Breast Health #58

Meredith Burgess:

Interestingly enough, is that we are one of the few states, I'm gonna say, like seven or eight states out of 50 where the number one killer in the state of Maine is cancer. And that needs to change. And that's gonna be done through education, screening and understanding some of the issues around it.

Dr. Caroline Hodsdon:

That's probably one of the biggest questions that women's women have is how often should I be screened for breast cancer and what's the best way to do it and when do I start?

Ingrid LeVasseur:

Thermography is a means of detection that uses the heat that is produced by the body. Really, mammography and thermography are completely different technologies. They're not looking at the same thing.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you're listening to the Dr. Lisa Radio Hour and podcast show number 58, Breast Health, airing for the first time on October 21, 2012 on WLOB and WPEI Radio Portland, Maine. As most of you are aware, October is Breast Cancer Awareness Month, also known as Pink Ribbon Month. Breast cancer has a personal impact, has had a personal impact on my life. My Memere, which is French for grandmother, had breast cancer many years ago in and she is a longtime survivor. Fortunately, unfortunately, many women don't have this story. Breast cancer is an ongoing issue. It kills far too many women each year, which is why we have Pink Ribbon Month and Breast Cancer Awareness Month. But we wanted to talk about breasts from more than just a cancer standpoint. We also wanted to talk about health. On today's show, we have Meredith Strang Burgess, a breast cancer survivor and Maine Cancer foundation advocate and also member of the Maine House of Representatives. We have clinical thermographer Ingrid Levasseur and we have Dr. Caroline Hodgson, OBGYN from Intermed here in Portland. I would like to point out that breast cancer, like pretty much all cancers, there's some ambiguity about it. There is some difficulty understanding exactly what we're supposed to be doing as far as prevention and detection and treatment. So what we're trying to offer on our show is a variety of different views and best guesses, best practices. So keep this in mind as you listen to the show. I think you'll find it pretty informative as we talk to Meredith, Ingrid and Caroline the Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of our collaboration, we offer a segment we call Wellness Innovations called this Wellness Innovation has to do with Breast Cancer Research in findings that are fundamentally reshaping the scientific understanding of breast cancer, researchers have identified four genetically distinct types of the cancer, and within those types they found hallmark genetic changes that are driving many cancers. These discoveries are expected to lead to new treatments with drugs already approved for cancers in other parts of the body, and new ideas for more precise treatments aimed at genetic aberrations that now have no known treatments. The study is the first comprehensive genetic analysis of breast cancer, which kills more than 35,000 women a year in the United States. For more information on this innovation, visit drlisabelisle.com for more information on the University of New England, visit une.edu.

Meredith Burgess:

Edu

Dr. Lisa Belisle:

Anyone who spent any time paying attention within the state of Maine to news events or breast cancer awareness, or really just in general paying attention, will have heard the name Meredith Strang Burgess before. Meredith Strang Burgess is currently in the Maine House of Representatives. I think you're finishing your final term there. I am, yes.

Meredith Burgess:

I'm there through December through December.

Dr. Lisa Belisle:

But in addition, you are a breast cancer survivor and an advocate for the Maine Cancer foundation and just have done so much in the field of breast cancer research, advocacy, all of these things. We thought it would be pretty important to bring you in and talk about breast, well, let's just say let's call it breast health as opposed to breast cancer during Breast Cancer Awareness Month. So thanks for all that you're doing for this cause and for coming in and talking to us today.

Meredith Burgess:

Thanks very much, Lisa. I appreciate the opportunity to talk to your listeners and talk about the importance of breast health. I think that's a great way to view it as we sort of say it's about any human being that's walking around with breasts Needs to be paying attention.

Dr. Lisa Belisle:

Mm. And this has been important for you as a Mainer because I believe you're a fifth generation Mainer. Is that right?

Meredith Burgess:

At least

Dr. Lisa Belisle:

your family is from where

Meredith Burgess:

my family is actually from. Core group is from Madison, Maine, and logging industry way back and actually have even traced back to Mayflower. There's a tremendous amount of Mayflower lines that crisscross into Maine. Maine is so old and so interesting, and so I'm really lucky to do that. But I was born and raised in Camden, which is a great place to be from. I'm very proud of that. But like a lot of Mainers, you have to kind of migrate down to the city here, down to the big city of southern Maine to make a living and get home. Never enough.

Dr. Lisa Belisle:

And you have three sons. You live in Cumberland now.

Meredith Burgess:

We live in Cumberland. And I do have three now almost grown sons. My last one's in college. It's close.

Dr. Lisa Belisle:

Well, how was this for them? You had a breast cancer diagnosis in 1999, correct?

Meredith Burgess:

That's correct.

Dr. Lisa Belisle:

And how was it for them to be going through this experience with their mother?

Meredith Burgess:

Telling the kids is sort of the universally hard things. If cancer isn't hard enough on a family, I think it's, you know, it has that extra twist when it's a young family. So My youngest was seven, and my other kiddos were 13 and 15 and three boys. And as you can imagine, because of just the ages and some of the guy thing, everybody took it different. Everybody handled that information different. My 7 year old, I will always remember when I finally was able to tell him, and it wasn't easy. I took them all out to dinner and we made it way past dessert before I could finally have that conversation. And he immediately, he was kind of like sitting beside me and snuggling away. And he immediately recoiled, looked at me and said, don't breathe on me. I don't want to catch it. So we had to talk about how that works. My 13 year old was basically like, if we don't talk about it, then it didn't happen. And my 15 year old had an understanding of it because he was in the fire department and had taken some EMT courses. And so he was. He pretty much internalized. Was kind of interesting to see how that plays out even years later. Kind of a fun thing. My son will kill me. But the 13 year old who didn't want to talk about it when he turned 21 got a tattoo. I wasn't particularly thrilled as the mom in explaining why he had gotten a tattoo which I had not seen. Went into this whole thing about my cancer and what an effect it had on him at that time and all of these feelings that he. He'd never expressed before. And I said, well, gosh. So I'm not quite sure exactly what this has to do with the tattoo. Unless, of course, you had a pink ribbon tattooed on your chest. And that's exactly what he did.

Dr. Lisa Belisle:

So you now have a son who's walking around, a grown son that has a pink ribbon tattooed on his chest in honor of his mom.

Meredith Burgess:

That's right. And he said, I can't wait to tell my children and my grandchildren why I have this tattoo and what it means to me. So pretty cool. And he has a pink plate on his car, too.

Dr. Lisa Belisle:

Well, let's go there a little bit. Does this pink plate from Maine?

Meredith Burgess:

This pink plane is from Maine. In 2008, in October, first, for Breast Cancer Awareness Month in 08, we kicked off a new program for Maine specialty license plate that's called the pink ribbon specialty license plate. And it benefits three different independent organizations, or I should say organizations that are based here in the state of Maine. So all the money stays here. We're kind of funny up here about this. We like to keep our money local, and it benefits sort of the three parts, if you will, of cancer, which are prevention. So we benefit the main breast and Cervical health program, and they provide free mammograms and Pap tests for women who are uninsured or underinsured, with the message being that if there's any woman out there that needs to have a screening mammogram and cannot afford to do that, that is not. Not a reason to not get screened. So Maine Breast and Cervical Health program. There are 800 numbers all over the place, and someone can find it certainly online@maine.gov. so we fund for mammograms for women who are 40 to 50, because that's an age group that tends not to be funded by the federal government. So we fund those. And then the next part of cancer is if you have cancer, you need help. And you need more than just medical help. You sometimes need help paying the bills. You need help paying for the gas. You need help paying for, you know, that CMP bill or the oil bill. You just, you know, you need $300, you need $800. You need something like that, not the world. So we have this great program. It's run by the Maine Breast Cancer coalition, and it's 100% volunteer group, and they have this patient service fund so that women can apply, you know, like writing a letter apply. This isn't like a fancy application for literally $300 help here to do that. So we support the license plate supports, one third to the Maine Breast and Cervical Health Program, one third to the Maine Breast Cancer Coalition, and one third to the Maine Cancer foundation, who funds actual bench scientific research here in the state of Maine. And it's a great program and we're trying to make a difference for the big long term picture. And that's just way cool because not only are we hopefully going to change the equation for cancer research and find some better answers to our treatment and ultimately what causes cancer and it all happens here in the state of Maine. And it's also creating Maine jobs. So it doesn't get any better than that. So that's why the pink license plate is out there. And so far we've funded those three organizations, have received over $540,000 to date in four years. And now we're trying to extend it to motorcycles. We've just gotten permission to create a motorcycle license plate and we're looking for 500 wonderfully thoughtful folks who have a motorcycle to go online to main cancer.org and be willing to buy for $25 a pink license plate. That's going to be for motorcycles. And we hope to bring it out next spring around time for Mother's Day in motorcycle season. But I'm looking for those 500 people who are will to go online and sign up in advance. After that it'll be available at DMVs all across the state of Maine. So we're looking for those pink motorcycle riders.

Dr. Lisa Belisle:

Good. So they can go to mainecancer.org if they'd like to sign your petition.

Meredith Burgess:

That's correct. And they can sign up. They need to have, you know, have a motorcycle. And when we bring the plate out, they will get one of the first license plates to come out. And besides, there's not a single motorcycle specialty license plates. So imagine having a nice snappy looking pink license plate on your big Harley.

Dr. Lisa Belisle:

I think that sounds great. So anybody who's listening, be sure to do that, please. Also while you're there, you could find out more about some of the other things that the Maine Cancer foundation is doing, some of the other events which we've talked about on our show before.

Meredith Burgess:

You have, thank you.

Dr. Lisa Belisle:

But go ahead and tell us about some of the things that the Maine Cancer foundation does to raise awareness and funds for breast cancer.

Meredith Burgess:

Well, the cool thing about the Maine Cancer foundation, from my personal perspective, is that it's 100% Maine grown. It's an independent organization, and it has this very strong medical background, if you will. It's been around since the late 70s, so it's not new, but we did sort of jazz it up a little bit in the last 10 years. And they've gotten involved with some fabulous programs and events that really are about wellness and have a lot of positive energy going out forth. And we started the Breast Cancer for me luncheon in 2002. We just had our 11th annual one of luncheon to do that. And that was obviously a little bit more about the pink. But Maine Cancer foundation is certainly for all cancers. And we're trying to solve the big cancer conversation here in support, supporting bench research and patient education. And we're also doing some patient scholars or some scholarships for even some of the oncology nurses. And it's turned out to be an amazing, amazing program. Last year they gave out, I believe it's $1.2 million that we actually distributed here in the state for different programs. So it really is starting to make a difference. And of course, the real crown jewel is a program that got started five years ago, which is called Try for a Cure. And I know you folks have talked lots about that. But the way cool thing, Julie Jordan Marchese was really the moving force behind that. And Julie had dragged me off to do a triathlon A few years before that. We did the Danskin down in Massachusetts, and that's for cancer, and we've done a few events. And she was very much into the whole health and got very much bitten by the triathlon bug. And you know what's so wonderful is when that happened, we had hundreds and hundreds of women all over the state that participate. But around in the Portland area, people were coming together and having really a different conversation. And it happened in my office. I sort of said to all the women, you know, I'll put you free registration, just do it. Obviously, it's a huge commitment. And I had a number of women in my office join in and participate, and gosh, people started sort of training. And the training is whatever you want it to be. But instead of the conversations in my office, anyway, instead of like, let's go to margaritas, it was, let's go run back bay and then go to margaritas. So overall, it was just a wonderful, healthy thing. And I know many different towns around here have brought women's groups together. They bike ride together, they train. It's just gone. It's created a Whole economy actually around health and wellness, and that's all fabulous. The better healthy you can be and good food and exercise and all that hopefully puts your body in the best position to never get cancer.

Dr. Lisa Belisle:

So that's almost cancer prevention at its most basic level, to the extent that we can influence cancer through healthy behaviors.

Meredith Burgess:

You know, make yourself set yourself up for success. You mean you don't have control perhaps over your genetics? You don't have control over certain things. And why cancer happens in me and not somebody else? Who the heck knows? But, you know, I really do know that we're going to figure that out. We've come a long way, and now we just have to really work on ways to be better tuned to our bodies. And screening, which is a whole other big conversation that's happening right now, which is around to mammogram or not to mammogram. That is the question. And that's a question that's also come into the political world as to what's the mandated correct thing, what insurance companies are willing to pay. And I think women know that. There's been a lot of conversation. A year ago it came out that said we'd been in the. If you're 40 years and over, you had a mammogram every year. And then the message came out last year to say, well, maybe you don't need to do it that often, or maybe you don't need to do it or you should do it different. And I think from there, the message was very unclear to people. And I think women are pretty confused and frustrated by that message. And what I've sort of come to understand around that message is that the real issue is breast density. So what's happening is that a lot of women, once you go through any medical thing, you become rather smart about the issues and you talk to lots and lots of people. That's one thing women do, is we talk and we help each other. And it's so important. It's so, so important to talk to someone who's been there, done that, and we're really good at doing that. But it's really interesting in all the different talk and all the different things that we do, we haven't really talked about density. So what it really simply means is that kind of go back to what happened. I think when people are 40 years old, Susan Love's. Dr. Susan Love's book, which is the Complete Breast Health Guide, should just drop out of the sky for all of us. You know, who would ever have known that these breasts that we all just couldn't wait to have would turn into such a pain. I have this great shirt and it says, you know, across the front of my T shirt it says, yes, these are fake. My real ones tried to kill me and gets a lot of attention when I wear it and you know, sparks a lot of conversation, which again, all conversation is good. And so what happened? I was diagnosed in 99, but I had just turned 43. And dense breasts have nothing to do with really your age or the size of your breast. However, having said that, they tend to be a little on younger people firm as we all work out more and more and more. In the old days it used to be by the time you were 40. Think back what our parents looked like when they were 40 and what we look like when we're 40. We think, oh my God, you know, we look 20 women probably didn't work out quite so much and whatever. And if you have mammograms, radiologically, a non dense breast or a breast that has a lot more fat tissue in it, radiologically, mammograms pretty much dark. And cancer radiologically is white. So the more dense your tissue is, the less fat you have. So radiologically, when you look at that breast, it's basically white tissue. Well, if cancer is white as well, then it's the proverbial snowball in the snowstorm. So it's not that mammograms aren't effective, it's that mammograms are not effective on dense breasts. So now you're into a specific detail of should you as a woman, you go and you get a mammogram each year and no one ever says to you, wow, has anyone ever told you you have dense breasts? And then of course you say, gosh, no thank you, or what does that really mean? Well, that means that if you have any precursor of any cancer in your family, which is more than breast cancer, hormonal cancers or prostate cancer, you know, the thyroids, I mean, all sorts of hormonal cancers, they all really need to be grouped together. Then maybe you should think about a different way of testing. Maybe you need to have an ultrasound, maybe you need an mri, maybe you need to have a PET scan. And I know you're going to talk more about all the different screening options and there's a ton of them, which is the great news. But then we have the next challenge, which is the political part of who pays for it, how does that, when is it medically appropriate and when isn't it. And that's where the medical community and the insurance community and if you will, the legislative community are coming together. We had a piece of legislation this past session to talk about the density. So, for example, a woman comes in now gets a mammogram. In theory, you're supposed to get and it's not a legal supposed, but a doctor is going to send you a note, whether it's a postcard, whether it's a letter to say your mammogram came back totally normal, see us again in one year. Should it say on there your breast density is, you know, high, medium, low, and then what does that mean? So that's the conversation that's going on. We decided not to legally, legislatively mandate it, but we are in the process, and I've been participating this summer and fall with Dr. Sheila Panett, who's the head of the CDC, and a number of other doctors and radiologists who are working on talking about how do we communicate this to women without. And it's funny, they all say we're worried we're going to scare women. And I say, you know what? We're already scared. We're already confused. How about just some straight information? So we're working on that. But women, right now, if you're listening to this and you're saying, I don't know if I have dense breasts or not, you should know that, because it's not that you should or shouldn't have a mammogram, it's that the mammogram that you're getting may or may not be effective mammograms for a woman that has some fat tissue in their breasts. And it's all mammograms are phenomenal. They really, really, really are our best frontline screening tool that we have. And it's that if you have dense breasts that perhaps you should use a different screening tool and you need to talk to your doctor and ask those questions is you need to find out where you are on that scale. And, you know, as you get older, probably the mammograms you see become more effective at really finding a cancer. So it's not that mammograms don't work. They do absolutely do. But if you can't see anything radiologically, then it's not going to work yet for you.

Dr. Lisa Belisle:

So it's about knowing to ask the question in the first place and having

Meredith Burgess:

an open talkative relationship with your medical provider, whether that's your GYN doc, whether it's your primary care doc. However you happen to access your women's care, you need to ask those questions. And it kind of comes back to, we all have this body that we're given. It's about personal responsibility, the whole conversation about health care and all. I really am a huge, huge believer that, you know, it's up to ourselves. You've got to be educated. You read the instructions manual when you get a new gadget or you get the new TV and you figure out how it works, shouldn't you do the same thing for your body? And as you get older, there are certain issues that kind of happen. You know, we've learned so much about stretching and exercise. And so you have these breasts. You know, you need to have a basic understanding of what you need to know about them.

Dr. Lisa Belisle:

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Meredith Burgess:

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Dr. Lisa Belisle:

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Meredith Burgess:

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Dr. Lisa Belisle:

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Meredith Burgess:

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Dr. Caroline Hodsdon:

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Meredith Burgess:

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Dr. Lisa Belisle:

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Dr. Lisa Belisle:

Well, one of the things I didn't mention earlier is that you're the founder of Burgess Advertising and Marketing, which I think many people recognize as being one of the more influential firms in the state for what it does. So clearly you've been about having a voice from for many years. What is it? Why? Has it been easier for you to have a voice? Or has it been easier for you to have a voice than it is at first for many women?

Meredith Burgess:

Great question, Lisa. I think it's one of those things where it's sort of basic communications, so things happen for a reason. I have different viewpoints of my reasons and different things. But bottom line is you are given something and you have a choice. You can either pull the covers over your head and just pretend it's not there, make it go away or whatever, or, you know, you can kind of deal with it head on. And so many people, you know, you need to have sort of a stubborn New England main streak in you, sort of honorary enough to go, I can stare this thing down because it, the process and the treatment process, it really sucks. And, you know, that's. That's just all there is to it. It's not a fun thing. I tell a lot of the folks I talk to that it's kind of like joining a fraternity or a sorority. The hazing is really rotten, really bad, really bad. But once you're over that, it's a pretty special club and people are very supportive of each other and that no one should feel that they're alone. And yet it's an individual decision. And there's a small, small percentage of the people I talk to with any kinds of cancer that chooses to do it the other way. It's a private thing. They don't really want to talk about it. And to do that, and that's a. Okay. Whatever you decide for yourself is what you've decided. I think overall, I think it's a little healthier to reach outside and be part Of a bigger conversation. Communication. It's all about communication. And so maybe I was supposed to get this and bring some communication and really ways to help us make a difference in the state of Maine and beyond with understanding of what cancer is, trying to do some research around making it stop, and also making sure that those that are in the heat of the moment feel that they're not alone. So I just got. I guess I got lucky or cancer got unlucky.

Dr. Lisa Belisle:

How do people who are listening today who are interested in breast health in general or breast cancer, how can they get more information about some of the resources that you've described?

Meredith Burgess:

Great question. As we all know, the Internet is certainly the answer to just about any question you have. And that's good news and bad news. A lot of times we tell people when you first get cancer to stay away from the Internet because you can sort of follow the information way out on a branch that may or may not be the branch that you're going to have to hang on. At the same time, it's wonderful because you can get questions answered so quickly. The American cancer society, which is cancer.org is certainly by far the number one place to go. It has incredible information on all different kinds of cancer, all different kinds of treatments, all different kinds of health tips. They have food tips. It certainly is sort of the real go to place. And then from there, within the state of Maine, you really kind of break down to each of the different kinds of cancer, have their own websites which have links to very specific things. And there's a lot of online. The word chat room isn't correct, I guess so much anymore. But there are support groups and folks and online communities. That's the right word. Online communities that are out there for different specific types of cancer. And then there are these wonderful, wonderful programs that have started all over the country. And Maine is very lucky. We have the cancer community center, which is in south Portland. And all that is is a place that different cancer survivors come together. And they have programs there that are absolutely at no charge to cancer survivors in their families and their caregivers. Everything from nutrition to yoga classes, to support groups to outreach, that's all going on. And of course, everybody's real now familiar with the Patrick Dempsey center of healing. And that's the same kind of program. It's actually not a hospital. It's actually a place where people can go. And it's become the sort of the center point for folks in the Auburn, Lewiston area to come together and have that kind of a programming. I know they're doing the same thing in Augusta at Maine General Eastern Maine Medical center and the Lafayette Cancer center is working on sort of really getting those programs up and going. There's some things in the county, there's some stuff happening down in Calais and there's networks all across the state for all these different kinds of cancers. So there's nobody should feel alone.

Dr. Lisa Belisle:

And the main cancer foundation website is

Meredith Burgess:

main cancer foundation website is www.mainecancer.org.

Dr. Lisa Belisle:

and there's a Facebook page as well.

Meredith Burgess:

And there's a Facebook page as well. Those tend to be some activities that are going on out there. Right now. We've just finished our pink tulip drive to plant and make the state pink next spring. They plant pink tulip gardens all across the state of Maine. There's garden clubs all across that have like bought these. And I have to tell you, I'm very untalented when it comes to anything that's growing. The tulip bulbs, they bloomed for me and they were the most amazing. They're an unusual variety of tulip. I guess it's a very bushy tulip. It's hard to explain that from a non gardening person. And funny thing for each time I've run for the legislature because going door to door, you know, usually candidates pass out a pencil or something like that. I have always passed out tulip bulbs. And even though, you know it's the perfect time, it's the fall, you plant your tulips. And I have to tell you, over the last six or seven years, every year, everywhere I go, women tell me, oh my God, your tulip came up. Even I could get it to grow. So the variety that we have is a very special variety and very hardy for me. So those are fun. We've just finished with those and then you can read about all the different research programs that are going on and the science that's really happening right here.

Dr. Lisa Belisle:

Well, I appreciate your spending so much time planting bulbs and planting hope and also growing hope within the state for breast cancer research and prevention. We've been speaking with Meredith Strang Burgess, who is currently in the Maine House of Representatives and is also a breast cancer survivor and founder of the Burgess advertising and marketing agency. Thank you for coming in.

Meredith Burgess:

Thank you very much for giving this subject some great air time. We appreciate it.

Dr. Lisa Belisle:

It.

Dr. Lisa Belisle:

As many people are aware, October is Breast Cancer Awareness Month. The thing about breast cancer awareness is that it's good to be aware of breast cancer, but sometimes that generates a little bit of fear. So instead we've decided to call this Breast Health Breast Health Show. This is what we're doing. And we have Ingrid Levasseur with us. She is a certified clinical thermographer and has a practice in Falmouth, which actually is rebuilt after a building that she was in burned down. So she's got also an interesting story on top of that. But Ingrid, thanks for coming in and talking with us about breast health.

Ingrid LeVasseur:

Thank you so much, Dr. Lisa. It's really great to be here.

Dr. Lisa Belisle:

So let me just start since I already set you up for this, but you were in a building that was in Yarmouth that just randomly burnt down.

Ingrid LeVasseur:

It wasn't random, it was arson.

Dr. Lisa Belisle:

Well, random for your life. How about that?

Ingrid LeVasseur:

Sure, it was a shock. It was a shock and a surprise. And there were 26 of us there. We all moved on and set up shop somewhere else. So I was fortunate enough to land in Falmouth on Fundy Road. And it's been a great spot for me, a great location. And now my patients are happy that I'm closer to Portland.

Dr. Lisa Belisle:

But you've also had some sort of changes that have been pretty significant in your life previously. You've had some sort of burning down of your past lives and moving on. This is sort of metaphorical for you.

Ingrid LeVasseur:

Yeah, no, absolutely. I mean, a 28 year old marriage dissolved and that's a long time to be married. And it's, you know, another shock to the physiology, certainly. And it was out of that marriage that really this business developed initially and, and it was great just to be starting something fresh on my own that was just about, you know, something I was creating by myself. So it was a great thing.

Dr. Lisa Belisle:

And before this you spent time working with Deepak Chopra?

Ingrid LeVasseur:

Mm, I did. Back in the 80s when he was still in Massachusetts. He was at the Ayurveda Health center in Lancaster, Massachusetts. And that was just an amazing time because it was when he. He was really coming into the forefront with ayurvedic medicine and was appearing on all these shows, and media from all over the world were descending on Lancaster, Massachusetts, to find out about ayurvedic massage and cleanses and things like that. So it was an amazing time in my life.

Dr. Lisa Belisle:

So how did you get into working with him or an interest in health?

Ingrid LeVasseur:

Well, my interest in health stem from a family tree that's just riddled with cancer and heart disease. And I just felt there had. Even at a very young age, I felt there had to be something that I could do proactively to not be following the footsteps of my family. Also at a young age, at the age of 19, I learned transcendental meditation. So it was from there, that connection and becoming a teacher of meditation that I then found out about the opportunity to work with Dr. Chopra.

Dr. Lisa Belisle:

How did you transition that into clinical thermography, which is a very interesting and unique approach to and yet researched, well researched approach to breast health and early detection of breast cancer?

Ingrid LeVasseur:

Well, it was really a very personal thing. I was of the age where it was time for me to have a mammogram, and I really was thinking, there must be something else. It was sort of the whole man on the moon idea that we put a man on the moon and what have we done to promote women's breast health? And I heard about this thing called thermography, didn't know much about it, started looking into it and realized that that was certainly a good thing that I wanted in my toolbox of how I take good care of myself. So it certainly resonated with me on many levels. And then certainly once I was divorced, and it just seemed like the right time for me to sort of venture out with this.

Dr. Lisa Belisle:

So describe what thermography is.

Ingrid LeVasseur:

Thermography is a means of detection that it uses the heat that is produced by the body. And if you think of things as the difference between anatomy and physiology, anatomy is more looking at structure, which a mammogram does. It's looking for a lump. What's the size? What's the shape? The thermography is looking at the heat, at the thermal pattern. That means what's the physiological activity that's going on in that breast that might support the growth of a tumor? So it's really mammography and thermography are completely, completely different technologies. They're not looking at the same thing. The mammogram, the mammography is really just structural and the thermogram is more physiologic. More of the. Yeah, more of the physiologic.

Dr. Lisa Belisle:

What I understand from having talked to you before coming in is that thermography is something that has to be done over time.

Ingrid LeVasseur:

Yeah, we feel that if you can look at the breast health over time, what we ideally would like to see is stability over time. But we're certainly looking for change over time. And the way we do that is a person, if they're coming for breast screening, would come initially, they'd come again in three months. And the purpose of that is we'd want to see is there any change that occurs in that short time frame, in that three month time frame, because the average doubling time of cancer is about 90 days, hence the three month window. So if we have stability in that three month period, then we say come back in a year. So ideally we'd want to see the person annually and each time with those annual visits, we'd be looking for hopefully stability over time, but potentially change over time. If we saw some change, that was quite dramatic. See you again in three months. So let's see, is this stabilizing now at this different place, or is it going back to something for my own? When I had my own thermograms done, my first one was what it was. The second one came back different. So I had to come a third time, you know, again another three months. And that first one and the third one were more of a match. When I went back later to look at what was going on in that timeline, it was during that second one that my husband had left and that we had split up. So even as much as I thought I was keeping it all together and I was handling things quite nicely still, that emotional turmoil in my life was being reflected in the health of my breast tissue.

Dr. Lisa Belisle:

Is this something, and I know people will ask, because they always ask me this question, is this something that's covered by insurance? Is it something that gets paid for? How does it, from a cost standpoint, how does it compare?

Ingrid LeVasseur:

The cost is very reasonable. The charge is $160. That includes the interpretation by the medical doctors who read the scans. So once the patient has paid me, I pay those doctors directly. And the patient does not have to just never receive a bill from the interpreting physician. Some insurances do cover it. The ones that do tend to be national plans. For instance, Blue Cross Blue Shield or Federal Blue Cross Blue Shield seems to cover it. I've heard CIGNA sometimes covers it. People check with their own health care provider. Most of the insurance plan plans that people have in Maine, which tends to be Blue Cross Blue Shield, doesn't tend to cover it for breast screening, though they have covered it for carpal tunnel. So that's a whole other topic, but generally not covered, reasonably priced. And there also is a foundation that will help women pay for it as well.

Dr. Lisa Belisle:

And what foundation is that?

Ingrid LeVasseur:

It's called the United Breast Cancer Foundation. UBCF Info. They can go there and apply.

Dr. Lisa Belisle:

You mentioned just briefly that thermography is used for other things like carpal tunnel.

Ingrid LeVasseur:

Yeah, absolutely.

Dr. Lisa Belisle:

Is this something that you do or is this something that other thermography.

Ingrid LeVasseur:

Oh, no. I can point the camera at any body part. So pretty easy to do. So sometimes people come in for head and neck issues. We can assess the carotid artery. So sometimes, particularly now that people are understanding that inflammation is so important, we can really get a sense of whether the carotid arteries are inflamed. It's one thing to know that they're blocked, which certainly you can find that out, but is that blockage inflamed? That's a really key piece of information that we can get in an instant with a thermal camera. Also, people sometimes, if they're concerned with dental issues and if there's some underlying infection that might not be evident on the surface, that will pretty much jump right out at us. So I like to say with the thermography that you can't hide. It doesn't lie, and you can't hide. You might not always understand why there's heat here or in some particular spot, but you can't hide from. From it.

Dr. Lisa Belisle:

Well, it sounds like you've had some significant fire in your life, right?

Ingrid LeVasseur:

It's all about fire.

Dr. Lisa Belisle:

It's all about. All about the heat and the fire. You had this building burning down in Yarmouth and you're now in Falmouth and comfortably there. It sounds like you had some fire in your personal life and now things are better. And so I would like to encourage anybody who's interested in thermography to get in touch with you. How can they reach you?

Ingrid LeVasseur:

My phone number is area code 207, of course, 781-6060. I'm located in Falmouth at 5 Fundy Road, which is right off of Route 1, very centrally located. And my website is www.myinnerimage.com thank you very much.

Dr. Lisa Belisle:

We've been talking to Ingrid Levasseur who is a clinical thermographer and the owner of My Inner Image in Falmouth.

Ingrid LeVasseur:

Thank you so much.

Dr. Lisa Belisle:

Recently I had the good fortune to intersect again in my own personal life with a doctor that I trained with at the Maine Medical center as a family practice resident. And she was an ob GYN resident. Now she's out in clinical practice doing full time work in the field. This is Dr. Caroline Hodson of Intermed who's an obstetrician gynecologist in the Portland area. I feel so fortunate to have you in here because I know that you're out there. You treat many, you've been treating many women in this area for how long now? A decade. A decade?

Dr. Caroline Hodsdon:

Yeah, almost 14 years.

Dr. Lisa Belisle:

14 years. And you have a wealth of clinical knowledge and practical applications. So this is why I wanted you to come in and talk to us about breast cancer screening, because there's a lot of confusion right now. People, women aren't really sure after last year's findings, they aren't really sure what should we do? It's not every year after 40 anymore. What do you talk to your patients about? How do you approach this?

Dr. Caroline Hodsdon:

That's probably one of the biggest questions that women have is how often should I be screened for breast cancer and what's the best way to do it and when do I start? If you look at a woman who has an average risk of breast cancer, I think that that is the most difficult. Women who are at high risk for various different reasons, their screening is more obvious. But for a 40 year old that comes into the office to say, should I have a mammogram? It's a little bit tougher. And the reason that it's tougher is that there are many learned bodies out there that have recommendations on what to do. And they range from a mammogram every year at 4:40 to having a mammogram starting at 50 and only having one every other year. And it's really hard to help women decide which option is best for them. The reasons for the discrepancy is that the studies are not clear. Just as you read in the newspaper about whether or not estrogen causes breast cancer, some people say absolutely yes, and some studies say absolutely not. The same is true with how effective is mammogram for screening women? And what is the benefit and the harm? And different learned bodies think of those two things in a different way.

Dr. Lisa Belisle:

And has there been some concern generated about the use of mammograms because of radiation exposure?

Dr. Caroline Hodsdon:

There is concern about that. And that is one of the reasons that the recommendations from the US Preventive Task Force have changed and they now recommend starting mammograms at 50 instead of 40. And there's a couple of reasons for that. One reason is because of the radiation exposure, we know that the younger a breast is, the more estrogen that's there. And that does make a younger breast more susceptible to radiation exposure. So an older breast has less exposure. I'm sorry, it has less toxicity from the exact same amount of radiation. A younger breast also has less chance of getting breast cancer. The risk of breast cancer really increases most with age. That's the biggest risk factor. So if you start at 50, the breast is less sensitive and there is a greater chance that you'll find something. Having said that, the risk of radiation exposure is incredibly small. The National Council on Radiation Protection and Measurements stated that the risk of having breast cancer caused by mammogram over a lifetime of mammogram is about one in a thousand. And the risk of dying from breast cancer caused by radiation is about 1 in 10,000. And of course, you have to balance that against what is the risk of your lifetime of breast cancer, which, if you lived a nice long life, is going to be one in nine. So they're balancing the risk of radiation exposure and your chance of getting breast cancer when they're making these recommendations.

Dr. Lisa Belisle:

What about the use of other technologies like ultrasound or even thermography?

Dr. Caroline Hodsdon:

We know that mammogram is better than ultrasound for screening. Ultrasound is specific. So when you find something on mammogram, then you can really hone down on that abnormality with ultrasound and better characterize. What does this look like? Does it look like a fluid filled cyst? Does it look like something more worrisome? You can't get a good screening with ultrasound only because the Breast is just too big to look at completely. As far as thermography goes, the American Cancer Society, the US Preventive Task Force for the National Cancer Institute, none of them recommend thermography as screening alone. It's unclear, I think at this point because there is a high false positive rate with thermography, how that is going to meld with other breast cancer screenings.

Dr. Lisa Belisle:

And by false positive you mean something shows up, but it's not necessarily cancer.

Dr. Caroline Hodsdon:

Right. Many women have had that happen to them. They go in and they see something on mammogram but they don't know what it is and so they ask you to come back and look again. And that happens much more frequently with thermography than it does with mammography. And that's one other reason why the US Preventive Task Force has recommended mammograms screening starting at 50 because a 40 year old breast is very dense and it's hard to see through that density. And so frequently they don't get the image that they want and they're unclear of what they're seeing. So that again becomes a false positive on mammogram and you need to come back.

Dr. Lisa Belisle:

Well, I think that you are making it very useful for people, very user friendly the way that you're approaching this. And what I'm hearing from all of this is that the recommendations are, they're out there, there's still some discussion as to the best way of dealing with all of this. But in the end it's about people taking responsibility for their own selves, their own bodies, taking responsibility for having a conversation with their own healthcare provider and really trying to individualize the way that they approach the screening.

Dr. Caroline Hodsdon:

I think that's an excellent summary. The risk of breast cancer is not 0 under 50 and all of us have friends that have had breast cancer in their 40s and it's very, very worrisome for us. So it makes a conundrum about how do you handle that lifetime fear that this could happen to me, especially if they've told me for years I need mammograms. And now you're saying, well, maybe you don't.

Dr. Lisa Belisle:

Well Dr. Hodgson, I'm so glad you've taken the time to come in here and try to clarify things to the extent that they can be clarified because it's a confusing discussion to be sure. But I appreciate your taking, giving us the opportunity today to hear more. We've been speaking with Dr. Caroline Hodson from Intermed, a local obstetrician, gynecologist and someone I'VE known for a long time and I appreciate you coming in.

Dr. Caroline Hodsdon:

Well, thanks for having me.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you've been listening to the Dr. Lisa Radio Hour and podcast show number 58, Breast Health Created in honor of Breast Cancer Awareness Month, first airing on October 21, 2012. As part of our show today, we've welcomed Meredith Strang Burgess, breast Cancer Survivor, member of the Maine House of Representatives and advocate for the Maine Cancer foundation, clinical Thermographer Ingrid Levasseur and Dr. Caroline Hodgson, OBGYN from InterMed here in Portland. We hope you'll take a moment to go to Dr. Lisa.org and find out more about our guests and also visit itunes and download this podcast or past podcasts, all for free. Please do find us on Facebook and like our Facebook page and let us know how you think we're doing. Also let our sponsors know that you really appreciate their supporting the show. This is Dr. Lisa Belisle. Thank you for being part of our world. May you have a bountiful life.