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【?? ??? ??】Lung Cancer Among Asian Americans: ‘It’s Okay to Ask’
Dr. Elaine Shum leads a discussion of lung cancer. Astra Zeneca created a campaign aimed at raising awareness of the disease, which is the leading cause of cancer-related deaths among Asian Americans.

When Chef Ming Tsai’s wife Polly was diagnosed in 2018 with Stage 4 lung cancer, she had one message to her husband and two boys.

“We got this.”

“Women are smarter and stronger. My wife consoled me. She’s diagnosed and I’m bawling my eyes out,” Tsai recalled.

Host of the PBS show “Simply Ming,” Tsai is known for his culinary mix of Eastern and Western flavors. Recently, the chef has become a leader in lung cancer awareness and urged the Asian American community to be proactive, be their own advocate and not wait if they are experiencing symptoms.

Lung cancer is the leading cause of cancer-related death among Asian Americans. Tsai discussed his family’s battle with lung cancer as part of a panel discussion on the disease among Asian Americans.

A panel of oncologists shared their experiences treating Asian American lung cancer patients. One of the biggest misconceptions is that lung cancer is primarily a smoker’s disease. Smoking is not the only factor that causes lung cancer; genetic mutation is one of the biggest lung cancer triggers.

Researchers have found that Asian Americans – including Japanese Americans – are more likely to have a specific type of lung cancer that tests positive for mutations found in the epidermal growth factor receptor (EGFR) gene. These mutations are commonly found in a subtype of non-small cell lung cancer (NSCLC), known as adenocarcinoma, the most common kind of lung cancer in the U.S.

The online event was moderated by Elaine Shum, M.D., New York University assistant professor and hematology/oncology fellow.

On the panel were NYU Assistant Clinical Professor Songchuan Guo, M.D., Ph.D.; Kin Y. Lam, M.D., certified hematology and oncology specialist with over 30 years of experience;?Northwestern University Associate Professor Young Kwang Chae, M.D., MPH, MBA.

There are a number of other reasons why the Asian American community is facing high rates of lung cancer. Cultural differences are an important factor, and stigma surrounding lung cancer may be a barrier to seeking medical help.

As a result, Asian Americans are often diagnosed at later stages of disease, which may lead to worse health outcomes compared to other racial and ethnic groups. Breaking down misconceptions and increasing awareness of biomarker testing in Stage 4 lung cancer may help improve patient outcomes.

Dr. Guo said he sees a lot of Asian patients.

“Quite often it is an Asian female who never smoked, present symptoms and never thinks they could have a diagnosis of lung cancer. They blame themselves, sometimes blame the husband, who is a smoker. That often leads to delay in diagnosis,” Guo said.

Shum advised that people with Stage 4 lung cancer should no longer feel afraid of this scary diagnosis because huge advancements are being made on how to address lung cancer. She said chemotherapy is not the only option as there already are other targeted treatments.

“We just have so many options nowadays. If the first option may not work after a while, we have other options. We just have so much research going on that there is almost always something else that we can use,” Shum said.

She expressed concern that there will be an uptick in lung cancer diagnosis because of a decline in preventative screenings due to the ongoing pandemic.

“We’ll see an increase in cancer deaths because of missed screenings because of COVID. Had symptoms in February but didn’t seek care until late summer,”Shum said.

“If there is a nagging cough that doesn’t seem right, do not ignore it,” she said.

Smoking is not the only factor that causes lung cancer and genetic mutation is one of the biggest lung cancer triggers. The proportion of never-smokers diagnosed with lung cancer has been increasing among Asian Americans, including Japanese Americans.

Other signs of lung cancer may include shortness of breath, chest pain, coughing up blood (even a small amount) and losing weight without trying.

In Polly Ming’s case, she was diagnosed after their sons reported that she was acting a little “weird” and disoriented, while Ming was away on a business trip. She was admitted into Newton-Wellesley Hospital, where they determined that she had had a seizure and finally, a series of testing and scans revealed the Stage 4 cancer diagnosis.

Doctors conducted biomarker testing on Polly and found she had the EGFR biomarker and was administered oral therapy immediately.

This targeted therapy is a once-a-day pill that is very convenient and?minimizes the disruption to daily life.

Ming and Polly Tsai with Dan Kuramoto and June Kuramoto of Hiroshima. The band wrote the music for Tsai’s show “Simply Ming.”

Chef Ming also said they eliminated sugar from their diets and his wife went vegan and gluten-free. They also reduced their stress; plans to open a fast casual restaurant were immediately put on hold.

“We started smelling the coffee, taking longer hikes, realizing how precious life was. When the clock started ticking, it’s a reality check,” Ming said.

Now, he said, “She is feeling great, looking great.

“It’s okay to ask. In the Asian community we’re such proud people. Don’t want to bother anyone. I know with COVID, people are reluctant to go to the hospital. Go to the hospital — ask.

“Our life may be even better after cancer. We have slowed down and realized what is the most important thing in life, and that’s the people you love.”

 

 

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