The Skinny Confidential Him & Her Podcast - Dr. Steven Frankel On Proactive Care For Yourself, Cancer Prevention, Screenings, & Human Care

Episode Date: March 18, 2021

#340: On this episode we are joined by Dr. Steven Frankel to discuss how to be proactive in caring for yourself. When to seek medical care, caner prevention, screenings, and what to look for with breast cancer.  Check Out Lauryn's NEW BOOK, Get The Fuck Out Of The Sun HERE To connect with Lauryn Evarts click HERE To connect with Michael Bosstick click HERE Read More on The Skinny Confidential HERE For Detailed Show Notes visit TSCPODCAST.COM To Call the Him & Her Hotline call: 1-833-SKINNYS (754-6697)  The Skinny Confidential’s Get the F*ck Out of the Sun is the practical, yet incredibly fun and accessible, preventative skincare bible by lifestyle guru Lauryn Evarts Bosstick. We all have our ever-growing list of skincare questions: What products are essential for a nightly routine? Will a jade roller actually take care of hungover, puffy eyes? Why is sunscreen so important, and does it really need to be applied every day? What oils and serums are best for glowy, dewy supermodel skin? Lauryn dives into all this and more with a voice reminiscent of a friend at a boozy mimosa brunch who has a little more experience (and a lot more research) under her belt. From product and beauty tool recommendations to Lauryn’s personal experience with facial massage, fillers, Botox, lymphatic drainage, and cryotherapy, this authoritative and cheeky book is essential for a DIY generation that’s all about shaking up old ideas about skin care and transforming the beauty industry. This episode is brought to you by BEV Bev is a female-first canned wine brand that was founded to change not only the way a product is consumed, but the way an industry and culture have operated for generations. Their wines are dry, crisp, and a lil' fizzy, super refreshing and delicious. They have ZERO sugar and only 3 carbs and 100 calories per serving. We've worked out an exclusive deal. Receive 20% off your first purchase plush free shipping on all orders. Go to www.drinkbev.com/skinny or use code SKINNY at checkout to claim this deal.  This episode is brought to you by Oshēn Salmon Oshēn Salmon was created for those who longed for their perfect protein match. One that was easy to prepare, packed with protein, and made us glow from within. Hello omega-3s! Ocean raised salmon has more than 1,500 mg of Omega-3 content which is double the Omega-3 contentus versus most wild salmon. To get your box of Oshen visit www.oshensalmon.com and use code SKINNY for 15% off plus free shipping.  This episode is brought to you by Nutrafol THIRTY MILLION women experience hair loss. But it’s not openly talked about, so going through it yourself can feel lonely and frustrating. It’s time to change the conversation and join the thousands of women standing up for their strands. Nutrafol is formulated with potent botanicals to help you grow hair as strong as you are and it’s physician-formulated to be one hundred percent drug-free. Visit Nutrafol.com and use promo code SKINNY for 20% your order and free shipping.  Produced by Dear Media 

The following podcast is a Dear Media production. 100 plus of the world's best skincare gurus. We have influencers, celebrities, doctors, kind of everything. And then of course, you can expect so many of my tips and tricks throughout the book. It is color. It is thick. It is pink. You want it on your Instagram feed. It is so fun. It's so cheeky and it answers every single skincare question you could ever think of. This is a book that you can take and display on your coffee table, but it's also a book that you're going to go to and you're going to bookmark the fuck out of it. You don't have to read it start to finish. You can just open it up and learn all about skincare. I have been working on this book for truly the last three years,

just picking up all the secrets and all the insider tips and tricks for you. Some of the top influencers are featured in my book. Kristen Cavallari, Patrick Starr, the Summer Fridays co-founders, Shea Marie, Griselle Lim, Jillian Michaels, Stassi Schroeder, Omni Song, The Lady Gang, Mandy Madden Kelly, Amelia Bell, Delilah Gray, Bobby Brown, Justin Anderson, and more. We also have all the top skincare doctors, Dr. Dennis Gross, Dr. Jason Diamond, Sonia Dakar, Georgia Louise, Barbara Sturm, and more. I am so excited to finally bring you this book. You can pre-order it where books are available. It's obviously on Amazon. Pre-order a copy. I'm telling you, I think you'll love it. It's very much up your alley. With that,

let's get into the show. She's a lifestyle blogger extraordinaire. Fantastic. And he's a serial entrepreneur. A very smart cookie. And now Lauren Everts and Michael Bostic are bringing you along for the ride. Get ready for some major realness. Welcome to the Skinny Confidential, him and her. So 40 is the quote-unquote magic number. That doesn't mean you don't start earlier if you've got some kind of history. For example, primary relatives mainly. Your mother and your sister. Certainly your father when they rarely get them also.

And if you happen to have a kid, if your daughter gets it, those things put you at higher risk. An aunt or a cousin is much less so. One thing that is very important to us on this platform is that we bring on people that we think can educate or tell someone something maybe that they didn't know. And one of those things that I'm passionate about is talking about breast cancer. We had on Shani from Keep A Breast, and she really talked about how important it is that we do self-checks. And so today, I wanted to have on Dr. Stephen Frankel. His specialty is radiology, and he is very, very knowledgeable about breast cancer. And we talk about all different age gaps. I think this is so important for women and also men to hear.

So how I found out about him is Libby, who works on the Skinny Confidential team, was telling me all about her father, who works at Cedars-Sinai, and we decided he needed to come on. In this episode, he really goes over all the questions when it comes to breast cancer, breast cancer screenings, self-checks, even what it's like to have breast cancer. Again, I think this episode is so important, and I hope it inspires some people to go out and get checked. On that note, Stephen D. Frankel is a radiologist at Cedars-Sinai. I could not believe how many of you messaged me on Instagram after he was on my

stories saying that you had seen him or you just had really nice things to say. He's so personable. He's a husband and he's a father of two, Libby and Haley. This episode gets into it when it comes to breast cancer. This episode gets into it. We're going to go there. With that, let's welcome Dr. Stephen Frankel to the podcast. This is the Skinny Confidential, him and her. How young should women and men be concerned about checking for breast cancer? The short answer is there's no magic age. As you get older, you have more of a chance of getting it. So, there's an arbitrary starting of getting mammography, which we can talk about why we

get mammography in a second, which is age 40 for a routine woman without any history of any sort, just an average woman to start at age 40. It's not like between 39 and 40, it suddenly jumps up from here to here. It's a gradual increase like that. And there's been arguments even in the 40s to 50s not to start to age 50, which I think is a big mistake because years of lost life in the 40s is more than years of lost life after 50. We all know we're going to, the average age a woman dies in the 40s is more than years of lost life after 50. We all know we're gonna, the average age a woman dies in the United States is ballpark 82 at this point. That's just gonna go up, hopefully, if we keep our health up in this country, COVID excluded.

So 40 is the quote unquote magic number. That doesn't mean you don't start earlier if you've got some kind of history. For example, primary relatives mainly, your mother and your sister, certainly your father when they rarely get them also. And if you happen to have a kid, if your daughter gets it, those things put you at higher risk. An aunt or a cousin is much less so. Is it any kind of cancer in the family? Like if, say, your dad had something, should you still get checked for breast? Like if it's different than breast cancer,

would you still get checked? Well, breast cancer is the most important. Most other cancers don't have a strong relationship with breast cancer. Ovarian cancer does. Certain people have a very high risk of ovarian and breast cancer if they have certain genetic mutations. There's one specific mutation called BRCA. There's a form one and two. One gives you high risk of ovarian cancer and a super high risk of breast cancer. Two gives you a super high risk of ovarian and a darn high risk of breast. So if you know you have these kinds of genetic mutations and there's others, then you would start earlier in getting checked. Besides genetics, what are the common denominator that you're seeing with men and women with breast cancer? Do you think, like this again may be a stupid question, but is it the cleaning supplies we're using? Is it the chemicals? Or is it,

do you think primarily genetics? I think there's a lot of genetics we don't know about, but there's got to be environmental things we don't understand. I think smoking, obesity, the fact that girls are getting their periods earlier and they're having kids later, they're exposed to estrogen longer in a form that can help push along things like breast cancer. So I think there's variants in our lives that have increased breast cancer, although at this point, we've kind of flattened out in the numbers of breast cancers we're seeing. I've never heard that before, estrogen being a factor to incite breast cancer. So you think that there's maybe an indication between people waiting longer in life to have children because estrogen runs more rampant in their system? I think that's

exactly right. Let's be real. My mother was married at 19. I'm married at 32 or 31. And people are waiting longer and longer and people are having kids in their 40s. So they're going to be exposed to estrogen longer. I think that there is some risk from doing that. You know, you have your personal life, you have your work life, you have other things that have changed since my mom, who was, you know, a stay-at-home mom and those kinds of things. So things are just different now. That's how society is. I don't think you can change those things.

But certainly you can do things about obesity and health-related things, eating the right foods. I don't know the exact correlation with those things, but let's be real. Even if there's zero correlation, we know it's better for you. Well, it's scary in a way because evolution doesn't give a shit about what we're doing. They don't care that we're waiting longer in life. So I think where people might be listening, they might get scared and say, oh, wait, but I still want to have kids later. But because of that, am I more at risk now for these things? So what can you do to mitigate

against that? Or it's just a lifestyle choice? I think it's a lifestyle choice. And I don't know how high of a risk that causes truly, but it definitely adds to it. Do you think that the influx of soy in our foods has to do with people being more estrogen dominant? For instance, like I was looking at Ezekiel bread, which so many people eat and they think it's healthy and there's soy in it. We're eating so much soy now, or do you think there's no correlation? I think there's got to be a correlation. I think soy is, I mean, I'm not an expert in food or anything like that or nutrition, but no doubt that I think soy is overused and I would go to other things if you're not going to use

the products that we all grew up on. COVID. Do you see less people coming in to get checked because of COVID and how is that going to impact people? I mean, it's crazy. People are not going to the doctor because of COVID. So what happens next year or the year after? Well, I will tell you when COVID started, which is ballpark a year ago, in March and April and going into May of last year, I'm at Cedars-Sinai and we do all kinds of imaging, mammography, part of that, and all kinds of things, chest x-rays, CAT scans, and all that, our volume dropped 75% over those two to three months. So for a time, two and three and four months into this, the volume was super down. So people were not only delaying things like their mammograms, but more importantly, they were not going to the

ER for strokes and heart attacks and things that caused immediacy of problems. So that was a super big problem with COVID. Our volume has bumped back up now. People, I think, got used to it. We know what to do now more. We have people sitting apart and wearing masks and doing this and that. The volume certainly isn't back to what it was, but it's pretty close. We love your daughter.

She works with the Skinny Confidential. She's here now taking Instagram stories. And she told me all about what you do. And I would love for you to tell the audience and the community how you got into this in the first place. Why breast cancer? Life has its funny twists. First of all, I mean, I don't know if you want the long drawn out boring story. Yeah, we do. All right. When I graduated medical school at the ripe old age of whatever, 26, I started my internship, which is your first postgraduate year. And six days into that, my parents found me passed out in the backyard. And long story short, I had what's called an AVM in my head, which is a venous malformation that they had to cut out. So I had neurosurgery,

lost my whole internship year. If you saw me walk in here, you saw that I walk funny. I have a bad gait, but I was completely paralyzed on the left side. Okay. And I had to relearn how to walk. I missed a couple of years of my training. And for some reason, unbeknownst to me, the program director took me back. He owed me nothing. I'd been there six days and he took me back. And really, that's why I became, that's why I ended up being able to go on with my career. So I had these delays. And with delays, you're supposed to apply for various things a year and a half in advance,

et cetera, et cetera. So I didn't know what I was going to do. I wanted to be a surgeon first, but I thought with my problem physically, I was also having seizures at the time that I thought being in the OR standing at a table for eight hours, possibly with a seizure, I better not be doing surgery and I better not be doing anesthesia in an OR because if I had a problem, that would not be good for the patient. So kind of falling into radiology, I thought, this sounds interesting. There's a lot of bells and whistles and cute gadgets.

And there's way more now than there were then. Was good. And you have all kinds of specialties that depend on you. So I thought this would be a good thing to try. So I did my radiology residency at Cedars-Sinai, as it turns out. And at the last minute, I decided that I would apply for post-residency, it's called fellowship, where you get subspecialized. And I decided the cutest thing back then, the funnest thing, the thing that seemed most on top of the new changes was CAT scans and MRIs and ultrasound. But I decided I would apply to one mammography program because we had one of the world famous mammographers at Cedars-Sinai at the time. And he trained at UCSF San Francisco with probably one of the most

internationally renowned breast imagers at that time and probably still. What year was this? I graduated my residency in 91. So this would have been for the year 91 to 92. You can tell my age by that. So I said, okay, I'll apply to this one breast program. It looks interesting. And I got in and I had buyer's remorse almost immediately. I thought, what the heck am I doing? Am I going to be able to do this the rest of my life? It's not like got all the fun bells and whistles like MRI does. Am I going to really like this? I was really, really, I thought I bought a car and drove it out of the showroom and I should have returned it. But needless to say, I found that I was wrong, as we often are when we're young. And I ended up

really liking it a lot. And as it turned out, it was something I was really good at. Not just my skill level, which I mean, I'm not blowing my whistle, but I think the way I talk to patients, it's not something you learn. It's really not. There's a lot of doctors that are brilliant that aren't so good at the bedside. Is it like lacking EQ? I think so. I think so. And if you were to see me in practice now, this many years later, when I have to do a biopsy on a woman, they're all scared. There's not one I've ever met that is happy to be getting a needle stuck in her.

It's a skill that you just can't learn, but I got to give myself a pat on the back, I can feel really literally how they're doing and is a joke appropriate, is being quiet appropriate, is being ridiculous appropriate. And I will tell you that it has served me well. I've gotten patients through these biopsies that would call me or send me a letter days, weeks, months later saying things like, you actually made that biopsy fun. I had a good time. You really helped me a lot. And I will tell you that it really gives me great pause

to say I did the right thing going into this field. Have you heard of ocean-ra raised salmon versus wild salmon? Okay, so we just started working with this brand, Ocean Salmon, and I can't even believe what I've learned. So basically, Ocean Salmon was created for those who longed for their perfect protein match, one that was easy to prepare, packed with protein, and one that made us glow from within because, hello, I talk about this all the time, omega-3s. First of all, ocean-raised salmon has more than 1,500 milligrams of omega-3 content, which is double the omega-3 content versus most wild salmon. So everyone who's talking about wild salmon this, wild salmon that, no. Actually,

where it's at is ocean raised salmon they have this premia atlantic salmon it's raised in open nets in the fresh waters of chile and you should just know that perfection takes time the growing cycle takes almost three years the healthiest salmon are carefully selected and transported in clean seawater so what i do is i order the one night stand it's an eight ounce portion duo, which I appreciate the portions. It's packaged in a skin pack to preserve freshness and taste. So once I get it, I preheat my oven and then I line my baking sheet with some parchment paper and then I put my salmon on. So I squeeze tons of lemon on top before and after with a little bit of fleur de sel salt. And then I do some Italian herbs on

top. I usually take it out at 20 minutes and then I put more lemon on top. I'm obsessed with lemon if you can't tell. Michael is obsessed with it. And now that I know the difference between ocean raised and wild salmon, I feel really good about giving it to Zaza too. The last thing you should note is that this salmon is free of microplastics, growth hormones, and heavy metals. I find so much when I go to the grocery store that there's all these salmons full of added shit, and Ocean Salmon does not have that. So get your Ocean Salmon.

I'm telling you, put some lemon, some crunchy salt, some herbs, maybe a side salad. Ocean arrives seven days fresher than anything you can find at your local retailer. To get your box of Ocean, visit oceansalmon.com and use code SKINNY for 15% off plus free shipping. That's O-S-H-E-N-S-A-L-M-O-N.com. Use code SKINNY. Ocean raised, ocean loved, salmon as it should be. Don't you think the empathy comes from what you went through you would like to think so but i'm a sarcastic son of a bitch and always have been and an angry pessimist so i don't know you'd think that that probably made me better and more empathetic empathetic but i don't know i think probably because you're seeing people at the most vulnerable

and you yourself have been in a vulnerable position. So you probably have something that's just inherent in your ability to recognize and deal with people that are in that vulnerable position where a lot of doctors, at least in my experience, like they may be there. They have, they're not able to do that. Like it's very, in my experience, personally, it's always been that it's very clinical, very science, very like you don't have the human connection. And when you're scared like that as an individual, that can be really challenging because you feel like you need to connect on the human level, not just the scientific. That's right.

And when I was sick myself and had my issues way back when, I will say that even before that, I'd had health issues at an early age, at 15 or something, and through college. And the doctors that handled me, the reason I went to medical school in the first place is because how these people were. Not just their skill, but their personal relationship and how they dealt with people. It meant a lot to me, and I felt like this was going to be the way for me to go. The people that dealt with you, did you have a good human experience or was this- You did. Both, human and skill. We had someone on yesterday that had spent time in prison. We were talking about prison reform

and you're talking about how sometimes the guards can be desensitized to the human experience that's going on in prison. And I feel like sometimes when, and I could be wrong, I'm not a doctor, but when you see the worst things and you people going through the worst illnesses, sometimes maybe you can be desensitized in a way. So I think there's gotta be some way that you can keep the human element and not just look at like another patient. I would hope so because you better have gone into this for something besides the income. There's a lot of burnout in medicine, and I think it's the stress of all the things we do. But the human connection is important to keep up. And part of the reason you do this, that I am able to do this, is because breast cancer is out in the news. It's always

being talked about. People have other kinds of cancer, lots of worse ones than breast cancer, and you don't hear much about it unless you know that individual personally but if you read you know the blogs or if you read the newspaper an old-fashioned thing or you you hear things on the radio or you you hear things on tv breast cancer is way up there and breast cancer was is the number two cancer for women in the united states it's bumped up to number one in the world now for cancers. One of my favorite books is this book called When Breath Becomes Air. And it's all about, I'm sure you've read it, but it's all about this brain surgeon that finds out he has brain cancer and he's dying. So knowing what you know about breast cancer as a doctor, you have two daughters. What advice are you giving your two daughters

you mean if they listen to me yes okay libby's listening libby's here she's listening her ears are wide they're not at high risk any more than any other average woman is because they don't have a family history the only things are the estrogen response i don't know when they'll have children anything like that they don't smoke so i think they have that going for them. So I wouldn't have them do anything different than their OB-GYN would tell them to do to start with as far as physical exams or breast exams. The thing about breast exams that women do is they feel lumps and bumps all the time, and it freaks them out. And obviously, most of the time, it's not cancer. Oh, that's good to know. So if you feel a lump or bump, you don't need to freak out right away.

I would give it a cycle and see if it gets smaller and then gets bigger again and then gets smaller. Give it a little chance. If you're concerned enough, go see somebody. It's not going to hurt. I've had implants twice. I have them now. Is there something different that people with implants should be doing than with people without? I don't think so. Same thing. Same thing. Okay.

So what are the things we can do at home to be preventative? I think like we talked about your diet and things like that. But as far as breast self-exams. Yeah. I'm not as into that as some people are. I think because of the reason that people feel things and they, they're most of the time, they're things like cysts or benign entities and it freaks people out. That being said, every single one of these young girls, women, sorry, that we've seen that are under 40 that are below the age that you would start mammography screening obviously felt something or somebody felt something. has been taught to you and done at the right time of your cycle and things to that effect.

Because obviously all these young women that I've seen in their 30s and some in their 20s, unfortunately, found it themselves. Because they're not starting mammography at that age. When you see a 20 to 35 year old come in and they have cancer, what is the protocol for them? Is it immediate chemo? Is it radiation? Is it case by

case? It's definitely case by case. When you hear the word breast cancer, it's not one thing. There's many subtypes, some at higher risk than others. So there's all kinds of testing of the tumor that would have to go on before you would know about things like chemo or radiation, surgery, mastectomy, lumpectomy, which is when you just take the tumor out. So there's a lot of forks in the road that have to be gone through before you really know what's going to happen. But the way all these young women start is they feel something. They come in, they get imaging, they may have seen their doctor first, but they get sent in for mammography, ultrasound. Those are the usually starting points. And then you go from there. And then a biopsy has to occur because even if it looks bad on the image, it has to be proven.

So they all end up getting biopsies if it looks bad. How important is a yearly physical for you? I go pretty religiously because I want to look at my levels every year. And I imagine that it's important to see any change in the body. Do you encourage those? Because I feel like people are doing them less and less now. Do as I say, not as I do. I am a typical MD. I am not religious about going in for routine physicals. I think part of that is I've had major health issues and I'm sick of doctors and things. So I'm not a good example. I think it's a good idea. I think certainly for women going to your OB-GYN once a year is definitely important. But you are a doctor too. So I feel like if you felt a lump or bump on you that you thought was concerning, then you would

handle it, right? That's different. I'm talking about you're feeling well and you go in for your yearly routine. Got it. But yes, if there was something that I felt, but I'm still fairly cavalier. How is men in breast cancer? Do you see a lot of men? I see an occasional man. Yeah. Occasional, like is it one out of 10, one out of 40? Is it like once a year? How occasional? I'd say out of all breast cancers men have less than one percent of them so low low but if they have high risk again

with those genetic issues or their sister mother etc they are at somewhat higher risk so when i look at a story like angelina jolie where she her mother had breast cancer and she went in and she removed her breast tissue, is that the right verbiage, to just get rid of the scare of cancer? Does that actually 100% get rid of everything or no? Nothing is 100% in this world, so no. People that have mastectomies, often they have breast cancer on one side and they decide they're going to want to eliminate both breasts, the one that's healthy and the one that has cancer, because they don't want to think about it. But there's been zero scientific proof that doing mastectomy is any better at survival than doing a lumpectomy, which is when you remove the tissue itself. There is no scientific proof that that increases survival. What is it like after someone's diagnosed and they have to, let's say they have to go through

the process of chemo and radiation, what kind of tool does that take on someone's mental health? I can imagine that that's almost more horrible than even being diagnosed. The process seems gnarly. Let's talk about hair and specifically hair growth. I noticed that my hair got thinner after I had a baby. And I've talked to a lot of you guys about this and you feel the same way. And I looked into it more and found out through Nutrafol that 30 million women are impacted by weakening or thinning hair. So a lot of us are dealing with it, but no, you're not alone. I actually met the creators of Nutrafol years and years ago. And when they told me about what they were doing, I was freaking out. So basically, they offer two targeted formulas for women that are clinically shown to improve hair growth and thickness. I've tried this through postpartum. I think it works.

My hair feels so much more luscious. It also feels thicker, stronger. Even when I'm shampooing my hair, I notice a difference. And I know that it's working because even the person that dyes my hair, shout out to Chris, commented on it. So what you're going to do is after you take Nutrafol, you're going to notice that your hair is growing stronger and faster in about three to six months. And along with that, they did this clinical study and they found that 86% of women reported improved hair growth after six months. I feel really good about recommending this brand and partnering with them because I have known about this brand for years and years. And I've talked to so many people that have used it and it's worked. And most importantly,

I always try to go to the experts. More than 1500 top doctors recommended Nutrafol as an effective and high quality solution for healthier hair, especially if you're postpartum or you notice a thinning hair. So you can grow thicker, healthier hair and support the skinny confidential him and her show by going to Nutrafol.com and entering promo code skinny, and you're going to save 20% off your first month subscription. And you should know this is their best offer anywhere, and it's only available to US customers for a limited time. Plus, you get free shipping on every order. Get 20% off at Nutrafol.com. That's spelled N-U-T-R-A-F-O-L.com, promo code SKINNY. Your hair is going to be fab. It's the not knowing. You know you have something. You're waiting for the biopsy, then you're waiting for the results. That's super hard for people. Then getting in to see the surgeon, the oncologist, the radiation therapist, making all these decisions, hearing people talk,

and it goes right over your head because you're nervous. You have a question that you thought of at home and you drove in, you went to see the doctor, you walk into the office, you forgot the question. You think of it later when you go home. I always encourage people, I say pen and paper, whatever device you use to write things down. So you remember the questions you want to ask before you get down. So you remember the questions you wanna ask before you get there. And you remember what the physician says when you've seen her or him in their office

because you will leave and you will be totally befuddled. It's also important to have an alternate brain with you. I'd encourage people to bring somebody with them. I know COVID makes it challenging now, but having somebody there, even a loved one that's not neutral or a friend, is still better than your brain alone. So I think that's very helpful because the process is really a lot of bumps in the road. What are some of the side effects of chemo and radiation that you see? And sometimes are there no side effects or are there always

side effects? No, there's not always side effects. I mean, there's usually some. The hair, depending on the type of chemo, can be a real tough one for women. That seems so difficult for hair and your breasts as a woman. I mean, I can't even imagine that. It's so crazy. Hair and eyebrows. I don't do chemotherapy. I'm here to diagnose you. But when I see women that come in with no hair and no eyebrows, that's hard. They wear a bandana or they're proud like Sinead O'Connor who didn't have cancer and just say, screw it. I'm a cue ball head and I'm cool.

It's hard. The feeling of nausea, vomiting, diarrhea, appetite loss, all those things can be part of what you suffer through during treatment. Not all treatments are like that, and every woman is different. And they are so much better now at handling these things, the oncologists and the radiation therapists. They've really got their shit together. And I think that's part of the reason why women are doing better. It's not just early discovery.

That's my job, catching things early. You can imagine finding thing that's pea size is gonna be better than finding it when it's softball size. Softball size? Well, that's rare, but some women wait and they wait and they wait and they wait. Why do they wait so long? They're scared? It's all fear.

Well, that's what I've had some friends that have since passed and some men in my life that they were so scared they never want to get checked out. And by the time they do, it's too late. I'm always on everybody that I know has a history or that's older, like get in there and get checked. Even though it is scary, the alternative is so much worse, in my opinion. Agree. Everybody's different. And some people think that, obviously mindset plays a lot into our life, but they think, well, if I don't think that I could ever get it, or I just have a strong mind, and I'm like, I don't know if the body is connected that much with the mind where a cancer couldn't live just because you feel like you couldn't get it.

Agree. I think that totally ignoring things is a definite. There's some people that are listening to this that I know are going to listen to this show that I want to go and get checked. And I just want them to hear that because the mind is not so powerful, in my opinion, that you can just shy away any illness in your body. You need to go and get checked and see what's going on with yourself. Even people that have good mind control, Buddhists, Buddhist monks, gurus in India, various people that can slow their breathing down and do all those interesting things. I don't think they're immune from dying.

I don't think they're immune from disease. We have such a big woman audience. If you could say something to all the women about getting checked, what would it be? Some maybe advice, some micro tips, tricks, anything when it comes to screening for breast cancer early. I would tell you to get over your fear and make sure you come in regularly at the times that are advised, especially when you hit the age of 40. Earlier, if you have those special circumstances that we talked about,

40 years old is the magic cutoff point to start routine screening. Screening is here for you to find something early. The screening studies, which have been done over decades, despite what you read in the literature or hear, the lay press I'm talking about, have shown a decrease in mortality from regular breast cancer screening. We're not talking that you get a mammogram at 40, you have a breast cancer and you're gonna die at 50. And if you waited and didn't a mammogram at 40, you have a breast cancer, and you're going to die at 50. And if you waited and didn't get mammograms, it would grow, and at 45, you'd get it,

and you'd still die at age 50. If that was the case, there'd be no point in getting screening. You would have five more years of knowing you had breast cancer than the woman that got it at 45. But if you don't live longer, we're not serving a purpose. The whole point of screening is longevity, survival. So the big screening studies with mammography have shown a decrease in mortality anywhere from 30 to 50, 60% from regular screening. So that I think is the most important thing.

All the treatments once you get breast cancer have helped extremely a lot as well. But as far as screening, the goal is to find it early. The goal is to find it before it's gone into your lymph nodes, before it's metastasized to other parts of your body. So regular screening is important. Walk us through the whole process from start to finish, what it's like to get, you keep calling it something, but I'm probably going to love it. Mammography. Mammography.

What is that whole process like? Well, I wish I had a machine here to show you. You could do it on me. Shit. We could do it on Instagram stories. That would be interesting. Would Leanne like that? We could pull my tits out right on the table. I promise you I've seen more tits than anybody. I'm sure you're immune for tits. You're never immune. Is that true? You're never immune? I can't answer that on the grounds that it may incriminate me. A mammogram is done. A technologist brings a woman into the room, and the machine is there to shoot low-dose x-rays into you, just like getting a chest x-ray, but this is down to your breast tissue, to create an image that we can look at and analyze for signs of breast cancer.

The breast is squeezed in between two plates to flatten it out, to decrease overlapping tissue so you get a better picture. And it also decreases radiation because you don't have to go through as much tissue when you're squeezed. So it's uncomfortable. Look, I've never had one myself, but most women tolerate it quite well. It's very tolerable and it's pretty short examination. When does Michael and Taylor need to go get their balls checked for prostate cancer? quite well it's very tolerable and it's pretty short examination when does michael and taylor need to go get their balls checked for prostate cancer i want his balls squeezed in a fucking thing like if i have to get my boobs squeezed like that when does he have to get his balls you can't have the balls the prostate is not at the balls the prostate is up higher and you have

to get a finger stuck in your butt i don don't need to know about the prostate. I'm so good. Yeah, don't worry. Let's focus on- It's at the butt. Inside. Okay, when do they have to go get their prostate checked? What age? 40, 50. And that's a finger up the butt?

Yeah, and getting a PSA, which is a blood test. Okay. I want to request that Taylor gets his prostate exam on the show and on Instagram stories. That ain't happening today. Yeah, it's not happening when I exam on the show and on Instagram stories. That ain't happening today. Yeah, it's not happening when I'm on the show. Does anyone want to give him one? You guys can sort that later.

What are some resources that people can go to maybe online or books or podcasts? Do you have any resources that you direct people to that have been diagnosed with breast cancer. Who doesn't love canned wine? And who doesn't love a canned wine that has five varietals, rosé, sauvignon blanc, pinot gris, pinot noir, and limited edition extra fizzy sparkling white wine? I am talking about Bev. Bev is a female-first canned wine brand that was founded to change not only the way a product is consumed, but the way an industry and culture have operated for generations. It comes in the cutest can. Their wines are dry, they're crisp, they're a little fizzy, super refreshing and delicious. You can add a little sprig of mint in them. I like to put them over ice, make a little spritzer, add a little sparkling water.

I personally like this brand because I'm always looking for zero sugar options, and this has zero sugar in it. It also has three carbs and 100 calories per serving. I am still on the journey of losing my postpartum weight, so to know what's in my can is good. If I was going to start with one, I would definitely get the rosé. That's my favorite. If I were to start with one varietal, I would definitely pick the rosé. It is so good, you guys. It's dry, like I told you. And it's perfect if you're cutting back on sugar and you still want to enjoy a glass of wine without overindulging. Here's another hot tip. If you

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going to go all in and order it. Go to drinkbev.com slash skinny or use code skinny at checkout to claim this deal. That's d-r-i-n-K-B-E-V.com slash skinny. Cheers. I tend to put them in touch with people that I think they might click with that have had it, especially the young ones. I've done that before. I call somebody or text her that had cancer that was young and say, I have somebody, she's about your age when you got it, would you mind talking to her? So I've done that a number of times. I find that the personal is very good. There's also, I'm sure there's groups, breast cancer survival groups and things like that. I don't know that reading some of the scientific literature, certainly going on

Google is a bad idea. You'll think you're dead yesterday. Can you talk about that a little bit? Because I think so many people, they get on the WebMD and the Googles and they freak out. I mean, they do it with everything, not just themselves, their kids. If their kids are sick or whatever, you just go down this rabbit hole. You go down a rabbit hole, you look at prescription drugs and everybody's going to die. Every doctor of notoriety that I've ever talked to says, stay off Google. Stay off Google. It virtually does nothing but alarm you.

You're literally the Google person. If something happens with the baby, she'll get a hangnail. He's like, hangnail on baby. I cut this baby's fingernail. I never cut a baby's fingernail. I have shaky hands. There's no way I could ever be a surgeon or do anything. I thought that I cut her finger off because it wouldn't stop bleeding. Because babies, you know how they bleed so much? On the fingernail? This thing was gushing. Look know, look, I'm objective. I can do blood and guts well, but not when it's my own. Oh.

So when my firstborn, Haley, Libby's older sister, was born, she had a, right after she came out, it was a C-section, she started gagging. Just like that. She had what's called a pneumothorax. Her lung collapsed partially. And here, Mr. Brave, Dr. Brave, leans up against the wall, slides down the wall, sweating, passed out. They had to put smelling salts under me.

Vascovagal? Vasovagal. Okay. Yeah. And so that's why you shouldn't treat your own. Makes sense. That makes sense. I mean, if I couldn't do it, that's why I shouldn't treat your own. Makes sense. That makes sense. I couldn't, I mean, if I couldn't do it, that's why I was freaking out the baby was trying to even know what to do.

I just like handing it around, but I want to go back. I want to stay on the web MD Google thing here is I think there's all this misinformation. People go on, they self-diagnose themselves and they, and I, and they just go down this spiral and lose it. I really agree. It's rare to find somebody that hasn't Googled when they come in. I'm not talking about when they come in for their routine mammogram that we're talking about. I'm talking about-

I wouldn't Google. I wouldn't Google. I don't Google. I would avoid Googling unless you want to find the name of a song that you can't remember. Yeah, I'm not a big Googler. I didn't Google anything about pregnancy when I had a baby, nothing. I would love to hear in your entire career what your best success story was, something that just went how it exceeded your expectations.

And then I would like to hear a story that didn't go how you wanted it to go when it comes to breast cancer they both resolve revolve around young people so people out of the typical realm of ones i see there was a 24 year old she came in with a lump she's so young i forget if she had history i don't remember this has been a couple years and let me just preface this by saying and i don't know if this is really scientific or not but i have not met one young woman not one i'm talking about the 35 and under not the typical age that isn't a stellar human being these are women and I've come home and told Libby and Haley and my wife this,

that you would be so happy to have as your daughter. It's unbelievable to me how every one of these women are amazing people. Anyhow, back to the 24-year-old. She's from Texas. She lives in L.A. Sweet as the day is, whatever the expression is. Terrific young lady. Took the news like a typical Southerner.

Very stoic with a smile on her face. We had to biopsy two areas in one breast. She ended up, I got her in right away to see a surgeon. She ended up getting mastectomy, chemotherapy, the whole thing. Now, move forward to now, about a month and a half ago, two months ago. She comes in to see her surgeon for a routine follow-up. She says, oh, you know, I have a little pain here. I think I pulled something.

And the surgeon felt something there. And she immediately sent her for a study, a special study to look there and elsewhere in the body. And she has liver metastases. And so I don't know her status now. She's back in Texas. And I will tell you that I lost a lot of sleep over her just hearing about this. I had felt good at the beginning, not good. She had done well at the beginning, and she deserved to do well as do many of these people.

And when I heard she had this a month or two ago, that was pretty downer for me. Is the liver correlated with the breast cancer or is it separate? It's totally separate. This is breast cancer that's spread to the liver. So the breast cancer spread into the liver? Correct. Through the bloodstream. So they thought they got all the breast cancer out and then it ended up... You can never get everything. There could be cells in the blood. There's just no 100%. What about a story that you're really proud of that you're so excited about? Okay. The best, the one that makes me the most happy is also a young woman, nine weeks pregnant, nine weeks pregnant, comes in with a lump. The greatest young lady I've, one of the greatest.

So we do the imaging. We do the ultrasound to start because she's pregnant and we don't want to give any radiation, even though it's low dose. When we saw what it looked like on ultrasound, we did get a mammogram and you can do it very safely. I don't want anybody pregnant to think you can't. We shield them. We put a lead shield on them. The dose is so low and you're squeezing up at the breast. So to get down by the ovaries or the baby is developing, there's just almost no dose. Anyhow, we were able to do that. We saw that it was only in the one area. We didn't see it anywhere else. We did the biopsy. It was breast cancer. Remember, nine weeks pregnant. She goes

to see the oncologist. They treat her with chemotherapy throughout the rest of her pregnancy, which is safe to do with some chemotherapy. She goes through chemotherapy. This thing shrinks. It's virtually gone. She had a lymph node that also had the cancer in it. That shrunk away to nothing. They did a C-section, got the baby out. This was, I think it was at about eight,

between eight and nine months, near full term, or maybe even was full term. Baby's out, baby's healthy, baby's great. Take her to surgery. They were able to do the surgery after the chemo in this case. And she's done great and she's like when i see her i just love seeing her she uses foul language she's sarcastic she's

just like me so that's that's my biggest memory of a good one that must feel so cool to have a career that makes such a difference like that. When it happens, it does. When I get requests from patients, remember, I see these patients once a year for a biopsy or to read their mammogram. It's not like you see your regular doctor. Most people don't know who I am. I'm behind the scenes reading their images like most radiologists are. But I've got a little bit of a fan club,

which is kind of nice. I mean, I think that one thing that's not as talked about so much for the medical community, it's got to take a mental toll on you when you have things go the way you don't want them to go. How do you cope with that? The good thing about my career is in radiology is, like I said, we're behind the scenes. So a lot of the stuff that go wrong, go wrong after me. The biopsy, I'm usually pretty darn successful. They get through that fine. Then they're off to see the surgeon if they're diagnosed or the oncologist, the radiation therapist. I don't see them again until they come back for their next mammogram or ultrasound. So the difficult events of chemotherapy, surgery, failures, things like that, I'm blessed to not have to deal with in my field.

Because I imagine that takes a huge toll on the people that are on the end of that. I would think you'd have to be of good strength. Yeah. What can men do to support their significant other while someone's going through something like this? I will tell you that a significant other being male or female going through this with a partner, I have found they try to be the strong one

and hold their shit together for the sick one. And sometimes they fall apart more than the one that has cancer. The one that has cancer knows what she has to do. She's got this, then she's doing this, and then she's doing that. And all the while, the spouse or the significant other is trying to hold the household together and trying to keep her spirits up and doing all this. And it can take a toll on significant others that you really are surprised at sometimes. So I say, significant other, don't forget a little time for yourself.

Go watch something. Go Netflix. Go exercise. Get away from her for a while. Go see your buddies. Go do something. You got to get away. If you don't take care of you, you ain't no help to her. I promise you. Yeah, it's counterintuitive, but it makes sense. Yeah.

Because I imagine the partner feels so out of control because they can't do anything about the process. They feel helpless. Yes. And they feel like all they want to do is do something to make it better. And the only thing they can do is be there to support her. And support her through her anger, through her feelings of loss of beauty. Let's not forget that besides feeding babies, there's a lot to breasts that are social. And especially these young ones that are unmarried, don't have children yet. There's a lot of social

overtones to this that you don't get with other cancers. The breasts are here. And I don't care if they're A-cups or D-cups. Breasts are in every advertising. Well, it's like, how would you like to get your dick cut off? Well, I think it's actually even different because your people aren't necessarily, I don't think they're not looking down that way all the time. Where like what he's saying is that your people, these are front and center. Front and center. It's hard. It's very hard.

Those are the things the significant other can try to do. But the significant other will not be successful unless he or she takes care of themselves in some way, shape, or form. And I don't mean heroin. I don't mean drugs or alcohol. I mean, a little bit is fine. A little margarita. A little margarita is good. Little wine. Yeah.

If you could leave our audience with kind of like a roadmap like do this when you're 30 do this when you're 40 do this when you're 50 what would it be i would start doing your regular gyne practice when you go to the gynecologist i don't know when you guys start that i guess when you get your period or maybe before and do that regularly i think that's step one because it's very important not all gynecologists know. They know from the breast down because they're here to take care of your ovaries and your uterus. But they know about breasts. And the good ones will get you to do the breast self-exam in a way to not freak yourself out.

And if there is something that you find and you're concerned and it's lasted more than one menstrual cycle or two, you should have it checked out. The first thing we would do in an underage, by that I mean under 40, premenopausal woman, at 30 or under, 35 or under, we would start with an ultrasound. Between 30 and 35, we might start with a mammogram. It varies. And get it checked out. might start with a mammogram. It varies. And get it checked out. Remember, ultrasound is sound waves. There's no radiation. Mammography is x-rays, so there is radiation. But I want to encourage you all to not be afraid of that. It is extremely low dose. If you've ever had to have a CAT scan or any of these types of studies, the dosage is astronomically higher. I don't want you to be afraid to get these tests. These tests are here to help you to get these

things early. So I would say start with that. When you're of the age, and I started my wife at 35, even though the quote unquote magic number is 40, because I know it's low dose and I figured, okay, let's start at 35. Can we talk about that for a second? Starting a little bit earlier. I think we've had some feedback saying, you know, it's harder to go because a lot of times the doctors will deter people from doing it if they're too young. And maybe there's an expense that insurance doesn't want to cover. Sometimes I don't know exactly how it works. But what I don't want to do is leave this episode with a bunch of freaked out people that are like, oh, wait, I'm 25. I'd be like, what, what can I do? And then I can't get tested.

So when, you know, and I know we've talked on this a little bit, but if they feel like they need to start earlier, but maybe their doctors or insurance is saying, Oh, you don't need to do that yet. Like, what would you suggest to those people? Like, listen, I just want to be super proactive about this. I don't care about the, the, the effect. I want to go and get the test anyway like do you say do that or do you still say wait because i think there's some gray area there when people should go get tested let's talk about insurance we all know insurance is horrible and a pain and difficult and it stops people from doing things that medically they should get so i try to make my decisions as best I can, ignoring insurance, even though I know it's practical not to, and I certainly ignore lawyers, because if I practice medicine with fear,

I wouldn't be doing a service to my patients. I have to do what I think is right. So, let me just preface what we're going to talk about before then. As far as getting a study and somebody says, no, you can't get it, I think it's your insurance company, if you have a lump, will cover it. I really feel they will. I don't think that that's going to be an issue. If by chance you're uninsured or whatever, for whatever reason, you're young and you figure you don't need anything, you're healthy. That's what people do when they're young. They're omnipotent, nothing's going to happen to me. And then when it does, you say, God, I wish I had insurance. If you went to Starbucks a little less and you skipped going out to that $100 dinner,

you could pay for your stupid ultrasound if it's necessary. So I wouldn't let money stop you from one of these pretty inexpensive tests. Because I imagine too, with patients, all the money and all that goes out the window when your life's in danger. People stop thinking about their career and all these things. Your health becomes the most important and the only thing at that point, right? It is. But of course, it's not fair if a woman has to go, whatever kind of disease you have, that you have to go bankrupt from it. That's unreasonable. You know, and also there are county hospitals. There's ways for people that are not of means to be tested. And I think you don't just have to be middle class or higher to take care of yourself.

I think there are detriments, and that's a whole different subject, is underserved communities. But in breast cancer, we definitely have underserved, just like we do in all medical things. COVID, we've all seen that. We've all seen that. You're a girl dad. In this off, Libby and Haley, tell us what you love most about being a girl dad. Well, what am I in for? I got a one-year-old.

Here's the deal. First of all, not only am I a girl dad, but I work with 98% women. Wow. 98% of the women I work with are, you know, 98% of the people I work with are women. The patients are virtually all women. I go home are women. The patients are virtually all women. I go home to women. The only estrogen I have is the little that I have left at 64 and one male dog, but unfortunately, he's had his balls cut off. So there is no testosterone around me anymore.

Sounds like Michael. It's just, it's too much. What's it like to have daughters? Well, I know we all try to be gender neutral and things like that, but I'm looking back at old videos now and I'm seeing them dressed as Cinderella and things like that. It's really fun for a young father to see some of these things that he didn't experience growing up. I experienced playing army and shooting fake guns and tree forts and riding bikes and things like that. And going through, watching them dance and watching them do plays and all these things I didn't do was really a lot of fun. It was really fun. The word of advice I

can tell you is the teenage years are the interesting years. But typically, at least in my household, not nearly as bad for me as they were for the mother. Because the estrogen-butting heads is difficult. And I don't know if that's even stopped yet. Has it, Libby? I definitely watch. I have two younger sisters. I watched that with my mom. I was a problem child when I was a kid. My mom told my dad, she's like, okay, you take him, I'll take the girls. And then later when you got to the teenage years, she wanted to flip that around because- I'm going to say you take the girls, I'll take the dogs. Dogs are a good way to start. That that's for sure i was a troublemaker too i got

away with it though because i got good grades oh i didn't i yeah i did not he did not michael was mooning the principal when we were i was doing all that stuff but my mother and father gave me a you know slide because i was pulling grades. It's amazing what you can get away with. I didn't get a lot of slides. Saza is very into Frozen right now. So it's the same as Libby with Cinderella. Michael and I just bought her a Frozen dress. I spent my morning on Amazon buying Frozen costumes and toys.

I didn't think I'd be doing that, but here I am. I don't know how many times I've seen those movies, Anastasia and all those things that we were watching. I've seen Frozen about 85 times in the last two days. You'll have them memorized soon. I got it. No, I can break into it. Thank you so much for taking the time out of your busy, purposeful schedule. You can come back anytime. It's been such a joy to work with Libby. She's so helpful. And that podcast was so amazing. So thank you. Oh, you're very welcome. Do you have Instagram? Yeah, but I'm 64 64 i don't do social

media but people can find you at cedars yeah if they want to come see you yeah okay website cedars that's all perfect i mean i have an instagram i have all that stuff but i really don't use it i love it that's cool thank you i look at yours oh such cute dad. Thank you for coming on. You're welcome. Don't forget to pre-order a copy of my new book, Get the Fuck Out of the Sun. There is so many insider tips and tricks on skincare. You guys are going to be obsessed.

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