hello and welcome to HealthLine this Tuesday evening.

I'm Jennifer Blomquist.

I appreciate you tuning in.

I appreciate you tuning in.

This is a great show.

No matter what the topic is every week you will guaranteed learn something.

Our focus tonight is going to be on oncology and we have a physician here tonight who is a gynecologist that specializes in high risk cancer and reducing your cancer risk.

So he's got a wealth of information to share with us.

That's why the phone number is at the bottom of the screen.

This is a live call in show.

So we are live in the studio tonight and yes, our guest is live.

This is our first live guest since gosh maybe well over a year to go because of the pandemic.

So it's nice to be back and having somebody in the studio with us.

This is Dr. Rod Hatun.

As I said, he's a gynecologist but he specializes in high risk cancer and cancer reduction so he will answer questions related to cancer.

So if you want to get your questions answered, get some free advice or maybe even a sense of direction if you have something you're concerned about, that's the number to call (969) two seven two zero.

Just a reminder if you're outside of the Fort Wayne area ,it's still a toll free call.

Just dial 866- first and then we'll get you through and then I want to remind you you have two options when you call in you can either ask Dr. Patton your question live during the show or if you prefer you can talk to the call screener and they will take your question and then I can ask it for you.

So let's go ahead and get started with our discussion and again, feel free to interrupt us at any time with any questions you may have want to talk about you practice gynecology and OBGYN or obstetrics for many years.

>> Yes.

And then you were in the service.

Yes.

And then went into the cancer specialty.

>> So can you talk about how that all ties in together?

Yeah well so I actually trained in both family practice and then obstetrics and gynecology after that so I had kind of a primary care base to start with while I was in the military the army specifically one of the soldiers that I worked with came back here to Fort Wayne to run a gynecologic oncology program, OK?

>> And so when I was getting out of the service he contacted me and asked me if I'd be willing to come and help them out and the opportunity was just too good.

The programs that they're starting here in Fort Wayne are really cutting edge ahead of a lot of the rest of the country as far as cancer detection and prevention.

>> Yeah, we were talking before the show about just what a vast array of services are available in our community which is amazing.

>> It really is it really is for a community this size there is a lot more going on than almost anywhere else in the country.

>> That's good to know and a relief that because a lot of people when you're sick or have an issue you really hate to leave your community to have to go seek help.

>> So exactly.

Well, I had watched a video that your office has sent to me and you discuss some of the things about cancer risks and I was amazed when you were talking about the genetics aspect of it, just the high percentages.

So I don't know if you could discuss that.

>> Yeah.

So it's we're finding more and more as time goes on and we get better at our science that our genetics is a major factor in people's risk of developing cancer and what we're finding is about one out of every twenty cancer patients has some genetic predisposition that makes them more likely to develop certain types of cancers.

If you just put those numbers in perspective here again in the greater Fort Wayne area we think there is about four thousand people that probably are walking around with a genetic variant that is outside what is considered typical or normal that makes them at significantly increased risk of developing cancer at some time in their life .

>> You know, the only one I feel like we hear a lot about is, you know, for women for cancer doing that genetic test to see if they're predisposed to that.

>> But due for other cancers or is it prevalent?

>> So the gene you're talking about is called the Brakhage.

There's actually two of them and it was the first ones that we found and really because they were the first ones they've been around the long and we have the most information on them so people are more aware of them and more comfortable with them.

Those genes were found in the early 90s.

Since then we found forty more genes that we are certain increased people's risk of cancer and another 30 on top of that that we are highly suspicious probably significantly in people's risk of cancer.

>> So there's a lot of different ones out there.

>> Do a lot of people get tested for stuff like that?

It is common that was yeah historically no but it is becoming much more common.

>> It used to be the limit was that the tests were very, very expensive.

>> Yeah.

And I thought I was going to say insurance didn't charge I never covered them just like a lot of technology we've gone from the very first person that had their entire genome looked at.

It cost three and a half billion dollars to do that.

Goodness, we can now test can't even how many zeros it is it's got to be a lot what we can now test any individual for about three hundred fifty dollars.

Wow.

So it's become feasible financially to do it in large numbers so a lot more people are doing it now it was going to ask do you recommend that people do and if so is it driven by their age or just their family history?

>> It's typically the family history so people that have a genetic variant almost always have an unusual clustering of cancers in their family.

So when we sit down and counsel patients about this stuff we can usually figure out based on their family history whether their insurance will cover the test and how much value there's going to be for them to get it right.

>> I yeah, I've heard some people because I've talked about we have my husband's family is a lot of a long history of cancer and I've heard some of his relatives say I don't know if I want to get the test.

I don't know if I want to even know, you know, but then others of them say no, I do.

>> Well, we get a lot of that and it's not something we try to force on anybody for sure.

One of the advantages that I think people don't always consider when these opportunities come up is that if you are a carrier, if one of these genes that means all your children have a 50 percent chance of picking it up from your grandchildren.

>> So giving them an opportunity to know is an important consideration as well.

>> Another thing I want to clarify was you know, I discussed the cancer history.

My husband's family and then you know, I've always wondered well does that translate to a daughter or does it does your daughter would like my daughter only have to worry if it came from my side of the family being the mother or that's not how it works either parent can have the gene and if the parent has the gene, half of their children on average will inherit that gene even if it's a cancer of the opposite sex like cancer or well and one of the important things for people to recognize too is when we talk about the cancer gene, the bracket gene, a male who has that gene can develop cancer.

>> The risk are nowhere near as high as a woman's but they're much higher than a man without that gene.

>> But their risk of prostate cancer is markedly elevated.

OK, so it's important to know that regardless of your gender.

>> Sure.

Yeah.

Well feel free to interrupt Doctor Patent and any time he's only here till eight o'clock and like I said he could answer some questions or help you out or maybe have a concern about yourself or even a family member or friend.

There's a number to call if you want to ask about a cancer related question, it's (969) two seven two zero again outside of Fort Wayne put in 866- in front of there.

It makes it a toll free call for you.

And again what tends to happen doctor patient is people wait and they think oh I'll just call it ten to eight or five to and the show actually ends a little bit before eight o'clock so I would call sooner rather than later .

What what do you counsel people then to do?

You know, either way with as far as the genetics are concerned because you can't change your genetics.

>> Yeah.

You can't change your genetics but if you know that you are markedly increased risk of cancer, there's several medical interventions we can use there are medications available that can significantly reduce people's risk of developing certain cancers and we can also be much more vigilant as far as the screening we can do.

Yeah, that's all I've heard about.

>> So we may not prevent the cancer but we hopefully will catch it early enough that the treatment has a much greater chance of being successful and also be much less onerous or potentially disfiguring for the patient.

>> And some of the guidelines have changed with those screenings.

I don't know if you would feel comfortable pointing out a few I know you know mammograms even some the pap smears schedules you know, for for women I've heard have changed a little bit.

So I think people get confused .

>> Yeah, it's very easy to get confused and unfortunately as a medical community at large we have not done a very good job being consistent with those things.

>> So if you look at cancer screening, different societies in medicine have different recommendations.

Yes.

Which makes it very confusing sometimes for people.

But the bottom line is we usually recommend somewhere around the age of 40 all women should start getting screened for cancer.

If you have one of the high risk genes then we started earlier in your life than that and somebody I think it was actually doctor told me that they've they've lowered the age for colon to get a colonoscopy that it was at 40 it used to be 50.

>> Now we're recommending at forty five forty five.

OK and again if you carry one of the genes that make you at higher risk then that's even substantially earlier than that.

>> So maybe check with your family doctor to get a scoop on all this.

>> That's a great place to check your primary care doctor is your best resource for that and if you've got a complex enough history that that's beyond their scope, then there's plenty of places like where I work that we can help them out now.

>> Good to know.

Yeah you can and it's nice many people have a long term relationship with their family doctor so I think it's a nice trusting relationship for a lot of that.

>> So we do have somebody who's calling in right now actually and I think wanted to ask you a question about cancer.

Linda, are you there?

I am.

I am.

Thanks for for calling in.

Go ahead with your question.

>> OK, my question is I am a cancer survivor.

I had cancer back in 2014.

It's been six years plus and one of the doctors here we just relocated to Fort Wayne and one of the doctors here said that she thought I should possibly discontinue taking Tamoxifen OK?

And I'm just concerned I mean I come from a family of cancer, ovarian cancer, all those things and I get a little nervous about just taking it off.

But now I also I'm a runner and I'm pretty healthy but I've also developed some ASEP and one of the cardiologists thought that possibly they were connected.

>> Well, I don't know that Tamoxifen is connected to the A fib but one of the problems in that scenario that you've painted for us is that unfortunately Tamoxifen like all medications has some potential side effects and one of them is it can increase your risk of developing blood clots, blood clots and somebody with a fib is a major problem so it becomes a risk benefit calculation that has to be made in your case whether or not it would continue to be in your best interest to continue taking Tamoxifen to continue to reduce your risk of a recurrent cancer knowing that there's a risk of the blood clots with your a fib as well.

Linda, did you want to ask anything else?

No, that was it.

Thank you so much Dr no problem.

>> Thanks for calling in Linda.

That was a great question and again I want to invite anyone else who has something cancer related cancer risk or how to reduce your cancer risk.

Please call in again.

There's the number at the bottom of the screen.

We'll keep it up for you throughout the show.

We had a gentleman call in earlier and wanted me to ask a question for him but he wanted to know can a cervical or cervical cancer be genetic?

>> So typically no cervical cancer is caused by a virus.

Oh all right people HPV human papilloma virus there are several different strains of them and some of the strains in susceptible people is what leads to cervical cancer.

Now when I say susceptible people I think we're finding more and more it's not as simple as saying there is a single gene that makes people susceptible but there is probably some type of genetic component to that susceptibility and if you are susceptible get exposed to the virus, you'll have the potential of cancer.

>> If you don't have that susceptibility, even if you're exposed to the virus, you probably won't.

It's interesting when when you answer that question because there have been a lot of public service announcements about getting your child vaccinated boys and girls against the HPV .

And I know when it first came out years ago our pediatrician's office which tended to be very conservative, they were not into that right now they are recommending it.

And I would just be curious on your thoughts on that because I think you know what's more vaccinations and then on top of all this stuff with covid, I think people get worried about well, there's a legitimate cause for concern.

>> Nobody wants to take medications that aren't necessary and even vaccines with very, very low risk profiles doesn't mean that there is no risk so people's you know, skepticism and caution is perfectly warranted .

>> This virus is one that we can easily control with these vaccines if we treat just females with it though we're leaving the reservoir.

>> Sure.

Where the virus can still stick around then people who haven't gotten the vaccine, those women are going to be very susceptible to those cancers and they started pretty young by middle school age.

>> Oh yeah.

You got shortly before double digits and ages one we can start giving those vaccines and now we can give them well into adulthood and still have positive beneficial with that.

Yeah, because it just has been in recent years we've heard a lot about it.

So I appreciate your thoughts on that.

I think as for parents or even grandparents it's a little concerning you want to make because these commercials all say oh you aren't you going to do what you want to save my life my really dramatic it's like well yeah but I want to know a little bit more before I make that decision.

We had another person Carol wanted to ask you if drinking coffee will reduce your chances of uterine cancer.

>> OK, the short answer to that is no no caffeine in coffee does help your body metabolize some of the hormones that are involved with the development of uterine cancer.

>> The effect though is extremely small.

So I would tell you if you're only plan is to drink several cups of coffee a day to reduce your chance of ovarian or uterine cancer.

>> That's probably not going to be very effective for most people I know that was one of the topics you want to talk about was just what you can do to reduce your risk of cancer.

I mean we've talked about you can't change your genetics but your lifestyle and lifestyle does have a huge impact on things and yet we're finding more and more environmental exposures that we are all susceptible to on a day to day basis.

>> So you know, the basic things like avoiding smoking heavy alcohol use is also associated with an increased cancer risk air pollution, water pollution, all those things are things that are part of modern society that we all have to recognize are increasing our cancer risk.

>> Older homes have higher levels of radon.

>> Yeah, radioactive exposure that people are going to have and then one of the other increasing concerns is with all the use of plastics that we have now, some of the chemicals that are used in the manufacture of plastics, we have some concerns that that can increase our risks as well too.

>> So just being moderate in all your activities and consumption habits are important things.

>> Diet is a big issue with cancer highly processed foods without question increase people's risk of colon and uterine cancer, whole grain breads and cereals, raw fruits and vegetables in significant amounts all significantly reduce those risks.

>> So and then the final thing with diet is we unfortunately in our country and worldwide for that matter have an obesity epidemic.

>> Yeah, people that are significantly overweight oftentimes have a marked increase in the production of a hormone called insulin and that insulin if it gets high enough and is high enough for long enough starts to dramatically increase people's risk of cancer development as well.

Yeah, I mean we see so much out there to address it but it's it can be hard especially for somebody who's older for them to change those happel it's it's very difficult but fortunately one of the best things that I have seen happen throughout my medical career is we have a much better understanding of how to help people manage their weight nowadays.

>> Used to be when I was in medical school we talked about that it was calories in and calories burned.

>> Right now we know there's at least 50 different components to an individual's own struggle with weight management and identifying what those are and helping manage those is much more effective than what we've historically been able to do.

>> What's funny I was going through my sewing basket the other day and I have this container that was from like a butter spread.

I'm not kidding this thing is from like nineteen eighty nine .

I don't know why I still have it but I keep my buttons in there and I looked and I thought oh my gosh there is nothing there was nothing on the back they didn't have any the right dietary content of it and it's just amazing to think now you just everything you pick up it tells you how much fat protein everything in it.

>> So and that's the stuff to pay attention to.

Right, exactly.

I wanted to talk to you too.

There's been a lot of talk about good fats and bad fats as far as how they affect your impact.

You possibly getting cancer.

>> So I mean not all fat is bad.

No, that's true.

And in fact fat is very important for all of us.

Every cell on our body is made with a lining that is mostly fat and cholesterol.

So without that none of us could survive.

The problem is if you are eating highly refined fats to a great degree those don't get digested as well and as efficiently in our intestinal system because of that that increases the risk of chemical production in the colon that increases cancer risk and also unfortunately the is also very much affected by that.

>> OK, not to think about just want to remind people we still have I know we're under ten minutes maybe like seven, seven, six or seven minutes.

Plenty of time to get some questions in.

So I want to remind you to call in if you have a question I would do it now it's (969) to seven to zero again.

Dr. Payton is a background in gynecology but he also is specializing now in high risk cancer and your risks and ways to reduce your risks of cancer.

>> What would you do in terms of the screenings?

Is there just and we've talked about this a little bit earlier is there anything that's changed dramatically recently that people need to know about?

>> I know we talked about discussing with your family doctor but yeah.

So one of the big ones is that you had mentioned a little earlier about pap smears.

>> Yeah.

And that's become kind of a confusing thing because of our knowledge of the HPV virus, its impact on cancer and because that is now part of the routine part of a pap smear test.

People with normal pap smears only have to be screened every three to five years now.

So that takes a lot of that burden.

>> Used to be every year it used to be recommended every year.

So it's obviously from an expense standpoint a convenience standpoint makes things a lot better.

That's assuming your tests are normal for your tests aren't normal if you are a carrier of one of the viruses then you have to be watched much more closely.

But that's been a huge change in how we do screening in just the last probably 10 or 15 years.

>> Yeah, I would still think you know and I know I'm bad about this but trying to go see your family doctor once a year is that still again recommend even if you don't do any screening?

>> Absolutely.

Your family doctor is the best place to start and if you've got anything going on that need specialty care, they're the best ones to be able to make that assessment for you.

So again, I think having a good relationship with a trusted family physician is one of the best things anybody can do for our health .

>> Sure.

All right.

We've got down to just a few minutes now.

But again, if you had a quick question, feel free to give us a call.

We're going to continue our conversation.

I just want to make that final pitch up there before the show is ended.

Something I want to talk to you too that I think is really neat about how cancer has changed.

I mean this whole idea of having your cancer team I mean we just ran into my husband's aunt and she had gone through some cancer and she just she referred to she's like my team was great.

Everybody was talking to each other and didn't used to be like that.

You'd go to one office and talk to this doctor and then you'd go for this test at this place and you didn't know if they were going to get the results of this.

>> So I don't know if you can talk to the whole concept of a cancer team.

>> You know, the cancer team has really revolutionized what we're doing for people that do have cancer and you know, basically almost every place now has both of not both but has surgical medical radiation specialists that are in constant contact with each other and frequently reviewing each individual case together as a team so that the decisions they're making are the very best ones for that patient each and every time.

Yeah, it's also much more convenient for the patient to be able to come one time and have everything put together as opposed to like you said, hop around to three or four places and potentially get different answers for the same questions.

>> I mean it's a scary enough experience and then when you're not sure if everyone's on the same page it's makes it worse.

I like I like the idea I think isn't someone called the Navigator.

Yes.

And that's like your main go to person.

>> Exactly.

And I've heard people say yeah navigator's that's yeah that's great.

And they talk to you in layman's terms kind of spell it out.

Yeah I'm going to see if we can quickly you only have two minutes left but somebody named Mary called in doctor and let's see wanted to why wanted to talk about the risk versus benefits of taking is it aromatase inhibitors on aromatase inhibitor again basically what those do is prevent your body from converting steroid hormones into estrogen type compounds.

>> OK, so estrogen is what is one of the major factors in female type cancers of the in the uterus.

So if you are at risk or have had one of those cancers, aromatase inhibitors can dramatically reduce the occurrence or the recurrence of them.

Now the downside to that is our bodies make hormones for beneficial reasons as well to estrogen is an important chemical for keeping a woman's bones healthy and strong.

There's also some evidence that they also keep your cardiovascular system healthy and reduce the risk of coronary artery disease and stroke risk as well too.

>> So we have to again always weigh the risks and benefits and depending on what the circumstances are would determine whether that medication is enough help to patient to take on the small risks of using it.

>> It sounds like a good thing again to talk to your family doctor about.

>> Absolutely.

Absolutely.

That's a great place to start.

Yeah, absolutely.

Yeah.

I can't one thing I've learned from all the physicians have come on this show is don't believe everything you read online.

>> No.

Well that's sometimes these search engines take you to pages that are not you know no doctor Google is not very reliable.

>> Your family doctor is a much better place to start.

I would think so for sure.

So well, this has been a delight.

Dr. Petten, thank you so much for joining us.

>> I appreciate it.

Thank you for having me and thank you for all you guys do.

The show is really a fantastic resource for the people here in Fort Wayne and we appreciate what you do for us all because we have great guests so we appreciate it.

>> All right.

Thank you and thanks to all of you for tuning in tonight for all your questions.

And don't forget there'll be another HealthLine same time this place next week.

Seven thirty.

Take care.

I'm Jennifer Blomquist.

>> We'll see you next Tuesday