Bonus Episode : Dr Steven Quay: Breast Cancer Awareness Month

Welcome to Why Not Me? Embracing Autism and Mental Health Worldwide?
Hosted by Tony Mantor, broadcasting from the heart of Music City, USA, Nashville, Tennessee.
Join us as our guests share their raw, powerful stories.
Some will spark laughter, others will move you to tears.
These real life journeys inspire, connect and remind you that
you're never alone. We're igniting a global movement to empower
everyone to make a lasting difference by fostering deep awareness
on wavering acceptance, and profound understanding of autism and mental health.
Tune in, be inspired, and join us in transforming the
world one story at a time. Hi, I'mtoni Mantor. Welcome
to Why Not Me? Embracing Autism and Mental Health Worldwide.
Today's episode is a bonus episode for October, which is
Breast Cancer Awareness Month. Joining us today is Stephen Quay,
who is the founder of Seattle based Atosa Therapeutics. With
an MD and PhD from the University of Michigan, training
at MIT and Harvard with ninety one US patents, Doctor
Quay is a global leader in medical innovation, ranked in
the top one percent of all scientists worldwide. His current
passion prevention of the two million yearly breast cancer cases worldwide.
He's a visionary physician, scientist, inventor and has so many
insights to share with us today. So before we dive
into our episode, we'll be back with an uninterrupted show
right after a word from our sponsors. Thanks for joining
us today on pleasure to be here. Yes, very happy
to have you. If you would give us a little
information on what you do.
So I am a physician scientist and have been a
career sort of developing new drugs, new medicines and then
getting them approved by the FDA and out to patients.
Can you expand and give us a little insight on
what type of drugs you've developed.
So the first drug was a gadolinium that us an MRI.
I've used about eighty million people. A contrast agent for
heart was used in about thirty six million people. But
I started a toast of therapeutics to try to prevent
breast cancer with a drug that I've invented called endoxyphen
So that's my mission.
That's a great mission. As you know, October is Breast
cancer Awareness month. Can you tell us what the benefits
are for performing a monthly self breast exam and how
it can help in the early detection of breast cancer.
Well, let me reflect on that and maybe we can
have a little bit of a conversation. So the way
that you detect breast cancer primarily is with a self exam,
which people wreck command different recommendations about doing it, but
I still like it. Some people say, don't bother, but
I like it. You pick the same time each month
and you get to know your breasts and that's very useful,
and then if you find something different, you talk to
your healthcare provider. The second is mimography. If a woman
has just background, you know, nothing special in her family history,
she starts at forty years old with her first mammogram,
family history is strong, maybe at thirty five, and then
you have them every two years. Some people say to
stop at seventy, but now people are living so long,
I think it's probably good to continue them even after that.
Many women will perceive a breast cancer diagnosis as a
death sentence. Oftentimes it isn't. Can you provide some detailed
information on breast cancer survival rates?
This is really really important. So breast cancer has emotional
overtones that can sometimes cloud just the facts, but it
actually for the majority of women who have breast cancer,
ninety five will be alive in five years, ninety two
will be alive in ten years. So the number of
women that die from primary breast cancer in a five
to ten year period of time is under ten percent.
So other cancers are sort of much more difficult. There
is one kind of breast cancer called triple negative, which
does have about a forty percent five year you know,
sixty percent survival rate. But the average bread and butter
eighty percent of breast cancers, the survival is greater than
ninety percent after five years.
Some women, they always fear the worst. How can we
support them in overcoming the mental and emotional fears associated
with breast cancer, empowering them to confidently seek screenings, engage
with support systems, doctors, and ensure the safety and well being.
So Tony, look, I mean, I've been in medicine my
whole life, and so one of the things, one of
the commonalities that happen in these situations is until you
know a path forward, whether you're healthier, whether you're going
to you can actually have some cheatment. That sort of
thing that's the highest time of anxiety, and so with
that knowledge, getting people to say, Hey, I am worried
about breast cancer, but what is the next thing I
could do? Remember that little fish in the kids moving?
You know, what's you know, the next right step sort
of thing. So it's getting a mammogram, or it's doing
yourself examinations, or it's talking to your healthcare physicians. So
information is power, and the more information you can have
the better. If cancer is caught in the breast, those
numbers are ninety to ninety five percent. If it is
metastatic in the body, we're now at a very different situation.
We're no longer able to cure women. Typically with metastatic cancer,
we fight really hard to keep it at bay, and
we can stand life for two or three or four
or five years. But it's a very different It's almost
like a light switch. So getting it while it's still
in the breast and hasn't spread is super important.
You've been a doctor and a scientist for a very
long time. Now what are some of the changes that
you've seen from when you first started to what it
is now? How has medicine and care evolved?
Yeah, so I'm going to give you one hundred your perspective,
so that's maybe more than you asked for it. I
wasn't around one hundred years ago. Just in case anyone's asking.
World War One was partially fought with chemical weapons, mostly
something called mustard gas, which is very lethal. Of course,
a man named Dana Farber in the forty said, could
I repurpose this, use much lower doses and actually try
to kill tumors. So that was the first idea of
doing anything but surgery and then radiation. It was chemotherapy,
but it was harsh because you were trying to balance
killing a tumor and not killing the patient. It wasn't
until nineteen seventy seven when tomosmin became available for breast cancer,
so first directed drug in any sort of cancer, and
it was breast cancer. And this was a drug that
blocked the effect of estrogen on the cancer. So about
eighty percent of women's tumors are actually driven by the
thing that makes them female, the estrogen hormone, and so
this drug, tomosman was intended to block that interaction and
stop the cancer from growing. And it was. It was
a miracle drug when it came out because while it
has some side effects and things it was not, you know,
mustard gas like chemotherapy. So since then we've continued to
refine both in getting better and better of efficacy and
then now trying to improve the quality of life. One
of our advisors is named doctor Laura Esserman, wonderful physician
at the University of California and San Francis who she's
a surgeon. Full disclosure, she was a medical student of
mind when I taught at Stanford Medical School, you know,
a long time ago. But her mantra is, Look, we've
gotten cure rates for breast cancer in the ninety to
ninety five percent of five years, but we still there's
still a lot of quality of life issues. When that happens.
Women know they've had breast cancer, they know they've been treated.
So now our focus is finding drugs that have that
same efficacy but then can reduce the side effects. And
that's one of the things that motivates us that are
TOASTA Therapeutics to develop the investigational drug Indoxophone, because it
does seem at least in our seven hundred patients so far,
to have a lower side effect profile, a better tolerance.
What do you tell people when they are first diagnosed,
how do you guide them down that path so that
they can know number one, it is not a death sentence,
and number two there may be some side effects but
they can still have a good quality of life.
Yeah, the key is what is the report you get
back from the biopsy that is done to start the process.
So what you want to know is is a breast
cancer or not? And of course you know that. Check
that box it's breast cancer. And then there's something called
the differentiation. So it's a big long word, but what
it means is the more normal the cancer looks like
to normal breasts, the more well differentiated is the better
it is for being a cancer that's not likely to
kill you. So there's well differentiated, medium differentia, and it
puorly differentiated, and each of those carries an increased risk
of cancer. So that's step one. You check that box,
it's this differentiation, and then you ask about what is
driving the cancer. So, as I've said eighty percent of cancers,
the doctor will tell you your cancer is driven by estrogen.
So it's what it's called capitally capital are positive, so
R positive breast cancer eighty percent of all cancers. There's
a second hormone that goes along with estrogen called progesterone.
So typically, again in about sixty of the eighty percent,
you are ER positive PR positive. There's a small number
that don't have the PR and that's like sort of
the alpha and omega or the A and Z of
the alphabet. So the ER is at the beginning of
the alphabet, the PR is at the end of the alphabet.
So that's the next thing. And then there's a third
thing called per two HR two and that's typically negative.
So there is a breast cancer called triple negative, which
is it doesn't have VR, it doesn't have PR, it
doesn't have her too. That is a different cancer. It's
in the breast, but it's much more aggressive, probably takes
some pretty harsh chemicals. But if you don't have that
kind of breast cancer, I'm sorry. There's one more factor
you need to do, and that's what's called the KI
sixty seven. How many cells are dividing, you know, in
your tumor. So it's a percentage. It varies between one
and you know, eighty or ninety. The lower the number
the better. If your number is under ten percent, that's
really really good. It's ten to fifty or sixty. What
you want to do is then see what happens when
you take therapy, because if you can get a blower
ten percent, really large clinical trial called the Poetic trial.
Every clinical trial has a name so we all can
remember them, but the Poetic trials showed that if this
particular marker go below ten percent and you're at the
time of biopsy and therapy, you would not have a
recurrence in about three years time. So it's very predictive
of the future. All of that information you have, you
know within the first month, and then your doctor or
your healthcare provider will begin to develop a care path
and that's where you really you know, you can settle
down and you can say, Okay, these are the things
I need to do. I need to prepare for surgery,
these are the things I need to do if I'm
going to have radiation or if I'm going to take
other drugs. And I find with patients the most challenging
time is between the diagnos and when you have a plan.
Once you have the plan, it really takes a lot
of the anxiety away, and then you know you do
have to follow the plan. But all of our lives
are full of challenges and this is unfortunately one out
of twelve women, and you are going to have breast cancer.
What is the typical timeframe from diagnosis to completing all
the necessary steps for treatment or resolution.
Yeah, and I'm going to talk in typical terms, and
very important, I'm not practicing medicine when I'm talking to you,
even though I'm a licensed doctor, because every patient is
different and every woman will have a different care path.
But typically with the R positive breast cancers, there's going
to be surgery. And the choice then is do you
take it out as a lump, do you do a
mass actomy and take the whole breast out? And there'll
be some other diagnostic tests, maybe some imaging tests to
see has it spread under the armpit and what's called
the axila. There are lymphnotes there that are designed to
protect to form a filtration system and an immune surveillance system.
So as a tumor spread from the breast to the axila,
which is a little you know, a little bit later
in the process, all those kinds of things will determine
what kind of surgery you have. And again it can
vary from a lumpectomy to a mastectomy. To a some
surgerty in the arm pit. There's often radiation accompanied that's
designed to after the surgery to prevent a local recurrence
in that spot, and then typically at the time of
surgery is done radiation. If you're going to have it
is done, you do what's called adjuvant treatment, which is
a five year process with either tomosfin or neuromides inhibitors
or hopefully are drug in the future, where you're trying
to do two things. You're trying to prevent breast cancer
in the breast that just had the surgery that add
the cancer. And once a woman has cancer in one breast,
she's at a much higher risk than the other breast,
and so you're preventing a new cancer in the other breast.
Five years of treatment is the standard of care. Now
some people will go to ten if the tumor was
a little more aggressive, but that's the mantrum. And so
typically between diagnosis and that surgery is maybe as little
as a month, and you know, maybe even you know,
four to six months if they want to do some
therapy between the diagnosis and the time of surgery. It's
not common through in the regular bread and butter kind
of breast cancer. But there's a process called neoadjuvant treatment,
where like from the day after the diagnosis until you
have your surgery, you're taking something to make the tumor smaller,
to begin to kill the tumors. This is called neoadjuvant
and so sometimes that is dumb, and sometimes sometimes you
actually wait four to six months to be sure that's
run its course, because the surgery can get a lot
easier if the tumor gets smaller. The seergery can get easier.
If you know some of the tumor is dead. By
six months, you are pretty much done with everything except
for that daily pill for the next five years.
Okay, So afterwards it's just a daily pill. It is
it is at that point in time, yes, okay, So
what does that daily pill consist of? Is it like
a vitamin pill you take once a day and then
all of a sudden it goes in and attacks the
cancer cells. Is that how it works?
There are two kinds of pills currently, and my investigation
and doxmen will will be sort of a third kind
of pill. So one kind is that traditional tomoxifin, which
goes into the body and blocks the estrogen from binding
you know, from a block estrogen activity basically in any
cancer cells and any cancer cells that have escaped either
the radiation of the surgery, so it goes through the
entire body. Obviously, it's a pill you take, and so
anywhere there might be a single cell or a couple cells,
it'll stop them from growing. The other drug it's given
in women who are postmenopausal after menopause, is called an
aromatase inhibitors or AI drugs. And it turns out that
when women are postmenopausal, of course the ovaries have stopped
making estrogen, so they no longer have any estrogen from
the ovaries, but they still have estrogen in their bloodstream.
Where do you come from, Well, it turns out there's
an enzyme that takes the testosterone. Women may remember, we're
both you and I have a little estrogen, We have
a little tesosterone. We have more tasosterone than estrogen for men.
It's the other way around for women. So but women
will take the testosterone they have as postmenopausal, and this
enzyme will convert it to estrogen, so they make a
little bit of estrogen even when the ovaries are shut down.
So the roma dase inhibitor is to stop that activity,
and so those are the two.
Are there any side effects to these?
They do have some side effects, which is one of
the reasons I'm developing my drug. Of course, women taking
tomoxfen will have hot flashes, night sweats, kind of the
menopause like symptoms, and sometimes the romeadase inhibitors cause arthritis,
joint pain when you get up in the morning in
that sort of We don't know, because my drug is investigational,
but we're really focusing on ken and oxaphone that we're
developing improve on those two kinds of side effects, because
at least in our preliminary trials, it seems to be
having an effect in that direction. But of course I
can't claim it because it's all investigation.
When someone first gets this diagnosis, I'm sure it has
to be panic. It's the big unknown. How do you
help them get through that? This way they can understand that, yes,
it may be invasive, even though it's going to be
six months or a year of trauma and then five
years of taking a pill. How do you get them
so that they understand the other side of that they
can live a very fulfilling life.
Well, you know, it's really important. And I have to
say again the women now may not remember back someone
like an Nancy Reagan and it was a big deal
because cancer wasn't spoken of. Was the time, actually before
I was practicing medicine, when you often didn't tell the
patient had cancer. You told their family, which is so
bizarre for me to even imagine. But we've come a
long way because a lot of you know, well known
people that women look up to or aspire to, or
know about Cheryl Crowe, she was very vocal about her
breast cancer and the journey of it. So there's a
lot of shared history. I mean again, I think one
of the things we all want to do is we
don't want to feel like we're alone, right, both existentially
and you know, in our communities and things. So being
able to tell a woman look at yes, this is
unique to you, but you know, one woman a minute
during this podcast with you, Tony is being diagnosed with
breast cancer. So it's a very common thing and most
women get through it. It's not pleasant, it's not you know,
it's not the year, the six months that you thought
you wanted to have. But a lot of women come
out the other end and then for the most part,
they go right back to the lives they had. You
can really not promise that, but you can say I've
seen a lot of this in you know, nine out
of ten times it's it's a blip in their life.
You brought up misectomes. What about the women that have
it in their history? Then they decide they have a
double masectomy.
Yeah, Angelina Jolie, the famous actress.
Yes, she was the one I was thinking of.
So there's a couple there's I haven't gotten to it,
but now you've introduced it well for me. There is
a special kind of cancer that primarily in the people
of Astronazi Jewish descent, which is sort of Eastern European.
About five thousand BC, there was a mutation in one
of these DNA repair enzymes that led to an increased
risk of breast cancer at a very early age, ovarian cancer,
and in men, prostate cancer. It's called the brockagene. For
these people, it's a real challenge because they're likely to
have breast cancer in both breasts. It's likely to be aggressive,
they're likely to have ovarian cancers, and so brave women
like Angelina and other women's have said you know, I'm
gonna I'm gonna stop this now. And so that's a
very special case. That's about five percent of all breast cancers.
You almost can predict based on family history. So you know,
you know, do you did you come from Eastern Europe?
Do you think you have some of that heritage in
your family tree or in your genealogy, because if you don't,
it's much much rare in people outside of that population.
There might be some of the listeners wondering does this
really actually work? Prior to the cancer prognosis, does a
double miss sectomy actually really stop it?
Well, yes, when you have a biledal mass ectomy, I
think the number is one to two percent, there's one
to two percent of breast issue left. But then the
chance of getting breast cancer and that is very little.
So it is entirely possible to be very sort of
unlucky and to have a double mass activity then also
get breast cancer. But it's so so rare, it is
not the kind of thing you worry about.
Okay, all right, So what can they do that is
very preventative something other than a double miss sectomy? Is
there something they can be proactive about that will lessen
their chances of getting this.
Absolutely, let's go there, because this is really really important.
If yugen drives breast cancer in eighty percent of the cases,
things that can lower estrogen can help prevent it, and
things that increase estrogen will actually increase your risk. So
what is one of the things that will reduce estrogen
in women? Not drinking alcohol? So you know, it's well
known that if you drink even one drink a day,
you will slightly raise your estrogen level. The change in
the risk for you may be very minimal, but probably
one out of seventy five, one out of one hundred
breast cancers are in women in which they're only one
glass of wine induced the breast cancer. I mean, that's
what the statistics would say. So keeping your alcohol consumption
to a minimum, or you know, if you prefer not at.
All, what about their diet? Can they customize their diet
in any way that might help it as well?
Things that cause inflammation, So if you have you know,
chronic infections or other sorts of inflammatory, eating foods that
are not high inflammation, so fatty foods, fried foods at
very high temperature, all of these will increase.
You're in Okay, that makes sense. What about exercise. Is
there any type of exercise that will help them as well?
Building skeletal muscle in the gym, Now, you're not going
to look like, you know, like a bodybuilder, won't They
may be manipulating their hormones to get that look. If
a normal woman goes into the gym and lifts weights
a little bit, they won't get buff. They don't have
to worry about that, but they will build muscle, and
that muscle will help build their disosterone and the ratio
of the two will shift. And so another thing that
women wrestle with during menopause is whether they should use
PalmOne in place with therapy. It does reduce the menopause symptoms,
but it does increase the risk of breast cancer because
you're stending the time of taking estrogen in these women.
One more thing, Tony, if we have time.
Sure, this is a conversation that many people need to
hear and hopefully they learn from it.
There is a period that's quite important. This is good science,
but it's not established science. But I still want to
bring it up for your listeners because I think it's important.
So a lot of people believe that the canners that
we have. The four major cancers, which are lung, coal,
and prostrate, and breast, arise from mutations in the DNA,
and it's actually a relatively small discrete number, maybe eight
or ten mutations to go from normal to growing too fast,
to growing too fast and a funny pattern, and then
finally into cancer. And that those accumulate one at a
time over maybe a lifetime. And so when a woman
gets breast cancer at forty five or fifty, it's not
because she just got breast cancers, because the eighth or
the ninth of the tenth mutation has just happened and
she's been getting them over her entire lifetime. So a
very vulnerable period for girls, for women with breast cancer
is puberty. So you go from having the buds in
the preprebescent nipple, little tiny clumps of cells that are
going to become the entire breast. And so from that
period of whatever it is begins at age six eight
and maybe a fifteen sixteen develops, so there's a lot
of cell division going on there. Things are changing, they're
growing breast and the docs and all of that, and
so that's a very vulnerable time. For example, if a
young girl is recommended to have an X ray, you know,
chest x ray during that time, I would want to
ask the doctor, is this really Is there any other
way to do this? Could you find it another way?
My own daughter went into a children's hospital in Seattle
with asthma kind of physician my wife is a cancer biologist,
and they were absolutely they wanted to be absolutely sure
she hadn't swallowed a spoon or something like that, so
they wanted to take a chest X ray, and I said,
you know, you can listen to the two sides if
she swallowed something, one side of the lungs should sound
one way and the other side should sound to another.
We were with there, you know she has asthma, would
you just And so they were, but they were hell
bent on giving her a chess X ray and we
didn't let them. But I really wonder if we hadn't
been so adamant about it. Unless you really have to,
don't X ray. And the other thing is fast foods
during that period of time causes a typical cells in
the breast. It's a really good study. Cast foods are
three things, sugar, fat, and very high temperature, and they
formed some chemicals that are called initial age, and they're
quite bad for your arteries and your general health, and
they also are bad for cells that are developing in
the area.
Of the breast. In closing, can you give us some
information that you think is very important that the listeners
care on what you're doing so they can better understand
and help them navigate their journey with hope and confidence
that if they do get a breast cancer diagnosis, that
it is not the end of the world and they
still can live a very fulfilling life. Yeah.
I mean, I have a website, you know, a doctor
quay dot com where I give general health information. I'm
not practicing medicine, so I will have blogs once a week,
you know, every couple weeks here, and so I do
like people to follow there. You know, getting information off
the internet is a two edged sword. I mean, you
can get good information and you can get misinformation. You
should all have a healthcare provider. So it's either a
doctor or a nurse or some sort of practitioner who
you turn your health care over to. It's very important
not to be your own doctor your own healthcare and
doctors are the worst.
So I believe it.
I know that, and I have friends who are doctors
that know that, so someone else should be primarily responsible
for the path there. But general health, take care of yourself,
get exercise, don't drink too much, don't eat high temperature foods.
The lower the temperature, the fewer the bad chemicals that
are made. And you know, general health, and not to
worry too much because breast cancer. You know we can
treat it. It's not pleasant, but really, you know, enjoying life,
enjoying your family and friends is absolutely critical.
Absolutely. Well, this has been great, great information, great conversation.
I really appreciate you taking the time to join us today.
Well, thank you, Tony. It's wonderful to have here, and
I appreciate your your interest in bringing this message to
women everywhere.
Oh it's my pleasure. Thanks again. Thanks for taking time
out of your busy schedule to listen to our show today.
We hope you enjoyed it as much as we enjoyed
bringing it to you. If you know someone who has
a story to share, tell them to contact us at
why NOTOMT World. One last thing, spread the word about
why Not me, our conversations, our inspiring guests that show
you are not alone. In this world,