The Beam: August proton therapy highlights including what cancers affect Asian men, summer hydration tips, and a staff profile

Which cancers affect Asian men; quarterly nutrition column with hydration recipes; dosimetrist Christine Oh.

Jonathan Chen on cancers affecting Asian men

Jonathan Chen, MD

This article first appeared in Northwest Asian Weekly.

Cancer is the No. 1 leading cause of death in Asian men in the United States. At Fred Hutchinson Cancer Center, we treat all types of cancer that affect this community, including cancers of the prostate, lung, liver, stomach and colon/rectum.

Prostate cancer is the most common type of cancer in men; it is estimated that 1 in 8 men will be diagnosed during their lifetime. Most are over the age of 65, but it can develop in younger men as well. Unlike other cancers, such as lung cancer, there are no specific behaviors that are known to increase the risk of prostate cancer. Therefore, it is important for men to undergo routine screening. Currently, the American Cancer Society recommends that men discuss prostate cancer screening with their doctor starting around age 50. Men at higher risk, such as those with a family history, should consider getting screened earlier, starting at age 45.

While prostate cancer is sometimes detected due to urinary problems, most men are diagnosed after screening with a blood test called the prostate-specific antigen (PSA) test. Always consult with your doctor for general questions on screening or determining if a PSA test is right for you.

Current studies suggest prostate cancer is less commonly diagnosed in Asian men compared to other ethnic groups, but it is not clear if it is due to biological reasons. It’s possible that it is related to lower screening rates. In some Asian cultures, talking about cancer is taboo, and men may be hesitant to discuss their health issues with family or even their doctor. Language barriers can also be a challenge. Exposure to the importance of PSA screening may also be less common in Asian populations. All of these factors can increase the likelihood of being uninformed about the significance of screening or harboring misconceptions about the screening process.

In addition to prostate cancer, there are other cancers that affect this community for which early detection and screening are critical.

Lung cancer is not the most common cancer found in Asian men, but it is the leading cause of cancer death for this population. Similar to prostate cancer, early detection can lead to better outcomes. For a long time, there wasn’t a screening test for lung cancer, and most cases were discovered in advanced stages. Now, studies have established the importance of screening CT scans for those with a significant smoking history. Men should talk to their doctor about whether CT screening is recommended based on their personal risk factors. For current smokers, quitting is still by far the best thing one can do to reduce the risk of lung cancer.

According to the American Cancer Society, colorectal cancer is the third leading cause of cancer death in Asian American men. It is also one of the few cancers that has effective screening tests. The U.S. government recommends screening for colorectal cancer starting around age 45 to 50 until at least age 75. There are multiple methods of screening, including colonoscopies and newer stool tests. Men are encouraged to talk to their doctor about the different options available to see what is best for them.

Liver and stomach cancers are both much more common in Asians, especially those who were born in Asia. It is possible that this is due, in part, to certain infections that are more common in Asia, such as hepatitis B and H. pylori. There are no proven screening tests for these cancers, but there are steps that one can take to reduce risk, such as receiving hepatitis vaccines.

Cancer is a serious health issue, but fortunately there are many effective treatments available. It is important for our community to be educated about the importance of cancer screening and prevention, which can lead to earlier detection and better outcomes. Let us encourage all men, especially Asian men, to take charge of their health and start the discussion today.

To request an appointment for screening at Fred Hutch, call us toll-free at 855.557.0555.

Staying hydrated during treatment

Quarterly nutrition column by Fred Hutch proton therapy dietitian, Laura Buono, RD, CSO

With the summer months in full swing, the need to maintain proper hydration is increasingly important, especially if you are undergoing cancer treatment. 

Laura Buono, dietician

If you’re on treatment, you need about 8-12 cups of fluid per day. This can vary depending on your treatment, disease and body size. If you are experiencing side-effects from your treatment, it might be difficult to drink sufficient liquids, so here are some tips to help with getting adequate fluid intake.

What if I don’t like to drink plain water?

The good news is that many different liquids count towards your fluid goals, even some foods! Soups and broths, popsicles, sorbets, clear nutrition drinks and even ice cream are some examples. Some fruits and vegetables, like cucumbers, celery, watermelon and strawberries, contain up to 90% water, so eating these foods can be another great way to stay hydrated.

You can make water more appealing by trying flavored sparkling water, adding berries or slices of lemon, oranges or cucumbers to a glass of water, or adding a splash of 100% fruit juice. Herbal tea is another great way to stay hydrated, and you can drink it either hot or cold. 

What are some signs that I’m not drinking enough liquid?

Dehydration can look different for everyone, but some common symptoms include dry mouth, dry skin, little or no urine output, low blood pressure, fatigue, dizziness and skin that “tents” when pinched (it stays up like a tent and takes longer than usual to go back to its normal flat position). These symptoms may also be related to your treatment, so talk to your physician if you are experiencing any of these symptoms.

How can I get enough fluid if I’m feeling sick?

Try drinking fluids throughout the day instead of waiting until you feel thirsty. Always keep water bottles with you. You can try sucking on ice cubes or ice chips, which might be easier than drinking large amounts at one time. If your mouth or throat is sore, you have a low appetite or if you are nauseous, you can also try calorie=containing liquids like popsicles, granitas or smoothies.

Do I need electrolytes?

Electrolytes, such as sodium and potassium, can be helpful if you are experiencing diarrhea or vomiting, but plain liquids are usually enough to stay hydrated. Broths are a good way to add some sodium to your fluids. Some sugar is added to electrolyte drinks to help with sodium absorption. Sports drinks contain a small amount of electrolytes, but the high amount of sugar outweighs the benefit of added electrolytes. Instead, try some of these homemade electrolyte drinks from Cook for Your Life, a nutrition and recipe service at Fred Hutch.

Savory electrolyte drink

  • 2 cups liquid broth, chicken or vegetable (not low sodium)
  • 2 cups of water
  • 2 Tablespoons of sugar

Warm both broth and water, dissolve sugar in liquid mixture.

Mint electrolyte drink

  • 2 cups mint tea
  • 1 cup of water
  • 2 Tablespoons honey
  • ¼ cup lemon juice
  • 1/8 – ¼ teaspoon salt

Bring water to a boil and dissolve salt and honey in water. Mix juice and tea with honey- salt mixture. Drink hot or cold.

Ginger ale

  • Juice of 1 lemon
  • 2 cups of water
  • 1 Tablespoon of honey
  • ½ Tablespoon grated fresh ginger
  • Sea salt to taste

Squeeze lemon juice. Add water, honey, ginger and salt.

Basic fruit electrolyte drink

  • ¼ – 1 teaspoon salt
  • 12 ounces water
  • 20 ounces 100% fruit juice (pasteurized) – apple juice, peach or apricot nectar
  • 2 ounces of lemon juice

Bring water to a boil and dissolve salt in water. Mix juices with the saltwater mixture. Chill and drink. Makes four 8-ounce servings.

Tomato juice

  • 2 ½ cups plain tomato juice
  • 1 ½ cups of water

Combine ingredients.

Piña colada electrolyte drink

  • 12 ounces of water
  • ½ teaspoon sea salt
  • 32 ounces of coconut water
  • 12 ounces of 100% pineapple juice (pasteurized)
  • ¼ cup lemon juice

Bring water to a boil and dissolve salt in the water. Mix in juice and coconut water. Makes four 8-ounce servings.

Introducing Christine Oh, dosimetry expert and outdoor enthusiast

Christine Oh was born and raised in Maryland, the middle child of three girls who all ended up in the medical field. The sisters had family connections to medicine. Their dad was a nuclear medicine tech and their aunt worked in medical imaging. After getting a degree in biology, Oh pursued a career as a radiation therapist, then decided to further her studies in the field of dosimetry as an added challenge. 

Christine Oh, dosimetrist

“Dosimetry is the treatment planning process where we determine the optimal beam angles with the shortest path length to treat the tumor. We work to minimize the dose to the surrounding critical structures in the best possible way,” says Oh. “Radiation oncology is a very specialized field, using a cohesive team working together to support the patient and their treatment.”

Oh received her degree in dosimetry from MD Anderson Cancer Center in Texas, and afterwards moved to New York City to work at the New York Proton Center in Harlem. When the opportunity arose, she decided to relocate to Seattle to work at Fred Hutchinson Cancer Center – Proton Therapy.

“Fred Hutch is a wonderful place and I’m so impressed with the convergence of research and clinical care,” says Oh. “My fellow team members are supportive and collaborative, and I’m excited about the advances in proton therapy happening right here in Seattle! There are many success stories, and I am looking forward to playing a role in our patients’ successful treatment outcomes.”

When she’s not at work, Oh is active – even when the weather does not cooperate. She enjoys swimming, biking and running, and has competed in marathons, ultramarathons and two Ironman triathlons! She loves hiking and exploring new trails, but two of her favorite hikes are Snow Lake and Bridal Veil Falls.

“I find hiking to be therapeutic, and somewhat meditative because you’re among such beautiful nature,” she says. “It’s a nice way to balance work.”

If you get the chance, please say “hi” to Oh, and be sure to tell her about your favorite hikes in the area! 

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