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I’m Dr. Rob Winn and you're listening
to Real Cancer Talk

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from VCU Massey
Comprehensive Cancer Center.

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I am Community Clo.

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Welcome to Community Conversations.

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And you know what I love about this show?

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It is a show of no copays
and definitely no

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white coats when my special guests
are medical doctors on the show.

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Doctor
Kandace McGuire is chief of breast surgery

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at VCU Massey Comprehensive Cancer Center.

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How are you doing, Dr. Kandace?

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I am doing great. I'm glad to be here.

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How are you doing?

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I'm good.

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And, you know, we always in a win
win situation when we have the director

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of the VCU Massey
Comprehensive Cancer Center.

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Doctor Robert Winn.

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How you doin Sis?

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You know what? I'm winning
even more when I'm with you.

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And thats the way that goes.

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That's how it goes.

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Now we're going to be talking
about the springtime.

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And we want our women
to spring into health.

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So we're going to be talking about cancer
disparities in women.

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And I know
folks are saying this is a serious topic.

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Why do you seem like you have energy?

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Because at the VCU Massey
Comprehensive Cancer Center,

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we're looking into cures
and not just getting you through.

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Right. Doctor
Winn and Doctor Kandace McGuire.

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Absolutely.

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Yes, ma'am.

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No, that was hot. Spring into action.

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We’re springing in.

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So before we get started, for folks
that are just joining us,

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the American Cancer Society, the 2024
highest cancer incidence in women.

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Now, I was shocked by
this skin is number one, breast, lung,

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colorectal and uterine doctor
Kandace McGuire.

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Delve into this for us.

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Skin is number one in cancers
when it comes to women?

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Absolutely.

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And men as well.

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I mean people don't think about, 
protecting their skin

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as much as they should.

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I think women think
just because they have girl

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parts,
that's the only place they can get cancer.

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But the skin is the largest organ
in our bodies, and it is, exposed to,

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that beautiful sunshine
that we see every day.

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But unfortunately, that beautiful sunshine
can harm your skin.

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Whether you're, white, black, Asian,
everybody's at risk

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for for for skin cancer.

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And Doctor Winn can attest to this.

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When we were growing up,
you know, as a as a brown girl

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and our black and brown people,

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we just put on a little lotion
and a Vaseline and that was it.

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We rarely thought
about putting on sunscreen.

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So you're saying the darker the skin
can be diagnosed with skin cancer as well.

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No, no, no, Kandace,
you are on to something,

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some saying that it's less likely
but still possible.

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And sometimes when it presents,
it presents in some different way,

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so that that myth that black folks
can't get, you know, skin cancer is crazy.

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You just need to talk to the black folks
that have had skin cancer

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to let you know that that also
just like putting Vicks VapoRub,

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on some,

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you know, cancer is going to make it
go away.

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That that that ain't true.

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Vicks VapoRub don't cure everything.

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And the truth of the matter
is, black folks. What?

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You know what that do. And don't be.

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Don't be cracking on our grandmothers
and their home remedies.

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Now, you know, Vicks VapoRub
back in the day.

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Stop playing it, stop playing it.

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Open up your mucous cavity
and all of that good stuff.

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Okay. We were snotting all over the place.

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Stop it, Dr.

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Winn But seriously,
I understand what you're saying.

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But, Doctor Kandace,
this is so interesting to have this show,

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because skin cancer.

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Who would have ever thought about it
when it comes to black and brown people

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as well?

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For a for a number of years, we should say
that was a white person's disease.

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But that's not the case
when it comes to skin cancer.

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Now, what should we look for on our skin?

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Whether you're white, black or brown,

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what should we look for
when it comes to skin cancer?

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So we should be looking at any moles
we have.

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And we should be looking for moles
that are changing in some way.

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Are they brand
new that you've never seen them before?

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Have they been there for a while.
But they're getting bigger.

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They're discolored,

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meaning you got one color on one side
and one color on the other.

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They got an irregular shape.

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It's bigger than a pencil eraser.

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And most importantly for our black
and brown

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colleagues, is to start looking
in the places where the sun don't shine.

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Those are very dangerous melanomas
and hard to find.

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So in between your fingers on the bonds
of your feet, those sorts of places.

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Other places, that we're not going
to talk about first thing in the morning.

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Those are the places
you want to start looking,

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because those are going to be the ones
they're going to be easily missed.

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And also so start thinking about
as you get older, getting a dermatologist

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or your primary care doctor to give you
a full, you know, once over, once a year.

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Okay.

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And moles on your feet next.

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Number one, that was skin cancer for folks
who were just joining us.

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We're talking about the American

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Cancer Society 2024
highest cancer incidence in women.

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Number two is breast cancer.

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I was shocked that breast cancer
wasn’t number one.

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That's the importance of having this show.

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What are we looking for.

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And are we still getting folks mammograms
at the age of 40 and up.

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Or are they recommended now for women
under the age of 40, Doctor Kandace?

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so yeah, I mean, breast cancer
sort of sort of my sort of my jam.

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And so, you know, I fully recognize

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it is not the most common cancer in women,
but certainly it is

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one of the most common, 
treatable breast cancers in women.

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And so the things that we want to do is
we want to look for any,

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any changes in our breast.

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We talk about less about breast exam
and more about breast awareness.

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No one what your breasts look like
and feel like, knowing what the skin

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looks like, know and you know, knowing
if there's lumps or bumps

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that have been there forever, knowing
if they're brand new,

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but also going in once a year
for that mammogram.

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40 start at age 40 regardless.

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Now the women who should go
earlier are women who have a family

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history of breast cancer
where it started early in their families.

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The women have, family members, 
breast cancer in their 40s

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or even in their 30s to start ten years
before their family member got it.

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And if you've got one of the gene
mutations that causes breast cancer,

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not only can you do mammograms,
but you could do MRI start as early as 25.

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So the really important thing is not
when to get that mammogram,

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but when to talk to your doctor
about your risk.

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Age 25.
Talk to your doctor about your risk.

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Figure out what you should start,
not when everybody else should start.

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This is good stuff.

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Doctor
Kandace, Chief of Breast Surgery at VCU.

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Massey

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Cancer, Comprehensive Cancer Center.

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Now, I had my mammogram recently,
and I got the letter VCU.

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Of course I got the letter.

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And they were like, well,
everything looks normal on your mammogram,

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but you have dense breasts,

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and you might want to talk
to your primary care physician.

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So what I did was schedule an ultrasound
that's coming up in a few weeks.

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Do you recommend that?

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Yes. Okay. With a dense breast.

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Yes. So,

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so there are a couple different ways
that you can, look through dense breasts.

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So one of them is a 3D mammogram
which most of us are getting these days.

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But you you know, but if you're not sure
what you're getting, you ask,

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the 3D mammogram can get
a lot of that density out of the way.

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If the radiologist really
feels like they're not,

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and especially
our radiologists here at VCU,

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if they don't think
they're getting the complete picture,

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they're going to tell you
and they're going to bring you back

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for something like an ultrasound
or maybe even an MRI.

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Those are the two ways to really,
look through dense breast tissue.

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They're not mammograms.

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The grand majority of women
with dense breast tissue,

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a 3D mammogram is going to be fine.

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But if they're not seeing
the whole picture,

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a good radiologist will tell you
and get you on back.

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Yeah. Well, thank you for that.

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Next up is lung
cancer incidences in women.

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Yeah.

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So lung cancer is up there with incidence.

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It's you know, it's
also one of those things but it is a

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that is probably more deadly
than some of the other ones

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because we don't have, as good screening,
as we've got for things

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like skin cancer and breast cancer.

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Women don't think about this one, too.

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They think it's a man's disease.
And it is not.

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And is not always a smoker's disease.

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Yeah, yeah.

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Can I help?

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You know, so, you know, you,
you know, we got talking lung.

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That's a sweet spot. So yes, it is.

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But the reality is,
I think that, you know, that

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McGuire brings up a really good point.

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We're talking about the incidence.

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That's this big, fancy term,
you know, frequency of you getting it.

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But when you think about 
what kills the cancers that kill,

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it remains that across the United States,
that lung cancer kill is the leading

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cause of cancer death in the United States
for both men and women.

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Yeah, I absolutely agree.

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I think it's something
that we don't talk about,

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and it's something we don't offer

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the people who are sometimes at highest
risk, like our young women,

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young women tend to be getting lung
cancer at a higher,

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higher rate than,
than a lot of other people out there.

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And these are women who don't necessarily
have a history of smoking.

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Community Conversations.

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I am Community
Clo, and I brought a few friends along

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medical doctors
so you can get the firsthand information.

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Doctor Kandace McGuire is Chief
of Breast Surgery at the VCU Massey

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Comprehensive Cancer Center, and Doctor
Robert Winn is the director.

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And we're talking about springtime
spring into great health,

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cancer displarities in women.

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Yes, us women.

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We talked about the incidences of cancer
before skin, breast,

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lung, colorectal, uterine.

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But now, Dr.

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Winn, you want to talk a little bit
about endometrial cancer

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colorectal and uterine, let's start there.

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These are things that still first of all,

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I wanted to make sure that we talked
that there are four preventable cancers.

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And we've named some of them 
colorectal, lung,

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breast, for women,

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are the three what we consider
to be preventable cancers.

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So and cervical.

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And so from my perspective,
there is no good reason

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why we can't get the number of people
dying from cancers down.

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If we were better about making awareness
for screening it.

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I don't know
if Dr. McGuire would would agree.

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But when we think about breast, colorectal
and I think about,

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you know, cervical and lung.

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We have existing processes
to be able to say catch it early.

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Right.

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And I think that framing it
that way would be really important.

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And I think this back half of talk
about colorectal and uterine cancers,

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cervical cancers, endometrial
in African-American women definitely

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I think is is an issue that definitely
you know that doctor McGuire could speak

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to as well. Yes. Please do Dr. McGuire.

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We want all of the information
to save our lives.

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Right? Right.

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And I think, you know, as I said,
I said earlier that, you know,

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just because we have girl parts, that's
the only place I think we get cancers.

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But but we do get
we get cancers that our girl parts a lot.

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And so, beyond the breast,
we need to think about cervix, ovary

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and endometrial cancer,
and cervical cancer.

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Luckily with with good screening,
screening like pap smears and the HPV

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vaccine, we're seeing the incidence,
you know, sort of, at least leveling off,

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if not declining.
Ovarian cancer is a rare.

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One that's a tough one to address.

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But endometrial cancer
is a little bit concerning.

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And that's the lining of your uterus.

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And, you know, it's
there is an increased, a rise in this

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in young African American women
and young women in general.

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And so,
you know, if you've got abdominal fullness

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or irregular periods
or someone's ever told you

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you have fibroids, tell them to prove it.

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Because you want to know for sure.

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You know, one of the, one of the things
I think that's just a nasty little secret

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about being a little bit overweight
or obese is that it does increase

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your risk of things like uterine cancer,
and breast cancer.

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And so while we all think about our heart
and our lungs, our joints,

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we got to start thinking about our cancer
risk, too.

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So I think those are

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the biggest things to get out
is to get in, see your gynecologist.

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If you're having issues,
pipe up about it sooner rather than later.

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And don't let yourself be blown off
if you're being blown off by your doc.

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And you know, doc and you know,
and the third thing is, is to

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is to watch that weight, especially
when you're young and you can watch it.

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You said a mouthpiece right there.

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If you're young

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and you can watch it and hold on to it
because it just started jumping on me.

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Don’t blame me, I didn’t say it.

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Were thinking about
how those pounds jump on you,

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Doctor Kandace,
and you had nothing to do with it.

00;12;25;05 - 00;12;27;08
Oh my God. Yeah.

00;12;27;08 - 00;12;29;14
But anyway, it's it's serious.

00;12;29;14 - 00;12;31;04
We're having this conversation.

00;12;31;04 - 00;12;35;28
That's why it is a show of no copays
and no white coats.

00;12;35;28 - 00;12;39;03
We're having serious conversations
with the heads.

00;12;39;18 - 00;12;42;25
Doctor Robert Winn, VCU Massey
Comprehensive Cancer

00;12;42;25 - 00;12;45;25
Center, and Doctor
Candace McGuire, Chief of Breast Surgery.

00;12;45;26 - 00;12;49;06
We're talking about lung, breast,
colorectal, pancreatic,

00;12;49;15 - 00;12;51;09
ovarian and cervical cancer.

00;12;51;09 - 00;12;55;19
Now, Doctor Winn,
you said lung cancer is preventable?

00;12;55;29 - 00;12;56;08
Yeah, yeah.

00;12;56;08 - 00;12;57;15
You know, the interesting thing

00;12;57;15 - 00;13;01;14
is, 30 years ago,
I was there when it actually changed.

00;13;01;14 - 00;13;05;02
We had no good ability to screen
for lung cancer.

00;13;05;02 - 00;13;05;19
Yeah.

00;13;05;19 - 00;13;08;19
And so we just didn't really do it.

00;13;08;27 - 00;13;13;03
We now know since 2010, believe it or not,
that we have something called

00;13;13;03 - 00;13;18;06
a low dose, CAT scan essentially that
if you have risk factors, for example,

00;13;18;06 - 00;13;21;06
if you have that been smoking cigarets
for a while,

00;13;21;10 - 00;13;22;22
we can talk about pack years old.

00;13;22;22 - 00;13;26;22
People just say that you've been,
you know, relatively on and off

00;13;26;22 - 00;13;31;18
or a regular smoker
if you're above the age of, in this case,

00;13;31;18 - 00;13;35;15
you know, 40 and at 50 range,
you're at risk for lung cancer.

00;13;35;15 - 00;13;40;03
And what happens is that we don't actually
have a good way of getting symptoms,

00;13;40;03 - 00;13;43;06
because it's usually what a cough
that lasts more than three months.

00;13;43;17 - 00;13;47;10
I'm going to consistently be on people
that it could be your sinuses,

00;13;47;15 - 00;13;48;23
but it could also be cancer.

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So if you have a cough
that you can't get rid of

00;13;52;16 - 00;13;55;21
and it's been three months or more,
get yourself checked out.

00;13;56;01 - 00;14;00;25
Because really is a low dose
CAT Scan can literally save your life.

00;14;01;07 - 00;14;04;13
And we have at least now
a fighting chance

00;14;04;13 - 00;14;08;02
of making sure that less people are dying
from lung cancer than we did before.

00;14;08;02 - 00;14;11;27
So yeah, the way to screening,
which I really appreciate, just like the

00;14;11;28 - 00;14;15;12
mammography, we now have the low dose
CT scan and screening.

00;14;15;13 - 00;14;18;01
The only fortunate thing
is that most people that you get screened

00;14;18;01 - 00;14;19;10
are not being screened. Yeah.

00;14;19;10 - 00;14;21;11
And what do we do to change that?

00;14;21;11 - 00;14;26;02
How do we encourage folks, even
under the age of 30 to go to see a doctor

00;14;26;02 - 00;14;29;04
because they feeling like they're young
and they don't need to.

00;14;29;10 - 00;14;31;22
What conversations do
we have, Doctor Kandace?

00;14;31;22 - 00;14;34;05
Do we go where they are to do
health screenings?

00;14;34;05 - 00;14;35;14
What can we do?

00;14;35;14 - 00;14;36;22
So I think we got to do two things.

00;14;36;22 - 00;14;37;27
We got to increase awareness

00;14;37;27 - 00;14;40;10
and we got to increase access
because increasing awareness

00;14;40;10 - 00;14;42;15
without providing the people
for people to see.

00;14;42;15 - 00;14;45;04
Yeah, is not going to do anyone any good.

00;14;45;04 - 00;14;49;07
So, you know, we're working on that access
part here at VCU Massey, and making sure

00;14;49;07 - 00;14;52;07
that if you need to see a doc,
you're going to see a doc.

00;14;52;08 - 00;14;54;22
You know, in terms
of how to get that message out there,

00;14;54;22 - 00;14;57;13
I think that it's a it's
a multi-pronged approach.

00;14;57;13 - 00;14;58;08
So we got to

00;14;58;08 - 00;15;00;11
we've got to use social media
because that's

00;15;00;11 - 00;15;02;15
where a lot of the young people
are, social media,

00;15;02;15 - 00;15;06;17
we got to use, you know, we got to use
we use people like you.

00;15;06;17 - 00;15;08;28
Good partners
like you. Yeah. To get the word out.

00;15;08;28 - 00;15;11;26
And then we have to go where people are.

00;15;11;26 - 00;15;14;09
There are a lot of people
who are just working too hard

00;15;14;09 - 00;15;16;13
and raising families,
and they're not on the internet,

00;15;16;13 - 00;15;19;06
and they're not listening to radio
and they're not on TV.

00;15;19;06 - 00;15;22;02
We need to knock on doors and find people

00;15;22;02 - 00;15;25;02
where they're at, at their places of work,
at their places of worship.

00;15;25;24 - 00;15;28;20
To to tell them,
you know, to tell them this message.

00;15;28;20 - 00;15;29;01
Yeah.

00;15;29;01 - 00;15;29;21
You got to do it.

00;15;29;21 - 00;15;33;15
Cancer disparities in women, black women
more likely to die from breast

00;15;33;15 - 00;15;34;27
cancer than white women.

00;15;34;27 - 00;15;39;18
Women between 35 to 54 diagnosed
with lung cancer at higher rates

00;15;39;18 - 00;15;43;23
than men of the same age,
while women ages 65, plus higher

00;15;43;23 - 00;15;48;15
mortality for colorectal cancer
than men of the same age.

00;15;48;15 - 00;15;51;17
Now we want to encourage all women
and you can get this done

00;15;51;25 - 00;15;55;08
at the VCU Massey
Comprehensive Cancer Center.

00;15;55;12 - 00;15;59;24
You can go to MasseyCancerCenter.org
or call 877.

00;15;59;27 - 00;16;03;04
The number for Massey Cancer screenings
include

00;16;03;04 - 00;16;07;04
mammograms,
colonoscopy, HPV and pap tests.

00;16;07;09 - 00;16;10;26
And as Doctor Winn mentioned,
long low dose CT scan.

00;16;10;29 - 00;16;12;01
Now, Dr.

00;16;12;01 - 00;16;17;03
Winn, I want to talk to you about this
colonoscopy and I man, what's the deal?

00;16;18;27 - 00;16;21;26
Where
we got God darn it, we all called up.

00;16;21;26 - 00;16;25;00
We don't even get the digital prostate
exam there because there's it's,

00;16;25;04 - 00;16;29;25
you know, real men understand that,
to take care of your family

00;16;29;25 - 00;16;33;09
and yourself and your community,
you have to stay alive.

00;16;33;16 - 00;16;36;19
And part of that is
that we have this ridiculousness of that.

00;16;37;08 - 00;16;39;23
We know the gold standard is colonoscopy.

00;16;39;23 - 00;16;41;14
And the reality is we still don't get it.

00;16;41;14 - 00;16;45;07
So the one cool thing that I know
is that, you know, we talk about,

00;16;45;07 - 00;16;46;28
you know, springing action for women.

00;16;46;28 - 00;16;52;05
Women typically spring into action for men
in a way of getting them to the doctors,

00;16;52;05 - 00;16;54;05
because typically, really,
we get ourselves there.

00;16;54;05 - 00;16;58;21
But I'm hoping to change that concept
that to stay alive is a manly act.

00;16;58;28 - 00;17;02;08
As opposed to what I think is a lack
of courage

00;17;02;08 - 00;17;05;20
is to go in there and get the prostate
exam, who going and get the colonoscopy.

00;17;05;20 - 00;17;08;15
They wind up with stage four cancer
that we can't do anything about.

00;17;08;15 - 00;17;11;11
To me
it doesn't seem any braver than that.

00;17;11;11 - 00;17;14;26
Courage is actually going in
in getting yourself checked out.

00;17;15;17 - 00;17;18;16
Get what needs to have been done
so that you can stay alive

00;17;18;16 - 00;17;21;05
and take care of your family,
your community and yourself.

00;17;21;05 - 00;17;23;14
And so I'm hoping to change that narrative
for most of the men.

00;17;23;14 - 00;17;25;08
But I'm going to say in this,

00;17;25;08 - 00;17;28;26
in this hoping think about springing
into action for hope, for women's health.

00;17;28;26 - 00;17;32;28
Yes, I want to say thank you to the ladies
for helping us men

00;17;32;28 - 00;17;34;24
in the context of
getting us to the doctor,

00;17;34;24 - 00;17;37;01
even when we too slow to get ourselves
there.

00;17;37;01 - 00;17;40;06
Appreciate y’all
if something don't thank you so much, Dr.

00;17;40;06 - 00;17;40;17
Winn.

00;17;40;17 - 00;17;43;05
And if something doesn't feel
right from the top of your head

00;17;43;05 - 00;17;47;09
to the soles of your feet,
please go to a doctor.

00;17;47;09 - 00;17;51;17
If not, just go to the VCU Massey
Comprehensive Cancer Center.

00;17;51;17 - 00;17;53;18
They will definitely help you out.

00;17;53;18 - 00;17;57;25
I needed to do some follow ups on an exam
and I went over to VCU.

00;17;57;25 - 00;17;59;29
Massey and I'm good. I don't have cancer.

00;17;59;29 - 00;18;04;18
The bottom line
is I'm taking the necessary screenings

00;18;04;23 - 00;18;07;21
to prevent cancer,
and that's what we need to

00;18;07;21 - 00;18;10;21
do as a community, not only in Virginia,

00;18;10;25 - 00;18;14;03
not only in the United States,
but around the world.

00;18;14;19 - 00;18;17;19
You have something you want to say about
the overall health of women.

00;18;17;23 - 00;18;20;24
You know, what I would say
is that I am one.

00;18;20;24 - 00;18;26;00
I just want to say to both of you
that, that I really appreciate the work

00;18;26;00 - 00;18;29;27
that you do and particularly the work
that you do in bringing awareness

00;18;29;27 - 00;18;32;27
to the fact
that we sometimes take for granted,

00;18;33;04 - 00;18;36;15
you know, that women
sisters are taking care of the family,

00;18;36;20 - 00;18;40;07
they are taking care of everything else,
and sometimes they taking care of

00;18;40;07 - 00;18;42;01
everybody else except for themselves.

00;18;42;01 - 00;18;46;22
So I just wanted to say, reach out there
and just say thank you to all the women

00;18;46;28 - 00;18;50;20
that are actually we get sometimes you
feel like you could take it for granted.

00;18;50;20 - 00;18;51;20
We see you.

00;18;51;20 - 00;18;55;12
And part of this show is really
to understand that we not only see,

00;18;55;12 - 00;18;57;17
but we want to be with you
and provide you with information.

00;18;57;17 - 00;19;01;12
So again, as we talk about
spring into action for women's health.

00;19;01;17 - 00;19;04;19
Let it be known that, I appreciate you.

00;19;04;19 - 00;19;06;09
And, what this information

00;19;06;09 - 00;19;09;17
has done in the context of,
just letting people know that

00;19;09;18 - 00;19;13;13
when you ain't feeling right, don't get
go get it checked out, it's okay.

00;19;13;13 - 00;19;16;13
And the reality is, I know
sometimes sisters feel like, well,

00;19;16;13 - 00;19;18;07
if they go get checked out
may take time up.

00;19;18;07 - 00;19;19;10
But just like, man,

00;19;19;10 - 00;19;23;00
if you don't take time out
to keep you healthy, then again,

00;19;23;06 - 00;19;25;04
there's a bigger impact
than just with you.

00;19;25;04 - 00;19;29;13
So I appreciate the show
and literally looking forward to,

00;19;29;13 - 00;19;33;15
as we talk about spring into action,
that we spring into action in the sense

00;19;33;15 - 00;19;38;09
that we see less and less and fewer
and fewer, women suffering from cancer.

00;19;38;09 - 00;19;41;03
Because, as I said,
most of these things can be prevented.

00;19;41;03 - 00;19;44;17
Doctor Robert Winn, thank you
so much for that health all the way up.

00;19;44;17 - 00;19;47;27
Sum up, Doctor
Robert Winn is director of the VCU Massey

00;19;47;27 - 00;19;51;02
Comprehensive Cancer Center,
and we've had a wonderful show.

00;19;51;08 - 00;19;54;13
And Doctor
Kandice McGuire, Chief of Breast Surgery.

00;19;54;25 - 00;20;00;26
For more information you can go to MasseyCancerCenter.org, MasseyCancerCenter.org

00;20;00;26 - 00;20;02;05
if you have any questions.

00;20;02;05 - 00;20;05;06
If you would like to make an appointment
and more, you can call

00;20;05;06 - 00;20;08;06
877 the number for Massey.

00;20;08;09 - 00;20;11;11
This has been Community Conversations.

00;20;11;11 - 00;20;14;26
I am Community Clo. Thanks for listening.