Welcome to the Breast Cancer Outreach Podcast

Today we interview, Dr. Alfred Levine, Co-principal investigator of the Staten Island Breast Cancer Research Initiative, Co-Director of the Center for Environmental Science and faculty member in the department of Engineering and Environmental Science and faculty member in the department of Physics. 

Transcript

 Welcome to Breast Cancer Outreach, a podcast focused on the latest information on breast cancer. Here is your host, Donna Gursley. Today as our guest, we have Dr. Alfred Levine, Professor of Engineering and Environmental Science as well as Professor of Physics here at the College of Staten Island. He is also Director of the Graduate Program in Environmental Science and my co-principal investigator in the Staten Island Breast Cancer Research Initiative. Welcome Dr. Levine and thank you so much for being our inaugural guest on the Breast Cancer Outreach podcast. It's a pleasure to be here. So Dr. Levine, why did we start studying breast cancer on Staten Island? The New York City Department of Health has determined that Staten Island breast cancer rates have been higher than the rest of the city for over 40 years. That's a very interesting fact. Once we became cognizant of these high death rates, how did we decide to examine these data to try and find out why these high breast cancer death rates were on Staten Island and not the other five boroughs? The first step was to establish what patterns there are in the individuals who died of breast cancer compared to patterns in individuals who did not. We therefore needed data on the life history of both groups of individuals. And how were we able to obtain that? We got two different data sets, one from the New York City Department of Health and Mental Hygiene, which were the death certificate information. The other was far more interesting. We got life history information from the obituaries in the Staten Island advance, an amazing resource. Now, is it true that you only looked at female breast cancer death rates and not males? Could you tell us the reason for that? The number of males in the data set was simply too tiny to pay attention. And we are really interested in the much higher incidence among women. So we have both data sets, the data that was obtained from the New York City Department of Health, plus these life histories of the obituaries. What did we learn? Well, first of all, I guess the correct question is, how did we analyze these data? The first step was to look at the patterns, to simply see what was different between the people who died of breast cancer and the people who didn't. At first step, we simply let the data show us whatever was in it. We didn't anticipate what we were going to see. During the course of this study, we found out that there was a clear pattern. The group that came down that died of breast cancer were much more likely to have spent their puberty years on Staten Island than the group that didn't come down with it. So there was a comparison of puberty years amongst women that spent their puberty years on Staten Island who died of breast cancer and those individuals that did not die of breast cancer and how the number of years they spent during their puberty years. Is that correct? Not the number of years. Where the location. If they spent any point of their puberty years on Staten Island, we counted it as having spent puberty years on Staten Island. And what are we talking about puberty years? The period age 9 through 19, just to make sure we capture all individuals. And what did you find? We found that the women who had spent their puberty years on Staten Island were 60% more likely to die of breast cancer than the women who did not. This is a strong effect and an unusually strong effect since the incidence of breast cancer occurred approximately 40 years later. So that is a very dramatic effect. Should we tell women not to spend their puberty years on Staten Island? Not at all. Not at all. Staten Island is a wonderful place to grow up. We should say if you have risk factors and spending puberty years on Staten Island constitutes such a risk factor, you should discuss that with your medical professional. So Dr. Levine, as an environmental scientist, why do you think that Staten Island, well let me phrase it differently, do you think that environmental factors could be causing these high breast cancer death rates? Everyone that I speak to about our results always says, oh, it's the dump. It's the dump on Staten Island. How would you answer those listeners that are interested in the environmental perturbations on Staten Island? We are still exploring what the main factors are. Right now, I believe it is not the dump because for our data set, most of the women spent their puberty years before the dump opened up. And therefore, it could not have been the dump. So why do you think it is Staten Island? Don't know at this point. That's why it's the Staten Island Breast Cancer Research Initiative. We want to find out the answer. Research shows that smoking can increase your risk of breast cancer. If you are a smoker, speak to your doctor about resources that can help you stop. This PSA is brought to you by the researchers at BreastCancer.org and the Staten Island Breast Cancer Research Initiative at the College of Staten Island, CUNY. So many times when I speak with individuals on Staten Island, they believe that the high breast cancer death rates are due to the fresh kills landfill, also known as the dump. I do not believe that our data supports that statement. Our results say that most of the women who died went through puberty before the dump was even opened. Now, we're very happy that the dump has been closed, but I don't believe that the risk factor was the presence of the dump. And finally, Dr. Levine, what is your advice to women and our listeners going forward about living on Staten Island? Staten Island is a wonderful place to live. If you did go through puberty on Staten Island, inform your health care provider of this fact so that you will get proper screening and treatment. Thank you so much for being with us today, Dr. Levine. We look forward to having you in the future. I'll be happy to come. Thank you. First, let me introduce Robin Johnson, the health educator for the Staten Island Breast Cancer Research Initiative. Each podcast, Robin will be talking about different topics in breast health education. Welcome, Robin. Thank you for having me. After hearing Dr. Levine telling us that women who spend their puberty years on Staten Island have a 60% greater risk of dying from breast cancer, what advice can you give our listeners to possibly lowering their risk of breast cancer? Is there anything that we can do? Well, the number is very startling, even to me as a health educator. The first thing I want to say is I am not a doctor. I'm a health educator. And SIBCRI offers a lot of resources, and there are other organizations on Staten Island as well that are here to help. So along the way, you're going to be giving us some of these resources as well as helping us with different tips that we can lower our risk? Absolutely. There are no guarantees, but you can try to reduce your risk with some basic lifestyle changes. So we always post these types of information on our website, on our Instagram. You can look at these on our Twitter regularly to keep yourself healthy and in check. Did you get your mammography this year? Many women have delayed their breast cancer screenings due to the COVID-19 pandemic. Speak to your doctor about when you should have your first or next breast cancer screening. This PSA is brought to you by the CDC and the Staten Island Breast Cancer Research Initiative at the College of Staten Island, CUNY. Robin, can you tell me what I could do to possibly lower my risk of breast cancer? I get my mammography every year. I try and eat healthy. But are there other things that I can do? My water intake is not great. I did stop smoking. Are there things I can do to help? There are things you can do. And that's why we always do lots of posts on Instagram to help our followers have a better understanding of small steps they can take. What do we call ourselves on Instagram? Our name is SIBCRI underscore at AT underscore CSI. And what can I learn from the tips that you put down or the suggestions that you put down on Instagram? I know that you're not a doctor, that you're a health educator, and I know we have to ask our doctor about what steps we can take to prevent any kind of health issue. But what do we find on Instagram? Well, you sound like you're already going in the right direction. Yeah. I mean, you've made some lifestyle changes. You stopped smoking. You have to limit your alcohol intake. A big change would be eating leafy greens, adding fruits and vegetables to your diet, to have a healthy diet, and not just once a week, but every day. Try to make those little changes. And one of the issues that I see a lot when I talk to people in the Staten Island community, particularly students, is that they're scared. They don't know who to speak to. They don't want to start the conversation. So you've suggested that you already go on your annual screenings. But if you are listening and you're scared to do this for whatever reason, I highly encourage you to talk to your doctor and find out what screening is best for you. I think that's important, especially for women of any age to have a good rapport with their doctor and be able to speak to them about not only breast cancer risks, but also the fear that's surrounding breast cancer. When we see numbers like 60% greater risk of spending our puberty years on Staten Island, that's a scary statistic. And we need to be smart about our overall health as well as our breast health. Absolutely. I would be sure to communicate, have a comfortable conversation with your doctor and say, I am at a higher risk having lived my puberty years on Staten Island. What other steps do I need to take? And since your doctor knows your personal medical health, they can help advise you on what to do. But doing nothing is never the answer. Robin, what about exercise? Exercising regularly may also reduce your risk of breast cancer. I need to do that a little bit more. So do I. Is there anything else that you would like to tell us on our initial podcast? I would want to make sure our listeners know that they should be taking good care of themselves, always, not just in the month of October. And speaking to their doctor about what they need. Those are the two most important things. Obviously, like we talked about, small changes to your lifestyle can make a big difference to your breast health. You're absolutely correct. In October, it reminds us we see pink. So we say, OK, I have to make my appointment for my screening. But it's not just in October. We should be aware of this all year long. Thank you so much for being with us. And we look forward to hearing the latest in breast cancer health. Next podcast, Robin, thank you so much for being here with us. Thank you for having me. Thank you for tuning into Breast Cancer Outreach. If you have any questions, please email us at sibcri.csi.cuny.edu. That's S-I-B-C-R-I at C-S-I dot C-U-N-Y dot E-D-U. This podcast is supported by the College of Staten Island, produced by José Colón.