Centered on Health 10-23-25 - Advantages of genetic cancer testing with Jessica Gatterdam, RN, Cancer Risk Navigator
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Speaker 1 (00:01):
It's now time for Centered on Health with Taftazel.
Speaker 2 (00:05):
On Use Radio Wait forty ELWODJS.
Speaker 1 (00:07):
Now here's doctor Jeff Tubble. Good evening, and welcome to
tonight's episode of Centered on Health with Baptist Health here
on news radio eight forty whas. I'm your host, doctor
Jeff Tumblin, and tonight we are talking about the advantages
of genetic cancer testing with Jesse Gadterdam, who I'm going
to introduce you to in just a minute. I just
(00:30):
want to let people know that four point eight million
people in the United States have undergone genetic counseling, and
this is typically for cancers like breast cancer, ovarian cancer,
and coorectal cancer. But there's still many things that impede
the ability to get these genetic testing done. And we're
going to talk to an expert tonight, and I want
to introduce you to Jesse Gatterdam, who graduated in two
(00:54):
thousand and four, but in twenty thirteen she decided to
get her nursing degree through an accelerated program at Bellerman University,
which she completed in twenty sixteen. She has had lots
of experience, including working in the OAR as a circulator
and in twenty eighteen had an unexpected life turn, which
I'm going to let her talk a little bit about.
She developed a nursing Pathway program at Ballard High School
(01:16):
and then went on to become a nurse navigator, working
with a multi disciplinary team of medical and surgical doctors
helping newly diagnost breast cancer patients and high risk patients
along their journeys. Now she's at Baptist since twenty twenty
four in the nurse navigator role. Welcome to Center on Health, Jesse, hi.
Speaker 2 (01:36):
Ja, thank you so much for having me.
Speaker 1 (01:39):
Well, you know we are. We're thrilled to have you here.
I mean, this is such an important topic about not
only breast cancer specifically, but genetic testing and certainly your
role in terms of navigating patients through this complicated process.
But your story is pretty unique, and I thought maybe
we could just sort of start by having you introduce
(02:00):
yourself in a little bit about your experience and kind
of what's led you down this pathway.
Speaker 2 (02:06):
Absolutely so, I found myself when I graduated nursing school,
I went straight into the operating room, and as I
was working there, I felt a lump in my breast
and I was thirty nine at the time. So if
as patients are aware who go for mammograms, the typical
age for your first mamorram is not till the age
(02:28):
of forty and so I had, you know, not been
for my first mamogram yet. So thankfully I was working
with surgeon in the OAR that day who had been
through her own breast cancer journey, and she really encouraged
me to seek out my first mammogram and just get it,
you know, looked at further. And I'm so thankful for
(02:50):
her for encouraging me to do that, because maybe I
wouldn't have done that otherwise. And sure enough, got right
in for my first ever mammogram. Right after they did
an ultrasound, and right after that they did a breast biopsy,
and two days later, sure enough, I.
Speaker 1 (03:07):
Was diagnosed with cancer at thirty nine.
Speaker 2 (03:12):
At thirty nine, Yes, what was that like for you?
Speaker 1 (03:16):
Did you process this as a provider, did you process
this as a patient? What was the initial response to
how you approached hearing that at such a young age.
Speaker 2 (03:29):
Well, I think when you're in the medical field, you
do tend to approach everything from a medical viewpoint. I
was thankful for my medical background. I kind of knew
what the doctors were talking about, but I did not
know anything about the breast cancer world. At that time.
Felt very strong in my own medical position, but I
(03:53):
did not have any idea what to expect when it
came to breast cancer. And as soon as you anyone
that's them through this journey knows, as soon as you're diagnosed,
it is a whirlwind. You are thrown into multiple doctor appointments,
multiple uh things, you know, results coming at you. You
meet with not only a surgeon, but a medical oncologist,
(04:15):
radiation oncologists, plastic surgeon, genetics at sometimes. So it is
a whirlwind and it was very overwhelming. So I was
thankful to have my medical team, you know, my medical
family around me during that time. But yes, you can't
you know, also have to approach it as you know
(04:36):
a patient as well, because it's the first time that
you've ever been through something like this, and it is
very overwhelming.
Speaker 1 (04:43):
Absolutely, And I mean we're going to be jumping around
a little bit because there's so many topics I want
to I want our listeners to learn from you, but
in general, and I know we'll talk about it in detail.
But would genetic testing have helped you in this situation?
Speaker 2 (05:00):
I think so. I think that genetic testing, you know,
we know that it's a way to you know, find
our high risk patients sooner. You know, it's an early
detection prevention key in helping, you know, identify patients who
may have that family history but not have a history
(05:21):
themselves yet, you know, so and getting imagen sooner, getting
into high risk clinics sooner, to find cancers earlier, that's
the goal I think with genetic testing. So yes, definitely,
I do think that would have been key.
Speaker 1 (05:37):
And and I know we're going to talk about the navigator. Well,
was there a navigator available to you at the time
of your your diagnosis?
Speaker 2 (05:47):
There was, Yes, I did. I was lucky enough to
have a navigator who kind of helped me along my
journey and really kind of planted that seed for me
for later on. So yes, she was very helpful.
Speaker 1 (05:59):
Oh that's We're we're going to obviously talk a lot
about that role and what our patients can expect. But
I just I wanted to just tell you something that
just happened to me about fifteen minutes ago. So I
just had a conversation with a colleague of mine who
works in the operating room, who just received a call
(06:19):
last week from her doctor's office that she had a
likely cancer and kind of was told this over the phone,
was given all these logistics, just like you said, of
these all these appointments that they needed to make. And
she looked at me and she said to me, I
am all alone, and I just wish I had somebody
to hold my hand through all of this. And this
(06:41):
is someone in the medical field. So I just found
that not only timely because of the conversation that we're having,
but that must be the experience of everybody who hears
this diagnosis.
Speaker 2 (06:54):
It is, and you're so right, it is. It is
so scary. Feel very alone. Although there is this huge
world of other patients, women, men who have gone through this,
you do feel very alone in it. So Jess, give
her my number, because I don't want to be that
support person for people out there. You know that's I
(07:14):
did come into this role to help people along their
journeys and not to throw, you know, more information into
the mix. But two weeks after my diagnosis, I found
out I was pregnant, and that was even scarier because
now I wasn't even fighting for my own life. I
was fighting for this baby too, And so I thankfully
(07:38):
had a friend in the OAR who her friend had
just gone through the same thing while pregnant, and it
was just a lifeline. I mean, I cannot tell you
enough how special that phone call was with a friend
of a friend. You know, I did not know her,
and we just sat and cried and talked, and she
just gave me the strength to know that it was
(08:00):
gonna be okay. And I'll forever be thankful for that
friend in the r but and the doctor that I
was working with too. But yes, it is important to
have somebody walk this journey with you and fold your
hand and say it's gonna be okay. There is going
to be a light at the end of that tunnel.
And note's scary and does not seem like that right now,
(08:21):
but yes, so I'm here for whoever. If somebody doesn't
have somebody, I will be their person because it's very important.
Speaker 1 (08:30):
That's that's amazing. And just in general, what is the
process to become a cancer navigator? Like like what you do.
Speaker 2 (08:40):
Typically you do and there's different navigator roles, so there
are different backgrounds for everyone, so you know, there are different,
you know, qualifications for each different role. Nurse navigating roles
typically tend to need to be a nurse and have aarification. However,
(09:01):
in a cancer risk navigator role where I am now,
you can have multiple different backgrounds that leads you to
this role. And you know, some of us have a
genetic background, some of us have a nurse background, some
of us have an imagery background. So it's a it's
a little bit of a wider spectrum in this particular role.
Speaker 1 (09:24):
Well, we are going to dive into your role and
what you're doing here at Baptists after we take a
quick break. I want to let everybody know you are
listening to Centered on Health with Baptist Health here on
news radio eight forty whas. I'm your host, doctor Jeff Tublin,
and we're talking tonight with Jesse Gatterdam, who is a
cancer risk navigator with the Baptist Hospital System. We'll be
right back. Welcome back to Centered on Health with Baptist
(09:55):
Health here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin, and tonight we're talking with Jesse Gotterdam,
who's a cancer risk navigator with the Baptist Hospital System,
and she's here to talk to us tonight both about
her role and genetic testing for cancers. Jesse, I want
to welcome you back to the show. You gave us
(10:17):
a beautiful introduction as to why these roles are so important.
But I do want to help people understand what it
is that we're actually doing, and I love to highlight
things that are being done at Baptist Hospital. So talk
to us about your new role, how you came into it,
and what's going on.
Speaker 2 (10:37):
Absolutely, thank you so much so. The CARE Program cre
IT stands for Comprehensive Assessment, Risk and Education. It came
about around four years ago in our producer market because
there we've really identified a need to find and help
identify high risk patients and get them the care that
(11:00):
they needed. So the CARE program came about, and it
is an assessment that all of our patients at Baptists
who are scheduled for a mammogram will be receiving an assessment.
It comes via text message and email. They can fill
it out on either platform, and it is an assessment
(11:22):
that gathers personal family history questions. It's going to ask
age you know if you've had children, your ethnicity, and
then it's going to ask personal history questions as far
as if you've had a personal history of cancer and
family cancer history questions the assessment. We use this assessment
(11:46):
for a couple different things. One is too we are
able to calculate a breast cancer risk score. We help
identify patients that are at high risk for breast cancer
and then we can get them the downstream resources, which
entail a referral to a high risk clinic that is
(12:06):
an appointment where they can go meet with a high
risk provider, discuss their breast cancer risk or discuss their
personal family history, and we can get them those resources
like we were talking about earlier, maybe a breast m
ry along with their annual mammogram, so increased screenings, risk
(12:27):
reducing options that could be you know, prophylactic mestectomies. They
meet with that hi risk provider and have those important
conversations if we do identify them at being at an
elevated risk. And then the second thing that we use
this assessment for is to see if they meet criteria
to receive genetic testing. Like we mentioned prior, genetic testing
(12:51):
is you know a tool that we can use to
see if a patient. If a patient has a positive
gene mutation, it could mean that they are at increased
risk for one of the cancer or cancers associated with
that gene mutation. So once again, it's just an early
detection prevention strategy to get them to that high risk
(13:13):
clinic so that we can increase screenings and find cancers
sooner rather than later. It's really a proactive measurement you
know that Baptist Health is taking to help identify patients.
We know that if we can find cancer sooner rather
than later, you know, early detection prevention is key so
in saving lives, and that's our goal here at Baptist
(13:36):
is to try to really identify those patients at high risk,
get them through genetic testing and that high risk referral
and hopefully, you know, identify cancers early. Jess. It's really
our goal.
Speaker 1 (13:50):
So that is amazing, And there's there's so many things
that you said that I want to like pull out
a little bit and talk about, because well, the first
thing I'll want to clarify is, so these are patients
that are already referred to have their mammograms, so we
don't know at the time of their initial mammogram that
they may be high risk or not. They're just being
(14:11):
sent by their primary care or obgu I N to
have this mamogram. Is that correct?
Speaker 2 (14:18):
That's correct. So as soon as a patient is scheduled
for their mammogram is when they will receive this assessment.
So it's when that scheduling process occurs that this assessment
gets triggered to be sent to them. Yes, and maybe
they've been identified in the past, you know, the primary
care or OBID or when obg IN has gone through
their family history, but things change, Things are changing all
(14:40):
the time, so you know, to get that assessment and
to get that accurate information is key. And as the navigator,
those assessments come into our queue and we're able to
go through every assessment. We pick up a phone and
call the patients. We talk to them to make sure
that they're history is accurate in there, that they've you know,
(15:03):
filled in for their assessment, and then we're really having
those open, honest conversations about genetic testing and those hig
risk referrals to the high Risk clinic.
Speaker 1 (15:13):
So it sounds like even if somebody is identified as
being high risk only after they've had their screening mammogram.
Not only does it help them know maybe for the
future how often or how to be screened or to
get genetic testing, but that information will end up being
useful to people that they're related to. So even though
(15:35):
they may not have had the genetic testing prior to
knowing that they were at high risk, once they have
their mammogram, this will capture them and then help not
only them but their family.
Speaker 2 (15:46):
Absolutely, it is a way for us to say, get
your mammogram, fill out the ausness right, you know, so
we can really capture that information and help as many
patients as possible. And I want to really kind of
pinpull that although this is an assessment that comes with
breast imaging, this we do not just are panel for
(16:07):
genetic testing does not just identify patients that risk for
breast cancer. There are seven other cancers that are associated
with our forty gene panel, and those you know are
it is breast o very uterine, but also pulo rectal,
pancreatic prostates, stomach melanoma, you know, pancs that we know
(16:29):
are very prevalent in a lot of our families, especially
in the Kentuckiana region.
Speaker 1 (16:36):
So meaning that once they're entered into being identified as
needing genetic testing, they'll be tested for all of these
other genes as well.
Speaker 2 (16:44):
Correct. Yes, this is a forty gene panel.
Speaker 1 (16:49):
Yeah. I was going to say, I think that's so
so important that you're you're mentioning that, because even in
my work with with you know, calling cancer screening and
things like that, I think one of the things that
it's important for listeners to wrap their head around is
that you might have a gene that is typically associated
with breast cancer or calling cancer, but as you mentioned,
(17:11):
there can be lots of other cancers related to having
any type of gene predisposition that you so your screening
goes beyond just that one type of cancer.
Speaker 2 (17:24):
Exactly. We you know, a lot of people know about
BROCO one BRAKA two, especially in the month of October,
and everyone's talking about breast cancer risk assessor, you know,
assessments and you know, getting screenings done. Everybody hears broco
one BRACKA two. But when I went through my cancer diagnosis, Jeff,
I went through genetic testing and sure enough, I have
(17:46):
what's called a check too gene mutation that puts you
at risk for breast cancer. Are you know, the Kentuckiana
region is you know, there's a founder mutation which is
the ms H two gene. It's seen here more here
in Kentucky, Ina than a lot of other places, and
that has to do with a Lynch syndrome. So are
(18:07):
the NHS two, the check to those genes are on
this panel. We are identifying patients, you know, with a
broad variety of family cancers that they could be at
risk for. So I do love pointing out to people
that it isn't just breast. You know, you could have
a family, a patient that has a history of prostate
(18:28):
cancer and their father and they you know, they say,
what does that have to do with me? Well, for instance,
with my check two gene mutation, it puts you at
risk for prostate and breast cancer. So I love sharing
that story sometimes if necessary, to just kind of give
that little nudge that says, you know, there's a lot
of research out there that shows, we know, down to
a particular part in a gene sequencing, that that there
(18:52):
are certain cancer or cancers associated with that. A lot
we see a lot of Lynch syndrome of family history,
you know, in our in our assessments that come through
our work cues. So because it's so prevalent in this area,
it's just important to really bring education and knowledge to
(19:15):
all these patients coming through.
Speaker 1 (19:18):
Absolutely, and we're gonna we're gonna take a quick break here.
We're going to talk to you about your role in
all of this when we come back. You are listening
to Centered on Health with Baptist Health here a news
Radio eight forty whas. I'm your host, doctor Jeff Tublin,
and we're talking with Jesse Godderdam, who's a cancer risk navigator.
We'll be right back after these messages. Welcome back to
(19:52):
Centered on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin, and
if you're just joined us tonight, we are talking with
Jesse Gotterdam, who is a cancer risk navigator who works
with patients about assessing risk for different genetic defects and
screening and helping them and their families navigate through these
(20:13):
complicated processes. So welcome back to the show, Jesse, and
I do want to talk to you a little bit
about your role, but I also wanted to highlight something
that I think I heard you say in the last segment,
which I want people to also understand, which is the
benefits of getting this screening done is so vast because
you even mentioned something like an MRI. So I think
(20:36):
what I was understanding was that if somebody is at
increased risk, not only would they have genetic testing, but
it might change the frequency or even the type of
testing that I might undergo.
Speaker 2 (20:48):
Absolutely jesf. Yeah, that's we know that MRI is kind
of king when it comes to breast imaging in these days.
It just picks up things that the MRI will pick
up things that the mammograms just might not, especially with
density of breast tissue. And so if we identify patients
who are at that elevated risk for breast cancer through
(21:10):
this breast cancer risk score, if they are at that
elevated risk, we will try to get them to that
high risk clinic to have that discussion of adding in
an additional screen every year that does include that breast MRI.
And the way that that works is that the patient
will stick, will keep their annual mammogram appointment, and then
(21:31):
in six months from that mammogram would have their breast
MRI and then six months later have the mamogram again
and then six months later the MRI. So it really
is an alternating schedule so that those patients that are
at high risk for breast cancer, you know, aren't falling
through the cracks. That we are really getting that additional imaging,
(21:52):
you know, in the hopes of it picking up things
much sooner than maybe just a mamogram would.
Speaker 1 (21:58):
I mean, it just sort of found like all around,
like you're just literally elevating the care for patients and
that's that's just amazing. So remind our listeners, how does
somebody get into this program. Is this something that when
they go to get their mammogram they have to say, hey,
I want to be a part of this program? Or
is a primary care have to remember to ask for this,
(22:20):
or what's the process of how a patient gets involved.
Speaker 2 (22:25):
It's actually automatically triggered, so as soon as that's mammogram
is scheduled, they will receive the assessment. You know, we
can't say enough you know, for our providers just to
encourage their patients to fill out the assessment and then
for our patients to uh to go ahead and fill
it out. You know, I do you hear from patients
(22:46):
sometimes in this world we live in They think it
might be a scam or a you know, spam coming
through and they tend to disregard it. So just real
encouragement really for our providers to say, hey, this is
going to come down the typeline, it's okay to fill
it out, and then you know, to give our patients
encouragement that it is legit and to you know, to
(23:07):
fill it out so that they can come into my
queue and that you know, those conversations can start to happen.
Speaker 1 (23:14):
So I was going to ask you how you prevent
the the robo call concern that they're just ignoring these calls,
but it's they've already been informed of this at the
time of their mammogram that this might be coming through.
Speaker 2 (23:27):
Yes, so it should come through prior to the mammogram. Jeff.
Speaker 1 (23:31):
Actually, so, oh okay.
Speaker 2 (23:33):
Prior to their mammogram. They will receive it if they
don't fill it out that fifteen day mark, which you
know some of us are procrastinators and we do it
closer myself, deslative, and so you know, they'll get it
five days prior, they'll get it a day before, they'll
get it the day of and as the as the navigator.
I really do try to for convenience for my patients.
(23:53):
I try to get a hold of them actually before
their mammogram and get that order signed and back so
that they can go the same day as their mammogram.
We really do like to try to make it as
convenient as possible. The genetic testing is a lab draw.
It's just a simple blood draw. They don't have to
fast or have an appointment, so it's very easy to
(24:14):
just you know, pop over to the lab after their
mammogram and have that blood drawn.
Speaker 1 (24:19):
So talk me through like the patient experience. So you're
sitting and you're getting this information into your queue and
you get some I would imagine some you know, data
that tells you, Okay, this patient may be at higher risk,
and then you call this the patient. So tell me
what that is like that somebody's on the other end
of the phone. They're picking it up and then they
(24:40):
meet you. How does that conversation usually go?
Speaker 2 (24:44):
Absolutely, We as the navigators for this program, we do
call every single patient. We do think it's important versus
in my chart message that they are getting hundreds of
those to actually get someone on the phone and say,
you know, we see your family hit. We discuss the
genetic testing process with them, the from the blood draw
(25:06):
to the insurance out of pocket costs to the what
the results will could mean. Results usually come back in
a couple of weeks to their my chart, So that's
filtering in so that they and their providers can see
those they do get free genetic counseling on the other
end with a positive gene mutation or even a variant
(25:26):
of on those significance if they want. And I'm you know,
following them that patient through that entire process. I'm watching
those results come through. I'm calling them to discuss you know,
next steps if they do have that positive gene mutation.
And as the navigator kind of there, like I said earlier,
to really hold her hand through the process, here, to
(25:47):
answer any questions, here, to just support any way that
we can. And what's really nice about Baptist Jeff is
that typically in my market, there is a breast navigator
that works at the imaging center, and then there's a
different breast navigator that works with more closely aligned with
the oncologists and the surgeons, and the three of us
(26:08):
really work together as a team. So maybe along the lines,
you know, when the patient has already talked to me
prior to their mammogram, They're going to go in and
meet that breast navigator at the imaging center too, and
have that navigator help them through their Mamma grand appointment.
If they do get identified as a high risk patient
or have to go see our high risk provider, they
(26:29):
may encounter the nurse navigator that's there at that center,
you know, to help them through that process. So we
really do at Baptists Health work as a team to
help our patients the entire way through. And so if
they come into my queue, yeah, I'm just calling every
single patient having those open and honest conversations. I'm a
(26:50):
pretty open person. I don't know my story with everybody.
It's just depends on the patient themselves and genetic testing
instant for everyone. So I really and honest with my
patients and say you have to know yourself. Sometimes people
don't want to know the information and feel like it's
hanging over their head, and some people want all the
medical information they can get. So it's really about meeting
(27:12):
the patient where.
Speaker 1 (27:12):
They are and are you the one who gives them
the results once the testing comes back, or do they
then meet with a genetic another genetic counselor or are
you the same person through the process for consistency or
how the results get delivered, and then more importantly, the
recommendations based on the results.
Speaker 2 (27:35):
Absolutely, it's a great question. So when the results come back,
they do get a message that their results are back
that they can view. I can see when they've viewed
those results, and I'm especially with my positive patients, calling
them directly just to say, hey, I see that you've
seen your results if it is positive, and or if
(27:57):
they have a variant of unknown significance, which Jeff all
that means is that we don't have enough research yet
to show that there's an actual cancer associated with that
gene mutation. But they can have They do get genetic
counseling at no cost to them. It's via telephone call typically,
which is actually how Mind was as well. It's a
(28:18):
great service, and they will go through what that causitive
gene mutation means for them, what it means for their family,
and the recommendations for further care. Once those recommendations are
filtered in there, then that's when I'm going back to
call that patient again and saying Okay, these are the
recommendations from that genetic counselor let's get a high risk
(28:40):
referral in just so that you can have those further
conversations with our high risk provider at that point.
Speaker 1 (28:46):
Well, I know, you know, our patients are certainly lucky
to have somebody helping navigate through all this information. And
then just briefly, you're doing a lot of this that
sounds like over the phone and you're making that initial call.
These patients are going typically for their screening mammograms, so
this might come as a surprise that they might be
(29:07):
at high risk. How do you establish that right away
and alleviate any fear over the phone? What what's that like?
Do people gravitate to that quickly or do you feel
like they get pretty shell shocked to hear this.
Speaker 2 (29:21):
I think that some of our patients, especially are at
high risk for say, breast cancer patients. A lot of
times those patients are familiar with them, you know, being
at high risk because they're typically at hig risks because
of a mother that had breast cancer or a grand
mother and a mother, you know, so a lot of
those patients are it's not unfamiliar to them. Genetic counseling
(29:43):
or genetic testing, excuse me, is kind of a new
world for a lot of people. So I do I
feel that I kind of explained that process in DNA
and how we get you know, a gene from our
mom and a gene from our dad, and it could
be something that comes from our dad instead of you know,
everybody thinks that's if breast cancer comes, it comes from
the you know, the mom's side. And so I'm really
(30:07):
able to help patients through that process, especially in my
own particular family when we got our genetic when I
got my genetic testing results back, your entire family can
get tested single side analysis testing for free, and so
my dad and mom got tested. My dad is the
carrier of our gene. I was positive and my brother
(30:28):
was positive too, So in our family, you know, that
was a really important piece of the puzzle. And so
I do use that sometimes that can you know, breast
cancer risk can come from your dad's side as well.
Speaker 1 (30:40):
Right, well, we're going to talk a little bit about
the genetic testing process as well, So we're going to
take our final break here. You are listening to Center
It on Health with Baptist Health here on News Radio
eight forty WKS. I'm your host, doctor Jeff Tablin, and
we're talking with Jesse Goddard in Cancer Risk Navigator. Down
Load the iHeartRadio app. It's free, it's easy to use,
and it'll give you access to tonight's show. We'll be
(31:01):
right back. Welcome back to Centered on Health with Baptives
Health here on news radio eight forty WHAS. I'm your host,
doctor Jeff Tumlin, and tonight we're talking about cancer risk
(31:22):
Navigation with Jesse Gotterdam. We've been talking all about breast
screening and mammograms and increased risk and genetic testing. I
want to remind everybody to download the iHeartRadio app. It's free,
it's easy to use, it gives you access to tonight's
show and all of our other episodes. So, Jesse, I
know that you know, nothing really helps people understand what
(31:43):
you do other than a real example. So I know
you work with patients all the time. Is there are
there any ones that stand out to you that you
might want to share?
Speaker 2 (31:53):
Yeah, definitely. I mean we've helped a lot of patients
through this program, Jeff, as you can imagine, and just
a couple that kind of stand out In the last
year that I've helped one a patient who was very young,
similar to me, who hadn't had a mammogram yet. Family
history of a grandmother with breast cancer came into the
(32:17):
work too, because she was scheduled for a mammogram because
she felt something, and so further imaging with a mammogram
was scheduled and therefore she received the assessment. I was
able to talk to her about the genetic testing process,
she agreed to go through with it. Sure enough, she
had a positive G mutation that put her at risk
(32:40):
for breast cancer. We immediately after her genetic counseling appointment
got her into our high risk clinic. Within a couple
of weeks, she got scheduled for an MRI. And guess what, Jeff,
That MRI picked up something that the mammogram a few
weeks prior had not seen. They went the head and
did that MRI for her, which is typically not the case,
(33:05):
but because she had felt something, but you know, it
had been unremarkable on the which means you know, it
wasn't nothing really stood out on that mamogram, and so
they just decided at that high risk employment, well let's
go ahead and do that MRI. And sure enough, Jeff,
that MRI did show something and we got her taken
care of. And if she wouldn't have come into that queue,
(33:26):
maybe she would have put that mammogram all off, or
maybe she would have, you know, not realized that she
was a positive communication making her elevated risk. So now
she you know, early detection prevention, right. So she's young,
you know, and that MRI really did help pick up
something that that Mamorgram didn't. Another patient example, yes, yes,
(33:50):
Another patient example was a patient of mine who her
Janette testing came back positive and she really wanted her
adult children to have genetic testing as well to see
if because we know, Jeff, that if if you are
has positive for a gene mutation, your children each have
a fifty percent chance of having that same gene mutation.
(34:11):
So she has a son and a daughter and they
were both over the age of twenty five. They you know,
I worked very closely with their nurse practitioners to get
a referral into our genetic counselor so that they could
have a telehealth appointment with them to get them that
single site analysis. It's sort of similar to what my
family did. And sure enough the son was positive and
(34:33):
the daughter's negative. But there we go again, where we see,
you know, now the information is out there. Now we
know that little puzzle piece to the medical history, and
that family and increased screenings can happen, early detection, prevention
can can occur. I'd like to do sometimes, I'd like
to explain genetic testing just as that it's a little
(34:54):
puzzle piece in our medical history. You know you mentioned earlier,
what can kind of maybe keep people from doing genetic
testing or kind of what scares people? Sometimes I really
do try to describe it as as just that it's
a part of our medical history that doesn't only help
us to know what we could be at risk for,
(35:14):
but also our children, our grandchildren. It really does help
that family history know what, you know, what we're at
higher risks for than others might be. But so that's
really how I try to encourage people, you know, if
they are a little a little afraid or when it
(35:35):
comes to hesitant, yes, to get that genetic testing done.
Speaker 1 (35:40):
Well, let me play the devil's advocate here. It's not
normally my normal mo o, but just to help kind
of bring it to light and maybe have the conversation
a little bit. So to be clear, having a gene
doesn't necessarily mean that you will ever manifest some kind
of condition. I mean a lot of times obviously it does.
(36:00):
What would you explain to somebody who says, you know,
I don't want my adult children to know that they
have this gene because they may never get cancer, and
then the insurance won't They'll have a thing against their insurance.
What's the reality in the world we live in about
having a gene that's identified but you might not ever
get sicked.
Speaker 2 (36:21):
Yeah, I do say that to all my patients. Having
a positive gen mutation does not mean that you will
get cancer in your lifetime. It just makes us aware
that you are at that elevated risk, and therefore we're
going to try to increase screens based on the cancer
or cancers associated. I do have open conversations with my
(36:42):
patients also, Jeff about the day and age we live in,
where you know, there are laws in place that protect
us against health insurance companies and employers from denying or
discriminating against a positive gene mutation. However, I do encourage
my patients to have a life insurance policy in place
because there is no law that protects life insurance companies
(37:03):
from seeing that, and you know, denying life insurance policy.
So those are all open, open and honest conversations that
are had amongst our you know, nurse navigators and with this,
you know, with genetic testing and with the program, and
it's just about making sure that people are educated. That
(37:26):
is a huge part of this, you know. Yes, And
I always, like I said before, you but do try
to meet patients where they are. Not everybody is ready
today to do this, But we're gonna be here. We're
gonna be here in six months, We're gonna be here
in a year. Come back. You know, you'll get the
assessment again next year with your mammogram. But I have
patients call me all the time six months later and say,
(37:48):
you know what, now I'm ready. I've talked to my kids.
They want me to do it. You know, it is
a family decision, for sure. So I just encourage everybody
to do it in their own timing, for sure, and
push anybody into this for sure.
Speaker 1 (38:05):
Yeah. I mean that's really well said, and I just
think it's it's good for people to hear. You know,
this is this is a tool, This is information and
it has a lot of benefits, you know, both for
them and their and their family. So tell us a
little bit about the program itself. Where where is the
program being done in the Baptist system, Where is it expanding?
Is it going to be more than just breast cancer?
(38:27):
What what's the future?
Speaker 2 (38:29):
Absolutely? So, we did start four years ago in Paducah.
It's been going on a little over a year in Lexington.
Richmond just came on board. We've been in Floyd in
Indiana since last February, and we are getting ready to
branch out into Lagrange next year, into Louisville hopefully Corbin
(38:52):
and Harden. Those are kind of on the list of
places that we are branching out in the upcoming you
know year to come hopefully. So if it's not in
your area, it's coming soon. But I do want to
let people know in the Baptist system just also, yes,
this is just an assessment that goes out to our
(39:14):
patients scheduled for a mammogram. We are hoping to grow
the program. We are hoping to reach other you know,
markets and areas within the Baptist healthcare system. But if
a patient is saying to themselves, well, I don't. I'm
not scheduled for a mammogram, and but I want you know,
I want to get genetic testing. We do have genetic
(39:34):
counselors in place, just that we can get a referral
for them to a genetic counselor to have that conversation
to get genetic testing a different way if they are interested.
And that's just a conversation that we can they could
have with our providers and we can help any providers
figure out how to put that referral in to get
them to the genetic counselors that we have. They're wonderful.
(39:57):
So there are other options you know as well.
Speaker 1 (40:02):
That is that's amazing, and I, Jessie, I have about
ninety seven thousand other questions I want to ask you.
So we're going to just have to have you back
because we are unfortunately this is we're out of time.
And that's going to do it. For tonight's segment of
Centered on Health with Baptist Health here on News Radio
eight forty whas. I want to thank jesse you so
much sharing your story and of course sharing what you
(40:24):
do with all of our patients who are benefiting from everything.
I want to thank our producer mister Jim Fenn, and
of course you the listener. Join us every week for
another episode of Centered on Health. I hope everybody has
a great week and a wonderful weekend.
Speaker 2 (40:43):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health or
(41:06):
regarding specific medical conditions. To find a Baptist health provider,
please visit Baptistealth dot com.
It's now time for Centered on Health with Taftazel.
Speaker 2 (00:05):
On Use Radio Wait forty ELWODJS.
Speaker 1 (00:07):
Now here's doctor Jeff Tubble. Good evening, and welcome to
tonight's episode of Centered on Health with Baptist Health here
on news radio eight forty whas. I'm your host, doctor
Jeff Tumblin, and tonight we are talking about the advantages
of genetic cancer testing with Jesse Gadterdam, who I'm going
to introduce you to in just a minute. I just
(00:30):
want to let people know that four point eight million
people in the United States have undergone genetic counseling, and
this is typically for cancers like breast cancer, ovarian cancer,
and coorectal cancer. But there's still many things that impede
the ability to get these genetic testing done. And we're
going to talk to an expert tonight, and I want
to introduce you to Jesse Gatterdam, who graduated in two
(00:54):
thousand and four, but in twenty thirteen she decided to
get her nursing degree through an accelerated program at Bellerman University,
which she completed in twenty sixteen. She has had lots
of experience, including working in the OAR as a circulator
and in twenty eighteen had an unexpected life turn, which
I'm going to let her talk a little bit about.
She developed a nursing Pathway program at Ballard High School
(01:16):
and then went on to become a nurse navigator, working
with a multi disciplinary team of medical and surgical doctors
helping newly diagnost breast cancer patients and high risk patients
along their journeys. Now she's at Baptist since twenty twenty
four in the nurse navigator role. Welcome to Center on Health, Jesse, hi.
Speaker 2 (01:36):
Ja, thank you so much for having me.
Speaker 1 (01:39):
Well, you know we are. We're thrilled to have you here.
I mean, this is such an important topic about not
only breast cancer specifically, but genetic testing and certainly your
role in terms of navigating patients through this complicated process.
But your story is pretty unique, and I thought maybe
we could just sort of start by having you introduce
(02:00):
yourself in a little bit about your experience and kind
of what's led you down this pathway.
Speaker 2 (02:06):
Absolutely so, I found myself when I graduated nursing school,
I went straight into the operating room, and as I
was working there, I felt a lump in my breast
and I was thirty nine at the time. So if
as patients are aware who go for mammograms, the typical
age for your first mamorram is not till the age
(02:28):
of forty and so I had, you know, not been
for my first mamogram yet. So thankfully I was working
with surgeon in the OAR that day who had been
through her own breast cancer journey, and she really encouraged
me to seek out my first mammogram and just get it,
you know, looked at further. And I'm so thankful for
(02:50):
her for encouraging me to do that, because maybe I
wouldn't have done that otherwise. And sure enough, got right
in for my first ever mammogram. Right after they did
an ultrasound, and right after that they did a breast biopsy,
and two days later, sure enough, I.
Speaker 1 (03:07):
Was diagnosed with cancer at thirty nine.
Speaker 2 (03:12):
At thirty nine, Yes, what was that like for you?
Speaker 1 (03:16):
Did you process this as a provider, did you process
this as a patient? What was the initial response to
how you approached hearing that at such a young age.
Speaker 2 (03:29):
Well, I think when you're in the medical field, you
do tend to approach everything from a medical viewpoint. I
was thankful for my medical background. I kind of knew
what the doctors were talking about, but I did not
know anything about the breast cancer world. At that time.
Felt very strong in my own medical position, but I
(03:53):
did not have any idea what to expect when it
came to breast cancer. And as soon as you anyone
that's them through this journey knows, as soon as you're diagnosed,
it is a whirlwind. You are thrown into multiple doctor appointments,
multiple uh things, you know, results coming at you. You
meet with not only a surgeon, but a medical oncologist,
(04:15):
radiation oncologists, plastic surgeon, genetics at sometimes. So it is
a whirlwind and it was very overwhelming. So I was
thankful to have my medical team, you know, my medical
family around me during that time. But yes, you can't
you know, also have to approach it as you know
(04:36):
a patient as well, because it's the first time that
you've ever been through something like this, and it is
very overwhelming.
Speaker 1 (04:43):
Absolutely, And I mean we're going to be jumping around
a little bit because there's so many topics I want
to I want our listeners to learn from you, but
in general, and I know we'll talk about it in detail.
But would genetic testing have helped you in this situation?
Speaker 2 (05:00):
I think so. I think that genetic testing, you know,
we know that it's a way to you know, find
our high risk patients sooner. You know, it's an early
detection prevention key in helping, you know, identify patients who
may have that family history but not have a history
(05:21):
themselves yet, you know, so and getting imagen sooner, getting
into high risk clinics sooner, to find cancers earlier, that's
the goal I think with genetic testing. So yes, definitely,
I do think that would have been key.
Speaker 1 (05:37):
And and I know we're going to talk about the navigator. Well,
was there a navigator available to you at the time
of your your diagnosis?
Speaker 2 (05:47):
There was, Yes, I did. I was lucky enough to
have a navigator who kind of helped me along my
journey and really kind of planted that seed for me
for later on. So yes, she was very helpful.
Speaker 1 (05:59):
Oh that's We're we're going to obviously talk a lot
about that role and what our patients can expect. But
I just I wanted to just tell you something that
just happened to me about fifteen minutes ago. So I
just had a conversation with a colleague of mine who
works in the operating room, who just received a call
(06:19):
last week from her doctor's office that she had a
likely cancer and kind of was told this over the phone,
was given all these logistics, just like you said, of
these all these appointments that they needed to make. And
she looked at me and she said to me, I
am all alone, and I just wish I had somebody
to hold my hand through all of this. And this
(06:41):
is someone in the medical field. So I just found
that not only timely because of the conversation that we're having,
but that must be the experience of everybody who hears
this diagnosis.
Speaker 2 (06:54):
It is, and you're so right, it is. It is
so scary. Feel very alone. Although there is this huge
world of other patients, women, men who have gone through this,
you do feel very alone in it. So Jess, give
her my number, because I don't want to be that
support person for people out there. You know that's I
(07:14):
did come into this role to help people along their
journeys and not to throw, you know, more information into
the mix. But two weeks after my diagnosis, I found
out I was pregnant, and that was even scarier because
now I wasn't even fighting for my own life. I
was fighting for this baby too, And so I thankfully
(07:38):
had a friend in the OAR who her friend had
just gone through the same thing while pregnant, and it
was just a lifeline. I mean, I cannot tell you
enough how special that phone call was with a friend
of a friend. You know, I did not know her,
and we just sat and cried and talked, and she
just gave me the strength to know that it was
(08:00):
gonna be okay. And I'll forever be thankful for that
friend in the r but and the doctor that I
was working with too. But yes, it is important to
have somebody walk this journey with you and fold your
hand and say it's gonna be okay. There is going
to be a light at the end of that tunnel.
And note's scary and does not seem like that right now,
(08:21):
but yes, so I'm here for whoever. If somebody doesn't
have somebody, I will be their person because it's very important.
Speaker 1 (08:30):
That's that's amazing. And just in general, what is the
process to become a cancer navigator? Like like what you do.
Speaker 2 (08:40):
Typically you do and there's different navigator roles, so there
are different backgrounds for everyone, so you know, there are different,
you know, qualifications for each different role. Nurse navigating roles
typically tend to need to be a nurse and have aarification. However,
(09:01):
in a cancer risk navigator role where I am now,
you can have multiple different backgrounds that leads you to
this role. And you know, some of us have a
genetic background, some of us have a nurse background, some
of us have an imagery background. So it's a it's
a little bit of a wider spectrum in this particular role.
Speaker 1 (09:24):
Well, we are going to dive into your role and
what you're doing here at Baptists after we take a
quick break. I want to let everybody know you are
listening to Centered on Health with Baptist Health here on
news radio eight forty whas. I'm your host, doctor Jeff Tublin,
and we're talking tonight with Jesse Gatterdam, who is a
cancer risk navigator with the Baptist Hospital System. We'll be
right back. Welcome back to Centered on Health with Baptist
(09:55):
Health here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin, and tonight we're talking with Jesse Gotterdam,
who's a cancer risk navigator with the Baptist Hospital System,
and she's here to talk to us tonight both about
her role and genetic testing for cancers. Jesse, I want
to welcome you back to the show. You gave us
(10:17):
a beautiful introduction as to why these roles are so important.
But I do want to help people understand what it
is that we're actually doing, and I love to highlight
things that are being done at Baptist Hospital. So talk
to us about your new role, how you came into it,
and what's going on.
Speaker 2 (10:37):
Absolutely, thank you so much so. The CARE Program cre
IT stands for Comprehensive Assessment, Risk and Education. It came
about around four years ago in our producer market because
there we've really identified a need to find and help
identify high risk patients and get them the care that
(11:00):
they needed. So the CARE program came about, and it
is an assessment that all of our patients at Baptists
who are scheduled for a mammogram will be receiving an assessment.
It comes via text message and email. They can fill
it out on either platform, and it is an assessment
(11:22):
that gathers personal family history questions. It's going to ask
age you know if you've had children, your ethnicity, and
then it's going to ask personal history questions as far
as if you've had a personal history of cancer and
family cancer history questions the assessment. We use this assessment
(11:46):
for a couple different things. One is too we are
able to calculate a breast cancer risk score. We help
identify patients that are at high risk for breast cancer
and then we can get them the downstream resources, which
entail a referral to a high risk clinic that is
(12:06):
an appointment where they can go meet with a high
risk provider, discuss their breast cancer risk or discuss their
personal family history, and we can get them those resources
like we were talking about earlier, maybe a breast m
ry along with their annual mammogram, so increased screenings, risk
(12:27):
reducing options that could be you know, prophylactic mestectomies. They
meet with that hi risk provider and have those important
conversations if we do identify them at being at an
elevated risk. And then the second thing that we use
this assessment for is to see if they meet criteria
to receive genetic testing. Like we mentioned prior, genetic testing
(12:51):
is you know a tool that we can use to
see if a patient. If a patient has a positive
gene mutation, it could mean that they are at increased
risk for one of the cancer or cancers associated with
that gene mutation. So once again, it's just an early
detection prevention strategy to get them to that high risk
(13:13):
clinic so that we can increase screenings and find cancers
sooner rather than later. It's really a proactive measurement you
know that Baptist Health is taking to help identify patients.
We know that if we can find cancer sooner rather
than later, you know, early detection prevention is key so
in saving lives, and that's our goal here at Baptist
(13:36):
is to try to really identify those patients at high risk,
get them through genetic testing and that high risk referral
and hopefully, you know, identify cancers early. Jess. It's really
our goal.
Speaker 1 (13:50):
So that is amazing, And there's there's so many things
that you said that I want to like pull out
a little bit and talk about, because well, the first
thing I'll want to clarify is, so these are patients
that are already referred to have their mammograms, so we
don't know at the time of their initial mammogram that
they may be high risk or not. They're just being
(14:11):
sent by their primary care or obgu I N to
have this mamogram. Is that correct?
Speaker 2 (14:18):
That's correct. So as soon as a patient is scheduled
for their mammogram is when they will receive this assessment.
So it's when that scheduling process occurs that this assessment
gets triggered to be sent to them. Yes, and maybe
they've been identified in the past, you know, the primary
care or OBID or when obg IN has gone through
their family history, but things change, Things are changing all
(14:40):
the time, so you know, to get that assessment and
to get that accurate information is key. And as the navigator,
those assessments come into our queue and we're able to
go through every assessment. We pick up a phone and
call the patients. We talk to them to make sure
that they're history is accurate in there, that they've you know,
(15:03):
filled in for their assessment, and then we're really having
those open, honest conversations about genetic testing and those hig
risk referrals to the high Risk clinic.
Speaker 1 (15:13):
So it sounds like even if somebody is identified as
being high risk only after they've had their screening mammogram.
Not only does it help them know maybe for the
future how often or how to be screened or to
get genetic testing, but that information will end up being
useful to people that they're related to. So even though
(15:35):
they may not have had the genetic testing prior to
knowing that they were at high risk, once they have
their mammogram, this will capture them and then help not
only them but their family.
Speaker 2 (15:46):
Absolutely, it is a way for us to say, get
your mammogram, fill out the ausness right, you know, so
we can really capture that information and help as many
patients as possible. And I want to really kind of
pinpull that although this is an assessment that comes with
breast imaging, this we do not just are panel for
(16:07):
genetic testing does not just identify patients that risk for
breast cancer. There are seven other cancers that are associated
with our forty gene panel, and those you know are
it is breast o very uterine, but also pulo rectal,
pancreatic prostates, stomach melanoma, you know, pancs that we know
(16:29):
are very prevalent in a lot of our families, especially
in the Kentuckiana region.
Speaker 1 (16:36):
So meaning that once they're entered into being identified as
needing genetic testing, they'll be tested for all of these
other genes as well.
Speaker 2 (16:44):
Correct. Yes, this is a forty gene panel.
Speaker 1 (16:49):
Yeah. I was going to say, I think that's so
so important that you're you're mentioning that, because even in
my work with with you know, calling cancer screening and
things like that, I think one of the things that
it's important for listeners to wrap their head around is
that you might have a gene that is typically associated
with breast cancer or calling cancer, but as you mentioned,
(17:11):
there can be lots of other cancers related to having
any type of gene predisposition that you so your screening
goes beyond just that one type of cancer.
Speaker 2 (17:24):
Exactly. We you know, a lot of people know about
BROCO one BRAKA two, especially in the month of October,
and everyone's talking about breast cancer risk assessor, you know,
assessments and you know, getting screenings done. Everybody hears broco
one BRACKA two. But when I went through my cancer diagnosis, Jeff,
I went through genetic testing and sure enough, I have
(17:46):
what's called a check too gene mutation that puts you
at risk for breast cancer. Are you know, the Kentuckiana
region is you know, there's a founder mutation which is
the ms H two gene. It's seen here more here
in Kentucky, Ina than a lot of other places, and
that has to do with a Lynch syndrome. So are
(18:07):
the NHS two, the check to those genes are on
this panel. We are identifying patients, you know, with a
broad variety of family cancers that they could be at
risk for. So I do love pointing out to people
that it isn't just breast. You know, you could have
a family, a patient that has a history of prostate
(18:28):
cancer and their father and they you know, they say,
what does that have to do with me? Well, for instance,
with my check two gene mutation, it puts you at
risk for prostate and breast cancer. So I love sharing
that story sometimes if necessary, to just kind of give
that little nudge that says, you know, there's a lot
of research out there that shows, we know, down to
a particular part in a gene sequencing, that that there
(18:52):
are certain cancer or cancers associated with that. A lot
we see a lot of Lynch syndrome of family history,
you know, in our in our assessments that come through
our work cues. So because it's so prevalent in this area,
it's just important to really bring education and knowledge to
(19:15):
all these patients coming through.
Speaker 1 (19:18):
Absolutely, and we're gonna we're gonna take a quick break here.
We're going to talk to you about your role in
all of this when we come back. You are listening
to Centered on Health with Baptist Health here a news
Radio eight forty whas. I'm your host, doctor Jeff Tublin,
and we're talking with Jesse Godderdam, who's a cancer risk navigator.
We'll be right back after these messages. Welcome back to
(19:52):
Centered on Health with Baptist Health here on news radio
eight forty whas. I'm your host, doctor Jeff Tublin, and
if you're just joined us tonight, we are talking with
Jesse Gotterdam, who is a cancer risk navigator who works
with patients about assessing risk for different genetic defects and
screening and helping them and their families navigate through these
(20:13):
complicated processes. So welcome back to the show, Jesse, and
I do want to talk to you a little bit
about your role, but I also wanted to highlight something
that I think I heard you say in the last segment,
which I want people to also understand, which is the
benefits of getting this screening done is so vast because
you even mentioned something like an MRI. So I think
(20:36):
what I was understanding was that if somebody is at
increased risk, not only would they have genetic testing, but
it might change the frequency or even the type of
testing that I might undergo.
Speaker 2 (20:48):
Absolutely jesf. Yeah, that's we know that MRI is kind
of king when it comes to breast imaging in these days.
It just picks up things that the MRI will pick
up things that the mammograms just might not, especially with
density of breast tissue. And so if we identify patients
who are at that elevated risk for breast cancer through
(21:10):
this breast cancer risk score, if they are at that
elevated risk, we will try to get them to that
high risk clinic to have that discussion of adding in
an additional screen every year that does include that breast MRI.
And the way that that works is that the patient
will stick, will keep their annual mammogram appointment, and then
(21:31):
in six months from that mammogram would have their breast
MRI and then six months later have the mamogram again
and then six months later the MRI. So it really
is an alternating schedule so that those patients that are
at high risk for breast cancer, you know, aren't falling
through the cracks. That we are really getting that additional imaging,
(21:52):
you know, in the hopes of it picking up things
much sooner than maybe just a mamogram would.
Speaker 1 (21:58):
I mean, it just sort of found like all around,
like you're just literally elevating the care for patients and
that's that's just amazing. So remind our listeners, how does
somebody get into this program. Is this something that when
they go to get their mammogram they have to say, hey,
I want to be a part of this program? Or
is a primary care have to remember to ask for this,
(22:20):
or what's the process of how a patient gets involved.
Speaker 2 (22:25):
It's actually automatically triggered, so as soon as that's mammogram
is scheduled, they will receive the assessment. You know, we
can't say enough you know, for our providers just to
encourage their patients to fill out the assessment and then
for our patients to uh to go ahead and fill
it out. You know, I do you hear from patients
(22:46):
sometimes in this world we live in They think it
might be a scam or a you know, spam coming
through and they tend to disregard it. So just real
encouragement really for our providers to say, hey, this is
going to come down the typeline, it's okay to fill
it out, and then you know, to give our patients
encouragement that it is legit and to you know, to
(23:07):
fill it out so that they can come into my
queue and that you know, those conversations can start to happen.
Speaker 1 (23:14):
So I was going to ask you how you prevent
the the robo call concern that they're just ignoring these calls,
but it's they've already been informed of this at the
time of their mammogram that this might be coming through.
Speaker 2 (23:27):
Yes, so it should come through prior to the mammogram. Jeff.
Speaker 1 (23:31):
Actually, so, oh okay.
Speaker 2 (23:33):
Prior to their mammogram. They will receive it if they
don't fill it out that fifteen day mark, which you
know some of us are procrastinators and we do it
closer myself, deslative, and so you know, they'll get it
five days prior, they'll get it a day before, they'll
get it the day of and as the as the navigator.
I really do try to for convenience for my patients.
(23:53):
I try to get a hold of them actually before
their mammogram and get that order signed and back so
that they can go the same day as their mammogram.
We really do like to try to make it as
convenient as possible. The genetic testing is a lab draw.
It's just a simple blood draw. They don't have to
fast or have an appointment, so it's very easy to
(24:14):
just you know, pop over to the lab after their
mammogram and have that blood drawn.
Speaker 1 (24:19):
So talk me through like the patient experience. So you're
sitting and you're getting this information into your queue and
you get some I would imagine some you know, data
that tells you, Okay, this patient may be at higher risk,
and then you call this the patient. So tell me
what that is like that somebody's on the other end
of the phone. They're picking it up and then they
(24:40):
meet you. How does that conversation usually go?
Speaker 2 (24:44):
Absolutely, We as the navigators for this program, we do
call every single patient. We do think it's important versus
in my chart message that they are getting hundreds of
those to actually get someone on the phone and say,
you know, we see your family hit. We discuss the
genetic testing process with them, the from the blood draw
(25:06):
to the insurance out of pocket costs to the what
the results will could mean. Results usually come back in
a couple of weeks to their my chart, So that's
filtering in so that they and their providers can see
those they do get free genetic counseling on the other
end with a positive gene mutation or even a variant
(25:26):
of on those significance if they want. And I'm you know,
following them that patient through that entire process. I'm watching
those results come through. I'm calling them to discuss you know,
next steps if they do have that positive gene mutation.
And as the navigator kind of there, like I said earlier,
to really hold her hand through the process, here, to
(25:47):
answer any questions, here, to just support any way that
we can. And what's really nice about Baptist Jeff is
that typically in my market, there is a breast navigator
that works at the imaging center, and then there's a
different breast navigator that works with more closely aligned with
the oncologists and the surgeons, and the three of us
(26:08):
really work together as a team. So maybe along the lines,
you know, when the patient has already talked to me
prior to their mammogram, They're going to go in and
meet that breast navigator at the imaging center too, and
have that navigator help them through their Mamma grand appointment.
If they do get identified as a high risk patient
or have to go see our high risk provider, they
(26:29):
may encounter the nurse navigator that's there at that center,
you know, to help them through that process. So we
really do at Baptists Health work as a team to
help our patients the entire way through. And so if
they come into my queue, yeah, I'm just calling every
single patient having those open and honest conversations. I'm a
(26:50):
pretty open person. I don't know my story with everybody.
It's just depends on the patient themselves and genetic testing
instant for everyone. So I really and honest with my
patients and say you have to know yourself. Sometimes people
don't want to know the information and feel like it's
hanging over their head, and some people want all the
medical information they can get. So it's really about meeting
(27:12):
the patient where.
Speaker 1 (27:12):
They are and are you the one who gives them
the results once the testing comes back, or do they
then meet with a genetic another genetic counselor or are
you the same person through the process for consistency or
how the results get delivered, and then more importantly, the
recommendations based on the results.
Speaker 2 (27:35):
Absolutely, it's a great question. So when the results come back,
they do get a message that their results are back
that they can view. I can see when they've viewed
those results, and I'm especially with my positive patients, calling
them directly just to say, hey, I see that you've
seen your results if it is positive, and or if
(27:57):
they have a variant of unknown significance, which Jeff all
that means is that we don't have enough research yet
to show that there's an actual cancer associated with that
gene mutation. But they can have They do get genetic
counseling at no cost to them. It's via telephone call typically,
which is actually how Mind was as well. It's a
(28:18):
great service, and they will go through what that causitive
gene mutation means for them, what it means for their family,
and the recommendations for further care. Once those recommendations are
filtered in there, then that's when I'm going back to
call that patient again and saying Okay, these are the
recommendations from that genetic counselor let's get a high risk
(28:40):
referral in just so that you can have those further
conversations with our high risk provider at that point.
Speaker 1 (28:46):
Well, I know, you know, our patients are certainly lucky
to have somebody helping navigate through all this information. And
then just briefly, you're doing a lot of this that
sounds like over the phone and you're making that initial call.
These patients are going typically for their screening mammograms, so
this might come as a surprise that they might be
(29:07):
at high risk. How do you establish that right away
and alleviate any fear over the phone? What what's that like?
Do people gravitate to that quickly or do you feel
like they get pretty shell shocked to hear this.
Speaker 2 (29:21):
I think that some of our patients, especially are at
high risk for say, breast cancer patients. A lot of
times those patients are familiar with them, you know, being
at high risk because they're typically at hig risks because
of a mother that had breast cancer or a grand
mother and a mother, you know, so a lot of
those patients are it's not unfamiliar to them. Genetic counseling
(29:43):
or genetic testing, excuse me, is kind of a new
world for a lot of people. So I do I
feel that I kind of explained that process in DNA
and how we get you know, a gene from our
mom and a gene from our dad, and it could
be something that comes from our dad instead of you know,
everybody thinks that's if breast cancer comes, it comes from
the you know, the mom's side. And so I'm really
(30:07):
able to help patients through that process, especially in my
own particular family when we got our genetic when I
got my genetic testing results back, your entire family can
get tested single side analysis testing for free, and so
my dad and mom got tested. My dad is the
carrier of our gene. I was positive and my brother
(30:28):
was positive too, So in our family, you know, that
was a really important piece of the puzzle. And so
I do use that sometimes that can you know, breast
cancer risk can come from your dad's side as well.
Speaker 1 (30:40):
Right, well, we're going to talk a little bit about
the genetic testing process as well, So we're going to
take our final break here. You are listening to Center
It on Health with Baptist Health here on News Radio
eight forty WKS. I'm your host, doctor Jeff Tablin, and
we're talking with Jesse Goddard in Cancer Risk Navigator. Down
Load the iHeartRadio app. It's free, it's easy to use,
and it'll give you access to tonight's show. We'll be
(31:01):
right back. Welcome back to Centered on Health with Baptives
Health here on news radio eight forty WHAS. I'm your host,
doctor Jeff Tumlin, and tonight we're talking about cancer risk
(31:22):
Navigation with Jesse Gotterdam. We've been talking all about breast
screening and mammograms and increased risk and genetic testing. I
want to remind everybody to download the iHeartRadio app. It's free,
it's easy to use, it gives you access to tonight's
show and all of our other episodes. So, Jesse, I
know that you know, nothing really helps people understand what
(31:43):
you do other than a real example. So I know
you work with patients all the time. Is there are
there any ones that stand out to you that you
might want to share?
Speaker 2 (31:53):
Yeah, definitely. I mean we've helped a lot of patients
through this program, Jeff, as you can imagine, and just
a couple that kind of stand out In the last
year that I've helped one a patient who was very young,
similar to me, who hadn't had a mammogram yet. Family
history of a grandmother with breast cancer came into the
(32:17):
work too, because she was scheduled for a mammogram because
she felt something, and so further imaging with a mammogram
was scheduled and therefore she received the assessment. I was
able to talk to her about the genetic testing process,
she agreed to go through with it. Sure enough, she
had a positive G mutation that put her at risk
(32:40):
for breast cancer. We immediately after her genetic counseling appointment
got her into our high risk clinic. Within a couple
of weeks, she got scheduled for an MRI. And guess what, Jeff,
That MRI picked up something that the mammogram a few
weeks prior had not seen. They went the head and
did that MRI for her, which is typically not the case,
(33:05):
but because she had felt something, but you know, it
had been unremarkable on the which means you know, it
wasn't nothing really stood out on that mamogram, and so
they just decided at that high risk employment, well let's
go ahead and do that MRI. And sure enough, Jeff,
that MRI did show something and we got her taken
care of. And if she wouldn't have come into that queue,
(33:26):
maybe she would have put that mammogram all off, or
maybe she would have, you know, not realized that she
was a positive communication making her elevated risk. So now
she you know, early detection prevention, right. So she's young,
you know, and that MRI really did help pick up
something that that Mamorgram didn't. Another patient example, yes, yes,
(33:50):
Another patient example was a patient of mine who her
Janette testing came back positive and she really wanted her
adult children to have genetic testing as well to see
if because we know, Jeff, that if if you are
has positive for a gene mutation, your children each have
a fifty percent chance of having that same gene mutation.
(34:11):
So she has a son and a daughter and they
were both over the age of twenty five. They you know,
I worked very closely with their nurse practitioners to get
a referral into our genetic counselor so that they could
have a telehealth appointment with them to get them that
single site analysis. It's sort of similar to what my
family did. And sure enough the son was positive and
(34:33):
the daughter's negative. But there we go again, where we see,
you know, now the information is out there. Now we
know that little puzzle piece to the medical history, and
that family and increased screenings can happen, early detection, prevention
can can occur. I'd like to do sometimes, I'd like
to explain genetic testing just as that it's a little
(34:54):
puzzle piece in our medical history. You know you mentioned earlier,
what can kind of maybe keep people from doing genetic
testing or kind of what scares people? Sometimes I really
do try to describe it as as just that it's
a part of our medical history that doesn't only help
us to know what we could be at risk for,
(35:14):
but also our children, our grandchildren. It really does help
that family history know what, you know, what we're at
higher risks for than others might be. But so that's
really how I try to encourage people, you know, if
they are a little a little afraid or when it
(35:35):
comes to hesitant, yes, to get that genetic testing done.
Speaker 1 (35:40):
Well, let me play the devil's advocate here. It's not
normally my normal mo o, but just to help kind
of bring it to light and maybe have the conversation
a little bit. So to be clear, having a gene
doesn't necessarily mean that you will ever manifest some kind
of condition. I mean a lot of times obviously it does.
(36:00):
What would you explain to somebody who says, you know,
I don't want my adult children to know that they
have this gene because they may never get cancer, and
then the insurance won't They'll have a thing against their insurance.
What's the reality in the world we live in about
having a gene that's identified but you might not ever
get sicked.
Speaker 2 (36:21):
Yeah, I do say that to all my patients. Having
a positive gen mutation does not mean that you will
get cancer in your lifetime. It just makes us aware
that you are at that elevated risk, and therefore we're
going to try to increase screens based on the cancer
or cancers associated. I do have open conversations with my
(36:42):
patients also, Jeff about the day and age we live in,
where you know, there are laws in place that protect
us against health insurance companies and employers from denying or
discriminating against a positive gene mutation. However, I do encourage
my patients to have a life insurance policy in place
because there is no law that protects life insurance companies
(37:03):
from seeing that, and you know, denying life insurance policy.
So those are all open, open and honest conversations that
are had amongst our you know, nurse navigators and with this,
you know, with genetic testing and with the program, and
it's just about making sure that people are educated. That
(37:26):
is a huge part of this, you know. Yes, And
I always, like I said before, you but do try
to meet patients where they are. Not everybody is ready
today to do this, But we're gonna be here. We're
gonna be here in six months, We're gonna be here
in a year. Come back. You know, you'll get the
assessment again next year with your mammogram. But I have
patients call me all the time six months later and say,
(37:48):
you know what, now I'm ready. I've talked to my kids.
They want me to do it. You know, it is
a family decision, for sure. So I just encourage everybody
to do it in their own timing, for sure, and
push anybody into this for sure.
Speaker 1 (38:05):
Yeah. I mean that's really well said, and I just
think it's it's good for people to hear. You know,
this is this is a tool, This is information and
it has a lot of benefits, you know, both for
them and their and their family. So tell us a
little bit about the program itself. Where where is the
program being done in the Baptist system, Where is it expanding?
Is it going to be more than just breast cancer?
(38:27):
What what's the future?
Speaker 2 (38:29):
Absolutely? So, we did start four years ago in Paducah.
It's been going on a little over a year in Lexington.
Richmond just came on board. We've been in Floyd in
Indiana since last February, and we are getting ready to
branch out into Lagrange next year, into Louisville hopefully Corbin
(38:52):
and Harden. Those are kind of on the list of
places that we are branching out in the upcoming you
know year to come hopefully. So if it's not in
your area, it's coming soon. But I do want to
let people know in the Baptist system just also, yes,
this is just an assessment that goes out to our
(39:14):
patients scheduled for a mammogram. We are hoping to grow
the program. We are hoping to reach other you know,
markets and areas within the Baptist healthcare system. But if
a patient is saying to themselves, well, I don't. I'm
not scheduled for a mammogram, and but I want you know,
I want to get genetic testing. We do have genetic
(39:34):
counselors in place, just that we can get a referral
for them to a genetic counselor to have that conversation
to get genetic testing a different way if they are interested.
And that's just a conversation that we can they could
have with our providers and we can help any providers
figure out how to put that referral in to get
them to the genetic counselors that we have. They're wonderful.
(39:57):
So there are other options you know as well.
Speaker 1 (40:02):
That is that's amazing, and I, Jessie, I have about
ninety seven thousand other questions I want to ask you.
So we're going to just have to have you back
because we are unfortunately this is we're out of time.
And that's going to do it. For tonight's segment of
Centered on Health with Baptist Health here on News Radio
eight forty whas. I want to thank jesse you so
much sharing your story and of course sharing what you
(40:24):
do with all of our patients who are benefiting from everything.
I want to thank our producer mister Jim Fenn, and
of course you the listener. Join us every week for
another episode of Centered on Health. I hope everybody has
a great week and a wonderful weekend.
Speaker 2 (40:43):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health or
(41:06):
regarding specific medical conditions. To find a Baptist health provider,
please visit Baptistealth dot com.
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