The Beam: Fred Hutch helps NASA develop and launch a patient program; fats during cancer treatment; meet our new provider

Fred Hutch proton therapy staff help NASA develop and launch a new patient program

NASA launched a new program in early November designed to help alleviate fear and anxiety about radiation treatment for childhood cancer patients or anyone nervous about treatment.

The program draws parallels between patients' experience during treatment and what astronauts go through as they prepare for space travel. It’s called "Mission: All Systems Go!" 

For the past two plus years, Fred Hutch Cancer Center – Proton Therapy staff worked closely with members of NASA’s SCaN (Space Communications and Navigation) team to develop the program, which includes a briefing video narrated by astronaut Kjell Lindgren, MD.

It also includes a specially-designed, immersive space that looks like a NASA control center. 

Seattle Children’s anesthesiologist Corrie T.M. Anderson, MD, FAAP, who works frequently at the proton therapy facility with young children needing anesthesia for treatment, sparked the idea.

He had heard from many children that the gantry — a machine that spins 360 degrees around a patient to access different treatment angles — looked like a spaceship. 

He shared this insight with SCaN media specialist, Al Feinberg, and after some discussion, a collaboration was formed.

“My excitement rocketed sky-high!” Anderson said. “I shared with Al how, just that week, one of our young patients had confided their dream of becoming an astronaut. I told our patient services manager, April Clements, about this, and the idea for a collaboration took hold.”

Feinberg said his management team at NASA was supportive of the program from the beginning.

“Part of NASA’s mission statement is ‘to improve life on our planet.’ Hopefully, Mission: All Systems Go! will help these kids and their families get through a very difficult and challenging time in their lives,” he said. 

Between the Fred Hutch team and Feinberg’s SCaN team, the group hashed out the exact needs of patients and how they could best be  communicated. Fred Hutch was also asked by NASA to beta test the materials with patients before its general rollout.

The main part of the program is the video narrated by Lindgren which combines live footage of him and custom-created illustrations. Patients watch the video before they begin simulation, which is a CT scan during which all the necessary information for planning treatment is collected.

“It’s important for patients to know we understand that what we are asking of them is not easy,” said Erin Behen, MS, CCLS, a child life specialist who was part of the proton therapy team consulting with NASA. “These are hard challenges and it can be incredibly impactful for us to make the connection with astronauts, who are viewed as brave and intelligent who do similar things that the ordinary person is not be able to do.”

Other aspects of the program include the immersive room — which includes a life-sized decal of an astronaut — posters in program-related exam rooms, a magnet board for patients to track their treatment progress, a space-themed playlist to listen to during treatment and a NASA-created graduation certificate. NASA also created a Q&A video for family and friends to better understand the connections.

"After extensive brainstorming with us, NASA chose the title 'Mission: All Systems Go!' for the project,” said Clements. “This phrase embodies the spirit of readiness and assurance, much like the final checks before a space launch. Similarly, before actual treatment, we check that all our systems are ready, from perfect alignment of the patient to communications systems, identity checks and more. We are trying to foster a sense of confidence in patients. Just as astronauts rely on their teams to ensure everything is in place for a successful mission, our team supports patients through every step of their experience. The term 'system' also bridges both worlds, as the body contains many systems that function together for the whole person.”

A kick-off party took place at the proton therapy facility November 2 with tours of the new room, a viewing of the video, speeches by patients and their families, as well as Lindgren and NASA representatives Kevin Coggins, deputy associate administrator and SCaN program manager, and Mark Weyland, Office of the Chief Health and Medical Officer, and NASA liaison to the White House Cancer Moonshot Initiative. Lindgren also bestowed patients in attendence with their own graduation certificate. 

“As a medical doctor, I’ve known how anxious and scared patients can get, especially young ones, when first faced with spending prolonged time in a huge, high-tech machine that can be loud and seem confining,” said Lindgren. “As a NASA astronaut, I’m thrilled to encourage patients by sharing how my spaceflight training and experience has similarities with what they’re about to undergo, and that they, too, can successfully complete their treatment mission.”

The program will be available on NASA’s website to all radiation therapy facilities in the country.

Fats and cancer treatment

By Laura Martinell, RD, CSO, CNCC

When you’re undergoing treatment, it might be difficult to get enough calories to meet your nutritional needs.

Side effects from treatment like nausea, feelings of fullness, bowel changes, trouble swallowing or a poor appetite can make it difficult to eat. But adding extra healthy fats to your foods can help you increase calories per meal. 

It’s important to have fats in your diet because they have many vital functions in the body. They help make energy, are crucial part of cell creation and absorb nutrients.

Dietary fats include:

Cholesterol: We need cholesterol to form cells, make hormones, produce vitamin D and absorb dietary fat from the food we eat. We cannot live without cholesterol, and our liver can make more if we need it. It is important to have healthy amounts of high-density lipoprotein (HDL) — what we refer to as “good cholesterol” in the body. That’s because HDL also removes other low-density lipoprotein (LDL) cholesterol from your blood and carries it to your liver where it is flushed from the body. Some foods that increase good cholesterol in our blood are avocado, olive oil and oatmeal. 

Polyunsaturated and monounsaturated fats: These fats are found in mostly plant-based foods. They help lower “bad” cholesterol levels. Examples of these fats are oils derived from flaxseeds or canola. Unsaturated fats are liquid at room temperature.

Omega-3 fats: These fats are found in both plant-based foods and fish. Because our bodies cannot make these fats on their own, we must get them through our diet. Omega-3 fats have anti-inflammatory qualities. Eating a diet high in omega-3 fats can help lower triglyceride levels, which are fats in our blood that the body has converted from calories we don’t need immediately. They are stored in our fat tissue until our body needs them. Good sources of omega-3 fats are salmon, walnuts and soybeans.

Saturated fats: Saturated fats are mostly found in meat and dairy products. A few saturated fats are created from plant-based sources, like coconut oil. High amounts of saturated fats can increase “bad” cholesterol levels. Saturated fats are solid at room temperature, such as butter.

Trans (hydrogenated) fats: These are typically “human-made” or “artificial” fats that are formed when a liquid oil is changed into a solid. Eating trans fats increases LDL cholesterol levels and decreases HDL cholesterol levels. Trans fats are now banned in the United States. 

If you are struggling to get enough calories during treatment, adding healthy fats can help!

Even though there are many foods that contain saturated fats and cholesterol, it can be OK to eat these foods during treatment because many of them provide added protein, vitamins and minerals. As always, check with your provider first before making any sweeping dietary changes.

Tips to maximize your calorie intake:

• Add olive oil or avocado oil to soups
• Add peanut butter (or any nut butter) to oatmeal or smoothies
• Add avocado slices on sandwiches
• Try whole milk dairy instead of low-fat (like yogurt or cottage cheese)
• Try tuna packed in olive oil, instead of water
• Add ground flax seeds to soups, oatmeal, or sprinkle on peanut butter toast

Or try these recipes from Fred Hutch's Cook for Your Life, which provides healthy recipes and nutrition resources for people affected by cancer:

• Chocolate avocado smoothie
• Lemony white bean hummus
• Olive oil mashed potatoes with garlic
• Spinach ricotta scrambled eggs 

Dr. Jamie Takayesu, new radiation oncologist, will specialize in gastrointestinal and genitourinary cancers

Radiation oncologist Jamie Takayesu, MD, recently joined the Fred Hutch proton therapy team.

Takayesu completed her residency in radiation oncology at the University of Michigan, Ann Arbor, and will be focusing on treating patients with gastrointestinal cancers, such as liver, pancreas and rectal cancers, as well as prostate and other genitourinary cancers.

She’s especially excited about using proton therapy in patients needing reirradiation, and to treat liver cancers in patients with poor liver function.

“For cancers of the liver, the use of protons can really make a difference in treatment outcomes,” Takayesu said. “Often, liver cancer patients have concurrent cirrhosis, which means sparing healthy tissue is even more important.”

Takayesu grew up in Hawaii before she came to the contiguous U.S. for her education and she chose to study oncology after a family member was diagnosed with cancer when she was young. When she learned about radiation oncology in medical school, she realized what a powerful tool it can be to treat cancer and to alleviate cancer symptoms to improve patients’ quality of life.

Though she is engaged in multiple lines of research, Takayesu has a special interest in the interplay between gender and cancer care. She studied the differences in how health care providers approach sexual function for women versus men.

“There is a tangible difference in how health care providers discuss sexual function with women and men, and an even bigger difference in how we quantify and manage their sexual dysfunction after cancer treatments,” she said, pointing to patient questionnaires that frequently ask men about sexual dysfunction, but not women.

"For men, there are multiple medications to help with erectile dysfunction," she said, "but for women, interventions generally include pelvic floor therapy and cognitive behavioral therapy, which are much more time-intensive. They also create a much larger barrier for women to receive appropriate therapy for sexual dysfunction.”

She has also investigated how gendered expectations in the workplace and at home disproportionately impact woman physician-scientists, leading to feelings of guilt and burnout, and which could in part explain why women are still underrepresented in leadership roles in medicine.

Currently, she is doing a meta-analysis regarding the use of different androgen deprivation therapy (ADT) medications during radiation therapy. She's also investigating long-term outcomes and effects of radiation in breast cancer and other disease sites.

Her work leaves little time to do other things, Takayesu said, but she does enjoy reading classic literature, as well as playing golf.

Please welcome Takayesu when you see her at the proton therapy facility. 

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