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Denard Fobbs, M.D.: From Detection to Prevention

Though breast cancer isn’t the cancer that takes the most lives (lung cancer wears that crown), it is the kind of cancer that most scares women. For decades, black women were less likely to get breast cancer than our white counterparts, though we were more likely to die from the disease.

But recent research from the American Cancer Society shows the first part of that equation is changing. Now we are catching up to white women in cancer occurrence rates. And in some states—Alabama, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma and Tennessee—black breast cancer diagnosis rates have surpassed those of white women.

To learn more about why this shift is happening and how we can take steps to address it, Black Health Matters spoke to Denard Fobbs, M.D., a Fresno, California, gynecologist and the medical director of Fobbs LifePoint Institute for Women.

Black Health Matters: In the past black women were diagnosed with breast cancer less often, but had a greater risk of dying of the disease. That’s changing. Do we know why?

Denard Fobbs, M.D.: We have things like Obamacare to thank for some of that. It’s really impressive when you look at the number of people who are coming into the system who have been out of the system for eight or 10 years. More people accessing care is really impressive. But African-American people have a tendency to avoid routine screenings and visits a lot, even when they have access. When you put these together, there’s the situation where later diagnosis comes at a more advanced time.

BHM: We talk detection, but not prevention. Why is this?

Dr. Fobbs: This is America, where prevention is not part of the big conversation. General Electric doesn’t make million-dollar prevention machines; they make million-dollar detection machines. The conversation is framed by the money interests. The money interests make MRIs and mammograms.

That’s one of the things that has frustrated me over the years, which is why I’m pushing the conversation toward prevention, even though the medical community doesn’t seem to want to talk about it.

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Did you learn prevention in medical school?

Dr. Fobbs: It’s talked about in medical school for about 10 to 15 minutes. I still remember my first day in medical school. One of our sage professors got up and made a profound comment: When you finish this medical school and go out and do whatever kind of clinical practice you’re going to do, about 85 percent to 90 percent of all the problems you’ll see will be grounded in issues of stress and psychology. That was said on day one. It was never repeated again. We never really studied a curriculum that addressed that. We studied each and every thing about every symptom of every disease, but that seminal comment about the ground substance of disease was never mentioned again.

That’s consistent with American medicine. We’re not entirely ignorant about this stuff, it’s just not what we do.

You’re about to give a talk about breast cancer, about interventions that can reduce risk while simultaneously improving cardiovascular health. Let’s talk about these interventions.

Dr. Fobbs: Most women in America have been misled into thinking hormones are dangerous. We try to reorientate so they’ll understand their normal hormones in proper balance are incredibly protective against chronic disease. One of those diseases is breast cancer. In the most jaded study, hormones reduce the risk by 10 percent, but lots of other studies suggest the reduction is more like 30 percent to 40 percent. That’s natural hormones that are well balanced.

That same hormone balance also has the beneficial side effect of reducing heart attack and stroke risk by as much as 40 percent to 50 percent.

OK …

Dr. Fobbs: That’s one intervention. Some are the kind of boring ones you’ve been hearing your whole life, like, your diet. Artificial oils contribute to fat and are dangerous to your general health. We need to be moving back to the same fats our grandparents ate, with emphasis on olive oil and coconut oil. Even butter, as long as it’s organic, is pretty healthy in moderation. Stop throwing away egg yolks; it’s one of the most nutritious parts of the egg. We have to relearn eating because we’ve been taught a lot of inaccurate things.

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What else?

Dr. Fobbs: One of the biggest contributors to cancer and disease is anxiety and stress. I know people who will work out four and five times a week, go on a pretty strict diet, but won’t lose weight because they refuse to deal with their stress issues. At a certain level in America, stress is almost celebrated. We look at stress as being something that means you’re a real go-getter and you’re working really hard. We’ve made it so that stress is embraced as a good thing. And it’s really not.

What do you recommend to reduce stress?

Dr. Fobbs: Most Christians don’t really know how to pray effectively. Meditation isn’t just for Buddhists or new agers. What has been proven in hundreds of studies is that the most effective way to eliminate problems with stress is meditation.

So we should practice prevention, work on our eating habits and eliminate stress. Tall order, right?

Dr. Fobbs: It’s a lot of work. Some of it’s simple, but it’s not automatic. It has to become a labor of love. A person doesn’t have to do all of these things. Each is beneficial. When you combine several, even better. If biology could do math, you could add these up and have a 75 percent to 100 percent reduction in risk of cancer. But if you can reduce risk by even 50 percent to 60 percent, that’s huge!

I’d like to see more women so busy doing what they can do to reduce their cancer risk—not to mention improve their general health—that they won’t have time to worry about breast cancer. I’d like to see them worrying little to not at all, but focusing on the things they can do.

Dr. Fobbs’ presentation, “Unmasking Breast Cancer: Changing the Conversation from Detection to Prevention,” on September 27 at the Palatine Building in Fresno, will discuss reducing breast cancer risk. 

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