A healthy smile requires everyone to commit to three simple actions: Brush twice a day, floss daily and see your dentist twice a year. You may have also considered new technology to make your oral hygiene routine a little easier and more efficient. New models of electric toothbrushes have prompted consumers to consider upgrading their manual toothbrushes to spinning brush heads that sometimes come with Bluetooth capabilities. So, which is better, manual or electric?
Studies show powered toothbrushes are slightly better at reducing plaque and gum disease. If cost isn’t a factor, electric toothbrushes are found to be safe and effective. They can also connect to your smartphone and track how well and long you brush. Manual toothbrushes are affordable, simple and your local grocer or convenience store may carry models with different brush handles that give you a better grip so you can reach all tooth surfaces.
All brushes, manual or electric, can be effective for removing plaque if used correctly — for at least two minutes at each brushing. All brushes will have to be replaced every three to four months. Choose a toothbrush that you like and will use properly with a fluoride toothpaste. Don’t forget to floss daily and see your dentist for an exam and cleaning twice a year so you can live well and smile more.
A healthy smile requires everyone to commit to three simple actions: Brush twice a day, floss daily and see your dentist twice a year. You may have also considered new technology to make your oral hygiene routine a little easier and more efficient. So, which is better, manual or electric?
With the holiday season upon us, it’s important to look after one’s mental health and emotional well-being. While the season typically includes family and social gatherings, holidays can also be stressful, and trigger feelings of grief, loneliness and depression. Consider some of these steps to help support your emotional health and find joy during the holidays and beyond.
✦ Breath & Health: The way you breathe can affect your mind and body. Full, deep breathing is a good way to reduce tension. In the Hawaiian culture, the breath is an important part of physical and spiritual health. Be aware of your breathing. Practice daily deep breathing exercises.
✦ Nutrition & Exercise: Key to your overall wellness and coping with stress is a well-balanced diet, plenty of water and regular exercise. Stay hydrated by drinking six to eight 8-ounce glasses of water daily. Steer clear of heavily processed foods that are high in sugar or saturated fat. Check with your doctor and keep him or her informed about any changes to your diet and movement routines, or if you’re thinking about starting a new exercise program.
✦ Alcohol Intake: Even small amounts of alcohol, such as one drink, can make depression worse and disrupt your sleep and mood.
✦ Depression: Grief, stress, physical challenges and changing life circumstances can trigger depressive symptoms, and other emotional health problems. Know when to get help. If you’re concerned about your mind and mood, talk to a personal physician or behavioral health expert.
✦ Self-Care Apps: Digital apps can help your emotional well-being and resilience. The myStrength app offers a personalized program that teaches mindfulness and other helpful behaviors. Calm is an app designed to help lower stress, reduce anxiety and improve sleep by using guided meditation. Learn more at kp.org/selfcare.
✦ Getting Help: Mental healthcare is not one-size-fits-all. Treatment differs for everyone — from the type of provider you see and how often you see them to the length of time it takes for treatments to be most effective. If you don’t know where to start, discuss options and next steps with your doctor. If you believe you’re having a mental health or medical emergency, call 911 or go to the nearest hospital.
KAISER FOUNDATION HEALTH PLAN, INC.
711 Kapiolani Blvd., Honolulu, HI 96813 808-432-5915 (TTY 711) | kp.org
More resources & tools: kp.org/mentalhealth kp.org/seniorhealthThis article contains health and wellness or prevention information.
With the holiday season upon us, it’s important to look after one’s mental health and emotional well-being. While the season typically includes family and social gatherings, holidays can also be stressful, and trigger feelings of grief, loneliness and depression. Consider some of these steps to help support your emotional health and find joy during the…
Telemedicine facilitates medical professionals in providing medical care to patients outside of the traditional office setting by using modern technology.
“Telemedicine” and “telehealth” are often used interchangeably. However, telehealth specifically describes the electronic and communications technologies being used to provide services remotely. Telemedicine can be viewed as the professional medical consultations you may receive remotely or outside of the clinical office.
One of the main benefits telemedicine can provide to kūpuna is increased access to care. For many kūpuna, it can be difficult to get to the doctor’s office due to lack of transportation, physical impairments and lack of caregiver assistance. Telemedicine enables patients to stay at home and to see their physician remotely using telecommunication devices.
However, not all kūpuna have the knowledge, technological skills or equipment to use telecommunication technologies.
Solutions include getting help from family and friends who are more savvy. They’re already adept at using devices like a cellphone, and can easily help a senior. And your family member or friend can be right there to help assist if it is difficult for the senior to see or hear their doctor.
Telemedicine facilitates medical professionals in providing medical care to patients outside of the traditional office setting by using modern technology. “Telemedicine” and “telehealth” are often used interchangeably. However, telehealth specifically describes the electronic and communications technologies being used to provide services remotely. Telemedicine can be viewed as the professional medical consultations you may receive remotely…
In Hawai‘i, everyone loves to spoil their loved ones with sweet treats during the holidays. It’s okay to indulge in a treat or two, but don’t forget the toll it takes on your teeth and gums. Here are some oral health tips when eating common holiday sweets:
❉ Arare (mochi crunch), candy canes and other hard candy: You’re putting your teeth at risk for decay when you let snacks dissolve in your mouth. And crunching on them could crack your teeth. Swap out hard candies for dark chocolate instead, which has less sugar and dissolves quickly.
❉ Pies, cakes and cookies: You’ve probably been waiting all year for that pumpkin crunch cake or custard pie, but moderation is key when it comes to these baked goods. Also, save yourself the toothache and scrape off the icing or sweet toppings before you eat them.
❉ Hot chocolate, eggnog or hot apple cider: These classic holiday drinks are full of sugar. Try your best to eliminate extra additions like marshmallows, alcohol or extra syrup that may harm your teeth or dry out your mouth.
❉ Mochi, caramels and other sticky sweets: Sticky sweets stay on your teeth longer, and their sugar and acids can break down enamel throughout the day. Brushing and flossing every time after eating them will save you an extra trip to the dentist.
Go ahead and enjoy some sweet holiday decadence, but be sure to balance that out with crunchy fruits and veggies (carrots are a particularly great choice) and whole grains. Dentists also recommended drinking water immediately after eating to help wash sugars and acids from teeth.
Be sure to discuss any changes in diet as well as other medical conditions with your physician and dentist. For healthier teeth, gums and total body health, a solid routine of brushing twice a day, flossing daily and seeing your dentist twice a year will ultimately help you live well and smile more at every age.
In Hawai‘i, everyone loves to spoil their loved ones with sweet treats during the holidays. It’s okay to indulge in a treat or two, but don’t forget the toll it takes on your teeth and gums. Here are some oral health tips when eating common holiday sweets.
Quit feeling guilty over your morning cup(s) of joe. Research shows that coffee can help prevent dementia, improve cardiovascular health and increase lifespan.
Coffee can help seniors maintain a healthy lifestyle. That is the conclusion of a plethora of studies on the steamy liquid that is synonymous with waking up for many Americans over 60. In fact, the morning brew has been shown to reduce a number of health issues. The main active ingredient in coffee, caffeine, is an antioxidant. Antioxidants help block damage related to aging:
• Coffee can keep cells more elastic, reducing the hardening of arteries that takes place over time that weakens the cardiovascular system.
• The risk of stroke is reduced by up to 22 percent. Even one cup of coffee per week was found beneficial to reduce stroke and improve heart health.
• Caffeine may prevent or delay age-related cognitive impairment, including dementia. One study that tracked people from middle age to the 70s found a reduced lifetime risk of dementia.
• Drinking caffeinated coffee cuts the risk of mouth and throat cancer in half and reduces the risk of many other types of cancer, as well as Type 2 diabetes.
• The mood boost associated with coffee can increase motivation and alertness, in turn lowering the risk of mental health issues like depression.
• People who drink coffee on a regular basis have an overall lower risk of death than those who do not.
How Much is Too Much?
Most studies have centered on consumption in the range of three to five 8-ounce cups, or up to 400 milligrams of caffeine. This amount reduces the risk of suicide for both men and women by 50 percent, and the overall risk of early death by 15 percent (this latter statistic holds true even for decaf drinkers).
The Healthiest Way to Brew
The method used to make the brew can have a big impact on LDL cholesterol, which can damage the arteries and triglycerides levels. Filtered coffee, which passes through a paper filter prior to consumption, filters out potentially dangerous oily chemicals called diterpenes. Seniors who use a French press instead of filters are at risk of raising their cholesterol and triglyceride levels. It may not be enough to affect their health, but if either of those values is high for you, consider switching to filtered coffee.
You may be relieved to know that, with warm weather approaching, iced coffee lovers can safely turn to cold brew. This holds true for both caffeinated and decaffeinated brews. Cold brew coffee is made by steeping the grounds in cold water for a period of hours, after which the coffee is strained through a paper filter.
Downside of Coffee
Michael Pollan, the author of “This Is Your Mind on Plants,” has called caffeine “the enemy of good sleep.” He relates how, after weaning himself from coffee, he “was sleeping like a teenager again.” Caffeine has other undesirable side effects for some people:
• Diarrhea and gastrointestinal issues due to high acid content.
• Rapid heart rate.
• Dehydration, possibly putting stress on the kidneys.
• Elevated blood pressure, which is a temporary condition.
When in doubt, ask your doctor if you should switch to decaffeinated coffee and if there are any other side effects you should be aware of. Seniors with migraines, insomnia, urinary incontinence, muscle tremors, stomach problems, or anxiety are more likely to have trouble with caffeine. Drug interactions are most likely to occur with ephedrine, echinacea and theophylline.
When attempting to reduce the caffeine content of their coffee, many older adults reach for a lighter roast. Wrong! “The darker you roast the beans, the more caffeine burns away,” explains Mike Balderrama, regional educator for Counter Culture Coffee.
Another caveat: Be aware of what you are stirring into your coffee. For all the benefits of the brew itself, many people negate them by adding cream, sugar, or processed alternatives that add calories and fat.
Coffee can be a key component in the healthy lifestyle of older adults. Enjoy it in moderation, knowing you are reducing your chances of getting cancer, dementia and a host of other diseases. Coffee can augment healthy food choices and daily activity to help you live your best life.
SCSA (Society of Certified SeniorAdvisors)
The SCSA educates and supports specialists in aging dedicated to improving lives of older adults. 1-800-653-1875 |csa.us
Quit feeling guilty over your morning cup(s) of joe. Research shows that coffee can help prevent dementia, improve cardiovascular health and increase lifespan. Coffee can help seniors maintain a healthy lifestyle. That is the conclusion of a plethora of studies on the steamy liquid that is synonymous with waking up for many Americans over 60.
If you’re watching your sugar intake, but need to satisfy a sweet tooth, using a sugar substitute can be less harmful to your teeth and body. Here’s a breakdown of substitutes and how they can affect your oral and overall health.
Artificial sweeteners and sugar alcohols: These can be a hundred times sweeter than sugar and can include saccharin, aspartame and sucralose. They contain little to no sugar, so they don’t contribute to tooth decay. But they potentially trick the body into craving sweets on a regular basis, which exposes you to the risks of sugar intake again.
Plant and fruit-based sweeteners: Stevia and monk fruit extract have no calories or carbohydrates. While these are generally safe, some studies have found that stevia disrupts your natural gut microbiome, which can disturb oral and overall health.
Natural sugars:Honey, coconut sugar, agave, molasses and dates have anti-inflammatory and antioxidant benefits, but they still contain sucrose and can contribute to tooth decay.
These substitutes should be consumed in moderation. Remember, drinking water immediately after eating is recommended to help wash sugars and acids from teeth.
If you’re watching your sugar intake, but need to satisfy a sweet tooth, using a sugar substitute can be less harmful to your teeth and body. Here’s a breakdown of substitutes and how they can affect your oral and overall health.
Lemonade, iced tea, smoothies and juices all sound delicious during hot summer days. But beware of the sugar content, especially if you’re drinking more than one glass a day.
You probably already guessed that the most important drink is water! It’s good for your body and teeth. Most flavored and carbonated drinks have high sugar content, dehydrating additives and other chemicals to enhance flavor, and make you feel like you’re quenching your thirst.
Water helps cleanse your palate, dilute the acids in your mouth, and rinse away bacteria or food debris from your teeth and gums. Water also regulates your brain function and energy levels and helps fight dry mouth caused by some medications. Dry mouth isn’t only uncomfortable, it also raises your risk of gum disease and tooth decay. It’s best to keep a bottle of water nearby and sip from it throughout the day.
If you must indulge in a sweet drink or food occasionally, be sure to rinse your mouth with water to flush out sugar and acids that can break down the enamel of your teeth. Also, be sure to brush your teeth twice a day, floss daily and see your dentist twice a year to live well and smile more at every age.
Lemonade, iced tea, smoothies and juices all sound delicious during hot summer days. But beware of the sugar content, especially if you’re drinking more than one glass a day. You probably already guessed that the most important drink is water! It’s good for your body and teeth.
Work-from-home “virtual” employees must take precautions in order to preserve the health of their eyes.
Computer vision syndrome (CVS) isn’t a specific set of symptoms — it’s an umbrella term to describe the varying eye discomfort and symptoms caused by screen-related issues. It is almost impossible to avoid progressive vision issues with regular computer use. Adding some basic tools to your home office is vital to help maintain your ability to work via a screen on a regular basis.
Studies have estimated that between 70 to 90 percent of workers worldwide who use computers regularly experience symptoms related to CVS. CVS, also known as digital eye strain, can occur from extensive use of any device with a digital screen. Symptoms include dry eyes, blurred vision, headaches, and neck and shoulder pain. Any combination of the following factors can lead to CVS: uncorrected refractive errors (nearsightedness, farsightedness and astigmatism), poor lighting, screen glare, and poor workstation setup for posture and viewing.
Some experts believe daily computer use may be a contributing factor to the rise in nearsightedness and dry eye disease.
The first step in protecting yourself from CVS is to correct any refractive error by visiting your eye care professional. Having the proper glasses, contact lenses or surgery to correct these issues will decrease any added strain on your eyes.
Next, make sure to properly arrange your workstation by:
• Positioning your monitor between 20 and 28 inches away from your eyes. • Adjusting your chair to allow you to view the screen’s center just below eye level at 15 to 20 degree downward angle. • Changing screen contrast and brightness to a level comparable to the surrounding light. • Using screen covers, lower lighting and curtains or blinds to reduce glare.
Also, take regular breaks and blink frequently to rehydrate your eyes; every 20 minutes, focus on an object at least 20 feet away for 20 seconds (the 20/20/20 rule); and try over-the-counter lubricating eye drops.
If CVS symptoms become chronic, speak with your eye care professional about computer glasses or treatment for dry eyes.
Work-from-home “virtual” employees must take precautions in order to preserve the health of their eyes. Computer vision syndrome (CVS) isn’t a specific set of symptoms — it’s an umbrella term to describe the varying eye discomfort and symptoms caused by screen-related issues. It is almost impossible to avoid progressive vision issues with regular computer use.
Diabetes disproportionately affects older adults. Approximately 25 percent of Americans over the age of 60 years have diabetes. The aging of the US population is widely acknowledged as one of the drivers of the diabetes epidemic.
Although the burden of diabetes is often described in terms of its impact on working-aged adults, the disease also affects longevity, functional status and risk of institutionalization for older patients.
While diabetes can be managed effectively, living with the disease as you get older presents some unique challenges. Every day offers a new hurdle. And as you age, jumping over those hurdles can become a bit more challenging — but it’s not impossible. Although increased risk for specific complications increases with age, with diligence and care, you can properly mitigate those risks.
More than 37 million people in the US have diabetes and an estimated 34.5 million have some type of hearing loss. Many are experiencing both concurrently.
A recent study found that hearing loss is twice as common in people with diabetes as it is in those who don’t. Also, of the 133 million adults in the US who have prediabetes, the rate of hearing loss is 30 percent higher than in those with normal blood glucose (blood sugar).
It is not understood exactly how diabetes is related to hearing loss. It’s possible that the high blood glucose levels associated with diabetes cause damage to the small blood vessels and nerves in the inner ear in the same way diabetes can damage the eyes and the kidneys. But more research needs to be done to discover why people with diabetes have a higher rate of hearing loss.
Since it can happen very slowly, the symptoms of hearing loss can often be hard to notice. In fact, family members and friends sometimes notice the hearing loss before the person experiencing it does.
Signs of hearing loss:
• Frequently asking others to repeat themselves
• Trouble following conversations that involve more than two people
• Thinking that others are mumbling
• Problems hearing in noisy places, such as busy restaurants
• Trouble hearing the voices of women and small children
• Turning up the TV or radio volume so that it becomes too loud for other people who are nearby
• Being unable to understand conversations over the telephone
Talk to your primary care doctor if you suspect hearing loss. You may then want to seek help from hearing specialist, such as an audiologist, a licensed hearing aid dispenser or a doctor who specializes in hearing problems. From a full hearing exam, you’ll learn more about your hearing loss and what can be done to treat it.
The American Diabetes Association in Hawai‘i is here to help. Learn how to thrive with type 2 diabetes through the ADA’s year-long program. Sign up for free at www.diabetes.org/living.
Diabetes disproportionately affects older adults. Approximately 25 percent of Americans over the age of 60 years have diabetes. The aging of the US population is widely acknowledged as one of the drivers of the diabetes epidemic. Although the burden of diabetes is often described in terms of its impact on working-aged adults, the disease also…
Poor oral health can affect overall physical health at any age. Without treatment, poor oral health can lead to pain, infection, malnutrition and even serious illnesses. Therefore, it’s important to incorporate good oral health habits into all stages of life. So if you’re weighing options for a long-term care facility for yourself or a loved one, ask them how oral health practices are incorporated into their care program.
More long-term care homes have expanded their nurse training to incorporate dental care. For example, the HDS Foundation created the Kupuna Smiles — Oral Health Training Program for nurses and other professionals who provide healthcare for seniors. Through this program, dental hygienists have conducted hands-on training for more than 80 registered nurses, certified nurse assistants and the managerial nursing staff of The Clarence TC Ching Villas at St. Francis in Liliha. Hygienists instructed each staff member on how to properly brush and floss patients’ teeth and care for dentures, reach difficult spots in the mouth, work carefully around mouth sores and identify signs of decay.
Long-term care facilities should prioritize oral health, especially if patients are unable to brush and floss on their own. The formula for good oral health is to brush, floss and see a dentist so you can live well and smile more!
Poor oral health can affect overall physical health at any age. Without treatment, poor oral health can lead to pain, infection, malnutrition and even serious illnesses. Therefore, it’s important to incorporate good oral health habits into all stages of life.
As we age, it may become more difficult to get a full night’s rest. This is caused by many things: changes in your body’s internal clock, spending less time outdoors or moving and a decrease in the hormones that help aid in sleep. It is a common misconception that we need less sleep as we get older. Sleep is still very important. Adults over age 65 should strive to get seven to eight hours of sleep a night.
Swedish massage, which should already be a part of your regular wellness routine, can also help you get a better night’s rest because it helps the body release serotonin and dopamine. These hormones help you relax and feel good, and can help your body achieve more restful sleep.
Another fantastic benefit of Swedish massage is its ability to connect you with your body again. As we age, there is tendency toward less movement. This can be because of injuries, or lack of balance or mobility. When we move less, we become less in tune with our bodies. A huge part of massage is to bring that awareness back.
In addition, humans are social beings and need physical touch. When babies are born they crave being held. The simple act of being carried brings them comfort. We still need this physical connection as we age.
Massage also helps us retain muscle tone. As we age, we naturally lose muscle strength. Swedish massage improves muscle tone by mechanically stimulating the reflexes within the muscle. Muscle tone/strength is important in maintaining balance, which helps in preventing falls, and also increases an overall sense of well-being and vitality. Your body also recovers from a fall faster if you have good muscle tone.
To enhance sleep, reconnect to your body and retain muscle tone, schedule a massage on a weekly, biweekly or monthly basis. It really depends on your needs. Massage can be done wherever you feel comfortable — at a massage facility, in your own bed or even a recliner.
Wherever you go, always communicate with your massage therapist. Let him or her know if you are feeling any discomfort from the pressure or the technique. Our goal is to help you feel relaxed and relieved from pain you may be experiencing. Regular massage can help you live a better, happier, more pain-free life.
As we age, it may become more difficult to get a full night’s rest. This is caused by many things: changes in your body’s internal clock, spending less time outdoors or moving and a decrease in the hormones that help aid in sleep. It is a common misconception that we need less sleep as we…
Here in Hawai‘i, we’re lucky to live on beautiful islands with multigenerational families in multicultural communities. We have city life, country life, sunshine every day and some of the best food in the world. But our lifestyle, diet and even our genes can put us at risk for cancer. Yes, even here in paradise.
Cancer is a big problem. But it isn’t just one problem. It isn’t even one disease. It’s hundreds of diseases that touch millions of lives. There were an estimated 18.1 million cancer cases around the world in 2020. Of these, 9.3 million cases were in men and 8.8 million in women.
According to the American Cancer Society (ACS), one in two men and one in three women in the US will be diagnosed with cancer in their lifetime and cancer will cause the death of one in five Americans.
In Hawai‘i, it is estimated that there will be 7,730 new cases of cancer and 2,590 cancer deaths this year. Today, tomorrow and each day of the year, 20 people will be diagnosed with cancer; seven people will die from it. Sadly, these nameless, faceless statistics may hit close to home.
In this article, we’ll introduce you to people who are on a cancer journey and others who are working to help them in different ways. We’ll focus on folks here in Hawai‘i, with an emphasis on men. And we’ll highlight actions we can all take to reduce our risk for cancer and improve our lives. This article endeavors to relay accurate, helpful information with an eye toward a hopeful future. Because the future does look hopeful. At present, a lot more people are living with cancer than dying from it. There are nearly 17 million cancer survivors in the US and more than 62,000 people are living with cancer in Hawai‘i.
Over the last 30 years, cancer deaths have decreased by 29 percent due to lifesaving cancer research, increased screening, enhanced diagnostics, improved care and less tobacco use.
While cancer deaths are on the decline, cancer incidence is on the rise. As the global population grows and life expectancy increases, cancer is projected to increase to 30 million new cases worldwide in 2040. In other words, the “big problem” is projected to get even bigger.
RESEARCH IN HAWAI‘I
Looking for the cure for cancer can be like opening a box only to find another box. But researchers are thinking outside these boxes to unlock the mysteries of this enigmatic disease.
In Hawai‘i, more than 600 local families (2,266 people) are participating in the Hawai‘i Colorectal Cancer Family Registry Cohort, an international research project that’s studying the impact of genetics and lifestyle factors on the risk of colorectal cancer which is the third most frequently diagnosed cancer in the state of Hawai‘i.
People diagnosed with colorectal cancer, as well as family members who are affected and unaffected, will help doctors better predict the risk for colorectal cancers and find new ways to prevent them. The study revealed that some family members were at risk for colorectal cancer — but didn’t know it — and received additional testing paid for by the research study.
“Data from the registry identified new genetic mutations that had not been categorized as causing colon cancer,” says Dr. Loïc Le Marchand, PhD, the associate director for ethnic diversity at the University of Hawai‘i Cancer Center (UHCC). “These findings are significant and clinically relevant to the study of cancer risk — especially for different racial/ethnic groups.”
WHO IS AT RISK FOR DEVELOPING CANCER IN HAWAI‘I
What determines who will get cancer and who won’t? Are lifestyle, diet and race/ethnicity factors? To better understand the roles that lifestyle, diet and genetics play in cancer and other chronic diseases, researchers at the UH Cancer Center and the Keck School of Medicine of the University of Southern California began collecting data from 215,000 men and women aged 45 to 75 in Hawai’i and California in five racial/ethnic groups: Japanese American, Native Hawaiian, African American, Latino and white.
The Multiethnic Cohort (MEC) Study, which began in 1993, continues today with about half its participants still living. The large number of participants and long span of the research have generated an invaluable body of data from the most ethnically diverse study of its kind.
A key part of the study was the collection of blood and urine samples from 75,000 participants in the early 2000s. Investigators have used the samples to take measurements “that may be predictive of the occurrence of cancer — not only to better understand who will develop cancer, but to understand the mechanisms,” says Dr. Le Marchand, the principal investigator.
The MEC Study, funded by the National Cancer Institute (NCI), has brought $150 million to Hawai‘i through federal research funding. To date, more than 850 scientific articles have been published using its data to advance the understanding of cancer risk, reduce health disparities and discover new and more effective ways to prevent cancer among all people.
Multiethnic Cohort (MEC) Study Findings
■ Native Hawaiians and Japanese Americans are at higher risk of pancreatic cancer.
Among all ethnic/racial groups in Hawai‘i, Native Hawaiians and Japanese Americans have a higher risk of developing pancreatic cancer. Previous studies have shown that African Americans are at increased risk as well. But the MEC Study gives scientists data to evaluate risk, incidence and mortality rates compared to lifestyle, diet and genetics among additional ethnic/racial groups in Hawai‘i.
■ Native Hawaiians and Japanese Americans have a higher risk of liver fat.
Native Hawaiians and Japanese Americans are known to be at greater risk for liver fat and conditions associated with it. A new investigation found a genetic link between liver fat and a variant on chromosome six, which is found in Japanese Americans and Native Hawaiians, and legumes are high-quality foods that were assigned higher dietary data scores in the study. Red and processed meat, alcohol, refined grains, sodium and sugar-sweetened beverages (e.g., sodas) are foods that the study recommends we eat less of.
■ There are racial/ethnic differences in ovarian cancer risk.
A recent study using data from the MEC showed large differences in ovarian cancer risk between racial/ethnic groups. Compared to white women, the risk for Native Hawaiians was 36 percent higher. For Japanese Americans and Latinas, the risk was 21 percent and 26 percent lower. For African Americans, the risk was similar to that in whites.
■ Diet relates to the risk of colorectal cancer.
A high-quality diet was related to a reduction of colorectal cancer in men (from 16 percent to 31 percent) and women (from 4 percent to 18 percent). Fruits, vegetables, whole grains, nuts and lower level of body fatness in Japanese Americans than other ethnic groups. Visceral (VAT) and liver fat, adjusted for total adiposity, differs by race and is highest among Japanese Americans and lowest among African Americans. A better understanding of the causes of these risk factors may lead to new methods of prevention and treatment. And ongoing research to develop blood markers of visceral and liver fat may help to identify high risk individuals.
■ Processed and grilled meats are linked to an increase in cancer incidence.
People who consume the greatest amount of processed meats, such as hot dogs and sausages, had a 67 percent higher risk of developing cancer over those with the lowest consumption. A diet rich in pork and red meat may increase pancreatic cancer risk. One key takeaway is that a healthy diet includes a variety of foods in moderation.
■ Race/ethnicity is a risk factor for obesity-related cancers and metabolic diseases.
Body mass index (BMI) carries different risks for cancer across ethnic groups. Its effect on breast cancer risk is stronger and observed at a not in African Americans, European Americans or Latinos. Identifying genetic variants for liver fat will help in the development of new strategies for prevention and early detection of liver disease and related outcomes.
■ Additional findings:
Alcohol consumption, even in low amounts, increases breast cancer risk. Smoking also increases the risk of breast cancer. Lung cancer risk due to smoking is greater in Native Hawaiians and African Americans. Smokers with newly discovered genetic markers have a higher lung cancer risk.
Ka‘ana Like Mana‘o: KĀNE VS CANCER
Native Hawaiian men (kāne) have the highest death rate from colon cancer among all ethnic groups in Hawai‘i. Yet, 90 percent of colon cancer can be prevented by early and regular screening. Early screening can detect cancer at an earlier stage, lead to effective treatment and result in a better outcome. But low screening rates among Native Hawaiian men can place them at risk for late stage diagnoses and death.
“Native Hawaiian men are not diagnosed as much with colorectal cancer. But they die more often,” says Kevin Cassel, doctor of public health and principal investigator of “No Ke Ola Pono o Nā Kāne” (for the good health of men), a research study at the UHCC.
Using culturally grounded approaches based on Native Hawaiian traditional practices of hale mua (men’s house) and community hui kūkākūkā (discussion groups), the study investigated why nearly 60 percent of Native Hawaiian men over age 50 had never been screened and 30 percent had not discussed colon health or screening with their doctors — in spite of disproportionately higher rates of cancer, diabetes, cardiovascular diseases and obesity among Native Hawaiians.
The study was designed to promote healthy behaviors among 378 kāne, with an emphasis on colon cancer prevention strategies such as the fecal immunochemical test (FIT). By the end of the study, 92 percent of the kāne had improved their knowledge about colon health, 91 percent said they liked the approach and benefited from it and 76 percent agreed to complete a FIT.
“We did find a couple of men who screened positive,” says Dr. Cassel, noting that everyone who needed care received it.
Attributing to the study’s success was the fact that only men were included in the groups, and even the community volunteers who conducted peer-led conversations were Native Hawaiian kāne. Another key that led to the success of the study and its program was bringing in cultural practitioners and kūpuna (elders) who shared knowledge about traditional practices.
Another topic the men covered in the hale mua was ‘ai pono — the traditional Hawaiian diet based on fish and root vegetables, with participants discussing the relevance of those foods today. Other conversations in the hui kūkākūkā centered around pule and the importance of prayer and maintaining spiritual health.
Each community hui kūkākūkā discussion included a physician who was present to field questions. The informal setting appealed to participants who normally only see doctors during office visits.
Nancy La Joy, executive director of the Pacific Cancer Foundation and Peter Kafka of the men’s online support group, Men’s Talk Story, recognizes alternative Hawaiian medicines such as the Noni fruit. Photo by Hideharu Yoshikawa
“Once the questions started, we’d just go wherever it went,” says Nathan Wong, MD, a study kauka (physician). Dr. Wong was one of five Native Hawaiians in the first class enrolled at the John A. Burns School of Medicine on O‘ahu. Now retired from family medicine, Dr. Wong, a member of the Native Hawaiian Community Advisory Board at the UHCC, is deeply concerned about disparities that challenge Native Hawaiian men today. “There’s something going on there,” he says. “We need to see what we could do with alleviating that significant differentiation between Native Hawaiian men and others. There’s no doubt that you have significant issues with and susceptibility to many cancers.”
Expanding on issues that affect Native Hawaiian men, Dr. Wong says, “Kāne don’t go to their doctor. Perhaps they don’t trust the physician; perhaps they’re too busy. And maybe they just don’t have enough information.”
He adds that women are more accustomed to going to the doctor for themselves and their children. So this discrepancy is more than cultural or socioeconomic; it’s also gender-based. “That’s why we focused on kāne. Only guys. That’s the whole point of the hale mua.”
Dr. Wong is proud to see the community hui kūkākūkā for kāne work as “a way of bringing them together in something that’s culturally familiar — to some extent, very much Hawaiian.” And, we got more men to do their FIT tests,” he’s proud to say. Introducing FIT to kāne through community hui kūkākūkā may improve outcomes and reduce deaths. “And to me, that’s the main thing — realizing the power of groups of kāne that can discuss health in a way that is comfortable for them.”
Kākoo: KĀNE SUPPORT SERVICES
“Men are a little bit different,” says Peter Kafka, who lives on Maui and runs support groups for men. “Our minds — our emotions — work differently.” And when it comes to taking care of their own health, he says, “You know, we treat our bodies kind of like our automobile.” While describing his 1998 Toyota truck with 200,000 miles on it, Peter explains, “We’re looking to fix things. You know, when something goes awry, we get on the internet and search.” And that’s what Peter did when he was told that he had an aggressive form of prostate cancer.
Peter’s search for information and advice from people who had walked the path before him led to a support group for cancer patients. But eight years ago, the only support groups he found on Maui were filled with women with breast cancer who talked about hairstyles and recipes, he said.
Peter’s search for a support group that he could connect with led him to the Maui-based Pacific Cancer Foundation (PCF) and a national organization called AnCan (Answer Cancer) that supported him in pioneering a movement when he began hosting an online support group for men called Men’s Talk Story. The group is still active and meets online regularly for men who are dealing with every stage of every type of cancer that want to connect and talk about their diagnosis, treatments, health insurance, relationships and more.
“We also have a group specifically for men under 60,” Peter explains. “We have an emotional support group called ‘Speaking Freely’ for just guys to talk about cancer in general and how it’s impacted their life and relationships, their work — everything. This is not just a male affliction. It strikes at the heart of a relationship. So we talk very honestly and open about things. To create a trustworthy group of guys you can connect with is really life-changing.”
And now that he’s retired as the maintenance supervisor at Haleakalā National Park, Peter has more time to talk story. “A lot of guys are uncomfortable doing Zoom meetings,” he says. “So I make myself available on the phone.” If you’d like to talk story with Peter, call 808-298-1655.
Ho‘okele: NAVIGATING A CANCER JOURNEY
What happens when your life’s journey is detoured by cancer and you come to a crossroads where you must start making choices right away? You meet new doctors. You hear about surgery, chemotherapy, radiation. You spend hours sifting through information on the internet.
For many people, navigating the healthcare system can be overwhelming. And having to make choices can be beyond overwhelming.
And while you have to take this journey, you don’t have to do it alone.
Patient navigators are health professionals who focus on providing education, guidance and assistance to help patients find their way through the healthcare system and to ensure that their healthcare needs are met. The PCF offers free patient navigation services for people on Maui, Lāna‘i and Moloka‘i.
“Everybody’s cancer journey is different,” says PCF Executive Director Nancy La Joy, who describes a patient navigator as “a lot like a social worker and a community health worker who really walks the journey with each person, one by one, hand in hand.”
Personalized care can make all the difference for a patient’s outcome.
“The patient navigator’s job is to eliminate any barriers to healthcare,” says Nancy, “Those could be educational, advocacy, understanding your diagnosis, understanding your treatment plan, understanding your medical team, and what the role is of each of the players.”
Transportation is one of the biggest barriers to healthcare, says Nancy. “A lot of times, during the course of treatment, people will get to the point where they don’t feel well enough to drive themselves. Or maybe they need to go to O‘ahu or the mainland for specialized treatment. We help with all of that — ground transportation, air transportation, and sometimes lodging.” When travel is necessary, the PCF will work with patients, insurance companies and service providers, including airlines and hotels, to find solutions.
PCF’s goal is, “to help people get through treatment without any trouble or missed appointments, missed opportunities for care — feeling better and doing better and getting on with your life,” says Nancy, noting that navigators also help people learn to live with cancer for months and years. Throughout the pandemic, the PCF has continued to provide free services through support groups, meditation classes, nutritional support, and its largest program — patient navigation.
Hale o Ka Mana‘olana: BUILDING HOPE
The American Cancer Society is built on hope. Its mission is to save lives, celebrate lives and lead the fight for a world without cancer. And one way the organization does that is by providing a free place for patients and caregivers to stay when they need to travel for cancer treatment — because often, the best hope for effective treatment is far from home.
There are more than 30 places in the US known as Hope Lodge.
The Clarence T.C. Ching Hope Lodge Hawai‘i in Honolulu opened in 2016 as the first and only Hope Lodge in the western US.
For nearly 1,000 cancer patients and their caregivers who’ve traveled from Hawai‘i Island, Maui, Lana‘i, Moloka‘i, Kaua‘i, Guam, American Samoa, and other Pacific Islands for cancer care on O‘ahu, Hope Lodge Hawai‘i has been a safe, caring, comfortable home away from home.
An average stay at Hope Lodge Hawai‘i is 14 nights. And by offering more than 5,000 nights of accommodations each year — free-of-charge — the ACS provides an annual benefit to cancer patients in Hawai‘i and the Pacific totaling more than $1.2 million. That’s a big help and a big comfort in a place built on hope.
Nā Mea No‘ono‘o Hana: LATEST INNOVATIONS FOR LIFE
Through innovations in cancer care in Hawai‘i, doctors have access to better tools that are giving patients better outcomes.
PET/CT (positron emission tomography/computed tomography) scans are key in detecting, staging and monitoring for recurrence of cancer.
Advanced medical imaging technology is now available in Hawai‘i, offering increased speed and quality for doctors, and enhanced comfort and safety for patients.
“Accurate diagnostic data can provide a roadmap for the treating physician to best assess a treatment protocol,” says Insight Imaging President Massimiliano “Max” Clini.
“Better scans lead to better data which lead to better care.”
The latest innovations in digital PET/CT scanners reduce the amount of radiation exposure to patients by up to 50 percent while reducing scan times by up to 90 percent. “Older technology would require patients to lie down on the scanner for upwards of 45 minutes,” explains Max. And that was the case just a few years ago. Today, cutting-edge diagnostic scans can be completed in less than 10 minutes.
State-of-the-art digital imaging can also benefit patient care. “The opportunity to detect smaller lesions can lead to earlier detection of cancers,” says Max, showing how innovative advancements in diagnostic tools can improve the success rate of
cancer treatments.
E Ho‘oikaika Imua: STRIVING FOR A BRIGHT FUTURE
The UH Cancer Center just celebrated 50 years of progress through cancer research, education and community outreach, as well as 25 years of continuous designation by the NCI.
“This is Hawai‘i’s cancer center,” says UHCC Interim Director Joe W. Ramos, PhD. “We focus on: How can we help Hawai‘i? How do we reduce the burden of cancer here? How can we better identify their causes here and use that knowledge to prevent cancers?” And just as urgently, Dr. Ramos adds, “How can we use that knowledge to attack cancers with these new therapeutics and new diagnostics?”
“We’re trying to figure out what makes different cancers form, grow, and move and metastasize,” explains Dr. Ramos. “If you can catch the cancer early, you have more options for successful treatment and a cure — if it’s early enough. But the problem is, if you catch it later, it may have already spread to other locations. So we’re working hard to better prevent, diagnose and treat cancer.”
To address these issues,” Dr. Ramos says, “We have great faculty and staff working specifically for Hawai‘i and the USAPI.” He describes the UHCC faculty as among the top in the country. And they’re bolstered by strong partnerships with local hospitals and healthcare groups, support from the state legislature and funding through grants that acknowledge the center’s high-quality faculty and top-level ranking as a world-class research institute.
What will success look like for the UHCC in the future? It will be as diverse as the populations it serves, with cutting-edge technologies, innovative research, expanded access to clinical trials here in Hawai‘i, an Early Phase Clinical Research Center, and a high-tech Organoid Generation Facility that will help ensure that Hawai’i continues to have one of the leading cancer research institutions in the nation and the world for the next 50 years.
Filled with hope, ACS Hawai‘i Board Chair Shane Morita, MD, also sees the promise of new technologies and innovations.
“I think the future is really bright,” he says. “We’re looking at different ways of treating cancer with immunotherapy and targeted therapy. There are breakthroughs being made every day.”
As medical director for surgical oncology at The Queen’s Medical Center, Dr. Morita draws inspiration from personal experience — his father died of cancer and his mother became a caregiver. And through professional experience, he sees a
path to a cure through clinical trials.
“They pave the way to find the next standard of care — the gold standard of how we treat patients,” adds Dr. Morita. “When I was training at the National Institutes of Health, a lot of the clinical trials that I was involved in were proven to be effective and have become the standard of care.”
Komo i Ka Noi‘i: JOIN A STUDY OR CLINICAL TRIAL
Would you like to help to advance scientific knowledge and have an impact on the fight against cancer? If you participate in a research study or clinical trial at the UHCC, you might play a role in the discovery of new ways to detect, diagnose, and treat cancer and other diseases, and reduce the chance of developing them in the first place. Volunteers of all ages and ethnicities are needed, and recruitment opens up for different projects at different times. To learn more, call the UHCC at 808-586-2979.
Clinical Trials Actively Recruiting Participants
■ Cyanotoxin Trial
There’s an urgent need to investigate cyanobacteria (blue-green algae) because men and women in Hawai‘i and Guam have some of the highest rates of liver cancer in the US; Native Hawaiian men and CHamoru men have the highest risk of liver cancer. The UHCC is recruiting 400 adults — especially Native Hawaiian men — aged 40 to 70 with no prior cancer.
■ Mediterranean Diet Trial
Researchers at the UHCC are looking for 240 Asian, Native Hawaiian/Pacific Islander and white people in Hawai‘i to go on a Mediterranean diet (seafood, vegetables, fruits, whole grains, beans, nuts and olive oil) or an intermittent energy restriction diet for six months for weight loss.
■ Breast Screening Study
Women 45 to 74 who are planning to get a mammogram are invited to join a research study and help improve future breast screening. The TMIST Breast Screening Study will compare 2-D and 3-D mammography and build a tissue bank for research that can help personalize screening based on personal risk factors and genetics.
■ Caregiver Study
Eligible caregivers, family members or friends of newly-diagnosed colorectal cancer patients may be eligible to receive a tablet with educational materials. Participants may keep the tablet when the study concludes. Researchers want to learn whether providing an educational curriculum in this way can improve quality of life for patients and their caregivers.
Noho Ana Maika‘i a Hau‘oli: LIVING WELL WITH CANCER
Brad Lum says he’s glad that he learned he had Stage 4 prostate and bone cancer eight years ago. If he hadn’t been told that then, he wouldn’t be living his best life now.
“Cancer isn’t the most important thing in my life,” insists Brad. “It is there. I acknowledge it. That’s about it.”
Active and fit, Brad enjoys hiking, surfing and going to the gym. He’s becoming vegan. And he encourages people to eat foods like kalo, ‘ulu, and ‘ōlena (turmeric) that were cultivated in Hawai‘i. Brad also strives to balance Western medicine with traditional Hawaiian la‘au lapa‘au. “You can do both,” he says. “Make it balanced.”
Kumu Brad keeps his balance through chant and prayer. Around the time of his cancer diagnosis, he realized, “I started to see clearly.” And that’s when he became a Buddhist.
The kumu hula and retired teacher is also glad to be making plans for his 70th birthday. “I’m gonna have two parties,” he says. “And I’m gonna jump out of a plane.”
For all his positivity, Kumu Brad keeps it real and he keeps it balanced. “I just wanna enjoy life,” he says. “Just enjoy, period.”
Cancer is a big problem. And our lifestyle, our diet, and even our genes can put us at risk to be among the one in two men or one in three women who will be diagnosed with cancer in our lifetime.
So take actions that will reduce your risk. Go for a walk. Smell the flowers. Keep informed. Eat more vegetables. Lose weight. Use sunscreen. Stop smoking. Join a research study. Enjoy the views. Keep in touch with friends and family. Stay balanced. And just enjoy life, period.
Here in Hawai‘i, we’re lucky to live on beautiful islands with multigenerational families in multicultural communities. We have city life, country life, sunshine every day and some of the best food in the world. But our lifestyle, diet and even our genes can put us at risk for cancer. Yes, even here in paradise.
A healthy smile requires everyone to commit to three simple actions: Brush twice a day, floss daily and see your dentist twice a year. You may have also considered new technology to make your oral hygiene routine a little easier and more efficient. New models of electric toothbrushes have prompted consumers to consider upgrading their manual toothbrushes to spinning brush heads that sometimes come with Bluetooth capabilities. So, which is better, manual or electric?
