By Nina Huang
Northwest Asian Weekly
As we begin Movember, an annual event to raise awareness for men’s health issues, Dr. Jonathan Chen shared some insights on how men can watch out for prostate cancer.
Born to Chinese parents from Taiwan, Chen grew up outside of Detroit, but was embedded in both Chinese and Taiwanese cultures. His parents strongly encouraged him to go into medicine.
Chen did his undergraduate studies at Stanford University and then went to Cornell University for medical school and residency. He moved to Seattle to start his current job at the University of Washington about two years ago.
“Growing up, I resented it because of that, I didn’t like being told what to do. I had an interest in biology and the sciences, but it seemed too cliche to be a doctor.”
Chen studied to be a biomechanical engineer, but a volunteering experience at the San Mateo County Hospital inspired him to pursue medicine.
Chen worked at an STD free clinic that was centered around patients seeking STD treatment and counseling. His job as a volunteer was to greet patients and direct them to the right rooms.
That experience made him realize there was a lot in the clinic setting that he didn’t get in the research setting. Because he also got a job at a biotech firm while continuing to volunteer at the clinic, he decided to pursue a combined Phd and MD program. The average program takes seven to eight years, but it took Chen nine years.
“A lot of students went into medical school knowing what to do, but I was an open book. There were no doctors in my family and I didn’t have a specific leaning.”
During his last two years of medical school, he tried different things. He liked a lot of fields, including obstetrics and gynecology, general surgery, gastrointestinal, and had interests all over the place. However, radiation oncology stood out to him after doing research with a radiation oncologist.
Chen didn’t know the field existed as a specialty until he was eight years into medical school. To him, radiation oncology seemed like the perfect marriage of biology, medicine, technology, and robots. This appealed to the engineer inside of him and he ended up really enjoying his rotation.
At first, he was scared of dealing with cancer patients and worried that it would be depressing.
“When you’re a cancer doctor, a lot of people have serious illnesses, and the gravity of their illness puts the doctor and healthcare professionals that care for him in a privileged position to change and impact their lives in a meaningful way. It’s a privilege to be able to help patients,” he said.
Whether Chen is able to palliate a patient’s symptoms or cure the cancer completely, patients are always grateful, and it’s very satisfying.
Chen said that in the modern era, and especially in Western cultures, patients are usually asymptomatic when it comes to prostate cancer. The official screening in the U.S. as well as Japan (the only Asian country to have an official screening program) is usually through a prostate specific antigen (PSA) blood test.
He noted that prostate cancer impacts the way one urinates, including trouble with stream, urgency, and/or the inability to empty the bladder. These are common symptoms for those who don’t get the PSA screening.
Eighty percent of men by age 80 will have prostate cancer, but a lot of them wouldn’t know they had it without PSA screening.
“We strongly recommend people over the age of 50 to talk to the doctor about the screening,” Chen said.
He acknowledged that prostate cancer screening is controversial. There are types of prostate cancers that don’t need treatment, but the official recommendation and U.S. government recommends that everyone 50 and older talk to their doctor about whether or not prostate cancer screening makes sense for them.
He added that there may be people who benefit from the screening, but the drawbacks include an IV blood draw with results that might lead to an overdiagnosis for patients who never needed treatment.
“They might die of something else before the prostate cancer grows. There are some drawbacks to screening so that’s why it’s not a blanket screening. It’s really about having a discussion with your doctor.”
He added, “There’s nothing you can do to prevent cancer 100 %…but there are things that are strongly suggestive to prevent it. Living a healthy life is the best thing you can do.”
For example, Chen recommends eating a healthy diet balanced with fruits and vegetables, because there are studies correlating high red meat intake and processed foods with higher incidents of cancer, and exercise is also shown to reduce risk of more than 10 different kinds of cancers.
Chen mentioned that there have been lots of research studies into why Black people do worse than whites when it comes to prostate cancer, but there aren’t as many studies that have looked into how it affects Asians. He said data suggests that there are fewer Asians with prostate cancer than Blacks and whites, and that there could be contributions from genetics and the environment.
Some research in Asia suggests that more red meat and processed food consumed by Americans could play a role in increased prostate cancer cases.
Chen also said that Asians, compared to whites, tend to get diagnosed at a more advanced stage.
However, he said there are studies that showed that Asians seem to respond very well to treatments, so you want to get screened, diagnose it, and then get the treatment if needed.
The Seattle Cancer Care Alliance is pretty unique as it’s one of 35 proton therapy centers in the country and the only one in the Pacific Northwest. They provide a newer form of radiation therapy that’s more targeted and exposes the healthy tissue near the tumor to less collateral radiation exposure. For some cancers, this means reducing side effects and also results in a higher chance of curing the cancer.
What cancers are the most commonly seen for radiation treatment? For women, it’s breast cancer and for men, it’s prostate cancer, where men would have a choice of radiation or surgery for treatment.
Chen said that radiation therapy is like a part-time job, unlike surgery. Once a patient begins radiation therapy, they would go Monday through Friday for up to nine weeks in the case of prostate cancer.
“It’s not one and done because it works slower than surgery and takes a few months.”
He added, “Usually we can tell how it’s working within the first six to 12 months after radiation treatment.”
Nina can be reached at email@example.com.