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[Music] welcome back to the healthy woman show here on wjr as always dr jonathan zayden of women's excellence alongside dr zaden we talked so much about uh the importance of getting a diagnosis early when we're talking about certain cancers and that of course means testing and there's lots of different types of testing well you know i think we're going into a new era of medicine where we're going to start to preemptively identify those people who are at best risk or at most risk and the way to do that is to look at you know the foundation of how we are built right to look at look at our architectural plan and that is really genetics and if if we can learn more about our own genetics we'll know who has more of a propensity to get a cancer and ultimately that will lead us to early detection like we just talked about and so you know i think that we just have some great opportunities here the technology has just expanded so much in this in this arena and i thought it was very important to have somebody on the show to talk about what's going on in the current field of genetics because i think many many of our women would be interested in what are the genetics that we you know genetic evaluations we can do for breast ovarian cancer even other cancers and of course we promise to make this all easy to understand when we're talking about it i think a lot of it is easy simple yeah a lot of people say oh i don't know if i could uh grasp all of that but we have nicole lambert the president of mira genetics laboratories joining us today the lab that first discovered the primary genes for hereditary breast and ovarian cancer and before joining myriad she had served as the genetic counselor in the houston medical center in the last 30 years myriad has accelerated innovation and advanced the science of genomics and the precision medicine with a focus on women's health welcome welcome nicole to our show we're so glad you could join us today it had to be an interesting experience for you i understand recently you went through the process of actually being a patient uh to experience what others experience when they come for genetic testing i did yeah thank you so much for for hosting me it's a pleasure to be here um yeah and first of all i want to say that the decision to undergo testing and the timing with which you undergo testing and the decisions that you make afterwards are really very very personal ones and i support all women in that journey and all the different choices that they make along the way um you know for me i knew that there was breast cancer in my family but we didn't really look like your typical hereditary cancer family you know we didn't have many many many people affected at young ages we didn't have a lot of deaths from cancer you know there were a couple of people that had breast cancer at later ages which you know breast cancer is a common disease so it really didn't look all that suspicious but what changed things for me was a conversation that i had with my aunt on christmas eve a couple of years ago she had just been diagnosed with metastatic breast cancer and she had had a completely normal mammogram just six months before and you know she was young and she was talking to me about all the things that she thought she was going to miss because of this diagnosis all the milestones in her children's life her youngest son was just about to finish high school and she was really thinking about whether she would make it to his graduation and in having that conversation i just realized you know i never never never want to have to have this conversation myself and i knew that it was time for me to undergo the testing i also you know i'm fairly young and healthy i knew that if the risk was really high and i needed to undergo a prophylactic surgery that i was young and healthy enough to do that so it all just sort of came together for me and it was really the right time to to move forward with testing you know what what i think nicole what you hear i hear that every day from patients i mean they're fearful especially when they have a friend who's been diagnosed or you know it's it's not so much their moms when their moms are diagnosed because typically you know by the time i'm seeing them they're not their mothers are older and there's more of an expectation that there's something that's going to happen and this is one of those things but it's when they have a colleague a friend or maybe someone even younger than them they go through that same experience and you know i hear so many people well you know when i offer them testing though i'll say you know once you get that you know we can do that testing for you here right and they'll say well i might just do it i i read about it online i i saw there's some place where i can do it online for 99 or whatever what's the difference between what we're offering i mean i know what it is but what you know from your perspective what is the difference so people can understand what that is because i think people right now are really fixated on finding out what their genomic tree is but that's really not telling them about cancer you know so tell us a little bit from your perspective as a president of the company doing genetics why should we use you you know why are these patients going to come and say to me yes dr satan i'll get it through through myriad and not just do it 99 bucks right absolutely great question and i think a lot of patients find that stuff online and you know if you're doing testing for recreational purposes to find out about your ancestry or you really don't have a medical indication you're just screening for a bunch of things and you don't plan to make real decisions based on information i think that's fine but if you have a family history and you have a medical indication for testing which you know those medical indications have broadened quite a bit in the last few years the american society of breast surgeons has said that every woman with a history of breast cancer has a medical indication for testing so if you have a medical indication a strong family history you want to get clinical grade testing that is actionable and you can be confident in decisions that you make for your health care based on that information and this is exactly nicole this is exactly what i tell them i say you know your insurance company in most cases is going to cover this right and you know in many cases i'll set them up with one of you know i'm fortunate enough to have a tele telehealth right is what everybody talks about we call it specialty virtual care here at women's excellence so i'm i'm fortunate enough to have that ability so we can set them up with one of our nurse practitioners to talk about these types of things so you know it works you know very well so it can be done very easily they don't even have to come back to the office and they can actually have a full discussion so that we can get the information that they need so that you know their insurance company can approve that test you know based on their risk factors you know but if there was one thing i think one thing that you could tell people as the president of myriad genetics what what is the one thing that you wish that women knew more about doing genetic testing the one thing i wish people knew is that this is really about empowerment right and switching from fear to empowerment i hear women say to me you know well i'm not sure that i would do a mastectomy if it was positive so why should i even undergo the test it's about getting the knowledge about your health care there are plenty of women who say that they would never do x y and z but once they actually have the test result they think very differently about it and so give yourself the chance to get the information you whatever you choose to do about it and whenever you choose to make those decisions it's all up to you but get the information you're worth it you deserve it this is your health care i think you have hit the nail on the head per se when you say that because it's so true people you know have fear we've said this a million times the only thing to fear is fear itself right and so with the exception of people that have excessive anxiety i typically you know we will refer them for genetic testing because i think that you know having a little more knowledge allows you to be actionable like you said and and you know you can't really do anything unless you have knowledge knowledge is power and you know this gives us that ability to order an mri for those people right when the insurance wouldn't cover an mri so they get a better test maybe for screening it gives us the ability for us to do other specialized blood tests maybe looking for things in advance and maybe do more clinical examinations which sometimes people desperately need because they're not doing their own self-breast exams and so forth so i mean there's so many things we talked about early detection in this in the show earlier and i i you know this is all about it and i'm so thankful to have had you on the show i mean this is a really great you know way for women to understand from somebody who's doing this every day is there anything else you'd like to tell the people yeah i mean i think the first step right is just understanding your risk so i think you know you have a link on your website we do on ours to hereditary cancer quiz www.hereditarycancerquiz.com or they can go to your website if they're local in your area and understand if they meet criteria and if testing might be right for them definitely appreciate you being on the show we'll promote you uh you know in your testing through women's excellence but more importantly will promote preventative care and that's what you've told us all about we will empower more women to do exactly what you said find out about their disease earlier get it treated nicole if i could just ask you before we let you go i'm just curious is there ever a time when people come in for genetic testing and that perhaps they uh get more information than they bargained for and maybe are left with more decisions to have to make is that possible or more questions than answers is i think what i'm trying to ask you um you know the testing that we do is very focused on cancer risk and so i would say that's less of a concern with the testing that we do because you know you've come in for a hereditary test about breast cancer you're not going to incidentally find out that you have this very high risk for cardiovascular disease or something like that because the testing that we do is very uh targeted and focused uh when you do a larger panel like dr zeta mentioned earlier with uh you know a a consumer test that's recreational you could find out just about anything right you could find out a different ancestry that you thought you had you could find out a risk for a disease that you you never really intended to um to find out about but the the testing that we're talking about is is very focused on what you the question that you came in asking nicole lambert is the president of murad genetics and of course dr zaiden at women's excellence has the opportunity for you to get genetic testing through this company thank you so much for joining us today nicole we really appreciated your information absolutely thank you [Music] welcome back to the healthy woman show here on wgr dr jonathan zayden alongside as he always is from women's excellence dr satan just if we could just close the loop on our last interview very quickly i know one of the questions that we were uh didn't get in about security and information security when people get genetic testing done is if i get genetic testing done is it out on the internet for all to see well i think that was one of the things that did didn't really come out but i had actually talked to nicole about this um you know prior and and we we understand that you know when people get genetic testing online at these at these services um they're getting a lot of information and i think a lot of patients are very fearful that that information might you know kind of be breached and and that they could be you know lumped into other patients as a result of those breaches um that's not the case with myriad genetics it's a very very private uh private medical record that you have so we're looking for a specific piece of medical information and that medical information is is protected under the health information protection privacy act so you know it's hipaa protected so a little bit different than when you're buying something commercially online