She’s at Risk: Rising Cancer Rates
May 6, 2025 | Episode 38
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Lindsey Gordon, Dr. Rath, Dr. Halaharvi Marcus Thorpe
Lindsey Gordon:
It's the word no one wants to hear. It's a word that may give you a visceral reaction or bring up painful memories, and this word, unfortunately, is being used more these days, especially for women. I'm talking about cancer. But listen, this doesn't mean it's all doom and gloom. There is hope, because we've made tremendous strides in prevention, detection and treatment. Thanks for turning into this episode of the wellness conversation and OhioHealth Podcast. I'm Lindsay Gordon and I'm
Marcus Thorpe 0:44
Marcus Thorpe. We have two medical experts here today to dive into this, help us understand why she's at risk. And our guests this topic is deeply personal as well. We are joined by Dr Deepa Halaharvi, who specializes in breast cancer surgery at OhioHealth, also a breast cancer survivor, and Dr Kellie Rath, a women's health doctor here at OhioHealth who specializes in gynecological oncology. Thank you both so much for joining us. We're really looking forward to this conversation today. Yeah, thanks for having us. Thank you so much for having us. Dr Rath, let's start with you. For those unfamiliar with cancers that are specific in the women's health space, what type of cancers are you really focused on in helping patients and their families
Dr. Rath:
Yeah, so I'm a Gynecological oncologist. That means that I take care of people who have cancers of the uterus, cervix, ovaries, fallopian tubes, vagina, vulva, and it's a little unique. I do both surgery and chemotherapy. So typically, cancer patients are used to having a medical oncologist and a surgical oncologist, we kind of combine both, and so it's super rewarding getting to build those long-term relationships with patients, both during surgery, but then all throughout treatment. Dr
Marcus Thorpe 1:49
Dr. Halaharvi, cancer survivor yourself. I know it's something that you've talked about publicly a lot, and it's been really inspiring to hear your story. How do you think that your own personal journey has impacted the work that you do every day with women?
Dr. Halaharvi:
Yeah, this is actually what I call an answered prayer. You know, I always say, Who's better to get breast cancer than a breast cancer surgeon? And you really don't understand what patients are going through until you walked in their shoes, the fear, the waiting, not knowing what the next steps are, the anxiety and what I know is breast cancer treatment is not just physical removal of the tumor, you know, doing the surgery and having them go home. It's more physical, emotional, spiritual. And what I have learned is to be there for the patient, to sit in silence and to listen to them and help them through the journey, and also to show up completely for each person.
MT:
I think about that moment where you're sitting down with your provider and they tell you that you have cancer or whatever it is, but then at the same time they say, Look, I've gone through this myself. I know it must be just, I know, so nice to go, Okay, I'm with the right team. I'm with the right person. And it's something that you don't get very often. So I think it's, it's got to be so I don't know, knowing that you have a guide that can walk you through this, I think that must be really nice for people.
LG:
Leading by example, right? If you can get through it with strength and courage and resilience. I mean, you can help that person sitting right across from you do the same. I want to ask you about a statistic that I see dominating my social media feed. I mostly am an Instagram user, and I saw this pop up a few months ago, and I sent it over to our teammate, Katie Logan. I'm like, Hey, do you think this is worth a topic to explore? Like, do you think this is real? And because it just shocked me. I could not believe what I was seeing. And the statistic was, cancer is now more than 80% higher than it is for men in women. And I want to know from both of you and maybe Dr Rath, let's start with you. Is this true or do we need to think about more behind this number?
KR:
Right? I think it's both true, and we have to think about a lot more behind the numbers. So every year, the American Cancer Society puts out their cancer statistics report, and that's where this data came from. And so it found lots of things, that some cancers are going down, some cancers are going up. We're doing better treating some cancers. We're not making as much progress in other cancers. But the one thing that it did show and kind of, I think what broke out in social media was that under 50 lots of people get cancer, and under 50 women are 80% more likely than their male current counterparts to to have cancer, and that's increased from 2002 so in 2002 That number was 51% and so obviously something's happened, happening. And so I think that knowing that that's there, recognizing it, gosh, I'm under 50, I am at risk. What do I need to learn about? What are my personal risk factors? You know, from other medical problems, genetics, things like that. So very true. But also need to understand more. Sure.
MT:
And DR. Halaharvi when you see that statistic out there, is there anything that goes through your mind like that? The person taking in that information? Is there something you wish they would know about that number?
DH:
Yeah. And I'm also shocked with this number, but at the same time, not so shocked, because I do see, I am seeing a lot of women in my own practice that are under 50 who are diagnosed with breast cancer, me being one of them. And so what are some reasons? I think, for me, just there's a lot of articles that come out, but in JAMA 2023 there's an article that came out talking about cancer in young people, in general, men and women. For women, for instance, there's a number of reasons. One is their hormonal factors. They're fertility factors, the lifestyle factors. So women are maybe having periods early, having late menopause and not having kids, or having kids much later than age 30. Those are your hormonal and fertility factors. There's lifestyle factors like smoking and alcohol use and environmental factors, the stress, excessive sun exposure, not sleeping. So those are all I would say, maybe causing, maybe the link to increased numbers that we are seeing in women. You mentioned
LG:
some of the causes and things like that. Factors to consider. You don't have to look far in your own world, your own circle, to find someone that's been touched by cancer in some way. I think about some of the athletes I played with in high school and college went on to have devastating diagnoses, and some of them aren't here today still, and I think, wow, they were the healthiest people. I just, I don't understand, like, how could this happen? Let's dig into that a little bit more. And the cause of cancer. What do we know? There's, of course, a lot that we don't know, but maybe unpack a little bit more about that and the work that's being done in the prevention space. So I don't know who wants to take that one first, because it's a lot to put you on the spot, but let's talk about that, the prevention space, and things that we've become more aware of to help us have control over something some of us feel we have no control over,
KR:
So I think in the GYN prevention space, I'll go first. I think the thing that's nearest and dearest to my heart, not the most common GYN cancer, but cervical cancer. So we know Cervical cancer is almost always caused by HPV or the human papillomavirus. It also causes head and neck cancers, anal cancer, among others. And we have a vaccine, right? We have a vaccine that we can give our kids between ages nine and 11 that should prevent 90% of those cancers. And so when we're thinking about prevention, when we're thinking about our young people, you know, your kids, your nieces, your nephews, whoever like that would be my number one thing that I would think about, like, we can prevent this cancer with a vaccine. I think prevention otherwise. We know, like you mentioned, lifestyle. We know that over half of cancers in the United States are related to lifestyle factors, related to obesity and metabolic syndrome. And so thinking about, you know, getting the right exercise, focusing on a healthy diet. I always say Mediterranean diet is best, fruits, vegetables, lean proteins, those are all things you can think about. And then genetics, if you have a family history of cancer, young people in your family would be important to think about. But, you know, there are all the other things, and that's why research is so important to find out. Like you said, the young, healthy people were like, Why did this happen? And that's why research and research funding is so important. So
LG:
Dr. Halaharvi, that was a lot. And I think you would agree with a lot of what Dr Rath just said, when it comes to the prevention space and what causes cancer, of course, there's a lot we don't know, but we're getting somewhere, right?
DH:
Yes, that is correct. And Dr Rath covered a lot of what I was going to say, prevention is the space that I really love, because that is where we can empower people. And when we talk about cancer, it's complex. It's many things that can cause cancer. It's not one thing. In fact, that's a question that I get asked about every day what caused my cancer. I've been exercising, I've been eating healthy. I you know, watch what I eat. I have I sleep well. I mean, all and you still can get cancer, having done all those things. What? When I talk about cancer, I talk about non modifiable factors, as well as modifiable factors. So the non-modifiable factors, of course, we can change our gender, you know, age and family history, genetics, those things we can change. So modifiable things we can change. So, lifestyle factors, we can definitely exercise more. You know, American Cancer Society recommends exercising half hour a day, five days a week, eating a healthy diet. I agree with Dr Rath. Mediterranean diet is probably the best diet, which includes lots of fruits and vegetables, chicken and fish and olive oil and limited sun exposure. I say you definitely need sun exposure in the morning time, but not excess use and exposure, which can then lead to skin cancer and stopping smoking and limiting your alcohol use. You know, breast cancer will always say less than two drinks per day, per not per day. I'm sorry, per week is what we if you're going to drink, we don't recommend going more than two drinks per week. And so, prevention is the key. There are 13 cancers that are linked to obesity. And so, if that's something that we can at least take control of exercising and eating healthy, that's going to help decreasing the risk of developing those cancers. So, we can't 100% prevent all cancers, but we can take those modifiable risk factors and change those so to help decrease the risk of developing cancer, I have
LG:
I'll just add to I have seen, at least on my feed, in my algorithm, that women in my age group, especially, are really taking this into consideration and major lifestyle changes. You know, I've seen women saying goodbye to alcohol and turning to other ways to decompress after the end of the day. I really see this movement, and it's inspiring, and hopefully it leads to better health outcomes for all of us.
Marcus Thorpe 11:00
And I love that everybody seems to be kind of related to the behavioral health space that people are talking about it. And the more it's out there, and the more people are hearing about these things, it'll jump start a lot of people to say, oh, if that person's doing it, I need to be going for prevention checks. And I love the openness of women conversations and those kinds of things. I think it's so critically important. So obviously, we don't want anybody to get cancer, but there's going to come a point in a lot of people's lives where that's what they have to deal with, and it's right in front of their face. So, let's transition to talking about detection. It's so important have the right team that you trust, that you know is going to find what you have and give you the right path for those kinds of things. Dr Rath let's talk about detection. Are we getting better at detecting cancer? What leads to better outcomes? Obviously, earlier is the better I'm assuming here,
KR:
yeah. So, you know, with detection, there are some cancers we have screening for, and so making sure that you know what those are and when you should get screened, right? Breast cancer, mammograms, colonoscopy, for colon cancer or Cologuard, the number recently decreased, right? It used to be 50 that we talked about screening for colon cancer. It's down to 45 which is exactly what we're talking about today. Cervical cancer, getting pap smears and HPV testing, as well as lung cancer, right? If you've had a long smoking history, there are low dose CT scans and so making sure that you know, what's my age, what are my risk factors, what are the things that I should be screened for? Asking your primary care provider, you know what those are and when you should be getting them done is so important. And then, you know, there's a lot of cancers that we don't have screening for and understanding. What are the warning signs for those cancers? What is normal for my body, what is not normal? And if you notice something that's different, finding a trusted healthcare provider that you can really go through those symptoms and get to the root of like, what is causing this, so that we don't miss anything. Yeah,
DH:
those are all really great points for preventing or screening for different cancers, I'll talk about breast cancer. So, screening mammography. We recommend screening mammography at age 40 for an average risk woman, and if you're considered high risk for breast cancer. Well, how do you know that? Well, you have to see your provider who then does a breast cancer risk assessment. And that's really an important topic to talk about when we are talking about women under age 50. In fact, the mammograms don't start till age 40, if your average risk, but if you have family history of breast cancer, your provider can perform a breast cancer risk assessment, give you that personalized number the risk of you developing breast cancer. Then we'll give you a personalized screening program, whether it's not just mammograms, combination of MRIs and breast exams maybe every six months, rather than once a year. I
Marcus Thorpe 13:45
I heard you speak at a luncheon a while back about your own personal journey, and it was so powerful and moving, and you just had a way of explaining kind of that initial fear of like this, this can't be me. I take care of myself, I do the screenings, I do all of these things. How do you think that helped shape the way that you care for patients and kind of the passion that you have for this right now? Yeah, I
DH:
100% feel the fear like I can actually feel it viscerally and initially, when I was diagnosed eight months after started working as a breast surgeon. So, the first year was tough for me to tell people their diagnosis, because I would replay my own story and my young kids and how they took it at that time. And now looking back, I just think, you know, I feel very empowered to have gone through the journey so I can help others. And you know, it's like making a message out of your mess, so to speak. And so, when a woman comes in and tells me, I've done everything in my power, I have worked out of taking care of myself, I just recently had an email who came in with, you know, breast cancer, and she's like, I've done everything. We hike. We hike 10 miles, and they go on all these trips where they're physically active, they don't drink all. Alcohol don't smoke. But guess what? As she was diagnosed with early-stage cancer, because she was keeping up with her screenings. Number two, she recovered really well after surgery, very quickly. And I see that a lot with patients, as you're taking care of yourself and your fault, keeping up with your screenings. If you do get diagnosed with cancer, it's usually early stage and good prognosis, good survival, and, you know, there's always hope, right? But we have so many newer treatments and newer guidelines that are changing constantly and evolving, and you're more focused on treating a patient rather than a diagnosis.
Marcus Thorpe 15:33
I know everybody's different when they hear those words, you have cancer, right? And we've heard those individual stories. I'm curious how, without getting into specifics of each individual patient, because everybody's journey is different, but is the reaction different for somebody who's like in their 30s versus somebody who's in their 60s or 70s? Because we're seeing these numbers skew a little younger, right? I think somebody in their 40s or 30s probably goes, I'm not going to get cancer right now, but we're seeing that more and more. And more. How do, how does that group take that news, versus somebody, maybe in their 70s or 60s or something like that? Is it different? I
DH:
think sometimes it is. I think, you know, young people aren't thinking that they might get cancer. But what I'll also say is, the older get you get, the younger you feel. You know, even if you're 60 or 70 in your head, you still feel 30 or 40. And so I think it's a really hard diagnosis, no matter how old you are, to hear from most people
Marcus Thorpe 16:30
and you're willing to fight. I mean, that's the beauty of, I think, the human resolve of just saying I'm going to fight like heck, to beat this thing, and we're going to do this together. So, I
KR:
often find the younger women sometimes they haven't, you know, had kids, yet, they haven't even thought of kids, right? And so besides the cancer treatment and the consequences of cancer treatment, they also have to worry about, you know, find finding a life partner. Would someone want to be with them with all these scars? Could they have kids the effects of anti-estrogen medication? So, there's number of things that go into it. Yeah,
it can be Yeah. And you know, one thing I didn't mention when we were talking about detection and this or prevention, I don't know which this kind of like rolls in, uterine cancer is becoming more common among young women, right? And the uterus is essential for carrying a pregnancy. And so, I see the same thing in my practice. A lot of young women are being diagnosed with uterine cancer and figuring out how to preserve fertility. Sometimes we can use hormonal treatment to preserve fertility and to get these women's cancers to regress and then to be able to go on and carry a pregnancy. And I think that that also leads us to detection and recognizing what's abnormal. There's no screening for uterine cancer, but almost all uterine cancers start or present with abnormal bleeding. And so, when you're post-menopausal, that's easy, right? You shouldn't have any bleeding. And if you have postmenopausal bleeding, you need to go to the doctor. But for younger patients, recognizing that this irregular bleeding that I'm having might not just be hormonal, there could be something else going on. And knowing I got to get to my doctor and make sure that I'm asking, you know, do I need to be worried about cancer? Should I be getting a biopsy to check for that? Because the earlier we find it, the more likely we are to be able to do this fertility preservation for these patients and to get them to the pregnancy. If that's what's important for their life. It's
LG:
just not lost on me. I know cancer affects men and women, but of course, for this podcast, we're talking about how it affects women, in many cases, more often and in complicated ways. We're talking about family planning, having a baby. These are cancer can just totally change you’re the course of your life in these ways, we've also had guests on the podcast who we've had two who were pregnant when they got their cancer diagnosis. I mean, that's crazy to me to know that they their body was changing so much, and they still knew this is not right. So I guess, what's your message for for women who are listening to really take charge of their bodies and really be in tune and and listen and don't hesitate to speak up if something feels often, at times, it could be maybe embarrassing, right? Like you talked about the bleeding. And sometimes if, if a problem is lingering, I know for me, like, say, I'm just, I'm ready to go. Like my two kids are sitting on the sidelines here today, because, you know life, and I thought, you know, when I was ready to have them. I was so committed in my head, like, let's go. I just can't imagine someone having to to have that decision of, like, do I freeze my eggs? Do i i just have so much empathy in my heart. So I have friends who have had to decide that, and it's so difficult. There's people I know who life didn't go as planned because of a cancer diagnosis in terms of creating a family, and they find a family in a unique way. But yeah, what's your message to inspire and encourage women to you? Not give up hope. As we say, I have the bracelets on. Keep making plans and advocate for yourself. Speak up when something's wrong. Yeah,
KR:
You know, I think kind of what you said, advocate for yourself. Know your body, know your risk factors, find the healthcare team that you feel comfortable with. I always tell my patients, you'll never hurt my feelings by getting a second opinion, and you'll never hurt my feelings if you choose another doctor, you need to be so comfortable with the team that's taking care of you. And that doesn't just mean cancer, right? That means your primary care provider, your OB, GYN, you know your endocrinologist, you need a physician or a nurse practitioner, a PPE, whoever it is that listens and hears you and don't ever be deterred by going to see somebody and having a bad experience. Just because you have a bad experience with one physician or provider doesn't mean that you will with the next person, and it's so hard, but just, you know, believe in yourself and keep looking until you figure out what's going on.
DH:
I agree with that. I think you really need to advocate for yourself, and that's we need to start teaching that in middle school, not even wait until high school. I think that's something not taught. I mean, I grew up in a generation where my mom did not take care of herself, so I just thought, that's what good mothers and wives did, they take care of others and not take care of themselves. Of themselves? I see that a lot in women that come to my office, and I always can figure out what's happened in their last five years of their life, some stressful event, you know, taking care of their family member, losing a job, going through divorce. There's something that happens that triggers, you know, I'm sure there is data to support that and advocating for yourself. Know your body if something changes, talk to your provider, get regular screenings, be physically active. We are doing a great deal of good work in the breast cancer space, where we're not just treating your stage of cancer or even the size of the cancer, we're treating the tumor biology, which means we have a lot of targeted therapies. If it's her two new positive or triple negative, we have targeted therapies with immunotherapy. And if you're hormone receptor positive, there's the hormonal therapy, CDK, four, six inhibitors. We're doing a great job in the survivorship space, where we're talking about fatigue and lymphedema and recurrence and fear and all those things. So we're not just treating cancer, but we're doing a good job of treating the whole person. So advocate for yourself. I think
Marcus Thorpe 22:28
I wanted to talk about treatment a little bit. You mentioned some of that. How has that evolved over time? How have you two in your career seen where it was when we started to where we are now? Are we doing a better job of figuring out what can be done, whether it's surgery, whether it's something else,
KR:
yeah, I think there's been so many advances in the last 10 years. I've been here 12 years now, I would say the biggest thing is immunotherapy. I know you just mentioned it a little bit. Immunotherapy is so effective for a lot of different cancers now, and we're able to cure people that, you know, when I started fellowship, we just wouldn't have been able to and I think also surgical advances, you guys have been doing sentinel lymph nodes and breast cancer forever, which is huge for patients, and decreasing lymphedema. I think it's something that we were a little later to get the technology to adopt it in GYN cancers. But you know, instead of doing complete lymph node dissections in the pelvis, I'm just taking I'm just taking out one or two lymph nodes, and like the lymphedema or swelling in the legs that women get has, you know, almost vanished, which is so exciting. So medicines and new surgical techniques are always coming up. And so thankful for all the people doing the research to help us find those things.
DH:
I just want to add to that, also, I talked about the immunotherapy, the targeted therapies. Even for surgeries, we went from modified radical mastectomies, where we removed breast and muscle, and now we are doing nipple sparing mastectomies, lumpectomies, and so we are hiding the incisions in the scars, so when women looks at them, you know, cancer is just one chapter, not their entire book.
Marcus Thorpe 24:00
Yeah, I think about you both. You know, obviously Women Helping Women, that's got to be super rewarding too, right? When you find that right fit for the right patient, and you see the success, and you know that you've kind of been there every step of the way. What is that like for you both to know how influential and how important you've been in these women's lives?
KR:
Yeah, it's incredibly rewarding. I just think. We were just talking about fertility, and I saw a patient in my office this week. I've been taking care of her for over 10 years, and we went from cancer diagnosis to a pregnancy and a delivery, and it's just amazing.
Marcus Thorpe 24:41
Yeah, that's why you do
DH:
Yeah, it is very rewarding. And to see that woman who is so scared when she first gets told that she has cancer too, she's now thriving and surviving and doing great things. She's now doing all those things she put off, and people come back with the pictures of their vacation or time spent with. Their family members, new children, new grandkids. And it's incredibly rewarding.
Marcus Thorpe 25:03
Yeah, makes it easy to get out of bed every day go and make a big difference in somebody's life. Yes, very fulfilling, for sure. I think this has been a great discussion. I always say this at the end of these I feel like we could talk for two hours and still not be able to cover everything. But we hope that you'll come back. Because I think this is something that we should probably do every six months where we have you two back and just dig into things and really talk about what's going on out there and talk about hope. I think that's the biggest part, is that, you know, cancer isn't the stop sign, it's just a pause, and we've got to figure out what's next for you, and I think that you and your teams are the best people to lead folks through that. So thank you for what you do for our patients, but thanks for what you're doing for this audience today too. It's been really great.
DH:
Thank you so much for having us. You know, really conversations like this. It helps people to empower themselves. It gives them knowledge. And you know, if they have questions, this is where they can turn to if they don't want to talk to someone because of the information that they receive. So thanks for making this platform for people. And I say we are really getting good at surgeries. We are really good at treating cancer, but in the breast cancer space, when a woman has surgery, her body identity is changed, her self image is changed, she goes through grief. And so for us, it's important to help the whole person, and not just the cancer diagnosis, not just treating the cancer. So having gone through it personally myself, I definitely feel that's a place that we need to emphasize more, is treating the whole person. And again, thank you for opening up this platform. Hope like you. Marcus, I believe it's a muscle. It gets stronger as we work on it and use it more and more. And I love the phrase keep making plans, because I use that a lot. So do we?
Marcus Thorpe 26:47
That's great. Well, we thank you, of course, for joining us for this episode of the wellness conversation and OhioHealth podcast. Before we wrap up, we do invite you to follow us on all major social channels, so you stay up to date on any new episodes, as well as other health and wellness topics. If you're looking for more information on OhioHealth services and locations, including our cancer services, you can go to ohiohealth.com the
Speaker 1 27:09
information in this episode is also available on the podcast page. Also be sure to subscribe and join the conversation. And a final note before we say goodbye, we are just getting started. Reviews and ratings help us keep this conversation going with you and allow others to find us and join the conversation too. As always, thanks for joining us. You.