Bay Area Asian American Immigrant Women more likely to get Breast Cancer

We have written how some doctors would not believe that Asian American women could get breast cancer, but in the past few years, I know a number of Asian American women who were diagnosed with the disease.   Previous studies of women in Asia show a lower occurrence of breast cancer outside of the United States and higher incidence in US born Asian Americans.  In contrast, a recently released study of Asian American women in the San Francisco Bay Area suggests what I have seen anecdotally – immigrant Asian Americans are more likely to get breast cancer than native born Asian Americans.

Of the Asian American women that I know personally that have had breast cancer, all were immigrants and most were in the Bay Area.  The Wife knows even more women who had breast cancer – all are Asian American immigrants too.  Tim’s mother also died of breast cancer,  The only Asian American woman who had breast cancer who was born in the US that I can think of is Ken Jeong’s wife. Is this some acculturation factor, like with South Asian Heart disease?  The authors tried to control for that, looking at BMI and length of time in the US, but controlling those factors left the same result.

Then again, the majority of the Asian American women that The Wife and I know are immigrants in the Bay Area, so my anecdotal sample is biased.  Similarly, the study’s authors mention that one possible shortcoming of the study is that it was limited to the Bay Area population.  One risk factor for breast cancer is higher socioeconomic (measured by income and education) status – this is borne out in studies of populations all over the world and is seen in the rise of breast cancer in parts of Asia and with Asian American women in the Bay Area.   Given the large numbers of affluent Asian immigrants in the Bay area and in certain cases, where the native born children of immigrants earn less than parents, this study might simply be showing the socioeconomic risk factor.

So what to take away from this study?   Given the limits on sample size, the authors suggestion that further cross national studies be done to confirm the results and to narrow down the particular risk factors that generate this result.  If the discrepancy is caused by mainly be income/education differentials, then some of the known breast cancer risk factors that come with affluence, such as a sedentary lifestyle, should be publicized in the affected communities and should be avoided.  The authors suggest that from a public health perspective, doctors should recognize immigrant status as a breast cancer risk factor with Asian American women and increase screenings, which have been low in the past.

(h/t:  John)

Asian American Medical Hazard: South Asian Heart Disease

Silicon Valley resident Mahendra Agrawal exercised regularly, maintained a health weight, and followed a vegetarian diet.  When he went to the hospital with shortness of breath, doctors found that the 63 year old had obstructed coronary arteries.  His reaction:

“I’m a pretty active guy and I eat very healthy, my wife makes sure of that.  It makes me wonder why this happened to me.”

Agrawal’s predicament is detailed in this New York Times article (also here if you ran out of free articles) that talks about another Asian American Medical Hazard – South Asian Heart Disease.  It also describes one potential benefit of being Asian American – how adopting a blend of Asian and American practices can lead to better health than either alone.

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Asian American Medical Hazard: Somatic Symptom Disorder

When she was 14, Diana Chao began experiencing severe pain in her eyes.  The pressure buildup in her eyes was diagnosed as uveitis, an inflammatory eye disease that caused her to go temporarily blind.  For the next four years, she repeatedly visited doctors to find the cause of her uveitis, which would recur every few months.   When an ophthamologist mentioned that she had seen the same symptoms in patients with mental illness, it dawned on Chao, who had been experienced depression as a child and was also diagnosed with bi-polar disorder as teenager, that her mind might be affecting her body.  This article from the Philadelphia Inquirer talks about Diana Chao and how somatic symptom disorder, a form of mental illness that manifests itself as bodily symptoms, is actually common in Asians and Asian Americans.

How does mental illness manifest physically in Asian Americans?  The article mentions that how chest pain, headaches, and stomach problems with no known physical causes are common in Cambodian refugees, many of whom are suffering from Post Traumatic Stress Disorder.  It also talks about a Filipina American who experienced daily stomach pains which an organic cause could not be found.  This Filipina traced back the source of her problems to being sexually abused as a child.  These kind of stories are very familiar to me.  I have a relative who had persistent stomach pains for which no physical source could be found.  Alleviating anxiety and depression were key to making her pain go away.  One explanation for why somatic symptom disorder occurs in Asians and Asian Americans is that many Asian cultures stigmatize mental illness and tend to repress talk about feelings, causing mental problems and issues to manifest themselves in other ways.

As for Diana Chao, she attributes fewer episodes of uveitis to better mental health treatments.  Her own story is remarkable.  Despite suffering from uveitis symptoms and dealing with bi-polar disorder, she is a photographer who has placed work in prominent places and is currently a sophomore  at Princeton University.   She advocates for mental health treatment, giving a TedxTeen talk on the subject and founding a nonprofit called Letters to Strangers, which aims to destigmatize mental illness and to increase access to mental health care for people aged 13 through 24.   I had previously written about Wendell Tang, who suffered from mental illness but did not receive treatment.  Diana Chao shows that students with mental illness can thrive, even at intense Ivy league institutions, when they receive treatment.

(h/t:  akj)

Asian American Family Sues Harvard, but not for what you might think

Lawsuits against Harvard and well-known selective universities contending discrimination against Asian Americans have happened over the years, with the lawsuit sponsored by Edward Blum still in play and actively opposed by Harvard.  In late 2018, another kind of lawsuit against Harvard was filed. The family of Luke Tang filed a wrongful death lawsuit against Harvard contending that the University was negligent in caring in for Luke, who committed suicide in 2015.

After a suicide attempt his freshman year, Luke Tang was hospitalized.  While he was there, he signed a contract with Harvard saying he could return if he received mental health counseling.  He was able to return for his sophomore year even though, the lawsuit alleges, Harvard personnel knew that he had not received the required mental health counseling.

Since his death, his parents have set up a foundation in his name to raise awareness of signs of depression and other mental health issues, especially as it affects Asian Americans.  In addition, a short documentary called Looking for Luke was produced by the Clay Center for Young Healthy Minds to educate and to destigmatize seeking help for mental health problems.  In the trailer above, the fact that Luke committed suicide is hidden for a long time and only told to one of his friends six months after his death.   My personal experience with the issue of mental health in Asian American families is that any problems are hushed up, considered a shame on the family that is not to be discussed openly, and likely not to be dealt with directly.  In particular, this article on Filipino Americans and mental health really resonated with me and other family members.  Our family, like many others in Silicon Valley, have known Asian American students who have committed suicide.

Harvard was required to respond to the lawsuit by January 9.  I haven’t been able to find the actual lawsuit text or any response since then (if someone has link to any of those, please include it in the comments). At the same time, the Luke Tang foundation is granting scholarships to students who have overcome psychiatric problems and welcomes donations.

Asian American Youth and E-Cigarette products

by Chris Sedayao

While a little less than 1 in 7 of all Americans smoke, around 1 in 4 Vietnamese American men smoke, according to the Center for Disease Control.  The use of cigarettes has decreased significantly in the United States since the days of the Marlboro Man, with young adults smoking 18-24 less than the average.  Still, cigarette companies have found ways to sell into this younger demographic.

Asian American youth have found an alternative to cigarettes, but like their predecessors, use highly addictive products such as vapes, Juuls, Suorins, and countless other e-cigarettes products. According to a study posted by the US National Library of Medicine of the National Institutes of Health, use of these products was high among Filipinos, Vietnamese, and Chinese Americans in that order. Filipino American use was higher than the overall US average.  Being a young adult and growing in an Asian American community, I have been exposed to all these products. I have seen the effects vary from person to person, but in general, most people who use these products become addicted. These companies have become successful in targeting the youth with their products over the last few years.

Despite that, there is still hope in changing the way kids look at e-cigarette products as the government did with cigarettes throughout many years of stigmatizing advertising. Starting with FlavorsHookKids.org, one can share the downsides of using these products and help limit the use of e-cigarettes for current users and future generations of youth.

ABOUT THE AUTHOR:  Chris Sedayao grew up in Northern California and is currently a student at Northeastern University.

(Disclaimerflavorshookkids.org is an advertiser on this site.)

Asian American Medical Hazard: Stroke

My doctor has always considered my high blood pressure to be a significant concern, and she makes sure I am managing it effectively.  After thinking about the Asian Americans that I know who have had a stroke and this recent report and video, I should really be thankful.  Preliminary results from an analysis of 1.7 million stroke cases between 2004 and 2016 reveal that Asian Americans are more likely to have more severe ischemic strokes and worse outcomes than whites.   In addition, Asian Americans studied were less likely to receive clot busting stroke treatment, although this difference seems to diminish during the studied time period. Study lead author Dr. Sarah Song, who revealed the initial results at the American Stroke Association International Stroke Conference, said:

“Asian Americans may have a distinctive pathophysiologic profile of ischemic stroke than whites.   Regardless, this study highlights the need for more focused research, improved stroke prevention and possibly different treatment strategies for Asian Americans.”

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Asian Squat Update: Why it’s good for you and why it’s going away

“A guru once told me that the problem with the West is they don’t squat.” – Rosie Spinks

One of 8Asians’ most popular articles continues to be Koji Sakai’s article on the “Asian” Squat

We recently got a comment from one of our readers on how the Asian Squat seems to be a way to help with a particular health problem but that the reader could not readily achieve the position.  Shortly after that, I saw this piece by Rosie Spinks about how the “Asian Squat” can be good for people’s health, but sadly, is going away with certain people in Asia.

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Breast Cancer Rates Increasing Among Asian American Women

Scarlett Lin Gomez
Scarlett Lin Gomez

A new study from the Cancer Prevention Institute of California (CPIC), with Scarlett Lin Gomez as the lead researcher of the study, is showing an increase of breast cancer in Asian American women.  This is particularly troubling because the rate among other racial groups has stabilized.

The study looked at women in the San Francisco Bay Area of California, from 1988 to 2013, and included women from different Asian American backgrounds, including Japanese, Chinese, Korean, Filipino, South Asian, Vietnamese, and Southeast Asian and compared it with results from non-Hispanic white women.

The rate of cancer has been growing fastest in South Asian (Indian and Pakistani), Vietnamese, and Southeast Asian (Cambodian, Laotian, Hmong and Thai) women.  The common thread among these women seems to be that they are among the more newly immigrated to the U.S. (and those that are newly introduced to American diets/environment/etc).

A recent NBC News article on this topic talks about how one doctor told his patient that Asian American women didn’t get breast cancer.  But of course, Asian American women do get breast cancer and in ever increasing rates.  The woman’s sister Mai-Nhung Le, a professor at San Francisco State University, studied the needs of Asian American women and found that Asian American women reported more “unmet daily physical needs”, such as needing help with cooking, housework, and transportation. Le also noted the significance of the CPIC findings that indicated Vietnamese and Southeast Asian women are more likely to have breast cancer before age 50.

My mother was diagnosed with breast cancer back when she was about 50 years old, but it almost didn’t happen.  She went in for a mammogram, which apparently the normal image would not have caught her breast cancer. Since her lump was so far off to the side, it presented as pain under her arm.  It was only because she mentioned her under arm pain to the mammography technician that he took a separate side image that caught the image of the lump in her breast tissue.

At the time she was lucky in that they diagnosed my mother as stage 1, and she received a double mastectomy along with many rounds of chemotherapy, and couple of years later was declared cancer free.  Fast forward 15 years later, and her cancer returned, metastasized and incurable.  She passed away a few years later.  I’m grateful for the many years we got to have my mom because of the early diagnosis, but I’m still mad that we don’t have a cure yet, and we had to lose her, too soon to see her own grandchildren grow up.

If you’re an Asian American woman, make sure you understand the warning signs and that you get your mammogram.  Don’t let a doctor tell you that Asian American women don’t get breast cancer.

8Questions: Dr. Sophia Yen of PandiaHealth.com, a new online birth control prescription service

Pandia_Health

I’ve blogged about my friend Dr. Sophia Yen in the past. She’s probably the most politically active person I know (and her brother served in Iraq and her mother Sandy Yen was in the Taiwan legislature.)

But by day, she’s not only a doctor but also recently launched her start-up, Pandia Health – “The easiest way to get birth control.” I caught up with her recently to learn more about her startup and her motivations.

John: Today we’re talking with Dr. Sophia Yen, a physician with a passion for making women’s lives better with improved access to birth control and prescription acne medications via her startup PandiaHealth.com

Dr. Yen: Thank you for having me on 8Asians.com! I love sharing my birth control knowledge with people to help prevent unplanned pregnancies.

As Asian Americans, I think many of us have gone under the “don’t ask, don’t tell” regimen about our birth control with our parents. I’m here and happy to answer anyone’s questions about birth control, sexually-transmitted infections, and acne. I hope our generation can be more open with our children.

Why did you start PandiaHealth.com?

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8Books Review: “Love, Loss, and What We Ate” by Padma Lakshmi

LoveLossPadma Lakshmi’s memoir, Love, Loss, and What We Ate is an intimate look at family, growing, grief, and eating through life’s ups and downs. Best known for her role as host on Top Chef, Lakshmi takes us from childhood to the present in vivid detail with humor, honesty, and self-reflection. She is fully willing to unveil her flaws, capitalizing on the gift of hindsight.

Lakshmi ably guides us through her triumphs and travails. She is unafraid to talk about her health issues (late diagnosis with endometritis), her sex life, her relationships, and her life between East and West. Inevitably, she returns to food–the foods of her childhood, those of heartache, what she makes for those she loves–interspersing occasional recipes throughout.

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National Science Foundation Funds Extensive Research Survey on Asian Americans

TaekuLee_2014-750The National Science Foundation has decided to fund an extensive research survey on Asian Americans.  The survey project, lead by Political Science Professor Karthick Ramakrishnan of UC Riverside, Law Professor Taeku Lee of UC Berkeley (shown here), Sociology Professor Jennifer Lee of UC Irvine, and American Studies Professor Janelle Wong of the University of Maryland, will expand on the National Asian American Survey.  This study aims to differentiate its data from other surveys by getting statistically significant samples from each of the six largest Asian American ethnic groups, with at least 400 interviews from each group, conducted in at least 11 languages.  Along with attitudes on various subjects, data on finance, health, and other areas will be collected.

I was curious as to how these professors got a grant from the National Science Foundation, an organization that I usually associate with technology and not political science.  Their grant award summary argues that since Asian Americans make a disproportionately large number of skilled STEM (Science, Technology, Engineer, and Mathematics) workers, understanding them and the barriers facing them will be critical to ensuring the economic competitiveness of the United States.  I think that is a valid argument, and it is gratifying to see the award as a recognition of the impact of Asian Americans.

The project will produce a dataset for public release in June 2017.

Are Asian Americans really the Healthiest Americans?

healthSince beginning the year, my family has been dealing with a number of medical issues, from emergency operations to life style changes stemming from chronic conditions.  When I saw that The Center for Disease Control has released a study looking at the Health of Asian Americans that declares that Asian Americans are more likely to be healthier than the average American, it really got my attention.  To its credit, the report disaggregates the data between Asian ethnicities, making conclusions such as Vietnamese Americans are more likely to have poorer health than the general population.  But what does it mean that Asian Americans are the healthiest Americans?  How applicable is that to all Asian Americans?  What does the study miss?

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