The Beam: Lung and breast cancer screening and prevention; heart health nutrition advice; meet a new child life specialist

Steps you can take to prevent and screen for cancer

As Ben Franklin once famously said, “An ounce of prevention is worth a pound of cure,” and that adage applies to cancer.

February is Cancer Prevention Month, which is the perfect time to reflect on the best ways to try and avoid a cancer diagnosis.

Fred Hutch offers routine screenings as well as personalized prevention plans. We also have dozens of prevention experts including medical geneticists, genetic counselors and experts in smoking cessation, exercise, nutrition and more. Read on for their advice.

Lung cancer

What increases your risk of developing lung cancer?

Current smoking or exposure to second-hand smoke or a past habit of heavy smoking are the highest risk factors for this cancer. About 80% of lung cancers are attributable to smoke inhalation. But exposure to certain substances such as asbestos and radon, as well as a family history of lung cancer or specific genetic mutations also increase your risk.

How can you reduce your risk?

If you smoke, the best step to take is to quit. Fred Hutch has several options and resources; there’s even a free app. Check them all out here. Other options include free quitting resources, the National Cancer Institute’s 1-800-QUIT-NOW hotline, and even medications such as nicotine replacement.

Other measures to reduce your lung cancer risk include avoiding exposure to air pollution, wildfire smoke and certain chemicals known to cause lung cancer. Eating a healthy diet and knowing your family health history are also important. Inherited mutations can increase the risk of developing lung cancer; if you have a family history of lung cancer, you can request genetic testing. Learn more here.

What screening should you do?

If you have factors that put you at higher risk for lung cancer, consider getting an annual low-dose CT (LDCT) scan. These scans can help find abnormal areas in the lungs that may be cancer even before you develop symptoms. Earlier detection usually means better treatment outcomes. Keep in mind that abnormal findings may not be lung cancer; scans highlight all kinds of anomalies that occur within our bodies, many of which are harmless.

How do you make an appointment?

If you have had an abnormal lung scan or finding such as a lung nodule, call Fred Hutch’s Lung Cancer Early Detection and Prevention Clinic at 206.606.6125. You can also be referred by your physician. If you are at higher risk but have not been screened, make an appointment or ask your primary care physician about screening.

If you’ve been diagnosed with lung cancer:

Fred Hutch has the largest, most experienced lung cancer program of its kind in the Pacific Northwest; we are also home to a lung cancer Specialized Program of Research Excellence or SPORE. 

Some lung cancers can be treated with proton therapy, only available in the Pacific Northwest through Fred Hutch. Learn about your options or about protons for lung cancer.

Breast cancer

What increases your risk of developing breast cancer?

Unlike lung cancer, there is no strong correlation between any one factor and developing breast cancer. Even men can get this disease.

There are lifestyle factors that increase your risk, though, including obesity, alcohol consumption and lack of physical activity. There is also a link between combined hormonal therapy for menopause symptoms and breast cancer risk. Family history and inherited genetic mutations may also elevate your risk, but risk is not the same as destiny.

How can you reduce your risk?

Reducing alcohol intake and increasing physical activity can curb your risk of many cancers, including breast; it also helps reduce the risk of other conditions like hypertension, or high blood pressure.

Knowing your family health history is crucial as well, as there are several genetic mutations that can contribute to breast cancers (some mutations such as BRCA1 and BRCA2 can drive multiple cancers).

Additionally, not smoking, eating a balanced diet, getting enough sleep and even breastfeeding can decrease your overall risk of developing breast cancer.

What screening should you do?

Annual mammograms are recommended for those age 40 or older, but those at higher risk should start getting them earlier and more frequently. You can also do breast self-exams, but these do not replace screening mammograms.

There are many genetic mutations that can drive breast cancers beyond BRCA 1 and BRCA2. Fred Hutch offers genetic testing for these mutations as well as counseling at the Genetic Counseling Clinic, which provides education and emotional support. By providing clear and useful information about genetic risk factors, Fred Hutch’s clinic can help you make the right decisions regarding your personal risk and ways to reduce it. If you have a family history of breast cancer, you can make a genetic counseling appointment by calling 206.606.6990.

How do you make an appointment?

If you are at higher risk of developing breast cancer or suspect you may fall into this category, call the Fred Hutch Breast and Ovarian Cancer Prevention Clinic at 206.606.6100 to discuss individualized plans for early detection, prevention and more. To schedule a routine screening mammogram, call 206.606.7800.

If you’ve been diagnosed with breast cancer:

Fred Hutch’s researchers and oncologists provide leading-edge treatments for breast cancer, with many state-of-the art treatment options   including proton therapy. Learn about your options or about protons for breast cancer.

High-Risk Cancer Surveillance

If you know you are at high risk of developing any type of cancer, you can be referred to the Fred Hutch High-Risk Surveillance Clinic. Once accepted into the clinic, we’ll help manage your risk, recommend screenings and surveillance, conduct follow-up care, and assist with preventive measures such as therapy, lifestyle changes or even surgery. Call the clinic directly at 206.606.6100 or have your physician — whether oncologist or primary care – refer you. Learn what to expect. 

Heart Health After Cancer Treatment

By Laura Martinell, RD, CSO, CNSC, FAND 

Sadly, certain treatments for cancer can put you at risk for developing heart-related diseases. Diet and lifestyle also impact your risk of developing heart disease.

Cancer treatments that can increase your risk include:

• Certain chemotherapy medications
• Radiation
• Aromatase inhibitors
• Androgen deprivation therapy
• Immunosuppressive medications
• Steroids

Health conditions that can increase risk include:

• High LDL cholesterol
• High triglycerides
• Hypertension (high blood pressure)
• Diabetes
• Overweight status
• Physical inactivity
• Smoking

In most cases, the impacts of cancer treatments can’t be avoided, because killing the cancer is the highest priority. However, certain lifestyle changes can help reduce your risk of developing heart disease from treatment. To understand how diet impacts your heart, it’s best to first discuss the types of nutrients found in food.

Fats

Generally, fats fall into two main categories: saturated and unsaturated fats. Saturated fats are found primarily in animal products like meat and dairy (and some plant foods such as coconut oil and palm oil), but they are often hidden in processed foods, such as commercial baked goods, crackers and even microwave popcorn.

If a food is shelf-stable, ultra creamy, very flaky or has chocolate, it probably contains more saturated fat than you think. Unsaturated fats are mostly found in plant foods, such as nuts, seeds and vegetable oils. There are two types of unsaturated fats: monounsaturated and polyunsaturated.

Monounsaturated fats are found in:

• Olive, peanut, and canola oil
• Avocados
• Nuts and seeds

Polyunsaturated fats are found in:

• Sunflower, corn, soybean and flaxseed oils
• Walnuts
• Flax seeds
• Fish

Experts recommend limiting your saturated fat intake to less than 10% of your total calories and focus on food sources that are higher in mono- and polyunsaturated fats (which include omega-3 fats).

Studies show that when saturated fats are replaced with unsaturated fats, especially polyunsaturated fats, it can lower “bad” LDL cholesterol and increase “good” HDL cholesterol. Most people don’t eat enough LDL-lowering unsaturated fats, so consider increasing your intake of these beneficial foods. Learn more about healthy fats (and find recipes!) at Fred Hutch’s Cook for Your Life.

During treatment, a higher fat diet might be recommended to better meet your calorie needs Generally, if your dietitian asks you to add these fats, the benefit of adding them outweighs the risk to your cardiovascular health.

Fiber

Another important nutrient for heart health is fiber, and it’s only found in plant foods. There are two main types: soluble and insoluble.

Soluble fiber helps lower cholesterol by binding to the cholesterol in your gut and moving it out of the body. Oats, barley, beans, lentils and fruit contain soluble fiber. Insoluble fiber can keep your bowel movements regular and make you feel full and satisfied. Examples of healthy fiber-filled foods are whole grains, nuts, seeds, legumes, fruits and vegetables.

Exercise and heart disease

A study in 2019 from the American Heart Association (AHA) determined that exercise can lessen the toxic effects of cancer treatment on the cardiovascular system and is also an essential part of recovery after treatment. The study found that “encouraging cancer survivors to be more active, sit less and take more steps every day could be a feasible approach for prolonging survivorship and reducing the risk of cardiovascular disease mortality."

The AHA study also found that at least one hour of moderate to vigorous activity each day, such as biking or brisk walking, reduced the risk of death from heart disease and stroke by 60% and other causes by 40%.

Fred Hutch experts also tout the benefits of exercise. “Exercise not only helps bone strength, but also heart health and muscles,” said Hanna Hunter, MD, the medical director of our Cancer Rehabilitation Program in a 2024 Fred Hutch news article. “It ripples into so many domains related to quality of life. It improves energy levels, it gives you better sleep, it improves mood, decreases the risk of falling. It allows you to do the things you want to do.”

There are other factors that contribute to heart disease with cancer treatment beyond nutrition and physical activity, so be sure to always discuss with your oncology or Survivorship care team.

Fred Hutch experts recommend a diet that emphasizes high fiber plant foods (fruits, vegetables, whole grains, legumes, nuts and seeds) and more plant fats and fish a couple of times per week. Minimizing foods high in saturated fats (meat, butter, beef tallow), sugar, refined carbohydrates and ultra-processed foods, coupled with exercise, tends to be the most beneficial for heart health.

Here are some heart health recipes found at Cook For Your Life:

Collard Greens and White Bean Soup

Salmon Burger with Cabbage Fennel Slaw

Wilted Chard Salad with Walnuts

Lentil Avocado Salad

Child Life Specialist Katy Tenhulzen joins the team at Fred Hutch – Proton Therapy

Katy Tenhulzen is a life-long Washingtonian and a Certified Child Life Specialist of 25 years. A pediatric health care professional who helps children and families understand and cope with procedures and treatment, she’s now bringing her expertise to Fred Hutch – Proton Therapy, where we treat most of the children requiring radiation for solid tumors from Children’s Hospital in Seattle.

After learning about the Child Life field as a Seattle Children’s Hospital volunteer, she transferred to Colorado State University to earn her degree in Human Development and Family Studies with a specialization in Child Life. Tenhulzen completed her clinical internship in Portland, Oregon, then spent 12 years as a child life specialist at Seattle Children’s Hospital in the oncology unit. She then branched out into parenting education, which sparked a love of teaching, motivating her to pursue a master’s degree in Family Studies from Central Washington University. Shortly after, she was hired as a full-time professor and served as the director of the university’s Child Life Program for seven years. She enjoyed teaching and engaging in research but missed interacting directly with children and families.  

Tenhulzen opened her own healing practice, Radiance Healing, where she offers the Safe and Sound Protocol (SSP) and Reiki. SSP is a music-based intervention that helps soothe and heal the nervous system. Reiki is a type of energy work that promotes relaxation, reduces stress and supports healing. She also joined the proton therapy team at Fred Hutch as a child life specialist in November 2025.  

“Oncology is where my roots are,” Tenhulzen said. “I enjoy providing procedural preparation as well as emotional support to the whole family.”

At Fred Hutch, child life specialists also support children of adult patients, as they, too, need age-appropriate information about their loved-one's diagnosis and help coping with strong emotions.  

“Because of my experience with SSP and neuroscience-informed care, I integrate nervous system support and education into my work as a child life specialist,” Tenhulzen said. “It empowers people of all ages when they understand the role their nervous system plays in emotions and helps them regulate their feelings rather than being controlled by them.” 

When Tenhulzen is not at work, she spends time with her husband and three sons, especially at baseball games; all three boys love playing the sport, she said. She also loves to hike trails near her home in Snoqualmie and spend time by the water.  

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