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Journalist Katie Couric on her recent breast cancer diagnosis

AILSA CHANG, HOST:

For better or for worse, maybe when you think of colonoscopies, maybe the face of Katie Couric immediately springs to mind.

(SOUNDBITE OF TV SHOW, "TODAY")

KATIE COURIC: I have a pretty little colon.

(LAUGHTER)

KENNETH FORDE: Actually, this is - this is good.

COURIC: But you didn't put the scope in yet, did you?

FORDE: Yeah, we're doing the examination.

COURIC: Oh, really?

FORDE: Yeah, we're doing it.

CHANG: The examination in that clip is the televised colonoscopy that Couric had in 2000. Oh, yeah, we got to see it in all its glory. She let it all hang out, so to speak, to raise colon cancer awareness after her husband, Jay Monahan, died from the disease in 1998. Almost 25 years later, Couric is trying to raise awareness about a different kind of cancer - breast cancer. And the catalyst this time was her own diagnosis.

To talk about this turn of events, Katie Couric joins us now. Hi there.

COURIC: Hi, Ailsa. It's great to be with you.

CHANG: It's great to have you. So I just first want to say how grateful I am that there is another broadcast journalist out there who, like me, instinctively shares about her internal bodily health. I mean, we should talk about it, right?

COURIC: Definitely. You know, I think this is very much, quote-unquote, "on brand" for me, I mean, given my work with raising awareness about colon cancer after Jay died and continuing to really emphasize the importance of early detection, whether it's through a colonoscopy or through a stool test like Cologuard. I just think it's really important for public figures, if they have an audience and people feel that they can trust them, that they share everything they learn that could have a potentially life-saving impact.

CHANG: Absolutely.

COURIC: So when I was diagnosed with breast cancer, obviously that was my first impulse.

CHANG: Right. But can I ask, your prognosis at this moment - it's good, right?

COURIC: Yes. My prognosis is excellent. It was Stage 1A. And I have completed 15 rounds of radiation and now am looking into taking something called aromatase inhibitors, which suppress - I believe suppress estrogen and progesterone in your body because, as an additional safeguard for five years, people with this particular kind of cancer, it's recommended that they take some kind of aromatase inhibitor. But I'm still in the process of reporting that out and talking to a lot of specialists about which will be the best one for me because they do have side effects.

CHANG: Yeah. I mean, I was wondering, like, was there a small part of you that felt like, look; I have done a lot of work educating other people about cancer, getting so many people to get their colonoscopy scheduled - why is this falling on me? Like, why doesn't that work inoculate me in some way?

COURIC: Yeah. I mean, I used to think being on television and being happy and having a healthy family and two great little girls inoculated me against cancer. And then my husband was diagnosed, and then my sister was diagnosed. So I've learned the hard way that nothing really inoculates you from this disease. Listen - and it's separate from my advocacy work. And to be honest with you, Ailsa, I thought, this sucks. But, wow, I'm so lucky that it was detected early. Both Jay and my sister Emily had advanced colon cancer and pancreatic cancer, respectively. So to be honest with you, I saw this as an opportunity to educate the public yet again about things that they could do to be more proactive about screening and potentially save their lives.

CHANG: So what is the most important thing that you want people to take away this time around in sharing your own personal story?

COURIC: Well, can I do two?

CHANG: Yeah, go ahead.

COURIC: One is, do not put off your mammogram. If you have, pick up the phone, make an appointment because it's extremely important. No. 2 - if you have dense breasts, like 45- to 50% of all women...

CHANG: Including me.

COURIC: There you go - age 40 and over, talk to your doctor. Ask if you have dense breasts. And it's indicated by a mammogram, not by touch. If you have a lumpy breast, that doesn't mean anything necessarily. And then find out if you would benefit from additional screening like a breast ultrasound. Because breasts ultrasounds sometimes see things that a mammogram can't. And breast ultrasounds for women in our category, Ailsa, are extremely important.

CHANG: As or more important than the initial mammogram - and a lot of women put off that ultrasound, that later screening.

COURIC: Right, or they don't know they need it because 38 states say, hey, doctors have to tell you you have dense breasts, but they don't necessarily know what to do with that information. And so we're trying to change the FDA guidelines, and we're trying to actually introduce legislation that will require insurance companies to pay for those breast ultrasounds.

CHANG: You know, another important thing that your essay points out is that there is a tremendous amount of privilege that is required sometimes just to navigate the health care system to get the treatment that you need. And not everybody obviously has that privilege.

COURIC: That's so true, and I could not stop thinking about that. During my treatment, I can't tell you how many times I thought, I'm so lucky that I have access, that I can afford the best quality health care, that I live in New York City. And I kept thinking, it's just unfair to have this caste system of health care in our country. What about women who live in rural America? What about people who don't have insurance? Black women have a 40% higher mortality rate from breast cancer than white women. Why is that? Access.

So it's critically important that all communities are aware of the importance of early detection and have access to the technology that will enable cancers to be detected early. Not just for breast cancer - it's for so many diseases. It's the so-called social determinants of health that we've learned about during the pandemic, and we have to address this because it is simply, patently unfair.

CHANG: How different does it feel this time around to talk about your own cancer versus focusing and reflecting on Jay's cancer or your sister's cancer?

COURIC: Well, I think that when Jay and Emily were both sick, I felt it was their story to tell. You know, I was extremely private about Jay and extremely private about Emily until they both died. And I felt that, through the education I had received trying to come up with some kind of solution for Jay, that I learned that there were proactive steps you could take that could help you diagnose the disease early or detect it early and prevent it altogether in the case of colonoscopies. With Emily, I - you know, I sort of dove into pancreatic cancer, but I didn't really talk that publicly about it. And now with - I mean, there's no one to consider, really, but me. And I think it's much easier. I don't feel like I'm invading someone's privacy or this is not my story to tell. It's me, and it is my story to tell.

CHANG: That is Katie Couric. Her company is Katie Couric Media, where you can sign up for her newsletter, "Wake-Up Call." Her podcast is called "Next Question." Thank you so much, Katie, for sharing this time with us.

COURIC: Thanks, Ailsa. Transcript provided by NPR, Copyright NPR.

Jonaki Mehta is a producer for All Things Considered. Before ATC, she worked at Neon Hum Media where she produced a documentary series and talk show. Prior to that, Mehta was a producer at Member station KPCC and director/associate producer at Marketplace Morning Report, where she helped shape the morning's business news.
Courtney Dorning has been a Senior Editor for NPR's All Things Considered since November 2018. In that role, she's the lead editor for the daily show. Dorning is responsible for newsmaker interviews, lead news segments and the small, quirky features that are a hallmark of the network's flagship afternoon magazine program.
Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.