Surviving Breast Cancer

LaToya Wilson sits in the Hollings garden
Breast cancer survivor LaToya Wilson shares her cancer journey to be an inspiration for others and encourage participation in clinical trials.
"I did my own research too, and I discovered that all medications were initially a trial drug before it came to be. So I was like, well, if I can do that, I'm not only helping myself, but if I can be a part of the big picture, you know, even if it doesn't work in my favor, then I can be helping someone else."
— LaToya Wilson, breast cancer survivor & clinical trial participant

 

MUSC Hollings Cancer Center Cancer Chat graphic

Episode Details

October 2021

Run Time: 23:35

Topics: breast cancer, breast cancer prevention, mammograms, clinical trials, cancer survivorship

MUSC Hollings Cancer Center director Dr. Raymond N. DuBois, Hollings surgical oncologist and breast cancer researcher Dr. Andrea Abbott and special guest LaToya Wilson, a breast cancer survivor, chat about the latest advancements for preventing, treating and surviving breast cancer.

Dr. Raymond N. DuBois: This month, we're focusing on breast cancer. We're going to try to highlight important advancements in treatment and prevention. We have two special guests today. First I want to welcome Dr. Andrea Abbot, a breast cancer specialist and surgeon here at the Hollings and USC. And later in the show, we're excited to have a breast cancer survivor, LaToya Wilson, join us. Uh, first of all, Dr. Abbott, thank you for joining us today.

Dr. Andrea Abbott: Yeah, you're welcome. Happy to be here.

Dr. DuBois: Great. Well, breast cancer is one of the most commonly diagnosed cancers in women. And, uh, that's your specialty? Uh, it's the second most common cause of cancer death among women next to the lung cancer. It's one reason we want to focus on advances in treatment and screening. So what are your thoughts about screening and prevention and why is that so important?

Dr. Abbott: Yeah, I think you've hit the nail on the head screening is great. It leads almost in a sense to early detection and for some people prevention, if they know that they're at high risk, the current recommendations are to start screening for most women at the age of 40 with a mammogram. Um, at Hollings, we have the ability to offer screening mammograms and, um, a lot of our locations in West Ashley, North Charleston, Mount Pleasant and downtown. So trying to get the screening out to where the patients are and soon we'll also be mobilizing our van that will bring mammography out into the community. So, um, we're excited for hopefully the launch of that in October. So starting at age 40 for most women, if there's a strong family history, then that mammogram screening may need to start sooner. When you ask why that's important, the smaller the cancer, the earlier the detection, that means maybe you can avoid some of the treatments like chemotherapy, um, maybe surgery and radiation are the only things that you need. So you have more options if you catch it early.

Dr. DuBois: Great. Yeah, I'm a big proponent of that. Uh, what about advancements in treatment and what's going on in that front?

Dr. Abbott: Yeah, so I think one of the things that we're constantly trying to do here at Hollings is, um, study breast cancer better, understand it, and really tailor treatments for patients. So instead of, you know, throwing the kitchen sink at something which may not be appropriate for every patient, we're trying to really hone down and figure out, are there particular markers or does your cancer have a signature that will allow us to tailor that treatment to you? Maybe you wouldn't respond well to a certain type of chemotherapy, so we can change that and give you only the drugs that you need for your case. Um, to that end, we offer a lot of clinical trials here. Uh, we are trying to, um, see what types of surgeries would be appropriate for patients. So maybe a patient would be a candidate for nipple sparing mastectomy, which would allow them to preserve the nipple, um, and kind of the cosmetic look, um, of their breasts. And we work very closely with our plastic surgeons to do that. One of the new exciting things that we're offering is, um, nerve preservation. So we're trained to do nerve grafting to the nipple to preserve sensation. Um, that's something new that we're really starting here and we're excited to hopefully offer that to patients in the future.

Dr. DuBois: That's wonderful. Um, what are your thoughts about improving, and you've touched on this, quality of life and the whole sort of breast reconstruction issue, that issue that comes up.

Dr. Abbott: Yeah I think, you know, this is a really difficult topic you're coming in with a diagnosis of cancer. And I think sometimes the first thing that you think about is I just want to live like that's, you know, take care of my cancer. I want to live, but I want you to start to also be able to think two years and five years and 10 years down the road, you know, we're going to do the best that we can to treat the cancer. But I also want you to be happy with your body image. I want you to feel free to go to the beach and wear tank tops and feel confident with yourself as a woman. And to that end, it's really trying to figure out what your priorities are. Um, you know, for some patients they want the simplest surgery so they can get back to work and maybe that's a lumpectomy for them.

Dr. Abbott: Maybe that's a same day surgery for other patients. You know, it may be the strong family history and the fear that, you know, I don't ever want to be back here again. And I want to do a really comprehensive approach to my surgery when I have bilateral mastectomy so that I have symmetry and, and that's important to me and I understand that's a longer recovery and maybe that's, you know, six or eight weeks and maybe that's multiple surgeries, but that's my priority. So it's really having that conversation being in a place where you have multiple specialists who can give you all that advice and then listen to you and put that all together to put the plan together. That's perfect for you.

Dr. DuBois: Yeah, that makes a lot of sense. You know, one thing that, uh, that's happening now is women are surviving longer with breast cancer. When I first started in my research career, it was not as long as it is now, it was much shorter and this, this has been a huge success for the whole field and a lot of kudos to people that support the research and all, all these efforts. But with that longer survival, you know, women, I think do need more support. And you've recently started this online support group, and I know you're working on a podcast and other things. Can you tell us more about that? And some of the topics you're going to try to hit on those?

Dr. Abbott: Absolutely. So there are over 3 million breast cancer survivors in the United States. And so absolutely we've poured so much effort into prevention and screening and detecting those cancers early. And now we also have to think about how do we support women, you know, after the treatment is over, you know, I think it's a very scary time to transition from you're seeing doctors all the time. You're well supported and now we say, okay, it's been, you know, five years. Good, good luck. Um, you know, follow up with your primary care physician. And I think for some women that can really feel like they're being abandoned and we don't want that feeling. I think, you know, getting in a community. So these support groups that we're starting are for women at any stage. So whether it's early diagnosis in the middle of treatment or long after, um, as a survivor, you can connect back with a community of breast cancer patients.

Dr. Abbott: And these are online. As you said, you can participate either through a video or audio only as much, or as little participation as you're comfortable with. And they're going to be led by a clinical psychologist. So her job is to facilitate the discussion and we'd like to focus on, you know, coping with the diagnosis, um, body image, the anxiety and fear. How do you deal with the thought that this could come back? How do you talk to your family and friends? You know, sometimes that's the hardest thing is telling other people that you have cancer and then you're managing their emotions as well as, as your own. Um, those are going be, uh, the third Wednesday of every month, they're going to run from 3:30 to 5:00 PM. There are QR codes that are posted at all of our locations. So patients can join easily and then we'll have that information up on our website. So even if you live in Greenville or Spartanburg, you know, that the location is doesn't matter anymore. You know, thankfully we're all able to join via the internet.

Dr. DuBois: That's great. I think that's going to be so important. One thing you mentioned, and, uh, I just want to follow up briefly is the male breast cancer, because, you know, it's fairly rare, but I did have a friend who, who was diagnosed with it and, you know, it was pretty difficult for him to deal with he, you know, to get to somebody who knows how to treat men like women and, you know, the clinical trials don't seem to be as robust in that area. Do you have any thoughts on that, Andrea?

Dr. Abbott: Yeah, so male breast cancer is just as severe as female breast cancer and sometimes, um, even more so because there is perhaps a stigma for men to present, to, you know, a physician and say, there's, there's a lump in my breast tissue. Um, typically we see that happening in later decades of life. So 60 to 70 year old, typically behind the nipple, there's a, you know, an accumulation of tissue. Some men want to play that off as like, oh, well I'm getting soft. Or, you know, I losing muscle tone, but, uh, you know, any additional tissue, especially if it's one side as opposed to both sides, that's something that should be checked out. And there are a lot of options for treatment. Again, the earlier you seek care, the more options we have to offer. Um, and, and the treatment isn't necessarily, um, different se between men and women. So it's just getting in and getting it checked out.

Dr. DuBois: Yeah, he's become a very vocal proponent and is now doing list serves with, you know, where clinical trials are for men and women and it's, he's, you know, it's really changed sort of his approach to life and everything. Uh, of course we always want to detect the cancer as early as possible. Are there certain populations or groups of individuals that are at much higher risk?

Dr. Abbott: So I would say that if you, um, have the opportunity, you know, the holidays are coming up, hopefully people are able to connect with their families, start having those conversations, you know, getting an understanding of what is the cancer history in your family. And once you know that you can start to see if there are patterns. You know, if there's a lot of people in your family who have colon cancer, maybe you should start thinking about, should I be screened for colon cancer early, the same for breast cancer? So if you know, mom or grandma had breast cancer or, um, ovarian cancer, that's another strong link breast and ovarian cancer are strongly linked together. Um, we are very fortunate to have a very strong genetics team here at Hollings. Um, so you can come in and just talk to them. There's no obligation, just go through your family history, tell them what your concerns are.

Dr. Abbott: And they can walk through that with you and see, you know, are you at a potentially high risk? And then you can decide if doing the genetic testing is right for you. Um, there is a lot, um, on the internet and on the news about the home genetic tests. And I would just strongly urge people that if you were to do that, and you got a positive result to go see a, a true genetic counselor, like come in and have the full evaluation, sometimes the genes that are tested in those home kits, aren't the true genes that we look for.

Dr. DuBois: Yeah. And they could cause a lot of alarm endlessly. Now, one thing we hear is the dense breast. And if that is that, uh, increased risk. And what do you tell your patients about that?

Dr. Abbott: Yeah, the concern for dense breast tissue is that maybe the mammogram can't pick up, um, small, early cancers. And so there is a law now that at the bottom of your mammogram report should tell you if you have dense breast tissue, if you see that, then ask your physician. If it wasn't offered to you, there should be supplemental screening. And that can either be with an ultrasound or an MRI, and that will help detect, you know, through that.

Dr. DuBois: Yeah. So there's lots of, uh, women wanting to participate in clinical trials. There's lots of different clinical trials going on all the time. Is there anything that you tell your patients to try to guide them on that topic and where to go and which ones to consider?

Dr. Abbott: Once patients are here, um, at Hollings it's easier, right? Because we're reviewing their case in a multidisciplinary tumor board. So that means all of the clinicians sit together as do our clinical trials team. So they have the whole portfolio in front of them. They're screening through the list. Seeing if a woman is a potential candidate. So clinical trials can either be something that's in addition to the standard of care, something we offer extra to help, or it could be if you know, you've gone through the standard of care and now you're looking for additional options. Maybe that's when the clinical trial comes in. Sometimes the clinical trials there to help you as an individual. And there can be a direct impact for you. And sometimes we don't know that answer yet. And what you're doing is you're helping future generations, which could include your own family members. Um, there is, uh, you know, there's definitely research. You can do online. We try to list our, um, active clinical trials online. So if you're a patient who's not, um, here at Hollings, you're somewhere else in the state, you could go online and see if there's an open trial for you.

Dr. DuBois: Yeah. That's great advice. Uh, Andrea, is there anything else you'd like to share with the audience?

Dr. Abbott: I think the most important thing that I could encourage people to do is talk to your family, um, understand your family history. I know those are difficult conversations. Um, and maybe you just start that conversation and you have to come back to it a couple of times, but, but understanding your family history, doing a self-breast exam, um, that is really important, understanding your own breast tissue so that if there is a change, whether you're a man or a woman, knowing that so that you can bring that to the attention of your doctor. Um, and I would also say if something doesn't seem right, don't stop until you get an answer.

Dr. DuBois: Great advice. Thank you so much. Uh, this is great information that we're going to share with others. I really appreciate your time today and actually all you do at Hollings to take care of these patients. It's really important. Next step, we have a special guest LaToya Wilson who wants to help share her message about the importance of screenings and participation in clinical trials. Thank you so much, LaToya. We really appreciate you joining us to share your experience. Uh, when were you diagnosed and how has your cancer journey been? I know it's been a long one.

LaToya Wilson: Yes, it's been a long one. And good morning. Thank you for having me. So I was originally diagnosed in August of 2012, and I had a reoccurrence in February of 2015 and it's been a journey. Um, the whole thing, um, from the beginning, um, with, uh, I actually found a walnut size lump in my breasts. Um, my son Daniel was about 11 months old and I went to my primary care physician and I was told I was young. It was probably a cloud deck. So, you know, don't really worry about it. If it gets bigger, if it becomes bothersome to come back. And so it never did bother me, but it did get bigger. Um, and so I came to MUSC again and I saw, I believe her name is Alison Neeson at Canon. And she was very, very, um, proactive. Um, and she recommended that I come to, you know, Hollings to have the mammogram done. Right. Um, that turned into biopsy, the biopsy, the whole shebang that day. I did the, um, the mammogram, the biopsy, and it's kind of like a waiting period after that for about a couple of days. And then I got the news, so kind of gathered myself, braced myself for what was to come. I knew I wanted to live. Um, so, you know, we did all the necessary tests and then we got dived into chemo.

Dr. DuBois: And that started pretty quickly.

LaToya Wilson: That started pretty quickly because like I said, the, um, the tumor was already about walnut size. So it had to have been there for a while. Yeah.

Dr. DuBois: Well, from what I understand, you've been very supportive of clinical trials and trying to help others understand what those are all about. Uh, can you tell me a little bit about your approach there and what you've been doing?

LaToya Wilson: So initially I was a little hesitant myself, um, initially, but, um, Dr. Brescia explained it to me, what was available, um, not only he, but also the clinical trial team. Um, they sat with me and explained, you know, what it entailed. What I liked about it also is that you're monitored very, very closely. So it's a lot of important, um, you know, appointments, but you don't slip through the cracks.

Dr. DuBois: We don't want that to happen.

LaToya Wilson: Right. And then, um, another one of my concerns were I was like, well, am I only going to be on the clinical trial? But I was, it was explained that I would be on the trial plus a standard drug. So I think the goal was to see if the two in conjunction would work. Right. Um, and so my family was not happy about it. They were like, why are you doing this? You know, you're being a Guinea pig. Um, and so, you know, I did my own research too, and I discovered that all medications were initially a trial drug before it came to be. So, um, and I was like, well, if I can do that, I'm not only helping myself, but if I can be a part of the big picture, you know, even if it doesn't work in my favor, then I can be helping someone else. So we did the trial, I think it was called tucatinib. Um, and I think if I'm not mistaken, is that like FDA approved now?

Dr. DuBois: I think it is. You probably helped with that.

LaToya Wilson: Yeah. So I, I did that. Um, I did that for awhile and it, it worked for me and then we moved on, um, for something else. But I think that clinical trials are really important if you have that option, you know, to be a part of one, I say go for it.

Dr. DuBois: I'm excited to hear you say that. Well, uh, so you know, the incidence of breast cancer in Black women is slightly lower than white women, but one of the issues that we're dealing with is that the outcomes are usually worse, right? And there are lots of reasons for that. Uh, and it's one of the areas that Hollings is focused on with our community outreach, try to get out there and detect those things earlier so we can improve the outcomes. And we really appreciate you, you know, helping all you can to educate the whole community, but especially that segment, you know, that have those worse outcomes. How do you stay so positive and how do you communicate your messages to, to be effective?

LaToya Wilson: Well, number one, my faith, not to be all religious, but, um, that's my driving force. Um, children, of course, I want to be around for a very long time and I want to be around, um, to, and, um, that's my driving force and just being an advocate and letting women know that just because you get the C diagnosis, it's not the end. Um, you know, and, um, just letting our women know, well, not only our women, but all everyone like to be inclusive, to you know, be, be proactive, know your body, get your mammograms. Um, you know, um, one of the things, uh, also is I do encourage a lot of people, but they don't realize that they encourage me as well. So, um, I do a lot on Facebook every now and then, you know, I'll put it and I'll share everything, but I share what I feel is necessary. And I'm very transparent, you know, I tell them the good, the bad and the ugly, but I always end on a positive note. You know, there's always a silver lining, right? It's not the hope there is hope, you know, there is hope and, you know, and so, um, I, that's basically kind of like my platform is social media.

Dr. DuBois: You know, we were talking a little bit earlier about some of the interactions you've had with your family. You have four sons, and I know you try to keep everybody up to date on what's going on. So how do you deal with that? And are there any special moments you've had, uh, with your, your boys that you think have really helped them understand what's going on?

LaToya Wilson: I think the second when I had the recurrence, that was very, very scary for, for them, for me, but especially for them. And, um, my little one Daniel, which all of them are special, but that's my heartbeat and that's my heartstring, but he, he asked me if I was going to die. So it was tough. And so, and I had to gather myself and like I was explaining to you all earlier, I broke it down to him, you know, how the genetics and everything works in a way that he can understand. And I think that because I've explained it to him, then it's less.

Dr. DuBois: Yeah. Less of a danger because there are options.

LaToya Wilson: There are. So I'm very, I don't tell them everything.

Dr. DuBois: Yeah, they’re younger and they don't know how to process it.

LaToya Wilson: Um, I'm very, very, um, transparent. And if there's, um, a new treatment that I have to start, or if I have scans coming up, you know, I let them know, Hey, by the way I got, you know, I have to do such and such. Yeah. So, you know, just a little, not too much just what's necessary.

Dr. DuBois: And not, you don't want them to feel like you're hiding something.

LaToya Wilson: Exactly. Right. Because it not only affects the, um, the patient, but if affects the entire family and, you know, everyone that you're connected to.

Dr. DuBois: Right. Well, if there's one message you could give our listeners about this, what do you think it would be?

LaToya Wilson: Um, it would be definitely early detection saves lives. The earlier you catch it, you may have more options. Be proactive. Um, like she said earlier, do your breast exams, um, clinical trials, if it's available, do your research. You know, um, I actually have a friend on Facebook, um, Mr. Green, he lives in Atlanta. And, um, he was given I think, six months and he, he had leukemia. And so he was a part of a clinical trial. 22 years later. He's still here.

Dr. DuBois: Yeah. It can save your life.

LaToya Wilson: So, you know, um, early detection be proactive, um, clinical trials and we're stronger together. That is my motto. So the online support group, I think it's awesome. I think it's fantastic to have that outlet because sometimes we can't always go to our family. Yeah. But if you have a community of people that are, have gone through or are going through the same thing, then you lock arms together and you know, and you just support. So basically just keep pushing, keep fighting and don't give up. It’s not the end.

Dr. DuBois: I love that attitude.

 

Episode Guests

Raymond DuBois, M.D., Ph.D. 

Raymond N. DuBois, M.D., Ph.D.

Director, Hollings Cancer Center

Dr. Andrea Abbott 

Andrea Abbott, M.D.

Hollings surgical oncologist

LaToya Wilson 

LaToya Wilson

Breast cancer survivor
Hollings patient