Podcast Summary

Episode Overview

In this special bonus episode of "Why Not Me? Embracing Autism and Mental Health Worldwide," host Tony Mantor sits down with Dr. Steven Quay, founder of Atossa Therapeutics and a globally recognized physician-scientist, in honor of Breast Cancer Awareness Month. The episode aims to demystify breast cancer, discuss advances in treatment, highlight the importance of early detection, and offer hope and actionable advice for individuals facing a diagnosis.

Key Discussion Points & Insights

Dr. Quay’s Background & Mission (02:23)

• Introduction: Dr. Steven Quay shares his career as a physician-scientist focused on developing medicines and getting them approved for patients.
• Notable Projects: Developed early MRI contrast agents used by 80 million people and a heart contrast agent used by 36 million. Now focused on breast cancer prevention with the investigational drug endoxifen.

“I started Atossa Therapeutics to try to prevent breast cancer risk with a drug that I've invented called endoxifen. So that's my mission.”
– Dr. Steven Quay (02:42)

The Power of Early Detection (03:09)

• Self-Exams: Monthly self-breast exams are recommended. While guidelines vary, Dr. Quay is an advocate: “You get to know your breasts and that's very useful.”
• Mammography: Begin at 40 years old for most, earlier (35) with strong family history, typically every two years. Dr. Quay suggests continuing beyond 70 as lifespans increase.

Survival Rates & Reframing the Diagnosis (04:00)

• Survival Stats: Most women survive breast cancer—95% are alive at 5 years, 92% at 10 years. Triple negative breast cancer is more aggressive (around 60% five-year survival).

“...for the majority of women who have breast cancer, 95 will be alive in five years, 92 will be alive in 10 years.”
– Dr. Steven Quay (04:05)

• Combatting Fear: Diagnosis is frightening, but the facts are reassuring for most cases.

Navigating the Emotional Impact (04:57)

• The Anxiety Gap: The period between diagnosis and having a treatment plan is the most stressful.
• Empowerment: Action steps like scheduling a mammogram or talking to a physician help reduce anxiety.

“Information is power and the more information you can have, the better.”
– Dr. Steven Quay (05:27)

• Importance of Timing: Early-stage, non-metastatic cancer is often curable; metastatic disease is much harder to treat.

A Century of Progress in Breast Cancer Care (06:11)

• Historical Perspective: Chemotherapy originated from mustard gas after WWI.
• Treatment Evolution: Introduction of tamoxifen in 1977 as the first targeted cancer drug, blocking estrogen’s effects; 80% of breast cancers are estrogen-driven.
• Current Focus: Matching high efficacy with lower side effects. Endoxifen seeks to improve quality of life compared to existing drugs.

The Path From Diagnosis to Treatment (08:21, 11:16)

• Diagnosis Process: Includes biopsy, assessment of tumor differentiation (well, medium, poorly differentiated), hormonal status (ER/PR/HER2), and proliferation rate (Ki67 marker).
• Treatment Timeline: Generally, surgery (lumpectomy or mastectomy), possibly radiation, and 5 years of daily pills (tamoxifen, aromatase inhibitors, or investigational drugs like endoxifen).
• Adjuvant Therapy: Reduces reoccurrence risk in both the treated and opposite breast.

“By six months, you are pretty much done with everything except for that daily pill for the next five years.”
– Dr. Steven Quay (13:28)

• Side Effects: Hot flashes, night sweats, joint pain—focus now is on developing drugs with fewer of these issues.

Proactive Measures and Prevention (19:14)

• Lifestyle Factors:
  • Minimize alcohol, as even one drink a day slightly raises estrogen (and thus risk).
  • Avoid high-inflammation foods (fatty, fried at high temps).
  • Exercise, especially resistance training, to improve hormone balance.
  • Consider hormone replacement risks post-menopause.
• Genetics: BRCA gene mutations—especially prevalent in Ashkenazi Jewish populations—may warrant consideration of preventative (double) mastectomies, as made public by Angelina Jolie.
• Double Mastectomy: Reduces risk to 1-2%, but is seldom necessary outside high-risk genetic situations.

Additional Science & Special Advice (21:06)

• Puberty: Most breast cancers result from mutations that accumulate over a lifetime; puberty is a particularly vulnerable time due to rapid cell division.
• Childhood X-rays: Avoid unnecessary chest X-rays during puberty to reduce risk.
• Fast Food: High sugar, fat, and cooking temps can affect breast cell development negatively.

Reliable Information & Staying Hopeful (23:47)

• Stay Informed: Use reputable sources like Dr. Quay's website (drkue.com), but always rely on a trained healthcare provider for medical decisions.
• Overall Message: With modern treatments, most women lead full lives post-diagnosis. Focus on general well-being and don’t lose hope.

“Breast cancer, you know, we can treat it, it's not pleasant. But really, you know, enjoying life, enjoying your family and friends is absolutely critical.”
– Dr. Steven Quay (24:38)

Notable Quotes & Memorable Moments

• On Early Detection:
  “You pick the same time each month and you get to know your breasts and that's very useful. ...if you find something different, you talk to your healthcare provider.”
  – Dr. Steven Quay (03:15)

• On Mental Health After Diagnosis:
  “Once you have the plan, it really takes a lot of the anxiety away. And then, you know, you do have to follow the plan. But all of our lives are full of challenges.”
  – Dr. Steven Quay (10:24)

• On Prevention:
  “If estrogen drives breast cancer, in 80% of the cases, things that can lower estrogen can help prevent it.”
  – Dr. Steven Quay (19:14)

• On Puberty and Prevention:
  “A very vulnerable period for girls, for women with breast cancer, is puberty... So, for example, if a young girl is recommended to have an X-ray... I would want to ask the doctor, is this really necessary?...”
  – Dr. Steven Quay (21:18)

Timestamps for Key Segments

• Intro & Dr. Quay’s Mission: 01:20–02:55
• Early Detection & Diagnostic Practices: 02:55–03:48
• Survival and Emotional Impact: 03:48–05:57
• Progress in Treatment: 06:11–08:05
• Diagnosis & Treatment Pathway: 08:05–13:31
• Adjuvant Therapy & Side Effects: 13:31–15:33
• Prevention, Lifestyle, Genetics: 17:18–21:06
• Special Risks in Puberty: 21:06–23:25
• Closing Advice & Resources: 23:47–24:48

Takeaways

• Early detection and regular screenings greatly improve outcomes.
• Education, support, and timely treatment planning are crucial for reducing anxiety after diagnosis.
• Most breast cancers are treatable and do not result in a “death sentence.”
• Lifestyle changes can reduce risk, especially in hormonally driven cancers.
• Genetic factors may necessitate more aggressive prevention.
• The medical community now prioritizes both survival rates and quality of life in treatment.

Dr. Quay’s expertise and perspective throughout provide both reassurance and tools for individuals and families navigating breast cancer, emphasizing information, action, and hope.