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Dr. Liz O'Riordan - retired breast surgeon and three-time breast cancer survivor
8.6k Plays11 months ago
Conversations with Phil & Dr. Liz O'Riordan
Hosted by Phil, a male breast cancer survivor and advocate, this podcast offers powerful conversations with Dr. Liz O'Riordan, a retired breast surgeon and three-time breast cancer survivor. Together, they explore Liz's unique experiences from both sides of the breast cancer journey—doctor and patient—and discuss the future of breast cancer treatment, genetic testing, and patient care. Through their candid discussions and expert insights, this podcast provides inspiration, information, and support for anyone affected by breast cancer.
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Transcript
Dr. Liz O'Reardon's Cancer Journey
00:00:14
Speaker
Today, Dr. Liz O'Reardon, breast surgeon and three-time survivor, shares her expert insights and personal journey in the fight against breast cancer.
00:00:29
Speaker
Hello Liz. Hi Phil. Amazing to see you. Me too. I know you as a two time breast cancer survivor and breast cancer. Three time. Three. Is your website of today's?
00:00:51
Speaker
possibly not well you can expand on that a little bit more and obviously yeah another thing is are you actually a practicing surgeon right now because it says you right you know not I retired you retired right okay i'm a consultant but I was a consultant breast surgeon um and two years after starting training I was diagnosed with breast cancer. I was 40, I had no family history. I had every treatment that my patients had and realised how little I knew about what it was like to actually have breast cancer.
00:01:23
Speaker
I went back to a work after 18 months of chemotherapy, mastectomy, reconstruction, radiotherapy, the works. And I'd had a nodule of scar tissue on my chest wall underneath my armpit. That was actually a two and a half centimeter local recurrence. And I had surgery and radiotherapy for that in 2018. And the side effects of that meant that my left arm didn't work properly and I couldn't operate anymore.
00:01:45
Speaker
And then last year, the day before my memoir Under the Knife came out, I noticed a little ulcer on my mastectomy scar and that was a second local recurrence. So I had surgery for that and I'm now on treatment for life to hopefully stop it coming back a third time. The thing to kind of share there is that, you know, recurrence isn't real. It isn't real.
00:02:09
Speaker
yeah Was it a worry, because you knew about it, was it actually a worry? Yeah, it was really hard because we know a lot about metastatic cancer when it comes back and it can't be cured in the treatments for that, but local recurrence where it just comes back in the breast or chest wall area is actually really rare.
00:02:29
Speaker
It's only about 3% of all breast cancer cases, so there's no trials, there's no data, there's no community groups, there's no support groups, there's no one else to talk to. And I found that really hard because I'm a surgeon used to having all the data at my fingertips and I knew it would increase the risk of me getting met, but you don't really know by how much. And it was this really weird place to be in.
00:02:49
Speaker
And again, this time my surgeon said it's a bit like um weeding the garden. We just keep nibbling away bits of skin and it keeps coming back in the skin and hopefully it will never come back anywhere else. But that fear is always there. Yeah. So as as a surgeon, had you seen a lot of recurrence in your patients?
00:03:11
Speaker
Yeah, so i I would often see people who came to the clinic with suspicious symptoms like a cough or some bone pain or a backache that ended up being metastatic disease. And I had passed them on to the oncologist to see they looked after them. But I have seen quite a few women who've had local recurrences like I did. And we just nibble them away and then hope that we never saw them again. But it doesn't happen very often. And because it's so rare, there are no trials. There is no data. You treat them based on, I guess, the best experience that you have. Yeah.
Breast Cancer Awareness for Men
00:03:40
Speaker
Now sadly I'm gonna have to kind of point something out then you said women. I just say women and men initially, but yeah I am very aware that whenever we talk about breast cancer and I'm guilty here, we say women because we see very, very few men. And actually when I worked in Suffolk, we have one of the highest areas of men with breast cancer in the country. And I will put my hand up and say, it's a slip of the tongue. We need people like you to remind us, for people like you, men like you, men do get breast cancer and it can happen at a young age. How hard it was for you to be in a very female environment.
00:04:17
Speaker
going through treatment. I mean we kind of discussed this when when I came on your insta-line. From my point of view it was always just a medical environment. It wasn't a gender-based thing. It was like you are getting surgery, you are getting treatment.
00:04:33
Speaker
it's the same regardless of your gender. I mean I was chatting someone the other day and they and I said you know men or women and then they they picked up on me and said I had to say people now I mean that pretty much covers everything. It does. People get breast cancer. One of the things that did um I don't know whether you've seen it but there was a transsexual man in America who sadly passed away but I the information that i kind of took from it was the the treatment that he received potentially caused the breast cancer again another thing i didn't i didn't know i didn't hear about that what treatment had he had so obviously they i i guess it was a hormone treatment yeah okay so estrogen bite doesn't cause breast cancer
00:05:26
Speaker
But if you have breast cancer cells or with estrogen receptors, then a lot of estrogen will make them grow more quickly.
00:05:36
Speaker
Does that make sense? Yeah. So there's obviously, because again, i'm um but yeah you know, every time I speak to somebody, I'm learning in something new. Yeah. Someone said, everyone has the BRCA gene. And I was like, what? i know what But it's- We do, but we don't have the mutation. the muter It's the mutation is the correct- Yeah. And I'm like, right, okay. Because it's just a continuous kind of journey of understanding as as you as you go along. Obviously from you, you would have done this over a long period of time and to a higher level than most people will
Writing and Cancer Myth-busting
00:06:12
Speaker
ever on understand. But and from a not you know like from a layman's point of view, there's literally a new thing
00:06:22
Speaker
lands on your lap every day and I guess why your book was so well received and recommended by a lot of patients because you know if you you've seen it from both sides of yeah and and obviously you're now able to explain it as a patient and as a surgeon. Yeah and so the second edition is coming out this October there have been 20 new drugs in the last five years that's incredible so we've got an updated version coming out Amazing. Well, I was gonna say, is there gonna be off another book? Is there another book in in this?
00:06:59
Speaker
So there's so many books, Phil. So the second edition of the breast cancer book is coming out. I'm just finishing my third book, which is looking at cancer myth busting, ah cancer generally. I want to write a book about exercise and breast cancer, but the problem is there aren't enough high profile cancer exercise experts in the social media space. So and my next mission is to boost their profiles. So publishers will realize we need these books. And then I've got thrillers. I want to work out how to kill someone on a train and get away with it.
00:07:31
Speaker
amazing. maybe and wow Who knows? Who knows? And maybe another memoir about Nom and I. um It's too soon to do that yet, but. Yeah, no, I mean, obviously, I've you endorse my um The book. Your brilliant book. I love it. It is a brilliant book. I do i still take, um I still struggle when people go, oh, it's an amazing book, Phil, well done. And I'm like, well, yeah, I mean, I can't take credit for the contents ah of it. No, no, you, it takes a hell of a lot of work to come up with an idea and see it through and collect an edit. And you have to learn to take a compliment, Phil. And someone says, thank you for what you did. You say, thank you and leave it there. Because without you, it wouldn't have happened. i Yes, I appreciate that. Thank you, Liz.
00:08:20
Speaker
I find crazy information out, which I've i've never heard of before, seven years into my kind of like breast cancer journey. Was there anything that kind of like, as a patient, you then found out, which was kind of shocking for you that you didn't know as a surgeon? Oh, I was talking about this before. The biggest thing for me was hair loss during chemo. And this is going to sound ridiculous. I knew you lost the hair in your head. I didn't realize you lost all your body hair.
00:08:50
Speaker
pubes, leg hair, I didn't realize that. And I didn't realize how emotionally disturbing radiotherapy was, how lonely and isolating it felt lying on that table. But I think as the years have gone on, I am shocked by the things people send me about the stuff they hear, what does cause cancer, what doesn't cause cancer, does this treat it? And I am shocked and amazed and terrified at just how much crazy stuff is out there.
00:09:16
Speaker
yeah yeah but and and to be honest with you there's only there's only you and a couple of other people that kind of are putting people right and i think mainly because not the majority of people in the breast cancer community are not experts they they won't Yeah, but I think it's also exhausting. If someone sends me a video that says carrot juice can cure cancer, I i feel and I need to counteract this because it's not true because people are avoiding chemo and drinking carrot juice. But it'll take me a day to go and do the research to make sure that what I'm saying is right and the energy and then negative comments you get from people who believe this, who depend on this. It is it is soul destroying. And when you don't have a million followers, it's very hard to actually make an impact in that space. There are days where you think, why do I bother?
00:10:02
Speaker
do Should I really be upset that people are choosing to drink carrot juice and have chemotherapy? Is it my fault if they die earlier? Because we know women and men with breast cancer, but it was a study in women done in the States. If you choose and alternative therapies instead of traditional treatments, you are six times more likely to die. Wow. I mean, that's worth knowing.
00:10:26
Speaker
no yeah And to kind of correct you a little bit, I know you say I haven't got a million followers, but you i I think the information you put out, oh a lot of people really value and and thank you um refer it to. So I don't think it's wasted. Plus, I mean, a because because of your background, it has more weight on it. Do you believe it? And it is shared. And you know, ive all I've heard is amazing things about ah people's opinion of you on what you're doing. So I think and i think the my the myth book is is a really good idea. um But yeah, I know what you're doing is it obviously is amazing, I think. Thank you. but Feeling the love, sharing it back. now we love how would sweet It's all good, isn't it? Well, how did you because you've got some quite some quite nice photos on your website. Yeah.
00:11:24
Speaker
Is that a conscious thing?
00:11:28
Speaker
Towards the end of chemo, my husband noticed that a local photographer had just won an Olympus Gold Award and he said, why don't you go and get a photo shoot done? And I said, don't be stupid. I look horrific. I do not want to remember looking like this. And then I thought, I hope I'm only going to look like this once. And why't it might be nice to have a photo just to look back on and see how I've changed. So we set up this photo shoot.
00:11:50
Speaker
And halfway through I just, it was almost like I could let my emotions out. I'd been hiding so much about what I was really feeling. I said, look, I just want to strip off and I want to show this is me. And I had some craving shots with me and then my husband and I topless took the waist up and it was just really emotional and raw and vulnerable. And I just kind of, this is actually what I'm feeling in front of the camera. And he was the most amazing photographer. They're really powerful shots.
00:12:18
Speaker
And then I went back to get some headshots done. And after my first recurrence, when I'd lost my reconstruction, I was flat. I thought, I want photos like this. But I wasn't really accepting what I looked like. I wasn't really looking in the mirror, but I wanted a photographic record.
00:12:34
Speaker
And then when I thought, I can't be an exercise promoter if I'm not in the gym, and I got really fit and I cut down and I got really muscly, I thought, right, I want to remember what I look like. And I've got photos of me just standing there in my knickers top, look arms up, feeling strong. And actually, I own my body. I accept who I am. And it's been incredible to have those and see how I've changed over the last eight years and really reflect on how amazing cancer it can change your life.
00:13:04
Speaker
Do you ever, this this is something that popped him into my head a few times, but I've never asked anyone. Do you ever look at your pre-surgery self and what kind of results? It's really weird, isn't it? I look at photos of me. And so I talk about photos.
00:13:30
Speaker
I knew I was going to find out I had cancer the day before I did, because I knew my biopsy was positive. So we went to the beach and there's photos of me playing in the sea with our dogs. And the day before I started chemo, I went with my husband. i want I want to remember what I look like before my world changes forever. And we've got cornfields nearest. And I was there and I stripped off in the corn with my hair, the wind. Like, this is this is me. And I look at that and I think, I don't know who she was.
00:13:56
Speaker
And I don't know how to feel like she was, and I'm not home now, but that sense of loss and that regret. And then I look at me during chemo balls, and I think, I don't recognize that woman. I don't know who she is. It's almost like this 10 year, just, she had no idea how amazing she was and what she was doing. And she didn't realize what life was all about.
00:14:20
Speaker
yeah it its that it's It's really hard. I just, I want to give her a hug and say, everything's okay. Cause I know she was struggling with so many issues and there's so much I wish I could have told her, but I'm glad I've discovered it now. But it's like, I look at photos of my wedding and think, God, did I ever look like that? Is that me? What I do have though is c cleavage envy. So as a surgeon, I'd be looking at women on the tube with the bus saying, yeah, she's had a boob job and she's had a boob job. And now I go, she's got really nice breasts. And so I miss wearing local tops and having a cleavage.
00:14:53
Speaker
i ah mean Can you tell the difference between someone that's just had kind of breast surgery, reconstruction and just like aesthetic reconstruction from a distance? and Boob jobs you can do because they don't sit the same. They're often much higher. They don't s flop round to the side. if if' often If they've not been done well and a lot of them haven't, then you can tell.
00:15:21
Speaker
when When you say that, when they haven't been done well, is that the The aesthetic ones. So often, um you often don't see many women who've had bob who've had breast surgery wearing very low tops, but not sometimes you can tell, especially because you haven't got the fat If you've had an implant, you haven't got the fat and the tissue over the breast to give it that subtle look. So often you can see the ripple of the implant. You can't see with a DF when they've used their fat in the tummy, because it's the same. It's not a natural shape. You can tell they are sitting up too high. They don't have that normal slope and takeoff. Yeah. Well, I mean, okay. So let's, um, when you were, do you look at your, Phil, do you look at your old photos? Why do you find it hard to look at your old photos? Or do you?
00:16:07
Speaker
I think it's completely different for men. Tell me. Well, do you know what? There wasn't a lot of photos of me topless because it's just not, er... Yeah.
00:16:19
Speaker
thing and then I found I found one photo of me in a swimming pool in in the south of France actually and and I was like oh um that's the i was like oh that's that's I think I've got it I think that's that's the yeah the only shot I've got um of my nipple and I'm like I don't know whether that looks a little bit different than the other one yeah did you have chemo and lose your hair no So you've not had that change, or as I had longish, thick wavy, blondie brownie hair, and then you suddenly me go to the short grey curls. So there's a really dramatic difference. So to go from, I was identified by my thick, huge, frizzy, wavy hair, and then to go to no hair and then a short chemo curls. It's like, it's a complete transformation that you didn't plan. Yeah.
00:17:07
Speaker
not going to dwell on it too much but I'm kind of grateful I didn't have to go through that but that's again things where people are like oh did you lose your hair I'm like shit no one of the things actually that has helped me keep telling my story was and obviously it relates to you it kind of was someone said imagine how often my my breast surgeon has to give bad news and he was able to give you good news and how happy they were to be able to pass that on. And I guess that must be something that you've experienced in the past. Yeah. I would have i could tell ted women a day on a Friday they had cancer and had come back, their margins are positive, they needed chemo. And some weeks it's all bad news. And to have and a week where cancer's out, you don't need chemo, you're fine. It's like, oh, this is good.
00:18:04
Speaker
Yeah. Why is it a Friday? Mine was a Friday. I don't know. It's the way at the end of the week you get the results in. I don't know. I hated it. Double mass. Just hated it. it was it's a weird It's a weird time. And then you go home and it's the weekend and there's no one to ring. We shouldn't give bad news on a Friday. Yeah. Is it? I mean, but it must be an, who the Friday idea. Cause it definitely is a Friday. my I got all my news on Friday.
00:18:35
Speaker
I think now it's the Wednesday, it just depends on hospital clinics and when they're set up, but yeah, it's not good. um Right. Do you want to, i and are you allowed to have an opinion on the Inher2 situation? amount Actually, does this does the Inher2 emergency affect you? No, it doesn't, but I do.
00:18:56
Speaker
I think we need to get more drug access and better drug access. And I think it's awful. And I know there's a lot of policy and red tape in the house and wise, but this is a drug that could potentially change lives of women and men who are dying at the moment. Now, we don't always check below her to be kind of say you're positive or negative. So I think we need to start saying you are her to one. you This may be an option for you. I think it's awful to hold back a drug that could extend people's lives. Yeah, I mean, the way it was explained to me was
00:19:25
Speaker
it won't It won't, layman's terms, it won't always have a positive effect on every low head patient is what my understanding is and that's why there's a bit of... Yeah, but you could say we give chemo to a hundred people to save five or six lives.
00:19:47
Speaker
you know, the threshold for giving chemo is often a five or 6% benefit at 10 years. And I don't know whether you're the one who's gonna get the benefit or you're the one who's not, but we give it. And I think that has to be the same within HER2, especially with people with metastatic disease. I hope we'll get there. I didn't, i well, again, I've learned something, I didn't realize the chemo success, chemo success rate.
00:20:13
Speaker
So I mean my benefit was 30 or 40 percent. It depends on your cancer but we can't be bad biology and we know that it can come back. Me, I had chemotherapy, surgery, ovary switched off, hormone blockers and it still come back twice. You can't be bad biology. All we can do is use and we've got the oncotype testing to now make it more accurate to say who is it worth giving chemotherapy to where the benefits are worth in the hands. What's that called? What was that called Ian?
00:20:39
Speaker
So the oncotype is one and mammoprint. There are two or three genetic tests that we do. If you are borderline benefit of chemotherapy, then we can do a profile of 21 genes. And there's been studies that have done that put you into a low intermediate to high risk of recurrence. So if you're borderline for chemo, but this has high risk of recurrence, we'll give it to you. If you're borderline, and this says with this extra information, you're a low risk of recurrence. We know we can safely say, not worth giving you chemo. It won't have an impact.
00:21:09
Speaker
right well it will have an impact but it won't affect you'd be having an awful lot of misery and side effects but you you probably wouldn't get the benefit at 10 years yeah what's your opinion on the current breast screening age in okay oh i've just been getting trolls from my latest mammogram video so again because Switzerland abandoned There are two schools of thought in the mammogram world.
Mammogram Screenings Debate
00:21:37
Speaker
There are a whole school of doctors who think they're dangerous, they don't work, they should be given. And then there were doctors like me who think they're a good thing. So that it's it's completely divided.
00:21:47
Speaker
And people don't understand the principles of a screening programme. So it's got to be something that is acceptable to a large portion of the population. It's got to be cheap to do, quick, reliable, accurate. There's got to be a proven disease and if it's cool early can reduce mortality. There are all these things that have to happen.
00:22:06
Speaker
The problem is mammograms work when your breasts aren't dense. They work in women when they're older and men because dense breasts issue is white and a cancer looks white so you can't see them. That's why we start at the age of 50 when your breasts start to get less dense because your hormone levels drop. They are not as accurate in younger women. So there's more odds if you're having a normal mammogram but there may be something very small that's hiding.
00:22:30
Speaker
Ultra sounds aren't a great screening tool. and MRIs aren't a great screening tool. And the minute, in some areas, only a third of women are going for their mammographic screenings because they're hearing shit online saying they're crazy. Big in America starting at 40 was really pushed by an awful lot of women saying, we want, we want, we want, we want, we want. And it's, you can pay to have the providers that's done. My worry is they can be falsely reassuring, especially if you have dense breasts, but we have nothing else.
00:22:57
Speaker
I think in the UK, we should maybe, we did a trial starting at 47 that didn't show a benefit, but whether two thirds of women aren't going at the age of 50, there's no point dropping it to 40 unless we're all gonna turn up. Wow, two thirds. Yeah, in some places, and half of women aren't going for their second screening mammogram. This is not just COVID, this is actually happening at the minute. And screening only works, you only save the lives if 80 or 90% of the population are going.
00:23:26
Speaker
So you could say the minute there's no point screening in the UK because women aren't turning up. um So we're not screening enough women to get the benefits. I mean, there's always going to be a percentage of people that don't do it. Yeah. whatever And it's hard, you know, you work, you have go into your appointment. There's lots of reasons why. But I don't I'm one of the things people pushing mammograms screening is that they save lives. Well, I think for every one live that you save, you'll over-treat three. And that means we're picking up cancers and women in their 60s and 70s who are very small, very low-growing. If they weren't treated, they may grow and spread, but that woman would die of something else, not of metastatic breast cancer. But mammograms mean that you're less likely to need a mastectomy, you're less likely to need chemotherapy, you're less likely to need invasive treatments. And we haven't got the studies to give ah that a quantifiable number, but they mean you need less treatment.
00:24:21
Speaker
Oh, so are you talking about it would be a lumpectomy rather than a... Yeah, so forget it's a DCIS sadly, that's the pre that's a-invasive breast cancer. Most of the time, that's a little bit. Sometimes you can have DCIS in the whole breast and you need to have a mastectomy. But if we're talking about a small cancer, if you catch a small cancer in a small breast, you need a lumpectomy. If you wait until you feel that as a lump four or five years later, that it may be too big, you may need a mastectomy.
00:24:49
Speaker
And if you've left to get bigger, it may have gone to the lymph nodes, you're much more likely to need chemotherapy. Whereas if we catch it when it's tiny, it's a Yeah. Which is obviously the aim, isn't it? Yeah. To do the least possible. Yeah. So what so what is, in your opinion, the the best breast screening tool?
00:25:14
Speaker
to use? I know that's a difficult question. but No, no, no. So at the moment, it's mammograms. And the thing is, when you have a screening mammogram, it is double read. So it's read by one doctor, and then it's read by another separate doctor at another time, completely independent. And we're using AI to see if that can be the second read. So it's double checked by two people independently. And if they both agree, it's normal. It's normal. If one of them says yes, and one of them says no, then you're called back for another look. It is double read, completely independent.
00:25:43
Speaker
You can't do that with an ultrasound because an ultrasound involves one person in real time slowly moving a probe back and forth side to side and then up and down and that probe depends. If it's not completely perpendicular it's like that you get a very different view and they cannot take a live image. To recall that ultrasound you may have 10-20 minutes of footage. No one has the time to go look at 20 minutes of a footage you see was there anything missed.
00:26:07
Speaker
So you don't have that tied in level of accuracy and it takes longer to do. And it's not as accurate. And again, someone with a Jacob breast is a very different ultrasound to someone with a double A.
00:26:19
Speaker
And MRI's are not great to screen the whole population because they are invasive, they involve having contrast, they can take, the fast ones take 10 or 15 minutes to do and involves lying on your tummy, they're noisy, they're claustrophobic. It's not a tool that's acceptable for all the population. We are looking at doing MRI's for women who've got dense breasts to see if that can increase the picket rates. But the moment mammograms are all we have,
00:26:44
Speaker
but um momgrams the way did I did speak to Gareth, professor Professor Gareth, I want to say Jones. He's the guy that kind of like, oh yeah and and he and he was out i was asking him about the mammogram and he said it's like 20 in a million chance of it causing Yeah, so mammograms do cause cancer through the radiation. A mammogram is the same as living in your environment for six to seven weeks. That's the amount of radiation you get from a mammogram. It's living in your environment from the background radiation from the sun and the soil. The risk is about one in 30,000. When you're 40, your risk of getting breast cancer is one in 60.
00:27:30
Speaker
So that actual increase in risk of a mammogram, and that's if you have your mammogram every three years or 20s, it is absolutely tiny. But people pick up on that and say, mammograms cause breast cancer, don't go. The tiny, to you tiny, tiny risk. Yeah, yeah, I mean, I think people need to understand that. Again, there's another one for you for your book, I guess. Yeah. To explain that fully. and no I mean, obviously the funny thing, you know, you can explain it in your words, but then for some people who are just average Joe blogs, they're going to kind of struggle a little bit to kind of understand. Cause there's a lot of figures being thrown around. Yeah. And that's why I use, I've got a load of like a thousand yellow pompoms. Um, because we're visual, I can say risk, but people don't understand relative risk and absolute risk of hazard ratios. And what does that risk mean to you? So I use number trees. Let's take a thousand women. And this is actually how many are affected that people can actually see and understand what that number means to them.
00:28:30
Speaker
Yeah, I think that's a good idea. Well, I think people can fudge the statistics to make something sound scary. So you then go and buy their product. It is very easy to be manipulated. It's what the headlines do. You know, there was a thing saying bacon doubles your risk for getting breast cancer. Actually, you need to eat bacon three times a day for five years. And yes, it may double your risk, but your risk is actually tiny. So it's like an extra half a person in 10 years. Yeah. But that doesn't sell newspapers. Obviously, like a lot of people refer to your information and are inspired by what you're doing. who it Who is it that inspires you online authors? Oh, there are quite a few doctors out there doing great work debunking things. David Robert Grimes, Adrian Chavez, this ah Joe, i I can't remember. There were lots of people out there putting a head above the parapet to
00:29:28
Speaker
debug things to try and make people lives better and I think they are brilliant and it is really really hard work. um There are some of crazy fitness people I follow, there's an amazing girl called Henley Fitness who basically swears at you and says come on now leave your effing arse. You know you can do it just being really inspirational but I don't actually use, I don't actually watch a lot of content myself because it was just, it was soul destroying and all consuming.
00:29:54
Speaker
And I now kind of see Instagram as a job and I'll put stuff out there and I might check my comments every once in a while, but I can't keep up with it. Otherwise I just get, I don't have time for me. Which sounds really bad, but when you're trying to manage communities on Facebook and YouTube and TikTok and Instagram and LinkedIn, and then you're writing and doing podcasts, it's just all too much. Yeah. So you obviously are wonderful.
00:30:19
Speaker
No, i wasn't I wasn't fishing for a carp. But often it's it's knitting and sewing and hedgehogs and garlic. It's not stuff in the cancer space. It's just stuff that brings me joy and makes me happy. yeah um But there is it's great there are so many of us out there now putting the same message out there and making breast cancer less scary and more accessible and just I want anyone diagnosed to know they're not alone and to find their tribe.
00:30:43
Speaker
yeah And I hope now, again, the Black women rising, there's all this South Asian stuff, trying to find people like you where you can share your experiences and know you're not alone. Yeah, absolutely. see So what's what's them what's the biggest myth of all the people that are oh the inspiring people that are correcting the myths? What's the biggest myth that you detest or see the most of or want to change? I think The diet stuff is huge. The whole sugar causes cancer, star sugar, detox, keto, all that, so and supplements.
00:31:18
Speaker
How did the sugar thing start? Because that was something I think I heard. Oh, OK. How long have you got? So there's a guy called Otto Wahlberg, who won a Nobel Prize, who discovered that normally when you get fuel, you break down glucose with oxygen to make fuel. Cancer cells do this without oxygen, even when there's loads of oxygen around. But you need a lot more glucose to get the same amount of energy. So he said, ah, cancer cells burn a lot of sugar.
00:31:45
Speaker
And that is because their mitochondria are broken. Therefore, if we starve the body of sugar, cancer cells will die.
00:31:53
Speaker
um Which sounds quite plausible. yeah But it's not true. Cancer cells can use sugar and fat and proteins for energy. And they use they do it without oxygen because they get fuel much more quickly and it creates an acidic inflammatory environment that's good for them.
00:32:12
Speaker
And you didn't get the Nobel Prize for discovering this, but the the real kicker is, if you want to cut sugar out of your diet, it means eliminating every fruit, vegetable, grain, legume. Because bread is sugar and peas are sugar and pasta is sugar. everything Every carbohydrate gets broken down to sugar. Now, the the sugars in donuts and cakes and sweets, that's processed sugar, that's still not great for us. We shouldn't eat a lot, but that's because you eat a lot, you get fat, and when you're fat, that increases the risk of 13 types of cancer.
00:32:43
Speaker
You can't cut sugar out of the diet unless you go carnivore and that's really really really bad for your health. Yeah. But people are making millions selling diets and courses and doing this and it's
Cancer Diet Myths
00:32:53
Speaker
BS. And I think the problem is, I never talked to cancer patients about what to eat because I assumed everyone knew you just eat a healthy diet. The Well Cancer Research Fund covers all the research and everybody, whether you've had cancer or not, should be eating a plant-based diet with a rainbow of fruit and veg, limit red meat to three times a week, cut down alcohol. You do not need supplements or vitamins. That's it.
00:33:16
Speaker
But there are 20,000 diet books about cancer on Amazon. People are desperate. And it's like, if I take a supplement, it's easy and I'll be cured rather than having to go and eat fresh food and cook it. And it's expensive and a privilege to be able to eat healthily. I get that. But the supplement industry. So you wouldn't recommend any cancer diet book? No. No. Unless you bring one out.
00:33:42
Speaker
But I won't because the World Cancer Research Federation of Diet, there is no cancer. It could just be like two pages. Eat well. The thing is I could say bananas cure cancer and make millions selling them and it's bullshit. People are doing it to make money off ah vulnerable cancer patients. There is no cancer diet. It is just common sense. 80% you eat well and then 20% of the time you have stuff for fun because you've had cancer and food should be fun.
00:34:08
Speaker
But the supplements, a third of supplements don't contain what they're meant to. They are not regulated by law. You could be buying turmeric and it could be talcum powder and you have no way of knowing. And they don't work and you don't need them. All you need is a basic multivitamin if you're not getting a lot of fruit and veg, and that's it. Yeah, that's not good. That's not good at all, is it? They're not regulated by law. Well, yeah, again, the average person wouldn't wouldn't realize that. No, no.
00:34:37
Speaker
i do I mean, I do see a bit more, um I've seen a few things recently where the advertising standards agency are getting into social media a little bit and saying, you can't start selling these things, you have no, I think it would be targeting celebs.
00:34:54
Speaker
were yeah so It is illegal to advertise anything that can cure cancer that is not a medicine given in hospital. It is illegal by the Cancer Act 1939 and yet so many people and supplements what they do is they say you know this can cure cancer this can help the symptoms then at the very bottom we are not allowed to give medical advice please ask your doctor if it's safe but up here they've said take this because it's been shown to cure cancer Wow, yeah that's crazy. i don't i't i'd never I've never heard of that law before that's interesting that it's not used often because I would stop a lot of people from doing it. It's hard to read it when you think of how many websites and companies and videos are produced every day they cannot regulate everything. It's almost up to us to say report them to the government saying this company is saying this can cure cancer and this is illegal.
00:35:44
Speaker
Yeah that's yeah well I mean people can do that I guess. I think so. Where would you like to see the UK's or even the worldwide kind of breast community being in five years time if if if anything positive could change and it'd be a better place for new patients?
Future of Breast Cancer Care
00:36:07
Speaker
10 years is that easier or?
00:36:09
Speaker
No, no, no, no, I'm just thinking, wow, no one's ever asked me that before. Great question. I would like to see an end to the postcode lottery. So every patient has equal access to trials and new drugs, because at the minute, it's if you're in the big cities with a big cancer center, and if you live in rural Suffolk, or the Highlands of Scotland, you're screwed. So equal access to trials, postcode lotteries, everybody should be in a trial to help better. I think that is one thing. I would love When you are newly diagnosed, instead of doctors like me saying, don't go on Google to be given a digital signpost to say, this is a list of approved apps, forums, websites, books, influencers that our patients and team have looked at and recommended because you're going to go on your phone and you've got to go and tell your mum or your dad what happened and you won't have a clue. And I think embracing the good online to digitally signpost people, to safe resources they can go to to help be really, really, really good.
00:37:07
Speaker
I would love to see more research money put into metastatic cancer, but also that research shared because you know my mum died of bone cancer. so It's really rare. they don't get the air They don't get the money. And I think whereas in COVID, everyone came together for the greater good to create a vaccine. Can we just share this to try and help other cancers to get the same impact?
00:37:28
Speaker
I'd love to see it disappear. And I think we need to get into schools and we need to tell kids who won't listen to us that drinking, being overweight and not exercising increased your risk of getting a lot of cancers. And you're not going to like hearing it, but we need to instigate these healthy lifestyle measures. So they carry them on throughout life to try and lower the incidence of breast cancer and every other cancer across the world. Can you make that happen, Phil? I think we can make it happen. And I'm talking generally to everyone. yeah hear you talking and people that I follow and that follow me, I think there's no reason why we can't make a dent in. I think it's the public health getting into schools and saying, A, breast cancer can happen, so you need to check your breast. Let us show you how to do it properly. Don't watch the videos with celebs. This is how you do it. This is why you should do it. This is what to look out for. This is what you say to your GP to go in to get an appointment.
00:38:25
Speaker
And yes, it's boring, but you've got to eat well and exercise. Sorry. It is boring. I'm joking. But it's it's hard to say. It's like, hey, it's like, I'll go and buy Davina's DVD and watch eating a pack of biscuits. I think I'm healthy because I can't be asked to put the work in. You know, it is, it is hard to start that habit, but it is really, really important. Plus most people with breast cancer, more people with breast cancer die of heart disease than people who don't have breast cancer.
00:38:50
Speaker
and exercise in a healthy diet can reduce that happening. You know, a bit of that is because some of the drugs are cardiotoxic, like I said, some of the therapy. More women, I'm gonna say women, because it's women in the studies. The studies have shown that more women with breast cancer die of heart disease than women who don't have breast cancer.
00:39:06
Speaker
So there's something about having breast cancer that can increase your likelihood of getting heart disease. Small risk, if you're listening, don't panic, but exercising, eating a healthy diet. but um Breast cancer drugs, a cardiotoxic chemotherapy can affect the heart, the anticyclines can, a septum treatments can affect the heart. So it's an even more of a reason to eat well and exercise. Yeah. Well, I mean, I mean, if you i mean if you're getting that treatment, there's no dodging those risks, though, is there?
00:39:35
Speaker
No, but exercise and trying to keep the weight down can help and it is monitored. But this is this is just normal people. Plus, the biggest killer of women is generally heart disease and strokes. Yeah. Right, to go back to your the perfect situation in five years' time, what would you the digital signpost. At the moment, where would you say that is? is it is it and I don't think there is one.
00:40:00
Speaker
I think you don't go on a hospital website to get information about breast cancer. Most people don't go to and NHS. They don't know the and NHS website exists. So they can only say things that are approved by the NHS. Most people will either go on Google or Facebook or Instagram.
00:40:16
Speaker
And if you've never had cancer, you're not aware the breast cancer community is there online because you've never been in it. You don't know what's out there. You don't know who to believe. You may go on Amazon and find a breast cancer diet book written by a shark, a quack, and think that's true.
00:40:31
Speaker
And I think what we need is for breast care nurses to maybe be able to collate by asking their patients. You know, you ask everyone at the one you follow up, which resources do you find helpful online? They can go away, have a look, check to see if they're accurate in everything space, and then say to their patients, right. These are the places our patients have recommended to us that they wish they'd known about when they were first diagnosed. They've done the hard work, so you've got a list of places to go to start you on this journey you are inevitably going to go down.
00:41:00
Speaker
and breast cancer now is the obvious of Macmillan but people want stories, you want to hear from other people. But then but then you've got the myth popping up at the same time and even you know like you say even in the community that's that's a thing isn't it?
00:41:17
Speaker
Conspiracies. So maybe we need to tell patients you're going to hear a lot of stuff online and you're not going to know what's true or not. But this is how this but I do have this bit in my book coming out. This is how you interpret. These are the red flags to watch out for. This is where you should be double checking stuff before you spend your money or believe it and educating people how to understand what they read online because we don't get that training at school. Yeah. Just because someone says it in a podcast doesn't mean it's true. No.
00:41:46
Speaker
So here's the question. Even though you were a breast surgeon, when you got that first diagnosis, and you obviously you said you knew by the biopsy, you just knew. Yeah. What was the first thing you did? I went on Google and I Googled metastatic breast cancer. And was that helpful or not? I'm a pessimist. I need to know how bad things are going to be so I can then climb up. That's how I am.
00:42:15
Speaker
I had never been a patient. I bought 10 books written by other patients because I had never had chemotherapy. I didn't know how bad tamoxifen was. Would zolodex injections really hurt? I scared myself shitless, trying to find information. How so? Did that help you in ah in a way? it helped and It helped me. I needed to i needed to try and find that information because it's a doctor I need information to make decisions and I had nothing I had no frame of reference I didn't know where to go I went on a couple of forums but then I people were saying stupid stuff and I want to see it but I'm a surgeon that's not true that oh god can we ask you stuff that no I can't and that's why finding doctors with cancer gave me that safe space to be able to talk about what I was feeling but
00:43:00
Speaker
I needed that online space to help and a lot of what I saw was dangerous, but I knew it was dangerous and I knew not to trust it. But not everyone is the same. Some people just, was my mum wanted to know nothing. I will listen to what the doctors tell me. When they tell me it, I needed to know everything and I did not know where to go. Did you feel you even when you weren't looking for information and then you had people requesting information that you almost went from a patient back to being a surgeon?
00:43:30
Speaker
It was easier to be a doctor. So did I feel like I had the support? and No. no a lot of It's hard treating a doctor as a doctor because people assume you know a lot of things and actually you don't, you're just a scared patient. It was easier for me to be a doctor in the forums because I could go into denial and give them advice, but I wasn't getting the support I needed.
00:43:56
Speaker
And it was only, I told Twitter I had breast cancer. It was the best thing I did because so many people gave me advice, but I found Trish Greenhouse who I wrote the book with.
Doctors with Cancer: Unique Challenges
00:44:04
Speaker
I found another couple of doctors who had cancer and they gave me the support because they understood how scary it is to be on the other side of the table with this knowledge we have of people like us who died.
00:44:16
Speaker
I can't unsee the young women I've looked after who've died. And that's why it's this it's really, really hard. And part of me is still in denial that I've had it three times, because I know what the future might be. A lot of people don't have that information. So it's so I've got a WhatsApp group with about 300 doctors with cancer. We can share what it's like for us to get that. Special is the wrong word, but the support we need. Well, you yeah. that Well, that support you can't get anywhere else, really, is it? No.
00:44:45
Speaker
people Is that, I mean, do do all, because obviously there's more than 300 doctors have had cancer. Is that well known, that group? So though most of us kind of find people, like it's not well known globally spread. It's kind of like a little word of a mouth thing. And I needed a lot in the beginning. Now I just dabble because I've kind of moved on from that part of my life, but it's lovely knowing it's able to help people all over the world just share their experiences of everything to do with cancer work, finances, travel insurance and stuff that normal people have, but
00:45:16
Speaker
we just have this different level of knowledge and it can be really scary and then i feel embarrassed asking my doctor a question because i feel i don't want to come across like i know more than you but i do know more than you now because i've been researching it and now i get what my patients are like where they came to me asking about a trial thinking oh my god i can't insult her it's really weird going on the other side obviously this isn't true but i kind of imagine you being a surgeon and a doctor that you're almost kind of treating yourself but of course you were you were then under another doctor where you were you had your own oncologist and surgeon and um um who I'd worked with they were colleagues they were friends yeah and was there any moments where you were like actually that's not what I want or that's wrong or was there any questionable
00:46:05
Speaker
I wasn't treated in the hospital where I worked as a consultant. I didn't think I had cancer for the first time. and I didn't want them being nosy about my breasts and an MDT. So I went to the hospital where my husband works, where I trained. I didn't think I'd have cancer. And my surgeon was a friend, a mentor. She trained me and she said, I don't know. I talk about this in my book. I don't know whether I can treat you because I know you too well. Where do you want to go?
00:46:29
Speaker
And I could have gone anywhere. I know everybody, but I wanted to stay local. If it was a problem during chemotherapy, I meant my husband could come, but we had to stop being friends. And I saw her in the coffee shop an hour later and she had to blank me because I can't be your friend now, I'm just your surgeon. And I've worked with the oncologist when I was a breast surgeon there. My husband was the medical director at the time. It was a really weird relationship to being in in that. And and you're sat in the clinic and people recognize you because you've been like, hi, how are you?
00:46:57
Speaker
No, no, this is a good I'm here as a patient. It was really, really hard. um Yeah, and giving up control and realizing you're just a vulnerable, frightened patient and learning to let people help you and to stop being in control. That was really hard. So what what would is that your advice to to people almost to Yeah, I think you can't control cancer. You just have to trust that the team looking after you are bloody good at what they're doing.
00:47:36
Speaker
And you can try every crack and gimmick of supplement and diet, and it can still come back because you can't be bad biology. And although I used to focus and obsess over how bad my stats were, will I be alive in 40 years? I've realized in time, it's 50-50. It kills me or it doesn't. And I could spend the rest of my life worrying every day. And we get that when you get a headache or a headache and think, oh my God. And you go into that awful roller coaster of anxiety, but it is out of my control.
00:48:04
Speaker
All I can do is the best I can and enjoy the life I have and accept what life has in store for me. And it took me five years to get to that point, but that helps me now. Yeah. You've mentioned biology on quite a few occasions. To my knowledge, you don't have any genetics. No, I don't. I think it's but so much we don't know about breast cancer. We know that it carries on mutating.
00:48:29
Speaker
So when when you have surgery to remove your breast cancer, there will probably be cells that are still floating around in your bloodstream, your lymph, they haven't found a friend, they're just there, they're dormant. And that's why we give things like chemotherapy and radiotherapy and hormone blockers to mock them up when they wake up and start to grow, these treatments go right down.
00:48:47
Speaker
but these cancer cells can stay asleep for up to 20-30 years and for some reason they just wake up, they start to grow, they form a little tumour, they can carry on mutating and that's why metastatic treatments stop working because cancer cells just keep mutating to get resistance. But some cancers are really aggressive from the beginning and it's We can have a small, estrogen sensitive hormone, positive cancer that's very small, it's low grade, it's snowed negative, and I've seen women dead in a year because there's still stuff we don't understand. Some cancers just have really bad biology. They're just really aggressive. Whatever we throw at them, just they keep coming back and coming back and coming back. And we don't know what makes that happen.
00:49:28
Speaker
We're hoping in the future as more genetic testing comes in, more personalized testing. We can now say, I've got a PIC-3 gene mutation, so if I get metastatic cancer, there's a drug that can target that mutation, will be much better at cherry picking and giving individual treatments for cancers. But at the moment, they're just sneaky little soand- so-and-so's. And you cannot predict what they're gonna do. I had genetic testing, what will be nearly eight years, what will be seven years ago. Yeah. Apparently, Mr. Gareth,
00:49:58
Speaker
told me I would have only been tested for BRCA1 and BRCA2 and he said you need to go back now and because there's now five other tests. Yeah. I think it's so and in sport that test is done. Do you have children Phil? I've got one daughter. That test is worth doing to see if you carry a gene mutation that might affect your daughter in the future.
00:50:23
Speaker
It won't have any difference on your treatment. We know there are drugs that you can have if you're BRCA1 and 2, elaborate, if you're a triple negative breast cancer with BRCA1 and 2. If you're not, there's no other treatment at the moment we would give you for your cancer to stop it coming back. But because you have a family, and I think it's worthwhile you going back to have those extra gene tests done. Because if they are positive, it may change what your daughter does in the future and whether you need to tell her in what stage she may do something. So I think that's probably a good idea.
00:50:53
Speaker
Yeah, so what would you recommend? Because I think the information I was given was if you had the new genetic test came in about five years ago. Yeah, the Pell being the check to stuff. Yeah, I'm not an expert test before what 2019, I guess. Yeah, probably need to go back.
00:51:16
Speaker
I think if if you are high risk enough to get a test in the first place, which may have just been BRCA one or two, you could write to your best cancer surgeon or geneticist if you saw and say, look, I'm aware there's some new genes that have been discovered. Is it worth me being tested again? I've got a family I'd like to know. And they they will tell you whether it's worth you having those extra tests based on your risk.
00:51:37
Speaker
Yeah, i guess well, again, this is something that's taught me a few months to kind of understand, even though it's relatively simple, what you just explained that now I'm like, right, I get it. so um' But it's also scary because it's a bit like HIV test. If an HIV test is normal, then you're fine. But if it's positive, it's life changing. And if you find out I have a gene, so your daughter may be under increased If you find out that you have one of these new genes, you're then like, okay, I need to tell my daughter, but when do I tell her? Because if it was a gene with an increased risk of breast cancer, we wouldn't operate until she was in her early 20s when the breast had finished developing. But when does she need to make that decision? How is it going to impact her life? And I have to live with this ticking time bomb to decide when to tell her. And actually,
00:52:19
Speaker
Do I not need to have that test until she is 18, 19? Because it's not going go to affect what she does now. The implications of a positive test are huge. And that's why the geneticists can sometimes take one or two years to go through the counseling. So you are prepared to act on what a positive result might mean. Yeah, it's not as simple as the blood test.
00:52:40
Speaker
it we Yeah, at the time, even on the even on the day I went in for my results, they were like, you don't have to have these. And I was like, well. Yeah. I think I need to, I think I need to know. i'm But obviously they was they were thinking about the bigger picture of a positive result. I mean, again, thankfully it wasn't, but but then that, weirdly that added to more confusion because I was like, well, what caused it? You know? Bad luck. Lifestyle, bad biology. Bad luck. So I kind of explained cancer like a series of spelling mistakes. If you imagine the word chocolate,
00:53:20
Speaker
And I drank like a fish at medical school. So that turned the C into an S. It was now a chocolate. You can still read it. And I didn't really exercise when I was a junior doctor because of my 14-hour shift. So that may change the the T at the end to a D. So I've now got a chocolate lad. You can still kind of read it. But you then need all those other letters to be changed in the right order at the right time for a cell to finally become a cancer. yeah A lot of it is bad luck and chance. A bracket mutation may have changed seven of those letters.
00:53:50
Speaker
but you still needed a little bit extra to change the other three, because not everyone with BRCA gets cancer. Yeah, well, again, the stats are quite low for... 60 to 80%, depending on the gene. Can I remember? Actually, because I always thought the stats was 10% of breast cancers are caused by genetics. Yes, so 5 to 10% of breast cancers are due to genetics.
00:54:19
Speaker
Yeah, I thought it was yes. Yeah. But if you have the BRCA 1 or 2G, your risk of getting breast cancer is 60 to 80% in your lifetime compared to 12 to 17%. But that still means 20, 30% of people with a BRCA mutation will not get breast cancer. Yeah. But you know, for the wider public, genetics play a small part. However, if you have the The mutation, the risk is massively elevated, especially BRCA2, isn't it? Yeah. It's all cheery stuff. But no, but people are living longer. There are new drugs being invented all the while. The the stats are incredible. I mean, say Crystal Enga, who sadly died, but she she survives at 12 or 15 years with metastatic breast cancer. The average life used to be two or three.
00:55:09
Speaker
yeah It is becoming more of a chronic disease for some people and I dream of the day when breast surgeons like me are out of a job.
Preventive Measures in Breast Cancer Treatment
00:55:18
Speaker
Well, well i get that was something we brought up last time and obviously you probably, well, breast surgeons but won will always have work to do, won't they? I guess. Not really. we're We're super specialists in removing bits of lumps from breasts. We're not very good at anything else.
00:55:35
Speaker
But it's always going to be a thing because, um well, I mean, it unless we cure cancer full stop, would you be amazing? But I think that's yeah not within our lifetime, maybe. But i yeah, I mean, I see I always thought I'd like to see the shift from.
00:55:51
Speaker
you know, aggressive treatment to more preventative treatments, which sounds like common sense. Yeah. Obviously that you can't ah shift. You can't prevent breast cancer because the biggest risk factors of being a woman and getting older. Can't change that. You can reduce the risk with healthy lifestyle measures, which are boring, which young people don't want to listen to. I don't know whether we'll ever find a way to prevent it.
00:56:21
Speaker
but by giving fewer people the aggressive treatment so everyone only gets the treatments they need. What's your what's your view on on everyone having a risk, like a breasts breast risk assessment? Yeah, i so I think that there's there's a brilliant one come from Australia called iPrevent.
00:56:41
Speaker
I prevent. And what that does is, as well as your family history, that takes into account how much you drink and how much you weigh. And I think it's useful for girls to do that in your 20s, 30s. And it will tell you what your risk is compared to a normal person of your age. Again, I think it's aimed at women. I'm not sure whether it's aimed at men, probably not because there just isn't the data. um And if that's the way of helping you think, okay, this will say if you cut down your alcohol and increase more, it will drop your risk.
00:57:08
Speaker
it It might be another thing to help someone say, I'm going to live a bit more healthily now. Yeah. I think we should all know. And if that encourages more people to check their breasts regularly and to go for screening mammograms, there are things you can do to lower the odds of it happening to you. Absolutely. I mean, not i mean that is something that people can't argue with. And like you say, it's pretty common sense, isn't it? did you Just as like in your lifetime as a a surgeon, did you see any any swing in the demographic changing slightly at all? Were there younger women getting it or were there a few younger women developing breast cancer? When I was training as a student and a junior doctor, breast cancer was a disease of old women. 60s, 70s, 80s. And I went away to do my PhD and I came back and suddenly we were seeing 20 and 30 year olds.
00:58:03
Speaker
And the average age of breast cancer kind of dropped from 55 to it now starting at 45. So it is getting younger and we don't know why. Part of it will be an unhealthy lifestyle. Maybe there's more women with genetic diseases coming through, not diseases, mutations. We know it's more prevalent in African-American women.
00:58:23
Speaker
And we also know that women are more likely to have more aggressive disease. And it's not that they if you're 40, you're more likely to live until you're 80 to get a recurrence. They're getting recurrences more quickly. And we don't know why cancers in young women behave so differently to cancers in older women. And again, women, just because that that's all we have the data on. with I mean, again, you might not know this data, but were more what wait Were there less younger women dying from breast cancer that were kind of undiagnosed? I don't think so. I think any if if you were diagnosed with metastatic disease at young cancer you would know, but it's the same. I've been i've operated on women in their 20s with bowel cancer.
00:59:07
Speaker
Deborah Jane is a great example. Cancer is happening at a much younger age now. We are seeing it more and more common in people in their 20s and 30s when it used to be 40s, 50s. But it's not it's not a case of awareness is making people be be able to be diagnosed. No, because there aren't screening programmes when you're young because because it's easy to think Instagram is full of young women dying.
00:59:30
Speaker
But it's not, it's, well, it is, but actually women in their 80s aren't on Instagram talking about their breast cancer. So you can feel it's more common. There are the screening programs because the incidence is still so low. It's not worth screening every 20 year old with a fecal occult blood test because the picket rate is so small. But it is. Have you actually noticed any trends over your lifetime as a surgeon? Just that cancer patients are getting younger and the younger ones are more likely to die than the older ones.
01:00:01
Speaker
Ooh, I mean, that's frightening. But I think part of that is they're more likely to live long enough to have a recurrence, if that makes sense. A lot of young people with with cancer will go on to live a long, healthy life. So I don't want to scare anybody, because this is like really scary. If you are young, it does not mean you're going to die. A lot of people go on to live. Most go on to live a long and healthy life. But proportionally, there are more people getting metastatic disease when they're younger compared to when if you're diagnosed in your 20s and 30s.
01:00:30
Speaker
compared to in your 80s and 90s. Yeah. Well, I suppose you need to balance that as well with the amount of, you must have been catching a lot of younger people and having lumpectomies or. Yeah. nice And actually, yeah. And actually the data that we have is based on trials of the 10 years old.
01:00:49
Speaker
So your risk of recurrence today is a lot lower because we've got all these new drugs, all these new treatments. So the data I'm talking about is with women who were treated 10 years ago. But as I said, there were 20 new drugs in the last five years, you are much more likely to survive for a longer period of time because we've got all these new drugs that can help. It's constantly changing. And it's exhausting to keep up with all the trials and all the data. And I'm not always up to date.
01:01:16
Speaker
Well, actually, you could just briefly tell people have you about the green tick, blue tick, tick. Yeah, the PIF tick. Yes, yes. So, and I keep meant to do this, there's a thing called the Patient Information Forum where trusted medical content creators can put this on their videos. And this means that I have to do my homework.
01:01:35
Speaker
I have to prove that the videos are the latest evidence-based medicine, that they are accessible language. There's no jargon. I check them every two or three years to make sure they're up to date and change them if they're not. There are a few of us out there who have them. I often put them on my YouTube videos. But if you see that, it means I am a trusted health information creator. And you can trust everything that I say is up to date. A lot of work to do. It took about three or four months to do the homework to get that to prove that I had a system in place. But we are slowly getting there.
01:02:05
Speaker
And you put that on your book. Yes. When the myth book comes out, or debunking myths. Yes. We don't want it to be a myth book, where we want it to be truth. So I think the people who need to read it won't because they do believe the conspiracy feelings, but if I can change a few people's minds.
01:02:23
Speaker
You are. I mean, you're doing amazing things. Question that probably everyone wants to know. Well, actually, I'll ask you. What's my favourite colour? I've had my nails done, especially for you. Look, I've got leopard clothes. Just written down yellow. So why aren't you wearing yellow and why yellow? I am. I've got yellow shoes on. Cold. um I never wore it.
01:02:48
Speaker
um But five years ago, I was in a style where I'm a mid-40s, I've had cancer twice, I don't know what to wear, and I just started experimenting with colour. um Because my my hair had gone grey, I had the blue, and I thought, oh, I quite like yellow. And it was it was good to have a thing. And again, when you're trying to brand and create an identity online, I like the colour yellow, my nails are always yellow, there's always something yellow in the background, it's just something you associate with me. And it's bright, and it's cheery.
01:03:14
Speaker
It's just my thing. What's your thing? Do you have a favorite color or something you always have on that makes you feel like you? Well, it's your glasses. I love my glasses. Thanks to the glasses. Yeah. Well, do you know what? we I was a little bit kind of when we when you sent that message to say let's chat, I was ah kind of like a little bit. I don't think I'd watch much of your stuff and I was a little bit wary. I don't want to say scared, but I do come across as scary at times. It's a surgeon in me. Well no, it's it's it's it's confidence and I was quite nervous talking to you for the first time.
01:03:53
Speaker
oh I'm friendly really. The videos are all in acts though. The videos are in that you watch that was fab. Yeah, it was amazing. It was good. I really enjoyed it. But yeah, because the glasses are quite unique. I've never ever seen your glasses on anyone else. So that's a good thing. They are 3d printed titanium mesh and they cost a lot of money. I've got them with the advanced my best cancer book. Right.
01:04:18
Speaker
Everywhere I go, if I'm in Denmark, people speak to me in Danish. If I'm in France, they speak to me in French. It's weird. Because the glasses are amazing or you look French in Danish. I think the glasses are so different. you I just kind of blend and it's weird, but I love them. And they they change colour. They are changing colour a little bit. They go black when you look to the side. And then you've got the mesh. You had a very dark, then light.
01:04:48
Speaker
But yeah, you've got, we've both got our, if you ignore the quiz, the glasses and the quiz, we've both got the same thing. But you see, I've gone to a few events out of my glasses on, people like wear glasses. So I don't know. I don't know whether I like them anymore. I don't know. I need a rebrand. You do. I don't know. Yeah. I love to think, I love to think about that. Um,
01:05:14
Speaker
Thank you for chatting to me, Liz. That was very informative and yes, not scary. Thank you for reminding me that men get breast cancer. It is hard. No, but it it is really, really important because I am conscious that I We say women a lot because they're most people we treat, but actually there are a lot of men who don't realise what the symptoms are. They think it's just joggers, nipple. It's really, really important to continue to raise awareness. So thank you for everything you're doing. Thank you for saying that. Well, you only have to say it 1% of the time and you you're statistically correct.
01:05:51
Speaker
So that's, but I just felt very, I felt the whole way through, you were very women and men, you kept saying. I know because, but actually, but it's true yeah because ah it's bad that we don't have the stats. You were like me with my local recurrence. Predict isn't really there for men because there aren't enough men to get the evidence to say you're in this lonely little club and it's really, really hard. Well, do you know what? I'm not, i know like the club's amazing. The people are amazing. So it's,
01:06:18
Speaker
If any men are watching this, reach out to the community and everyone, everyone people are people. so um And they're a good bunch of people. um I like helping support them and encourage them and doing my bit. It's nice to turn something positive out of what could be a very dark time, isn't it?
01:06:37
Speaker
Yeah, absolutely. Well, look, I'll let you go and walk your dog. Thank you for chatting. When are we going to meet, though? When are we going to meet? We need to do... But you live so bloody far away from me. You live bloody far away from me. but Well, if you're in Boston next week, I can meet you there. No, I've been advised to Florida to a Braca thing. um But you don't have Braca. Why are you flying over there if you don't have Braca? They wanted to pay for it. They want to give me an award.
01:07:06
Speaker
Seriously, what for? For my efforts in the community. That's amazing. Yeah, I need to, that was Bracka Strong. Bracka Strong. Wow. Oh, it's incredible. See, I didn't get flown to Florida. Well, it hasn't happened yet, so let's... but Manifest. I'm going to the Nip charity. They've invited me as a VIP to their gala dinner.
01:07:34
Speaker
Nice. You definitely need a Brie brand for that. Yeah, well they want me to get a nipple tattoo and I'm still not convinced, I don't know. Don't do it for them, do have a tattoo because you want it not for them. Get a temporary one from Claire's Access Rise.
01:07:51
Speaker
I don't know how I feel about that. But temporary stick-on ones, literally, temporary tattoo for the event that will wash off in the shower in a couple of weeks. They they actually do a temporary one for you. I don't know if it's like henna or something, but apparently they're better than the NHS ones. No, but like you can have like a rose or a Dalek. Ah, a Dalek. Whatever, but you know, you you can get Amazon, you can do fake transfer tattoos that you just kind of soak on for for a laugh, for a fancy dress party. Got some care bays. Yeah.
01:08:23
Speaker
and all right well um We have changed subjects. thank ah point ah now i'm sure At some point we will meet i this year. i'm i'm certain of it and I hope we do. um Thanks Liz and I hope you have a nice dog walk. Thanks Phil, thanks for chatting.
01:08:44
Speaker
Conversations with Phil. Inspiring survivor interviews of hope, resilience and triumph over adversity.