. it's called a fit test. And so it's non-invasive. Why not start at 45? How is it non-invasive? Same thing.

You're putting your poop in a little kit, sending it in the mail, and there we have it. It's just more accurate than the fugal cult blood test from the past. Now we hear early detection saves lives. So why don't we screen everybody for everything all the time as soon as possible? Well, how's Canada dealing with the screening situation right now?

That's good point. Right? For a moment, I forgot. You forgot that. But there are this, There are this small little niche of people that are paying fortunes to go get pet scans from head to toe. And then you're left with another issue because you find things, right? And you find things.

And then you have a well-worryed person. But back to the screening, I do want to say about the breast cancer stuff too, is that even though the breast cancer, now we're screening at 40 instead of 50. So that's been lowered as well. And our screening reports are more detailed. Density is now being called out on the reports. requiring the more dense breasts to have ultrasounds or additional testing outside of mammograms. I remember seeing a tweet. It must have been at least two years ago, maybe three years ago,

where an AI at UCLA medical was able to detect a tumor of some form of cancer, months, if not years before, it would have been visible for doctors to detect. How, is AI playing into this new detection protocol? So I don't think it's yet being integrated, but I think we are in the works, and we are already seeing it as it pertains to, like, reviewing breast cancer, mammograms and things like that. It is going to be exceptional.

I hope it doesn't replace radiology altogether, a radiologist, but hopefully it will take on a whole new beast, and it will be able to detect not just breast cancer, but a whole slew of other cancers very early. Is cancer writ large something that is detectable in the blood? So good question. I think we don't know yet. There are certainly some cancers that we are starting to learn about.

I was just enrolled in a study actually where they took my blood and they tried to match it to my tumor cells to see if there was any match of those circulating cancer cells. And we know now that we think it's going to give us about a year to two look at when, you know, to be able to say you're negative, it will likely give some person reassurance, whether we just don't know the sensitivity or the specificity of this type of test. Yeah.

But we are well on our way. Yeah. I mean, what sort of future do you envision for testing for all of these diseases? Is it going to be something where you spit into a tube or you pee into a jar or they take a little bit of blood and that's it. They'll be able to do a battery of tests of all the most significant. significant and aggressive cancers that we want to avoid?

I think there's a couple things. I think first of all, we're going to be able to probably do some liquid biopsies or some blood tests that are going to detect early cancers, which would then lead to early treatments. I think we're going to have this AI in place where we're going to have way better, you know,

we're going to have earlier diagnosis, but more sensitive and specific diagnosis. And I think we're even starting to see treatments. underway like melanoma. There's vaccines for melanoma. Are there? There are vaccines for melanoma. And no, we're not vaccinating pre-melanoma. Yeah. But we are vaccinating so melanoma doesn't reoccur. That is unbelievable. How much does family history play into whether or not somebody should get tested early or more often? Huge. Yeah. Huge. Yeah. And does it depend on the cancer? It depends on the cancer and it depends on the family history. So I have people coming into my office saying,

I had three great aunts and two, you know, great, great grandmothers, you have to, you have to act with some reason. Yeah. But yes, it does come into play for not just cancers, for cardiovascular health, for metabolic health, for autoimmune conditions, for mental health. Yeah. It really is a big deal. Are there any cancers that we don't screen for because we just, we don't know how yet?

Yes, there are. So, you know, pancreatic cancer, we know that we can start. screening for that. We can screen if there's a strong family history. We don't screen for a lot of cancers where we don't know, like for example, prostate cancer we screen for, but even then, it's, it's not exactly a firm screening. So we kind of give the patient an option because most people die with prostate cancer, not from prostate cancer. And this is in Canada, right? So. Yeah. Well, let's talk about a scenario where somebody has been getting tested.

They're getting up there in age. And whatever they're feeling inside themselves, they're just assuming it's a natural byproduct of aging. What do you tell those people about those feelings? You mean like the 20 patients that came in today and said, I'm just so tired. I don't know what to do. Something's wrong with me.

I'm tired. Really? It's those vague, it's the people that come in with all those vague symptoms that are so tricky as a family doctor. because we want to reassure, but we can't until we rule out everything else. Yeah. So those type of diagnoses and these vague cancer diagnoses that could be lurking within you

that we've screened for and that are negative, we have to rule everything else out first before we, you know, say this could be cancer. You know, and there's also red flag symptoms that come with red flag features that come with symptoms. So are you losing weight? Are your symptoms waking you up in the middle of the night? Do you have, you know, like night sweats? Are you losing weight?

And you can see they can kind of, you know, be very similar to other type of diseases. But yes, those are the classic symptoms of red flag symptoms we look for. Okay, what about the scenario where somebody is in tip top shape? They feel amazing and they have no history of cancer in their family anywhere. What do you tell them? Well, I was one of those people. like, yes, I've had cancer and other relatives not first degree. And I've had, you know, they've not been breast cancer.

Unfortunately, we can't, what can we do? We can't just, you know, put you through pet scans from head to toe at the age of 20 because you think you might have it. But we can listen. We can follow. And we can rule out the things that we, that are scary if we need to. Is there an online portal or some online information that people can go to, to get information on all, should it go to the Cancer Society?

There are and then there's chat GPT. Everyone uses. No, they shouldn't use chat. It's like, isn't that like using WebMD? Exactly. Yeah. It's, it's, but you can't contain it. You're not going to tell someone, don't, don't look something up and don't advocate

for yourself. Yeah. I don't love it. Yeah. But that's what people are doing. All right. Well, you're not going anywhere because we want to turn the page to a word that gets thrown around constantly.

and I guarantee nobody understand, or not enough people understand. Dr. Rochelle Grossman sticking around to dispel the myths and answer your burning questions about pari menopause. Don't go anywhere. If you are a woman from a certain generation, you're going to want to listen to this next segment because vital information about things that you may be going through or things you have gone through. And if you're a man who has a woman in his life who is of a certain generation, pay attention because knowledge is power. and in certain cases can provide security and have you avoid being an ass. We're talking about perimenopause. Our guest, Dr. Rochelle Grossman, has stuck around to answer all the questions we might have.

Before we get to perimenopause, let's talk about menopause. Every woman goes through it. What does it entail? So the average age in Ontario of menopause is 51. And the definition is one year without a period. Okay. Okay. So perimenopause, yes, every woman goes through it, but it can be impacted by many different factors.

Genetics, when did your mom go through it, race, and also can be induced early by certain medications and certain diseases. And for a lot of people, it's, I mean, for the longest time, there were the negative connotations around menopause and perimenopause. It meant, okay, you know, if you listen to like the worst descriptions of it. I'm crossing a threshold into a part of life that signals decay, right? I'm not saying that that's right. I'm just saying that's what the public perception was. Totally. And so what do you want people to know about it today?

How do we smash? Because there's a stigma around it, right? So I think the stigma is now becoming less of a stigma. And I actually think it's becoming a big buzzword, perimenopause. And people are starting to understand that this is a chronic disease. That is variable. I just thought it was a transition. I hate to talk about it as a disease.

Because it's actually something that every woman goes through. It's a part of life. But it comes with the same type of disabilities or morbidities that other diseases have. Okay, so let's go through them because honestly I'm coming into this clean slate. And as a man, just don't call a girl crazy when she's going through paramedicose. Because that's the main thing. It's like, is she crazy? No, this is a fluctuation in hormones.

and if you men had the same thing, he'd be acting the same way. Okay, so what, yeah, so what am I, yeah, what am I seeing and what's going on inside the woman? So those changes are more typical for the perimenopause. Okay. Because perimenopause is the area, is the time spanning around 11 years before the menopause.

Wow. So before those hormones shut off completely, you have fluctuations. Okay. And it's those fluctuations that bring up out hot flashes, cognitive changes, word-finding problems, insomnia, you know, dry, dry vagina, you know, low libido, you know, heightened anxiety. And those are all real.

And now we know they're real. Am I wrong for hearing in that, like, you're checking boxes. It feels to me like some of those are characteristic of what happens to certain women after childbirth. Right, because there's fluctuations, right? But we know that childbirth, you know, it's reversible, right? Whereas perimenopause, Although now, you know, there's hormone replacement therapy and things that can really help.

It's not. It's a stage of life. This is what a woman is going to go through inevitably. And it's going to end with menopause. Going to end with menopause. We're living in a world of peptides. Are there peptides out there? I don't know what a peptide even does.

But are people flocking to peptides to help mitigate these things or improve life? I don't think they're doing it per se for Perry or menopause. But I do think, actually, they do. relate. It's interesting you brought that up because they relate in the way of women, you know, their body changes. Their fat deposition goes into different places. That fat in the lower belly is so much harder to get rid of when you hit peri to menopause. And so then they start reaching out for, hey, can I get on a Zempec, Dr. Grossman? I don't know what to do with this leftover, you know, flabby part of my stomach. So they do go hand in hand, but in terms of, like,

is there a bona fide to help with that? No. There are hormones. there are other medications that are non-hormonal that can help with all the symptoms related to perimenopause. So are women supposed, because I understand when you're in menopause, you can get hormone replacement therapy, but while those fluctuations are happening during perimenopause, you're supposed to ride that out? Absolutely not.

You're supposed to start those hormones well before menopause. In fact, won't that increase the fluctuations? No. So there is a window of opportunity where a woman should be discussing any of these vague symptoms if they're in the 40s range prior to menopause because actually those hormones are cardioprotective if initiated within a certain many years of onset of symptoms and if initiated

usually before the age of 60. What do you mean cardioprotective? So that means they protect your cardiovascular health. What we know about menopause also is once that estrogen withdraws, you are at a higher risk of stroke and heart attacks and cardiovascular issues. So it's also another very physical problem. Are there any benefits to changing one's diet, changing one's exercise routine, anything like that?

I think those are soft evidence. I don't think a diet is going to help. I don't, you know, maybe some naturopathic doctors might have something to say about that or functional doctors. I'm not well versed in that, and I don't think the studies are robust. enough, I think it's very important that if women are thinking that they are fitting the picture,

don't think, oh my goodness, because I'm still getting my periods, that I'm not in perimenopause. In fact, you can be in perimenopause and still have regular periods, although one of the classic features of perimenopause is when your periods start to get a little wonky and unpredictable. What about hormone replacement therapy? If women are supposed to be looking into it in perimenopause, What does a round of therapy look like? So there's different things. So depending on early menopause or age, if someone's still at risk of getting pregnant, we would consider a low dose oral contraceptive pill.

And keep in mind, we're not adding hormones, we're replacing hormones. Yeah, okay. And then later on in menopause, or if we're not worried about someone, you know, getting pregnant, then we could use something like a hormone replacement therapy, or if someone has an IUD, which has progesterone, has progestone, it, then all we need is to add a little bit of estrogen. And again, this is guided by a doctor because there are other conditions or people who are not candidates for hormone replacement therapy.

But yes, and there are non-hormonal things you can do for your symptoms, for your hot flashes. So there are medications just for hot flashes. So for the symptoms? Yep. For the symptoms, if someone A can't be on hormone replacement or chooses not to be on hormonal placement, you can be on a medication like an SSRI. or something for mood, that mood medication can also improve hot flashes, not just your mood. There are insomnia medications that help with insomnia and hot flashes now.

So there's Daveygo, which is a newer, insomnia medication also helps with hot flashes. So there's other things to do. What would be a reason a woman would choose not to go through hormone replacement therapy? Good question. So again, there are different people with different fears, right? So some people just absolutely don't want to put anything like that in their body. I mean, it's weird because then they'll go have a cigarette or something like that. But smokers, for example, should not be on hormone replacement therapy or any hormone.

There are people that choose not to because, again, they hear bad things in the media. It used to be that hormone replacement therapy was terrible. It was the devil. Now everyone wants some. And what are some of the myths around it? I mean, I have to believe some people think it's going to reverse the clock. So I think the myths are it's going to help with everything. Right? And it's going to make you live longer and all, you know, the hormone replacement therapy, like I said, there are so many benefits to it. There are also benefits for your bone health because once you hit menopause, you are high at risk of fractures and osteoporosis. So it helps with all, it has these secondary benefits, but people are coming in asking just for those benefits. Like I want my hair to be thicker and my hair and my face to glow and my skin to be beautiful. We're not going to just give it for those reasons. But, you know, again, yeah, they,

do have secondary benefits as well. Well, there's a lot of information there that I'm was new to me. I'm sure it's new to a lot of the people listening to the show. Dr. Rochelle Grossman, family physician at Yorkville Medical Clinic. Thank you very much for being here. Thank you.