Latest / The XX Lab / Shira Boehler: The Cancer That Kills More Young Women Than Breast, Ovarian & Colon Combined | #16

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Shira Boehler: The Cancer That Kills More Young Women Than Breast, Ovarian & Colon Combined | #16 · The XX Lab

• speaker-0: I created the XX Lab to highlight science and stories that matter to women. The underlying idea is simple. Understanding your body and your brain helps you feel seen, heard, and understood. It also helps you take better care of yourself so you can live healthy and well. Today's episode is about that, but it starts with a different question. It's not about what your hormones are doing or what your brain is up to, but instead about a growing health risk facing young women that most of us don't spend any time thinking about. My guest today is Shira Bowler. She's a runner, she doesn't smoke, she's a self-proclaimed kale enthusiast, and she was in her early 40s and by every measure in excellent health when a scan she almost didn't get found a mass in her right lung. Lung cancer. Caught early, she's fine, but here's what she wants you to know. Lung cancer kills more young, healthy women than breast, ovarian, and colon cancer combined, and almost no one is screening for it. She recently wrote a book called One Scan Saved My Life, and she started a nonprofit called Cancer Doesn't Care. And as you will see, she has a very specific ask for every woman listening. This is the XX Lab. I'm Dr. Sarah Hill. Let's get started. She's a Bowler, welcome to the XX Lab. speaker-1: Good to see you. I'm excited. speaker-0: So good to see you too. And today we're going to be talking about you have a new book that came out called One Scan Saved My Life. And we're going to talk a little bit about your story. And I think that it's one that's really important for women to hear because I think that so many of us are concerned about our health. And I think that most women are very proactive in terms of trying to, you know, stay on top of their health and make sure that they're you know, doing all the things that they need to do to avoid something like a cancer diagnosis, which is why I think your story is so important. Because ⁓ sometimes even when we think that we've got everything pointed in the right direction with our health, we can end up with a diagnosis in our lap. And so I think that your message is an important one because it really highlights the need for screening. And so let's just talk a little bit about your story. So your life changed because of one scan that you almost didn't get. Can you tell us a little bit about that? speaker-1: Yeah, you're right. So Sarah, I have always been, like you said, trying to do the right thing. So I always yell at my kids like snacks out of the pantry are not allowed, snacks out of the fridge are recommended. You know, I when they come home from school, I lay out all the cut fruit and cheese and cut vegetables. And they always, you know, their kids, they want to run into the pantry. And I'm like, Nope, that's for, you know, when you take a snack at eight AM and need to eat it at six after soccer practice and you can't take fruit in your backpack all day in Tennessee. But I've always been really focused on that. I'm a big runner. So I run this like six mile loop with a girlfriend of mine at least once or twice a week and then love to wait work out. It it's kind of like my life raft. So I joke with my husband sometimes 'cause he'll I'll be in a mood and he'll be like, why don't you go work out or go for a run? And I'm like, ⁓ you think I need to work out? You know, like He's commenting on my physique and he's like, you know that it's not about that, you know. So I I have, I've always tried to do the right thing. On the other side of things, my husband and I have been in the healthcare industry for 20 years. And so both my parents are doctors, my brothers are doctors, his dad's a doctor. We do all the medical things. So we're on the investment side, but our family's on the healthcare side. And so we do both. So like I had my full genome sequence when that came out, paid extra for the cancer panel. We did 23andMe. I've been doing that gallery grail blood test annually for about six years. And so when the full body MRI became available, the Prenovo or Function Health is doing it also, he signed up and he was like, Let's check it out. I want to learn about it. Let's see what the app is like. I am extremely claustrophobic, Sarah. So I was like, No. And he was like, Yeah, we're gonna do this. I was like, no. And we went to New York where the machine was and I canceled it because I was in New York and I wanted to see my friends and I had no interest in, you know, sitting in a machine for an hour. I just couldn't get it out of my head. speaker-0: Well, and especially like if everything else that you've always gotten back in terms of these other screens come back negative and you looks like you don't have any genetic risk factors and you're a self proclaimed kale enthusiast and a runner, I'm sure that you're thinking like, Why do that? Right when I could be hanging out in New York. I could be hanging out in New York, going shopping and seeing a show. speaker-1: Yeah, see my friends. So we went back and forth a bunch and ultimately he won, which like kind of annoying, but he won. And I went and did the scan. I'm actually not sitting here telling people to go do this scan. It's expensive. It's not everywhere yet. The scan actually came back and it had revealed a 3.8 centimeter mass in my right lung, but the doctor's notes and had stated kind of don't worry about it, that it's a minor finding, that you're You know, you don't smoke cigarettes, you don't have a tobacco history, you're a runner, you don't have symptoms, kind of don't worry about it. And so I didn't. I just kind of moved on. A couple months later, ⁓ my aunt had passed away. I was at my endocrinologist getting a normal checkup and I showed him the app more about how cool is this? Look at this app, look at the technology around it. And I was scrolling through it and You know, I said, ⁓ it says I have nodules on my thyroid, which I understood because I have thyroid disease. So he was like, Yeah, but we know that. You know, I was kind of showing him it's interesting to see. And I showed him the lung mass. And he, as well as my dad, who's a lung doctor, had both said to me, Well, when we look at our lungs, we actually don't use MRI machines. MRIs are great for dense organs. That's why they'll use them for, you know, breast after breast mammography sometimes or for your livers or kidneys, but not lungs. And so we walked through it and he said, Do you want me to order you a C T scan, a low dose C T? And it was the same thing my dad had said and other people and I thought, sure, why not? Again, probably more because it's interesting. I'd never had a low dose C T. Let's see what it's like. speaker-0: We didn't you didn't we weren't concerned at all, even when when they're like ⁓ no ⁓ wow speaker-1: Told anyone I was going to get a low dose CT, wasn't concerned at all, went for a run, felt fine, went and did the low dose CT. ⁓ and that scan came back actually as a 4.1 centimeter mass. But again, the doctor who read it stated, 4.1 centimeter mass, correlate with symptoms, non-tobacco user, you know, follow up if interested in a few months. And they kind of dismissed it. At that point, I was a little bit like, hmm. You know, I've always been taught to be a self-advocate and take care of myself. And I was like, that's weird. Still doesn't matter because I'm running and I'm active and I don't have an inkling of anything. And being the daughter of a lung doctor, I was always told if you smoke, you get lung cancer. Even though what I've learned is if you have lungs, you get lung cancer, or you can. And so I went back and I was like, can I get the CD? Like, you know, old school style, got it. My girlfriend here in Nashville actually is a lung radiology specialist. And she and I've spoken for years about her practice and all of the research she does. She's a professor also. And the work that she does as on the professor side and the research is actually very focused on women's health. So I got the CD, I gave it to her husband in the carpool line because she's always working. And she called me on a Saturday night when I was at a concert with my son and just said, I need to see you on Monday. Like, where's your husband? And I thought that was a little weird because we don't we're friends, but we're like Saturday night chit chat on the phone friends. And I don't think she'd ever ask me where my husband was. Like, I don't, you know. Right. And so he was overseas for his other job. And we had to kind of figure out how to get him home. But that Monday morning I went for a run. I had to run faster. I remember I told my girlfriend we have to run fast because I have to go see the doctor. I went and did another CT scan because she made it sound like she wanted me to do it at Vanderbilt. Like it was a better machine, but I think it was more she needed one more look. And then I walked into the office and the doctor was like, You have lung cancer. And I was n I've never been so surprised. I just kept saying, No, I don't, wrong person. And he kept saying, I understand, but you have lung cancer. And I was like, My hair's sweaty. I'm in my running clothes. Like, wrong person, wrong scan, there's an error, the electronic medical records, like, you don't understand this isn't me. And he kept saying, I understand that you think it's not you, but I believe you have lung cancer. I saw it on the scan over the weekend and I believe that and tomorrow we're gonna do a bronchoscopy and I understand that you don't believe me, but you have lung cancer. And it was that point when I was, you know, you're in shock. And he said to me, You know lung cancer is killing more young healthy women than breast cancer, and ovarian cancer, and colon cancer combined. speaker-0: Yeah, it's staggering. And and yet, you know, so many people think that the biggest threats to women are, for example, breast cancer, right? Like they think that that's the big one. And we're certainly hearing more now about colorectal cancer in younger people, but there's not any awareness of lung cancer in is particularly in non-smokers. I think that we still tend to think about lung cancer as being a smoker's disease or being ⁓ a disease of, you know, very old. people, right? Not young, healthy and women. And and from what the research that I've been doing, I was poking around in the literature and it seems like there's a growing concern in oncology circles, particularly about the growing rate of lung cancers in young, otherwise healthy women. speaker-1: Crazy Sarah. So I had half my right lung removed and was recovering in the hospital. And I started to just, you know, dive in and read everything I could because I was still in shock, but I was like trying to process it. Like what I think often, if you look at the literature, 40% of us are gonna get cancer in our lifetime. That's their prediction right now. And I guess I always thought I would get breast cancer. And I also felt breast cancer was like the cancer to get. Right. Right. So if you like back up a second, I would say my be all end goal with everything I'm working on is to make cancer chronic illness something you die with, not from. And I feel like we've been really successful at that. Let's say, you know, being a child of the 80s and 90s, like HIV. We were all really scared. And now I'm sure there's still HIV. You don't hear about it. They found an amazing medication and others, and they take the medicine and they eventually you know, it's a chronic illness that they take medicine for. And I feel like we're close to that with breast cancer, as we're able to detect it early with mammography and MRIs and and doing the biopsies, that I just always assumed that would be my route. I've seen a lot of friends go through it. It's not an enjoyable thing, but it's something that our society has luckily been able to overcome. And I think a lot of the time, and it's not killing people as much anymore. And so that was, I guess, my plan. I thought, okay, if you know, nearly half of us are gonna go through this. I think what is amazing is what you said that people think lung cancer is for people that smoke. And it does increase your risk, but it isn't the only answer. I think what we're seeing in with the women side, in Asia they did a study. They found that women in Asia who were not smoking were actually getting lung cancer at a faster and higher rate than the male counterpart. That was smoking. So there's some female health crisis going on, and like we don't understand it. There's not like an understanding. I think the smoking cessation campaigns, which were amazing to help people stop smoking, were very like, if you smoke, you have a higher risk of getting cancer for your lungs. So stop smoking. And for whatever reason, this the slogan turned upside down and became if you have lung cancer, you speaker-0: Smoke. Right, you were probably a smoker, yeah. speaker-1: Yeah, and the reality is if you smoked, it's okay. Like you shouldn't be ashamed. It's not your fault if you get lung cancer. It's not a deserved disease. We should just try to catch it early, like breast cancer, and and maybe we have an opportunity to to beat it. speaker-0: Yeah. And I know that you had said that one of the things that people tend to assume, right, when you tell them that you well, one, you know, if if I'm sure that if you tell them that you were dealing with a cancer diagnosis, everybody assumes breast cancer to start with. And then it's like, no, you know, it's it's lung cancer. And then the question is, ⁓ did you smoke? And I remember you you saying, 'cause you did not, and you're a runner and you're very healthy. And nonetheless you got it. I mean, asking somebody that is is very similar to if somebody has breast cancer. Like nobody says, like, well, what did you do to get that? Like it's it's like it's like we see lung cancer as being almost like ⁓ a disease that is is like somebody's fault. Right. I think that people see see that as being more like almost like deserved. Yeah than than speaker-1: Think of it as deserved a lifestyle choice. speaker-0: A lifestyle choice, right? And ⁓ and oftentimes it's not. And and and even if it is, I mean, there's so many lifestyle choices that all of us make, you know, that ultimately, you know, mo very few people live a perfectly pristine life where they're not doing anything that's going to increase their risk factor of getting something or or the other. And I'm I'm sure that for you, like one of the things with like for people who have had breast cancer, for example. There's like a whole community around this, right? Where it's like seen as this, you know, you wear the pink ribbon, and there's, you know, sort of this like, ⁓ you're part of this, this club, you know, the people who've had breast cancer, and it's like a sisterhood. And lung cancer doesn't have that. speaker-1: You're right. Sarah, you know, I've it's been an interesting journey. So I was diagnosed in October, so it's been eight, nine months. Being a lung cancer survivor is actually really lonely because I think for two reasons. One, not many people survive it. You don't have symptoms until it's too late. So your lung cancer spreads to your bone and brain first, and those are harder to beat. ⁓ and the medicine And the research is all, you know, 10, 20 years behind because of the deserved disease aspect to the way we thought about it. The other reason I think is because of the stigma around it, people don't talk about it. So it's interesting. I think you're right. There isn't that community. And the stigma has made it so that there are a number of very high profile women that I've met through the last eight months that have reached out to me that have said, Hey, I have. I'm a lung cancer survivor, don't tell anyone. They don't want their public, you know, maybe they're the CEO of a publicly traded company, they don't want the stock to go down, they don't want to lose their job, they don't want people to think automatically that they deserved it, that it was their lifestyle choice. And so instead of coming out and yelling and screaming, they kind of brush it under the rug. And I think that's similar to maybe how breast cancer was seen, not with the stigma, but people didn't talk about it as openly 20 years ago as they do now. But it is lonely. And I've tried to reach out and kind of coach and work with people to come out and tell their family because I try to remind them that it's not their fault, that it's not deserved, that it's not a lifestyle choice, and that even if they did spend their college days or post-smoking, it's okay. And you know, it's not their fault. speaker-0: It's really crazy to me because when you consider the like there's lifestyle choices that people make every day, like not to exercise, right, or not to eat leafy greens, or not to, you know, eat cruciferous vegetables. And people make these kinds of decisions all the time. And nobody sees other types of cancer that they don't have that sort of stigma that that lung cancer does. Right. speaker-1: And Sarah, like we're all human. I mean, I try to eat out of the fridge, not the pantry, but sometimes the fridge sick Diet Coke comes out and I'm like, well, today's my day, you know? And I'm not thinking I'm any sort of perfect specimen or make all the perfect decisions. We all, I would imagine, want to have that Diet Coke or chuck chuck chucky or, you know, it's your birthday and you want whatever the new dot cake is. And I just think that's also okay, right? We all have to live. speaker-0: Do think that the the fact that lung cancer oftentimes is seen as a quote unquote deserved disease is partially responsible for the fact that it doesn't get the kind of attention or funding that some of the other types of cancers do? speaker-1: 100%, 100%. That's why when I often talk about it, I talk about it that it's not deserved, even if you did have a tobacco use. But also like they found that breast cancer survivors have a two-fold increase of getting lung cancer within five years of diagnosis, holding radiation constant, not from treatment. And they're not screening breast cancer survivors. They're not talking about it to breast cancer survivors or anyone. And so I think that. What we're finding is lightning can strike more than once and it maybe isn't lightning. There's something going on in our female bodies, whether it's the environment or the food or some combination of what's going on that's causing this a huge uptick in cancers across the board and then in female cancers. And so instead of thinking of it as deserved and brushing it under the rug, we should talk about it and figure it out. And I Have so many amazing friends that are breast cancer survivors. And now I'm the one telling them, go get your low dose chest CT, you know, and read my book so that you understand the risks, because it's smoking is a risk, but radon is a risk. There's occupational hazards that are a risk, there's family history that could be a risk, there's other cancers that can be a risk. And if we get this low dose chest CT, which is all we have today to detect it, and we catch it early like I did. Stage one, they they say I have over ninety percent chance of the five year survival. So I'm fine, you know. And if you're stage three or four, it's harder. speaker-0: It is. Yeah. And one of the things that I noticed, and I did a little bit of a literature search, just trying to understand what we know about lung cancer in young women in particular, because there are growing rates as noted. And nobody really actually seems to know what the risk factors are. That's like a staggering, you know, omission from the research literature. And One thing that I was thinking about as I was looking at the differences in the age of diagnosis and the risk factors between men and women is that, you know, we might be dealing with and they're different types of cancers oftentimes, right? They they tend to find that women are more likely to get one type of lung cancer and men are more likely to get the other, but that's not always the case. And the risk factors seem potentially to be different. I think that this is another reason that one of the things that I'm ⁓ a big advocate of and I've I've been writing about this and and talking about this and speaking about this, ⁓ is just studying sex differences in biomedical research and in psychology research. And and this is one of those cases where it's like, I really think that it might be useful to study this disease separately in men and women. Right. And and because I I think that what we're gonna find is that the the risk factors, the the the treatment of the disease may be something that is very much sex differentiated. I read a really fascinating paper. I think you'll think that this is interesting. I read a really fascinating paper where the researchers were actually arguing that the reason that we've made so much more progress in things like prostate cancer and breast cancer than we have in other types of cancers is because you're necessarily studying it only within one sex. And that when you try to lump men and women together to try to study a disease progression, so whether it's colorectal cancer or lung cancer, that you can actually slow the progress of disease because oftentimes the disease related processes are going to be different between men and women. speaker-1: I mean, that's fascinating. You're probably right, Sarah. I mean, I think back, even if you put cancer aside and you talk about a heart attack, which to me, heart, lung, you know, they're in both of us and you know, we study them together. I think a decade or so ago they would talk about if a man if somebody, they said somebody, presents in the emergency room with like the elephant on their chest and the numbness down their arm, that that you should triage them immediately. That's symptoms of a heart attack. What they found about a decade ago that there were like atypical symptoms. And the atypical symptom was for the woman. So it was atypical 51% of the time, because we are more than the men. And this atypical symptom in a similar sense to a man flu was a woman would come in and be like, I'm feeling off. I'm hot. I want to lay on a cold floor. I'm nauseous. I don't feel good. And they would put those women in the waiting room. And they were dying of a heart attack. And so what we realized is those atypical heart attack symptoms, which were really more typical because it was 51% of the time, was how a female presents. So like a man flew, they're like laid out and can't function. And a woman gets the flu and they're still driving the kids and going to work and managing the life, right? So in a similar sense, a man gets a heart attack and it's like that crushing elephant, numbness, they can't function, they're freaking out. And a woman's like, something isn't right. I'm off. And it's like a heart attack and heart attack, you know, those are killing more than cancer, right? And so we ha it took us a while, but we realized that women's symptoms of a heart attack and man is very different. And I think in a similar way, you're saying is so right. Like when when I look at my lung screens and I look at ⁓ what it looks like to the radiologists and they explain it to me. My lungs do not look like an old man, let's like a Marborough with the cowboy hat and like the wrinkled skin that's all like overtanned, you know, like we think of with like that lung cancer. That is not what my lungs look like. They don't. It's just totally different. And I think that's part of the reason why I had so many doctors look at it and tell me, no symptoms, you're fine, go on with your life, even though there was like a four hundred ten centimeter millimeter mass sitting there. Which I think you're right. That's fascinating. It is speaker-0: That's yeah, that it that that's just it yeah, that's crazy to me. And I I do think that, you know, there's likely different risk factors for lung cancer for men and women and that and that we haven't identified what those things are in women. And until we start studying women separately and studying the disease process and ⁓ you know, and and what the actual identifying what the actual risk factors are. it's it's gonna make it really difficult for women like you and other young women who are silently, you know, having this disease that when it goes, you know, you can have a really nice ⁓ survival rate if you catch it early, but so few people do because nobody takes it seriously. I mean, the fact that you had a mass on your lung, I mean, it's like to me, you know, and most people don't even get that far, right? Like most people have no idea that that an MRI would would catch this little thing this little blip on the radar. And so women oftentimes have no idea. And we really need to do this research in men and women with this disease separately, I think, to be able to identify what those risk factors are. Because surely there's something going on that you and other women who've been diagnosed that are young have in common that then we can identify. And it might be something hormonal, right? It I mean, we we we just have no idea. And that's too bad. And I I'm I'm so happy that you're bringing more attention to this particular condition, especially in in young women, because it's something that, like I said, you look at the the research literature and there's growing concern among oncologists, particularly about young women in lung cancer. And so this is something that nobody likes to think about, but everybody needs to know about, right? And it's something that we need to increase conversations about. speaker-1: Think too, like when I look at the uptick in colorectal cancer, which is terrible, but we very quickly were like, okay, colonoscopy seemed to help identify it early. We moved it 50, 45, right? That's where it is now. And maybe we're heading to 40. I don't know. But there's so much awareness. And I think that that awareness is coming from survivors that are like, hey, pay attention over here. And I think if we Can catch it earlier, will have more survivors and we can have more high profile survivors that will, you know, wave the red flag or wear the white ribbon. So lung cancer is a white ribbon. So sometimes I've talked to people, one of my doctors says that she works on a pink and pearl campaign. So breast cancer and and lung cancer, because it if it is tied to this female health crisis, we need to, you know, check our boobs and our lungs, right? And so there's like a pink and pearl moment. And I just think it's, you know. the awareness around it, I want to, you know, yell from the rooftops and tell everyone I know, go get a low dose chest CT. That's it. It's a one minute scan. Colonoscopy is two days of work you're missing. Mammogram hurts. A low dose chest CT don't even take your clothes off. speaker-0: To talk to you for a moment just about being a young mother with a cancer diagnosis, because I think that there's a lot of listeners who've either gone through this ⁓ with some sort of a cancer diagnosis of their own or are even just like worried. I think a lot one of the big things that ⁓ people worry about is about getting cancer. And ⁓ one of the things that I know from my research is one of the ways to best manage anxiety. is to be able to walk yourself through your own worst case scenario. Right. And so like understanding like, okay, if this bad thing that I don't want to have happen happen, like what would I actually do? And I'm just really curious if you can tell us a little bit about the experience of you know being a mother and and being faced with this diagnosis. Like what what was it actually like for you to get this diagnosis? And especially like such a scary diagnosis, because most, you know, I'm sure The statistics on this don't look great because so few people catch it early. So few people catch it early because people aren't getting these low dose CT scans. And ⁓ and so it doesn't look great when you're, you know, just like reading up on like, you know, what the Google it. Yeah, do not Google it, like what the survivability is just because of the the late catch. Like what was that like for you? speaker-1: You I mean, Sarah, so what happened that Monday, they told me I had lung cancer and I didn't believe them. My husband was there and I said, Okay, you go pick the kids up from school, I'll go home and like pull it together because I was hysterical and let's talk to them. But we're not gonna use the C word, right? Like just that sounds really scary. So he picks them up from school and he brings them home and we say, Okay, guys, everyone on the white couch. It's the TV room couch, is actually green now, but it was white. And so we still call it the white couch, you know like this. So like everyone on the white couch, even though it's green, but it's okay. And the white got really dirty. So we, you know, had to move to dark green. So bad choice. Don't you so we sit down and my daughter says, Are you guys getting divorced or does mom have cancer? speaker-0: Well, kids, I understand it. speaker-1: The first thing. And my husband and I freeze. So we were sp I didn't want to use the C word. And we go, ⁓ we're not getting divorced. How do you know this? And my daughter goes, Well, dad has never picked us up from school before. speaker-0: ⁓ wow. speaker-1: And then we all kind of laugh because true. And we sat down and we said, Well, we don't know for sure if it's cancer that mom has a procedure tomorrow, you know, and we're just trying to walk through. I'm very like, tell them everything. Probably why I wrote a book too. I'm just like an open book. And I think for kids it's better for us to be that way. The kids were, I think, eight to thirteen. Now they're nine to fourteen. We walked him through and my son said, Well, what are the chances that It's cancer. And I think he thought we were going to say like one or two percent or point one percent. And my husband said 90%. And then they laughed. And I think that was like their shock of like, what? Not one or two percent, 90. And then we cried and we talked a lot through it. Sarah always say I'm like the luckiest girl in the world that I caught it early, that I, you know, had the means and the bulldozer of a husband that. That was a Monday and I had surgery the following Monday. So it was only I only knew about my cancer for a week and it was stage one. It wasn't in my lymph nodes. There's actually no medicine for me to take, but it's okay because it's all out. So I like didn't lose my hair. I don't look sick. My kids joke that it's fake cancer because I don't look like the cancer patient on television that they think about. speaker-0: Did you let them know that I mean, ⁓ clearly they saw that you were upset. Did they know that you were scared? Or like did you feel like you had to put on a brave face? Or did you j were you just like vulnerable and say, like, I don't I don't know what's gonna happen? speaker-1: Yeah, no, I did. I said, I don't know what's gonna happen. I have to go to the hospital, I'm gonna have surgery, like you guys will visit me. It's gonna be like scary for a little bit, but we'll tell you everything. I asked them not, you know, a couple of them were teenagers. So I was like, I don't think you should look online right now. We'll let you know when you should. And then as I've gone through this and I've spoken about it and I wrote the book, they've listened. Sometimes they'll come. But I did. I never said to them my Deepest, darkest fears. So my youngest was eight, and I remember, and I still do when I get into a bad place, think like, will I see her graduate elementary school? Will I see her graduate middle school? Will I see my kids finish high school? Oftentimes, like I've always said to my husband, like, I love our kids, you know, they're away at camp for a couple weeks right now and I miss them so much. But there's something fun too about, you know, you fall in love with someone and then you have a family with them, and it's like crazy and wild and you don't have that much time together. And then one day they're all out of the house and I say to him, like, I can't, it's not that I can't wait for the kids to be gone and grow up because I'll miss them a lot, but I look forward to like, you know, bopping off and skiing for a few days without having to think about soccer games and, you know, softball practice and class. You know what I mean? I can just be like, hey, let's like do our meetings on Zoom and go. speaker-0: Yeah, the Jackson hole. Yeah. Yeah. speaker-1: Yeah. And so that stuff is really scary too. You wanna see your kids walk down the aisle. All these like little milestones that I had never thought about before and then became like so important to me. speaker-0: Yeah, practically speaking, with ⁓ having to have surgery and then the recovery, like logistically, like how how did you manage that? Like how did you keep the household running when you're trying to because I think that, you know, ⁓ mothers so often we feel like we can't even like get a, you know, a paper cut. Because, you know, God forbid we we take our attention on ourselves for a moment, you know, to try to manage and go get ourselves a band-aid because we're so busy taking care of everybody else. Like how like how did you keep the household running and keep the kids going and all of that when you're in the middle of trying to recover all of this and navigate the the medical landscape? speaker-1: Yeah. I mean, again, I was really lucky. My parents came for the week that I was in the hospital. Being that my dad was a lung doctor, I and my mom's a doctor, I just wanted them in the room. And then the week that I w was home but I wasn't allowed to drive, my husband's parents came. So like that's probably what kept me afloat. But a lot fell. I think that I was micromanaging a lot and having to do I was doing more than other people maybe thought I was doing. And then when I was doing nothing The house spiraled a little bit out of control. But we managed through it and figured it out. And my friends, you know, were amazing. Like I don't I looked like a floral shop. Everyone wanted to bring me soup and, you know, food and pajamas and soft socks and help with the kids. It's interesting, Sarah. I often say that diagnosed with breast cancer, people say, How can I help with the kids? What can I buy you for food? You know, what can I do? And then for me with lung cancer, people would say, ⁓ I didn't know you smoked. Did your dad smoke? Is it secondhand? But I think as I started educating people, they were like, ⁓ God. And because our community is so great at supporting other women and moms as they start they, you know, do the breast cancer process, people kind of knew what to do. Like I remember a friend after the double mastectomy, I said, like, what's the hardest thing? And she goes, I can't get the milk out of the fridge. Right. She couldn't lift her arm up over her head and pull the milk out. And so funny things like that. So then when it was my turn, you know, I just was like, Hey, somebody has to be with me all the time because I can't get the milk out of the fridge. Not that I was drinking milk, but it would become what I would say. And so I think the kids stepped up, my parents and my in laws stepped up. I think it just helped. And then, you know, I think sometimes like it gets to be a lot in your house, right? To have all these people there l all the time and They were understanding and I always had somebody with me in the hospital. But I think between like my husband and my parents and then like the babysitters that were help had always helped with the kids, we tried to keep the kids on a routine. And so it made it a little bit, you know, but my husband still works. You know, we all had to it was crazy. I would say that I was really f fairly immobile and needed to kind of lay low for about two weeks. And then I started building strength back. And I think because I was running and healthy going into the surgery, I was back on a plane four weeks later yelling and screaming in Washington DC and then running about six weeks later. speaker-0: Yeah, I think that one of the takeaways it sounds like is for w women who, if there's anybody who's listening and you find themselves in a situation like yours, is not being afraid to ask for help, right? And that that can really make a big difference. And I actually just had on a friendship expert from ⁓ UCLA, and her research finds that one of the ways that we can really actually deepen our friendships is by asking for favors. And so, you know, in addition to being something that would be able to help. us out if we're in a situation where we need an extra set of hands because ⁓ life is hard. It also can deepen our friendships with others. I'm sure that you found that ⁓ in a situation like yours, that it's like it it does deepen your friendships and it makes you like people really oftentimes will come and and rally and and support you, even if even if you're somebody who doesn't think that you have a deep well of friends, I think that sometimes things like this really do bring out the best in people. speaker-1: Yeah, I think for me too, when I think back on that time, it was less that I needed help, I guess, driving the kids because my parents or my in laws were there. It was more like I needed somebody with me. And so sometimes I would say, Can you come over and sit with me for an hour? And it would just be like to distract me, to chit chat, to just be there. Sometimes I would walk my driveway with someone. And that kind of gave me a lot. of like the mental health support I needed. I remember my doctor after the diagnosis and going through the surgery and stuff, she said, I can tell that your life raft is built around running and exercising and being with friends. And when you're in the hospital, it'll be harder to be with friends and you're not gonna be able to run and exercise for a while. So let's figure out other ways that we can fill your life raft so that you can get through this period. And I was like, okay, you're right. And so I picked up the phone a lot and I would just like text a friend and be like, Hey, you have to chat with me for an hour when I was in the hospital or things like that. I I knew that about myself and then I had to find new ways to help because I couldn't, you know, go for a run when I was in a mood. speaker-0: Yeah. And so I was gonna ask you, was that the primary way that you were able to manage your mental health during that time? Was just calling friends and making sure that you were able to be distracted? Did you have a therapist? Did they recommend for you to get a therapist? speaker-1: It's really interesting actually. It was my surgeon who said to me right before surgery, he said, I'm not a therapist, but I want you to know that over a third of my thoracic surgery patients end up in very bad deep depressions. I'm not telling you what to do, but I would highly recommend getting ahead of it. And I thought, that's weird, but he sees it anecdotally. Right. So I reached out to my doctor. They didn't want to start me on any like Luxapro antidepressant stuff. speaker-0: Wow. speaker-1: prior to surgery because it was all would be new in my system. But after surgery, they put me on a really low dose and they were just like, let's just see, like very proactively, not I wasn't depressed yet or did ever. And then they also got me a therapist that I would go meet with. And it was, it was interesting. I'd never really been through that. I did it for like three months or so and I was like, I feel fine. So I ended up going off the Luxapro and continued to just meet with someone because it was interesting that my surgeon was the one who said it. And I I forgot about that actually, Sarah, until you just brought it up that I did. I I met with they were amazing, this woman and and helped me kind of navigate that period. When I look back to now that you're reminding me, my husband was amazing and supportive and a total bulldozer and got me through everything. But he's it was hard for him. And I sometimes think he would have benefited more, I think, for more help because I think the people around us also need that support. I think oftentimes like he, like many men, like want to fix it. So when I was like in the hospital and leading up to the hospital, he was in like fix it mode. He's like calling doctors, calling the CEO of the hospitals, trying to get me in the OR, finding the right, you know, person to ask advice. He's in fix it mode. But then when I look at that weak. or two that I was home and not able to drive and was like kind of in recovery mode. That was like not great for him. speaker-0: Right. Yeah, I'm sure, because he c there's nothing he can fix anymore. And speaker-1: And he's like, You're fine, you don't have cancer, everything's fine. And I'm like, Well, I mean, not but speaker-0: Yeah, yeah, yeah. Well, I think that it's hard. I think it's hard, especially sometimes for men, because they I don't think that they like to grapple with their feelings. And and there's plenty of research evidence that suggests that this is the case, that they just have a harder time like understanding and even being able to identify what they're feeling. And I think that the feeling of like just fear around the possibility of, you know, losing the person that they love the most in the world is. overwhelming for men and because they aren't, you know, they're not even good at identifying what emotions they're feeling to that then they don't know what to do with that because they're feeling this thing that's overwhelming and they don't know what to do with it and they can't fix it. I think it's really important in general for caregivers to have somebody that they can talk to. I think that I shared this with you when you and I met in Washington, but my my husband had lymphoma and ⁓ and he was very sick. And that was a really hard time for I mean it was obviously it was worse for him than it was for me, but that was a very difficult time for me trying to manage that. Yeah. speaker-1: I like want to tell my surgeon that he should say next time that both parties should get help because my husband was having like breakdowns, and I think it was because he couldn't say to like, I love you and I don't want to lose you. He just was like, you know, couldn't handle it. And I think I just haven't thought about it. And and it isn't right. You know, and I as I'm thinking through this, Anne Wojiski and Janet Wajiski wrote the forward of my book. Anne is the founder of 23andMe. Her sister, Janet, is a physician at Stanford. Their sister, Susan, was the CEO of YouTube and passed away from lung cancer, you know, not from smoking disease. She was a runner like me, her hip hurt, and the cancer was found in her bones. She passed away in August of 24. And when I talk often with insurance companies about how they should add low dose CTs to catch it early, one of the things I talk about is the effect on the family and the effect on my family. Lasted a few weeks, right? Like to get back and recover. But the effect on someone like Susan's family, where she was in this end-of-life care, she was taking chemo and all these other drugs that are really hard on a system. You know, her husband, her father ended up passing away, her son ended up passing away of an overdose. Like the strain and stress on that whole family for 18 months of struggle was terrible. And like we didn't address it. And when I talked to insurance companies, I'm like, look, you had to pay for my scan, which you didn't, but you eventually did. You had to pay for my surgery, which you didn't approve originally, but then you eventually did. So what did I chop? What did I cost the insurance system? $100,000. I don't know. $200,000. That was it. Whereas, like with somebody's family that has to go through all this, like, think about the husband's. medication and therapy they need, the children's medication and therapy, the the mother, the grandparents, the sisters, the aunts, uncle. I mean, it it's not just this big. Or even think about like the effect, where would YouTube be today if Susan was still running it, right? So it's like a ripple effect in astronomical for a $200 scan. You know? And it's amazing. And as you say this, you're right. Like my surgeon should say I worry about the mental health of my patients. I see a third of them struggle. I also see the spouse and the children struggle. We need to like have that whole picture. A lot of times as women, we talk about that early cancer diagnosis and we need to do the fertility treatment around it before treatment of the cancer because we want to make sure. And I I mean, I'm lucky I didn't have to go through that. I was 43. Baby making was behind me for that. But You know, I think it's bigger than that, it's also like the mental health of the people around you. speaker-0: Mm-hmm. Yeah. I think that the mental health of managing your mental health, and I love that your surgeon was so wise as to give you that advice. Cause I think that anytime that we're in new frontier, you know, I I think it's always challenging. And and whether that new frontier is good, like like imagine that you start like a really great new job. I mean it's challenging and it's helpful to have a mentor or somebody that you can talk to. And then when you're going through something like this, like a diagnosis that can feel so scary and ⁓ in in the case of lung cancer in particular really isolating. I'm glad that you that your doctor like put you on the path. But yeah, you're right. I think that the caregivers ⁓ also need need support. And so good information, good information to have. How did all of this change you? Has it did it change you? Like do you feel like you're different after after having gone through this and like what like how how has this changed you? speaker-1: I think that I mean, I've always tried to live in the moment. I probably do that more and people probably say that. I also think it put me on a new mission in life. And a lot of times I read that like women have a reset in their 40s. I think this was that for me. That same surgeon actually I remember I was walking on my driveway a little back and forth and I was home from the hospital and he called and he said, I have good news. We just got the lab results back and I had clear margins and it was not in my lymph nodes, right? So when he said that, I remember I dropped and was like sitting on the driveway, which is kind of gross. But you know, you just like have this moment and I kind of fell down and was crying with happiness. And then he said to me, Shira, he was he's very religious and spiritual. So he he won't always wanted to pray with me. And he said, I need you to know that I've been praying for someone like you. And I said, What? And he said, okay, let me say that again. I haven't been praying that you would get lung cancer. I have been praying that if I found a young healthy woman who was diagnosed with lung cancer, that I would be able to take it out and call them cancer-free after surgery. Because what we need is somebody to yell from the rooftops that this is killing more young healthy women than breast ovarian and colon combined. We need someone to advocate and yell and scream and help. And he said, I haven't Googled you yet, but I'm going to. And I'm going to figure out a way to get you in front of the world because this is not a disease that should be killing so many people. This is not a disease that is deserved. This is not a disease that should be ignored. And I have been praying for somebody who had the strength to get up and yell and scream. And I was like, ⁓ And he goes, No pressure, no pressure. I'm like, what about it? And I had done all this research, I was like, well, someone's gonna have to do it. And I was like, okay, let's see. If I'm not enjoying it or I don't feel good about it, or it takes too much time from the kids, like I can always stop. And what I realized in the last few months, you know, the lead up, the book came out in April and end of April on hip New York Times bestseller. And it was like this adrenaline rush. And as I've been like talking to people and yelling and screaming to get their lungs checked, I've had I can think of four people that have called me and said I went and got my lung screened and I have lung cancer. But I'm gonna beat it. speaker-0: Wow. speaker-1: And I'm gonna beat it because it's early. And I don't wish lung cancer or any cancer on anyone, but if forty percent of us are getting cancer and lung cancer is killing the most, why don't we just catch it early and then not die from it? And I think that that has given me a new lease on life too. And I think it feels good and it has changed me. I never thought I would get up in front of rooms of thousands of people and talk or get on a podcast. My husband's always been, you know, speaks in front of groups of people or he's on television a lot and I would always say, like, Are you nervous? Like, what do you do? And I'd be doing his makeup. And now that I'm doing it, I'm okay. And I think it's because when you're passionate about something and you really are in it for the right reasons and you know the story better than everyone else, it gives you adrenaline and excitement and it feels good because I just speaker-0: Yeah. speaker-1: want more people to be okay. I think, you know, I mean, Sarah, how many mammograms have we all had in our lives? A lot if we're over 40. Yeah. And I'm never scared when I go get a mammogram. I'm never like, I don't even know if I tell my husband or kids, I have a mammogram today. Just like, ⁓ go to the doctor. It is what it is. As I've taken a lot of people to get their lungs checked, they are visibly and emotionally scared, crying, nervous, worried. And when I realized in all that is they're scared that they'll have it. And I'm like, hey, it's okay if you have it. We'll catch it early. Just like a mammogram. You don't cry when you get your mammogram, you know? And so I think there's like a whole mental health, a whole stigma, a whole like rewiring that we need to do. And like that side of it has been really rewarding for me too to I take my friends all the time. We can take you, Sarah. We'll go get your low dose CT when you're in Nashville or anywhere. And I stand next to them and and do it with them and show them it's not scary. speaker-0: I think that having you as as somebody who's out there who's surviving and thriving and who caught things early is so important because I do think that a lot of people are afraid to go and do it as you noted, because they're afraid of you know what it looks like on the other side, right? Like the CEO of YouTube, right? They're afraid that they're going to go in and be told that they have a terminal diagnosis. And ⁓ and everybody wants to push that away because it's really scary to think about. And so I think that having someone like you out there and ⁓ and with your new book, One Scan Saved My Life, I think that I'm I'm hopeful that it's going to encourage women to really be proactive with their doctors or their healthcare providers about this and about the possibility of getting a low dose CT. And if a woman wants to do that, so if somebody's listening and they are they want to do this. Like what what what is the conversation that they need to be having with their doctor? speaker-1: Okay. That's a good question. And it's a really hard one to answer right now because it's not an easy ask because the doctors are gonna give pushback. So let me back up a second. In order for your low dose CT to be paid for by Medicare or Medicaid or insurance, the guidelines that were set forth are that you must be over the age of fifty and you smoke a pack a day for fifteen years. speaker-0: Yeah, it's crazy. I mean it's it it that's just yeah, that's crazy. speaker-1: Crazy. So many people don't meet that or they don't want to admit that or they're not over fifty. The problem with that is that in twenty twenty-five, Northwestern did a study and found 70% of people diagnosed with lung cancer did not meet those guidelines. speaker-0: Seven seventy percent of people diagnosed with lung cancer did not meet the criteria for getting your scan paid for by insurance or Medicare. Unbelievable. speaker-1: Unbelievable. Okay. So that study came out at the end of twenty five. So like the guidelines are outdated. They're antiquated. People vape or do other things or smoking is not the only risk factor. So okay. So now that we know that and we go to our doctor and we're like, I want a low dose chest CT, your doctor will say, You don't meet guidelines. Your insurance won't cover it. There's radiation, which is very low and you're fine. You don't. It's okay. So they'll be pushed back. And it's not that they don't want you to get it. It's that that that's how they've been educated. That's not the guidelines say. So I started a foundation. All the money from my book that I make goes to it. It's called Cancer Doesn't Care because it doesn't. And my website, cancer doesn't care.com, there's a whole section about how to get a low-dose chest CT because people get pushed back. So you can go there, but basically it'll tell you your doctor will say no for this, tell them this. Your doctor will say this, tell them this. And you go back and forth. And then the reality is once your doctor orders it, because low-dose chest CTs are a shared decision-making process, unlike a mammogram. If you want a mammogram, you just call the radiologist and you're like, I'm coming in for a mammogram. They're like, no problem. You don't have to have doctors and this and that order it for you. You're over 40, you're a woman, you go get your mammogram. Different for low-dose CT. Your doctor has to order it. So it is a complicated process because your doctor will give pushback. My foundation is there because I want to be able to pay for people screens that can't afford it because cancer doesn't care. These screens are about $200. They are not expensive for a lot of people, but they are too much for others. So I always say, you can afford it, go push your doctor, go get your low dose chest CT. That's my advice to people. And there's information on cancerdoesn't care.com to help you navigate your doctor to get it. There are also like a nurse practitioner, someone like that can order it. There's other ways around it. I've worked actually a lot with Vanderbilt. They've been amazing. They've reduced their price from when I did it around seven hundred bucks to four hundred fifty at the first of the year and now it's about two hundred dollars. speaker-0: And that's and that's ⁓ without insurance. That's speaker-1: Without insurance. Right. And so we tell I tell people often, tell them you don't have insurance. For some reason, the way our system works, if they bill your insurance and insurance denies it, you pay more. You'll just be like, I don't have insurance. I want to pay out of pocket. Here's my credit card. I want the scan. A lot of times, too, doctors will let people order a low dose CT to look at their calcium scores of their heart. And it's actually the same test for your lungs. It's just like, This is the picture for your heart and like this is the picture for your lungs. So I always like sometimes recommend say you want a calcium score test, but you want it like a little speaker-0: Zoomed out. I really want to see my I want to see my heart in context with my lungs there also. So speaker-1: and so often doctors will order that and that's not in guidelines and that's not covered by insurance. So one of the things I'm hopeful my book and my work will do is to re-educate the doctors. Similar to what we talked about with the heart attack, how a man has the chest, elephant on the chest and the woman is off, we had to re-educate the doctors and say, Okay, we've realized that women present one way and men present another way. So another thing we're gonna have to educate them on is we're realizing that. 70% of people diagnosed in 2025 did not meet guidelines. And Sarah, my fear with a number like that, to be honest, is that the N is off. Those people diagnosed in 2025, me one of them, that did not meet guidelines, me one of them, found it incidentally. Maybe someone had back pain and they realized it was, you know, lung cancer. Maybe someone, you know, broke a rib in an accident and then they did a scan to look at the ribs and realized there was lung cancer or the heart test and they saw a little nodule and realized it. If we start scanning people that are actually at risk, I'm worried that that number is much bigger because we're missing so many people because we're not scanning people, right? The N is is off. speaker-0: Right. Right. And I mean and and eventually, unfortunately, there it it's gonna get caught up, but then o oftentimes too late, right? 'Cause these people will be sitting there with this undiagnosed tumor for mowe long it takes for them to ha you know, to have it really progress and and take over. speaker-1: And the medicine today, like I'm not on any, but I've met a lot of stage four lung cancer survivors actually and that's like the worst diagnosis you could get and they're they're surviving right now. You know, they're there's all this new medicine and clinical trials that are going on and hopefully there'll be more and more and they're taking them and you know, they're year one and two and six and seven and and it's amazing. speaker-0: Yeah, I have a I have an aunt who's lived almost so far 10 years with it. I think that she I don't know if she I think she was a stage three and ⁓ and she's doing great. Yeah, totally. And I and and ever since the advent of the immunotherapies and that sort of big unlock where ⁓ doctors and and researchers began to realize all of the different ways that you can program the immune system to try to keep cancer from progressing and and killing cancer cells. ⁓ I feel like we're speaker-1: That's amazing. speaker-0: moving into a new era of, like you said, your your hope of having cancer be a a disease that you die with but not die from. I feel like we're getting closer. Not close enough, but we are living in a time, thankfully, where these things are happening. And so that's also just another reason to try not to let the fear of the scan set you back from getting the scan. And because I I think that for a lot of people it is a big mental hurdle. And and just seeing you and hearing your story and, you know, and just seeing like This is what it looks like, folks. You know, it's like Shira over here. And and and I think that you know that's really it's it's very inspiring. And I think that it really does help to eliminate some of that fear. speaker-1: Yeah. It's funny when the publisher, when I gave him my book, he was like, Okay, two things. One, you're using a lot of exclamation points in all caps. Because I'm like, that's my personality. And two, he presented me the cover and it had a photo of me on it. And I was like, ⁓ that's weird. Why is my picture on the It's not like it's a memoir of and I'm some famous person. And he said, People need to know that that's what a lung cancer survivor looks like. It's not the Marvel man. And I was like, hmm, you're right. You know, it's true, right? Like we think of breast cancer survivors as these hot moms. Like, we should all be so lucky, right? speaker-0: Yeah, exactly. No, I love it. I love it. And I think and I'm I'm so grateful that you that and like your doctor, like I would not have wished lung cancer on you. But ⁓ since you had lung cancer, I'm so glad that you're willing to to share your story and to be out there and and show people that it's not the ⁓ always the Marlboro man, right? Sometimes it's the soccer mom, right, who brought snack last week. And and just happened to, you know, skip out on seeing a show in New York and get an MRI. And then the path continued. So ⁓ I'm so glad you're sharing your story. Can you can you tell us a little bit about you started a not-for-profit called Cancer Doesn't Care, which I love because again, you know, you you spent your life trying to live a very healthy lifestyle and and and cancer didn't care. It was like, sorry, I'm picking you anyway. And And so can you tell us what what is it? And and you'd mentioned some of the things that you're doing, which helping to pay for screening for people who can't afford it. Tell us a little bit more about ⁓ about what you're hoping to do with your organization. speaker-1: Yeah, that, you know, it doesn't care. It doesn't matter if you're rich or poor. Sometimes if you eat right or not. And I realized that I was really lucky, right? I paid for these scans out of my own pocket. When I got a call, my ⁓ diagnosis was on a Monday. On that Thursday, this Vanderbilt called and said, Your insurance has denied the surgery for next week. So, you know, we're gonna cancel it. And I remember I was like, No, here is my credit card. speaker-0: ⁓ speaker-1: Like just hold my OR spot, right? It's hard to get an OR spot. And by the time my surgery happened, insurance covered it. You know, they were trying to play catch up, maybe. And I realized like other people are not that lucky, right? They couldn't just put their credit card down. They would just say, okay, I'll deal with insurance tomorrow. And then their OR spot goes to someone else and then, you know, pushes out another week or two weeks or three weeks. And that's really scary. So I think that I just realized like, This is crazy. Cancer doesn't care and we need to fix it. And so all like I said, all the profits of my book go to it and I'm starting to kind of go out there and talk more about it. The American College of Radiology's been really supportive of me with it all, which has been great. And my hope is that what we have today is a low dose CT and we're not covering it by guidelines. And so I'll help people cover it now. And I joke sometimes that I hope it goes out of business or that I can use it to, you know, fund good research to have a blood test or for good chemo or radiation or therapies, immuno or targeted ⁓ in the future. It's but my focus right now is is on early detection because that seems to be the best answer for us today. And I'm hopeful that it changes and we get great meds and and ⁓ better ways to get a ⁓ early detection diagnosis through blood or saliva or cheek swabs, but today that's what we have. speaker-0: If you could rewrite the screening guidelines yourself, like starting totally from scratch, what would they look like? speaker-1: That's awesome, Sarah. I love that question and I get in a lot of trouble when I answer it. So in a perfect world, like why not do it like a mammogram? That's how I feel. I think it's important to understand that our lungs have nodules, like our skin has freckles. So if we have a baseline picture, like a skin check, but a lung check, we can better answer what happens to those little nodules going forward. So our nodules a lot of times don't change. They're one. millimeter, they're irrelevant, they're there forever. Maybe they're a small scar from a cold at one pneumonia at one point or fungal infection or I don't know, like a freckle, a little birth spot. So if we could all get a low dose chest CT at 40, we could all have that photo. And there's amazing AI technology that wraps around our low these low dose CTs and other technology now that maybe would tell us, great, you look good, see you in five years, see you in six years. Or ⁓ Come back in a year. Similar to a colonoscopy. If you don't have a polyp, they're like, see ya later, right? Like there's a decision to be made about when to come back. That is my hope and dream. Okay, so now let's back up a second. They will never let me do that. They'll they think that's crazy. They think that people will go down rabbit holes and worry about stuff and there'll be too many bronchoscopies and things like that. I think when you look at these scans, there's an idea of like this is cancer. this is not cancer, but there's like that indeterminate group that they don't know. And that's the group that the current administration and and a lot of doctors worry about because you don't want an over biopsy. It's not like a breast biopsy that is easier to do. It's more invasive. I think a lot of the technology that we have is going to reduce that. Like maybe if there's a cheek swab or a blood test that says there is or is not floating tumor DNA, you'll know that that indeterminate person is the not cancer bucket. Or maybe we know, okay, let's re-look at this person in six months and see if that nodule changed, right? If it's growing or not. But at the very least, Sarah, I think that patients who have a family history, an occupational hazard, radon in their home, breast cancer survivor need it. And so I think that there's an opportunity that to easily move 50 and smoking down to 40 and these risk factors. Like your parents smoked. They don't care about family history. They don't care about secondhand smoke. They don't care about occupational like veterans. They're around those burn pits. I mean, that would not be good, right? Or I don't know what some other occupational hazards of factories or I don't know. You know, there's gotta be other things. Radon is the number two reason. There's a couple of radon companies where you can buy these like two like $200 to check on in your house. We all have carbon monoxide. you know, monitors and smoke monitors, it's similar monitor. ⁓ and it tells you radon and radon's the number two reason they're finding. So in an ideal world, we would get that first picture at 40, especially for some of the higher risk individuals. But like we talked about at the beginning of this, we don't know all the risks, right? And so why are women getting it more than men? We don't know. So in my perfect world, We would all just go get the LODO C T and get that picture at the beginning and follow up in six or seven years, maybe. speaker-0: Yeah, I mean, I even think that, especially given like when when you look at the research with the younger women being diagnosed, I mean, a lot of these women are being diagnosed in their 30s. I mean, they're young, they're young, young, young. And I just wonder whether, you know, doing a a low dose CT, just like a baseline, one, you know, $200 test for the insurance company, like when you're 30, just in and then with the idea being that if there's not anything to that it seems interesting, you know, or or important or you know, catastrophic, that then you revisit it at forty or you revisit it, you know, at a forty five, or it just seems crazy to me that something that has the effect of of killing more people, as you said, of of breast cancer, colon cancer, and whatever the other ones are all combined. That it just seems speaker-1: Yeah. speaker-0: Exactly. I mean, it seems like common sense to change a guideline. I'm so grateful for the work that you're doing. I know that you're working hard in ⁓ Washington trying to get these guidelines to change ⁓ and to better reflect the actual face of lung cancer. I'm so grateful for you for showing us the face of lung cancer and that it doesn't look necessarily like the Marlborough man. and also being able to give us something to remember if we're gonna go and get this low dose CT. Or we're not totally freaked out and talk ourselves out of doing it because we're afraid that it means, you know, a death sentence. ⁓ because you are a testament to the fact that you can live and not only that, but you can thrive having had this, ⁓ and that it can go into your rearview mirror. So if if a listener takes away just like one thing from our conversation today or from reading your book, ⁓ one scan saved my life, ⁓ like what would you want it to be? speaker-1: I want everyone to get their lungs checked. So that's what I would love. Go get a low dose chest CT, get that baseline, advocate for yourself. It's gonna you know, it's not an easy ask, but advocate for yourself because, you know, we deserve it. speaker-0: Yes. Yeah. And I'm I'm so glad that you shared with us that your that your website for Cancer Doesn't Care has some language that people can use to go if they're talking with their doctor and and when your doctor says this, that then you can say this and that you have this in one scan save my life. ⁓ where can where can listeners find one scan save my life and where should they go to learn more about cancer doesn't care? speaker-1: Yeah. So you can buy my book on Amazon. I do the audio of the book. So if you're a book listener instead and my voice doesn't annoy you, you can do it that way or the Kindle app, but it's there on Amazon. It's also in a lot of local bookstores because it hit New York Times bestseller. So hopefully it it trickled out to the country. And then cancer doesn't care dot com without the apostrophe and doesn't is a great place to go. There's a whole resources section actually. You can even put your zip code in. And it'll give you an accredited radiology group that you can go to to get your scan. And so oftentimes I tell people also there, it has like that one pager that tells you what to say to your doctor. So you can put in where you want to get your scan, print that one pager, walk in and say, I want the low dose CT. This is where I'd like to go. Please order it for me and see what happens. I understand the guidelines aren't there for me, but this is why. I often tell people to blame Shira. It's okay, I'll take it. My inner Instagram, Shira Bowler has information. Like I'm just trying to reach as many people as I can. speaker-0: I love it. I bet that there are a lot of people who are gonna go to their doctor and go get their lodo CT and they're gonna say, I'm here because of Shira. And they're gonna say, ⁓ Shira, we are so tired of hearing about Shira. But you know what? It's a good thing that people are hearing about Shira because I know that you're saving lives. And ⁓ and I'm so appreciative of you and your time and for joining us. And for those of you listening, I encourage you to pick up the book One Scan, Save My Life. ⁓ or Audio, the proceeds go to Cancer Doesn't Care to help ⁓ encourage those low dose CTs for people who don't who aren't able to afford it themselves. And also just go and get your low dose CT and have your lungs looked at. So thank you so much for your time today, Shira. speaker-1: Thank you, Sarah.