In this episode of Sofia Unfiltered, Riley talks to Dr. Simran Malhotra, Triple Board-Certified Physician, Certified Health and Wellness Coach, Founder of Wellness By LifestyleMD, Diplomate of the American College of Lifestyle Medicine (ACLM), and BRCA1 Previvor and Advocate for Cancer Prevention
A Physician's Journey with BRCA1
Dr. Simran Malhotra, a triple board-certified physician, is an inspiring advocate for preventive health and a BRCA previvor. Her personal journey with the BRCA1 genetic mutation has shaped her approach to medicine and patient care. Growing up, cancer was always present in her life, with her mother being diagnosed with breast cancer when Dr. Malhotra was just 13. Over a decade later, after several family members faced similar battles with cancer, Dr. Malhotra discovered she too carried the BRCA1 mutation, dramatically increasing her risk for breast and ovarian cancers. This revelation came just as she was completing her medical training and preparing for marriage, creating a deeply personal intersection of her professional and personal worlds.
Her experience with the BRCA1 mutation made her passionate about raising awareness, particularly among women, about genetic testing and cancer prevention. Dr. Malhotra emphasizes the importance of proactive health measures, especially in communities where discussing illness is often taboo. She explains how genes like BRCA1 and BRCA2 typically protect against cancers, but mutations can significantly increase one's risk.
Steps To Prevent Breast Cancer
To help prevent breast cancer, it’s essential to focus on proactive health measures such as regular screenings, genetic testing (if there's a family history), and adopting healthy lifestyle habits. Maintaining a balanced diet rich in plant-based foods, engaging in regular physical activity, managing stress, and avoiding smoking and excessive alcohol can significantly reduce the risk. For those with a high genetic risk, like BRCA1 or BRCA2 mutation carriers, preventive options such as enhanced surveillance, chemoprevention, or risk-reducing surgeries may be considered. Prioritizing these habits alongside regular medical consultations empowers individuals to take control of their breast health.
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Preparing for Genetic Testing: What You Need to Know
Genetic testing has come a long way, and understanding the risk for certain cancers, like breast and colorectal cancer, is now more accessible than ever. Before jumping into at-home tests like 23andMe, it's crucial to first gather detailed family history, identifying patterns such as who had cancer, their age, and the type. While convenient, at-home tests may only provide limited information and can lead to false reassurance if they don't detect less common mutations. The best approach is to consult a genetic counselor, who can guide you through a comprehensive panel of tests that covers multiple genes, including BRCA1 and BRCA2, and help you make informed decisions.
Receiving a genetic mutation result can be life-changing and overwhelming, as it often involves making major decisions about your future. It's important to be mentally and emotionally prepared before undergoing genetic testing. For example, finding out about a high-risk mutation might mean planning for children, considering preventive surgeries, and making tough choices about your health and future. Despite the challenges, the experience can shape resilience and a deeper understanding of oneself, serving as a transformative foundation for the person you become.
The Power of Choice in Cancer Prevention
Facing a BRCA1 genetic mutation, the journey of becoming a cancer previvor is both challenging and empowering. The key difference between a cancer survivor and a previvor lies in the proactive steps taken to reduce cancer risk before diagnosis. The author, who learned about her mutation at age 26, had years to research and weigh her options, including preventative surgeries like a bilateral mastectomy and a hysterectomy. She emphasizes the power of choice and how it gave her control over her health, unlike her mother and many patients who faced cancer without such options. In 2020, she opted for aesthetic flat closure without reconstruction and a total hysterectomy, entering surgical menopause at the age of 32.
However, making these decisions wasn’t easy, especially when her medical team initially pushed for reconstruction. Advocating for her own body, she found a second team that respected her choice. Despite the challenges, including the fear of early menopause, she found support in her gynecologist, who reassured her that hormone replacement therapy would help manage the effects of menopause, including preserving her sexual and mental health. The experience reinforced the importance of listening to one’s body, making informed choices, and seeking the right medical team to support those decisions.
Balancing HRT and Lifestyle Medicine
Hormone replacement therapy (HRT) has faced skepticism for years, especially after the WHI study, but current evidence shows it can improve women’s quality of life and lower the risks associated with heart disease, bone loss, and cognitive decline. Women facing surgical menopause, genetic risks, or simply aging should consider HRT, but it's essential to recognize that lifestyle choices play an equally significant role in managing health during menopause. Beyond medication, lifestyle medicine—emphasizing nutrition, exercise, sleep, stress management, and social connections—can dramatically reduce the risk of chronic diseases like metabolic syndrome, heart disease, and even breast cancer.
What’s empowering is that these everyday habits don’t just address one issue. Eating healthy, staying active, managing stress, and sleeping well simultaneously support heart health, reduce cancer risks, and improve overall well-being. As women juggle careers, family, and aging, it's important to realize that small, intentional lifestyle changes can have profound, interconnected benefits. The key is recognizing that proactive choices in diet, movement, and mindset don’t just prevent illness—they can enhance quality of life and longevity.
Realistic Goals for Lasting Lifestyle Change
When it comes to creating lasting lifestyle changes, it’s important to recognize that each of us is in a different season of life. Setting radical goals without considering our current circumstances often leads to failure. Instead, acknowledging your unique season allows for realistic, bite-sized goals that gradually become sustainable habits. Start by choosing one pillar of lifestyle medicine, whether it’s movement, nutrition, or stress management, and focus on what’s possible for you. This approach makes it easier to adopt healthier behaviors that will have a long-term impact on well-being. Small, consistent choices, like opting for a whole food snack over processed options or walking for 10 minutes, can yield big results over time.
Self-care should be viewed as self-preservation, not an indulgence. It’s about what we do daily to take care of our mental, physical, and emotional health. Blue Zone populations provide powerful examples, where healthy lifestyles naturally lead to longer, more active lives. Incorporating movement, managing stress, and surrounding yourself with positive relationships are essential. Remember, it’s not about perfection but consistency, and removing toxic influences from your life plays a crucial role in creating a healthier mindset. Focus on micro choices and habits that align with the big picture of longevity and wellness.
More from Sofia Health
Check out the full episode of the Sofia Unfiltered podcast, "The BRCA1 Mutation and How it Affects Your Breast Cancer Risk with Dr. Simran Malhotra", available on Apple Podcasts and Spotify.
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Disclaimer: The Sofia Unfiltered Podcast by Sofia Health is for general informational and entertainment purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. No doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have. For any health concerns, users should seek the assistance of their healthcare professionals.
