Jeanna Brouwer, an outpatient oncology dietitian with the OSF HealthCare Cancer Institute, says understanding your vitamin D levels is one of the first steps in supporting your overall health during treatment. She emphasizes that vitamin D, a fat-soluble vitamin, helps support bone health, immune function and recovery, making it a crucial part of cancer care.

"It's a pre-hormone, or a precursor to a hormone, that is like a 'master key in our body,'" Brouwer says, adding it helps regulate many important processes inside of you.

There are two forms of vitamin D: D2 and D3. Brouwer says the body utilizes vitamin D3 more efficiently than vitamin D2. Vitamin D3 is naturally found in animal-based foods, including fatty fish, and is generally more effective than vitamin D2 at raising and maintaining vitamin D levels.

Why vitamin D is important during cancer treatment

Brouwer says vitamin D is almost always a beneficial part of a person's cancer journey. If someone hasn't had a recent vitamin D blood test, she recommends having one ordered so a baseline can be established before determining whether a supplement is needed.

"When we're deficient, our body isn't functioning to the ideal level that we need it to," Brouwer says. "We don't have the ideal immune system that can help us during cancer treatment. So, if we're deficient, we want to start there and bring it up to a healthy level."

Brouwer also says studies show an association between adequate vitamin D status and better outcomes in certain cancers.

For some people, supplementation becomes even more important depending on their diagnosis and treatment plan.

"So, for example, prostate cancer patients; if you get put on something called ADT therapy, where it's blocking testosterone, that's going to alter our bone health. So, anybody put on that medication oftentimes (recommended by their oncology team) start supplementing with vitamin D and calcium," Brouwer says.

Supplementation can also help protect against osteopenia and osteoporosis.

People with pancreatic cancer can face a different challenge. Brouwer says pancreatic insufficiency can prevent the body from properly breaking down fat, leading to malabsorption. Because vitamin D is a fat-soluble vitamin, traditional vitamin D supplements may be less effective for some patients.

Choosing a supplement

Although sunlight helps the body produce vitamin D, Brouwer says supplements are an excellent way to get the nutrient without spending long periods of time in the sun, which can increase the risk of skin damage and skin cancer.

She also understands that choosing the right supplement can be overwhelming.

In general, Brouwer recommends choosing vitamin D3 over D2. She says products containing vitamin K2 can also help direct calcium into the bones more effectively.

People should keep in mind that the amount of vitamin D found in many calcium supplements or multivitamins is often not enough to meet their daily needs.

Most people need between 1,000 and 2,000 international units (IU) of vitamin D each day, Brouwer says. Reaching that amount through food alone can be difficult. For example, it would take about 10 glasses of milk a day to provide that much vitamin D, which is not recommended.

For people taking multiple medications, pill burden is a real concern. Brouwer says liquid-filled or gel capsules are often easier to swallow. Vitamin D also comes in gummies which are more palatable for some people.

Some formulations may also improve absorption. Liposomal supplements contain fat, which helps the body absorb vitamin D more effectively. For people who have difficulty absorbing vitamin D through the digestive tract, such as some pancreatic cancer patients, liquid drops may be a better option.

"Doing a sublingual bypass anything in the gut area. You hold the liquid under your tongue for 30-60 seconds, and it's going to absorb into the tissue in the oral cavity," Brouwer says. "So, if you get drops that are liposomal, best of both worlds."

Look for third-party testing

Because dietary supplements are not regulated by the U.S. Food and Drug Administration (FDA), Brouwer encourages people to look for products that have undergone independent, third-party testing.

She recommends looking for certifications such as USP (U.S. Pharmacopeia) or NSF (National Sanitation Foundation) on the label to help verify a supplement's quality and contents.

Before starting any vitamin D supplement, talk with your oncology care team or health care provider. There are scenarios, such as high calcium levels caused by cancer, where taking supplemental vitamin D can be problematic. A simple blood test can determine whether you're deficient and help identify the supplement and dosage that's right for you.

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Creatine is a naturally occurring compound made from three amino acids. Your liver, kidneys and pancreas produce it, and it's also found in foods like red meat.

While your body makes creatine on its own, and you can get some through your diet, those amounts typically aren't enough to provide the performance benefits seen with supplementation.

Best known for helping muscles work harder during high-intensity exercise, creatine is one of the most researched sports nutrition supplements available. The most studied form is creatine monohydrate, which has been shown to improve exercise performance and increase lean muscle mass when paired with resistance training.

"There are three different forms that creatine can come in. It can come in a pill (capsule form), it can come in gummy form, or a powder form. There are different types of creatine; the most well-studied form is creatine monohydrate," says Gabrielle Raucci, outpatient clinical oncology dietitian with OSF HealthCare Cancer Institute. "All the studies we've seen say the best form is going to be powder. It's better absorbed by your body, and you can just take a scoop of it, add it to water and shake it up really well."

Most adults who choose to supplement should aim for about three to five grams per day, Raucci says.

Emerging research also suggests creatine may have benefits beyond muscle health. Recent studies have found promising evidence that it may help support brain energy metabolism and cognitive function, although researchers say more studies are needed to understand its long-term effects in healthy adults.

For people with cancer, however, timing matters.

"The main thing we focus on is that if you're undergoing an active treatment, like chemotherapy or immunotherapy, the kidneys can sometimes take a hit with those treatments. When your body breaks down creatine, it breaks it into a byproduct called creatinine," Raucci says. "When your oncologists are closely looking at your blood levels, we wouldn't want to take a supplement that could potentially bump your creatinine. So, make sure to talk with your care team if you're on an active treatment and you want to use one of these supplements. Because it could potentially affect your kidneys."

For cancer survivors who have completed treatment, creatine may be an option to help rebuild muscle mass, particularly when combined with regular strength training.

"If you're in survivorship and are looking to build your lean body mass up, it could be a safe supplement," Raucci says. "Check with your care team, they'll double-check your medications and see if it's something to build yourself up after treatment."

As with any supplement, people undergoing cancer treatment or managing other medical conditions should talk with their health care team before starting creatine to ensure it's appropriate for their individual situation.

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Now, emerging research continues to point to multiple factors of why hundreds of thousands of people worldwide are dying from the disease each year. The World Cancer Research Fund (WCRF) reports lung cancer as the most common cancer across the globe, attributing most of the cases to people in China, the United States and Japan from data released in 2022. The Journal of Thoracic Oncology says 1.8 million people die each year from lung cancer.

Between 10-20% of patients diagnosed with lung cancer are non-smokers.

In part one of this two-part series, Jun Zhang, MD, PhD, a thoracic oncologist and the vice president of oncology research with OSF HealthCare Cancer Institute, discusses five main reasons that patients who do not smoke are being diagnosed with lung cancer. Part one discussed both PM2.5 (Particulate matter) and radon levels being major causes of lung cancer among nonsmokers, while this article will dive into the next three categories.

#3: Cooking fumes leading to lung cancer

The World Health Organization (WHO) reports that each year, 2.9 million people die prematurely from illnesses caused by household air pollution, specifically by the “incomplete combustion of solid fuels and kerosene used for cooking.”

Of those deaths, 6% are from lung cancer, the WHO says, adding that roughly 11% of lung cancer deaths in adults are attributed to “carcinogens from household air pollution caused by using kerosene or solid fuels like wood, charcoal or coal for household energy needs.”

"This is one of the reasons there's a higher incidence among Asian people, because of cooking style and the importance of food," Dr. Zhang says. "Over there, the way we cook delicious food is using the really hot wok (large bowl-shaped pan used for high-heat cooking) as the way to cook. Especially if the cooking involves using animal fat, it can create droplets (fumes), that can be inhaled and cause problems." 

#4: Secondhand smoking

Just as there is no safe level of smoking, the same can be said for secondhand smoke (SHS). The U.S. Centers for Disease Control & Prevention (CDC) says even brief exposure to SHS can be harmful. This should be a wakeup call to both smokers and those who are around smokers, and lung cancer isn’t the only health concern.

The CDC reports other health problems that can be caused by secondhand smoke (in adults who don’t smoke) are coronary heart disease, stroke, as well as reproductive health effects in women. For infants and kids, SHS can cause sudden infant death syndrome (SIDS), respiratory infections, ear infections and asthma attacks.

Especially in the 1940s through 60s, smoking was seen more broadly as "cool" and was a norm in many American households. So, secondhand smoking, Dr. Zhang says, is another major contributor to non-smoking lung cancer diagnoses. 

"Whether it's a parent smoking or a coworker smoking, this leads to indoor air pollution," Dr. Zhang points out. 

SHS causes more than 7,300 lung cancer deaths each year in American adults who don’t smoke and increases the risk of lung cancer in adult non-smokers by 20-30%.

#5: Genetic predispositions

Your genes can play a role in your cancer risk as well, Dr. Zhang says. A family history of lung cancer in a first-degree relative account for approximately 25% of attributable risk in never-smokers – the largest single risk factor. The germline variants in certain genes like EGFR and STK11 can increase lung cancer susceptibility among never-smokers.

Dr. Zhang says with genetic testing, these variants can be found.

"It turns out that if you have germline variants in the EGFR gene, people have a higher susceptibility to have lung cancer," Dr. Zhang says. "With AI (artificial intelligence) and more in-depth sequencing, we'll be able to find more genetic predispositions."

STK11 (also known as LKB1) is another prominent gene that its germline variants my result in increased susceptibility in many non-smoking lung cancer patients. Germline mutation of this gene can lead to Peutz-Jeghers Syndrome, which leads to the growth of polyps in the gastrointestinal (GI) tract or other parts of the body. It also increases lung cancer susceptibility regardless of environmental exposures.

Current screening guidelines

Low-dose CT scans are available for certain patients, but the current guidelines require you to be at least 50 years of age and have a 20-year smoking history (one pack of cigarettes a day for 20 years, of ½ pack of cigarettes for 40 years). You also need to either be a current smoker or have quit in the last 15 years. 

Dr. Zhang says findings like this argue for expansion of lung cancer screening criteria, especially among Asian females, which is aligned with the findings from FANSS (Female Asian Nonsmoker Screening Study), which screened 1,000 eligible Asian women, ages 40-74. Using low-dose CT (LDCT), the findings showed a lung cancer detection rate of 1.3%. This was higher than a separate study called the National Lung Screening Trial (NLST) which studied high-risk smokers.

Dr. Zhang says that if you have any concerns like lingering cough that lasts for multiple weeks, talk to your primary care provider (PCP). You can get a chest X-Ray to make sure you don't have pneumonia.

You could also have GERD (acid reflux), and these are important to be seen for. If none of the common benign cases are identified, this is where patients should advocate for themselves and ask for a CT scan to check for lung cancer.

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The American Cancer Society (ACS) says other than skin cancer, prostate cancer is the most common cancer in men in the United States.

The good news? Prostate cancer, when caught early, is also one of the easiest to treat.

Salman Syed, MD, a radiation oncologist with OSF HealthCare, describes today’s current treatment options as “exceptional,” noting that most men diagnosed with prostate cancer at an early stage are successfully treated and remain cancer-free after therapy.

The best way to detect prostate cancer early is through screening with a PSA (prostate-specific antigen) test, Dr. Syed explains.

PSA is a protein produced by the prostate that can be measured with a simple blood test. Higher PSA levels may indicate prostate cancer or other prostate conditions. "It correlates with the amount of prostate tissue that you have," Dr. Syed adds.

“In general, we like to see PSA levels below four, but the interpretation depends on a patient’s age and overall risk,” Dr. Syed says. “Some men can develop prostate cancer even with a relatively low PSA, which is why screening decisions should be individualized and discussed with a physician.” 

If you have a strong family history of prostate cancer, you may need to start PSA testing at a younger age. “Current guidelines recommend discussing PSA screening as early as age 40 to 45 for men with higher-risk features, including a family history of prostate cancer, African ancestry or certain inherited genetic mutations.”

Inherited mutations such as BRCA1 or BRCA2 can increase the risk of developing prostate cancer, among other cancers, and can be passed down from parent to child. So, knowing your family history and if you or your parents have genetic mutations is helpful in assessing your cancer risk, Dr. Syed suggests. 

Doctors might also use genomic testing, which analyzes the activity of certain genes within a prostate tumor. These tests help determine how aggressive the cancer is likely to be, allowing physicians to tailor treatment to each patient.

“In some cases, genomic testing helps us safely avoid unnecessary treatments,” Dr. Syed explains. “In others, it tells us when we should treat more aggressively to give the patient the best chance of cure.” 

New and improved ways to diagnose, treat prostate cancer

The OSF HealthCare oncology program has several advanced technologies that help detect prostate cancer earlier and treat it more precisely, often with fewer side effects.

“One of the biggest advances we’ve seen in prostate cancer care is the ability to combine better imaging with more targeted treatments,” Dr. Syed says. “That allows us to detect cancer earlier and personalize treatment, so patients get exactly what they need.”

One example is the multiparametric MRI (mpMRI), an advanced imaging test that provides a highly detailed look at the prostate. This scan can identify suspicious areas that may not be visible on standard imaging, helping doctors detect prostate cancer earlier and guide more targeted biopsies and treatment.

Another breakthrough is PSMA PET/CT, an advanced scan that can detect extremely small amounts of prostate cancer throughout the body. Because it is far more sensitive than traditional imaging, it helps doctors locate recurrent or metastatic disease earlier and plan treatment more accurately. 

OSF HealthCare also offers proton therapy at OSF HealthCare Cancer Institute in Peoria. Proton therapy is an advanced form of radiation that allows physicians to deliver radiation to the tumor while reducing exposure to nearby organs such as the bladder and rectum. 

"With proton therapy, we can often reduce the dose to surrounding healthy tissues compared with conventional radiation," Dr. Syed explains. "That can translate into fewer long-term side effects and better preservation of quality of life for many patients." 

Another highly advanced option available at OSF is high-dose-rate (HDR) brachytherapy, which delivers radiation from inside the prostate.

“HDR brachytherapy is one of the most precise forms of radiation therapy available for prostate cancer,” says Dr. Syed. “Because we deliver radiation from inside the prostate itself, we can sculpt the radiation dose very tightly around the tumor while minimizing exposure to nearby organs like the bladder and rectum. At OSF, this treatment is typically completed in just two sessions, which allows us to deliver a very powerful and focused treatment over a short period of time while maintaining excellent cure rates.” 

Together, these advanced tools allow the OSF oncology team to diagnose prostate cancer earlier, personalize care and deliver highly effective treatment while minimizing side effects. 

Radiation versus surgery: Is there a better option?

In terms of radiation versus surgery, Dr. Syed says they are both highly effective treatment options.

"In terms of cancer control, surgery and radiation have very similar success rates for most patients," says Dr. Syed. "The choice often comes down to differences in side effects and what best fits a patient's lifestyle and priorities."

Rectal irritation, like diarrhea and looser stools during treatment, and other side effects are possible during radiation, but that improves over time, Dr. Syed points out. 

Side effects from surgery include temporary erectile dysfunction (ED), which is regained after surgery. As well as urinary incontinence (accidental urine leakage caused by lack of bladder control), which can tend to last post-surgery as well. Men are encouraged to wear supporting underwear (Depends) to prevent urinary leakage. 

The best starting point is a conversation with your oncology team to discuss what your lifestyle looks like.

If you are actively working and can't have urinary incontinence, radiation will likely be the recommendation. If you have urinary issues already, there are certain radiation options that would be better for you. 

Exercise helps decrease your risk of cancer. Dr. Syed recommends maintaining a healthy weight and staying up to date with your health maintenance and primary care provider, as well as avoiding alcohol and smoking.

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When it comes to lowering your risk of cancer, what you add to your plate can make a meaningful difference.

Jeanna Rich, an oncology registered dietitian with OSF Cancer Support Services, says the key is nourishing the body with whole grains, colorful fruits and vegetables, fiber-rich foods and Omega-3s.

As someone who works closely with cancer patients, Rich encourages people to think of food as a daily opportunity to fuel the immune system and support long-term health.

Why fiber matters

Most Americans fall short on fiber; a nutrient vital for good gut bacteria, healthy digestion and lowering the risk of colorectal cancer.

Rich says increasing fiber can be simple. Start by working whole grains into meals: oats, wild rice, flax seed, walnuts, pumpkin seeds and chia seeds. They can easily be sprinkled onto cottage cheese, Greek yogurt or oatmeal to boost texture and nutrition.

Research backs up these benefits. A large group of researchers from 15 international cohort studies, including scientists from the American Cancer Society (ACS), analyzed data from more than 842,000 men across North America, Europe, Australia and Asia. Their findings suggest that dietary fiber may lower the risk of developing advanced and aggressive forms of prostate cancer. Additional ACS findings note that whole grains may help fight against advanced prostate cancer.

Rich offers a practical approach to building a fiber-forward breakfast.

"Another great way to add fiber is with our yogurt. A lot of us make yogurt parfaits, but here's a way to take it to the next level. Add chia seeds, flax seeds, pumpkin seeds and walnuts," Rich says. "Top them with berries, which contain a ton of fiber."

Berries – whether fresh or frozen – are packed with vitamins, antioxidants and deep pigments that signal high nutrient content. Rich recommends buying frozen berries and storing them in the fridge to thaw, making them easy to add into yogurt, cottage cheese or morning oatmeal. Frozen produce can be a cost-effective option, especially when items are out of season, Rich says. Thanks to the flash-freezing process, these foods retain their nutrients and offer the same high-quality nutrition as fresh varieties, she adds.

Other high-fiber additions include quinoa, lentils and canned beans, which are paired well with salads, vegetables and hearty meals.

The power of Omega-3s

Omega-3 fatty acids play a crucial role in reducing inflammation and strengthening immune cells.

Some plant-based Omega-3s are found in foods like ground flax seed, but Rich notes that fish-based sources are more efficiently used by the body.

"Some Omega-3s will be found in ground flax seed. However, your body doesn't utilize it as effectively. So, you want to go for those Omega-3s, found in salmon. Keep it frozen in your freezer and choose products that are wild caught. That will have a higher concentration of Omega-3s," Rich says. "Omega-3s help decrease inflammation in our body and increases our fighter cells, so it's a wonderful way to protect from chronic disease and cancer."

Salmon can easily be added into breakfast dishes, salads or purchased as salmon patties. Canned sardines are another convenient, nutrient-dense option.

A need for more vegetables, and more variety

Despite growing awareness of the benefits of produce, Americans still struggle to get enough vegetables into their diet.

"A lot of us are not getting enough vegetables. Many Americans are getting a decent amount of fruit, but vegetables are the tricky ones. When it comes to veggies, diversity is key," Rich says. "On average, most of us only use the same 10 vegetables in our eating routine."

Rich encourages using easy steamer bags filled with multiple vegetables. These mixes often include an array of colors – a good sign you're getting a wide range of nutrients that help fight cancer and chronic disease.

The benefits of polyphenols

Colorful fruits and vegetables bring another powerful nutrient group: polyphenols.

"Polyphenols, flavonoids and lycopene are some key words you may be hearing. Those are the things that are activated in your body and helping protect you," Rich says. "Polyphenols are becoming very popular and are in studies about the gut microbiome. That is considered a source of prebiotics, as well. All these different colors can help feed that good bacteria that helps your immune system be healthy."

Lycopene – found in red and orange produce like tomatoes and peppers – is known to help protect against prostate cancer. Cooked tomatoes are especially beneficial because heat increases lycopene concentration.

Rich suggests adding tomatoes into soups, stews and chili to boost cancer-fighting potential.

What kinds of cancer can a healthy diet protect against?

According to Rich, the right dietary patterns can help protect against a wide range of cancers:

• Breast
• Ovarian
• Gynecologic
• Prostate
• Colorectal
• Gastric

Fiber, Omega-3s and polyphenols are particularly powerful against colorectal and gastric cancers.

Additionally, managing weight through a balanced diet can reduce estrogen production in adipose tissue — a factor that increases breast cancer risk.

Fiber, protein, fruits and vegetables help reduce that risk and help us live a healthier life.

Surprising ways to get more protein

Protein also plays a crucial role in prevention and is especially important for those undergoing treatment.

Rich offers several easy, creative ways to boost protein intake:

• Scrambled eggs: Whisk in cottage cheese to make them “extra fluffy and packed with more protein.”
• Greek yogurt: Blend into red tomato sauce or pasta dishes or use it to make spinach artichoke dip.
• Oatmeal: Add kefir to boost protein and probiotics, helping reduce blood sugar spikes and inflammation.

Foods and drinks to limit or avoid

To best support your health, Rich recommends minimizing:

• Ultra-processed foods
• Artificial additives
• Alcohol
• Excess red meats
• Color dyes
• Processed meats

These items contribute to inflammation and can increase the risk of several types of cancer.

To learn more about how cooking and nutrition work together to improve your health, visit the OSF HealthCare Cancer Institute Teaching Kitchen's website. 

John Rinker, DO, of OSF HealthCare, is in his mid-40s and in good health but he recently embarked on a journey that began with a quick swab inside his mouth to find out if he was at high risk of any of 10 major diseases.

The test that includes a simple cheek swab is polygenic testing. Polygenic testing focuses on the cumulative effect of many common genetic variations to determine a person’s risk for developing complex diseases, while genetic testing typically focuses on a single gene or a small number of genes to identify specific genetic conditions or mutation. Why did he get the test? Dr. Rinker believes knowledge is power.

“And potentially, how is it likely if I’m affected, I want to make sure that I’m aware for my children, right? And so personally, I chose to get the test done, because if there’s anything that I found, I would want to do everything in my power to make a change, if at all possible, so I can live a healthier life and a longer life.”

Dr. Mark Meeker, DO, is former vice president of Community Medicine at OSF HealthCare, now vice president and chief medical officer of OSF HealthCare St. Mary Medical Center and OSF HealthCare Holy Family Medical Center. Meeker explains polygenic testing creates Polygenic Risk Scores (PRS) that aggregate the effects of thousands of genetic variants to assess a predisposition to common diseases such as cardiovascular disease, diabetes and various cancers.

“(It’s not) looking for a specific change in a gene that puts you at risk of a specific disease. It’s risk categorization. So, do you have an elevated risk for something like Alzheimer’s or diabetes or colon cancer or breast cancer? Not ‘Do you have the BRCA (Breast Cancer Susceptibility) gene, the specific gene that puts you at risk for breast cancer?’ But ‘Do you have a compilation of genes that puts you in a higher risk category?’”

OSF HealthCare has been offering polygenic testing at five OSF Medical Group locations including Peoria, Galesburg, Kewanee, and Pontiac. The test carries an out-of-pocket cost of $275 because it is currently not covered by insurance. But, for some people it’s worth the cost to have the knowledge or peace of mind that comes with knowing if they’re at high risk for common cancers and diseases such as coronary artery, atrial fibrillation, and stroke.

Dr. Rinker has a family history of prostate cancer and fully expected he would turn up at high risk for that. However, his results showed Dr. Rinker at high risk for Alzheimer’s disease. There’s no cure but he says good diet, exercise and – importantly – getting enough sleep can help with prevention.

“That’s definitely something I’ve been trying to maximize or improve, not only from an Alzheimer’s perspective. But, you know, you’ll find a lot of these things in the human body all interact with something else, and you’re not just getting one improvement and one small outcome that you’re looking at. Well, that might be what the impetus for change is (but) it’s going to have a whole trickle-down effect on a whole host of other health issues or prevent a whole number of other health issues.”

Who is a good candidate?

The target group of individuals to get polygenic testing is between 20 and 65 because that’s when added screening and any lifestyle changes can have an impact. Dr. Rinker is excited about the potential to prevent disease among those who are at high risk.

“The more that we can find or identify a disease early the more we can either prevent the disease or get upstream of the illness occurring; always leads to better outcomes.”

Dr. Meeker explains that polygenic tests expand the analysis beyond family history and genetic testing to broader examination of the human genome.

“If you use a questionnaire, for example, a family history and stuff to screen for certain cancers, if you add polygenic risk scores to that, you can increase the pool of high-risk people by two- or three-fold, because it catches more people than these preliminary screening tools just don’t catch.”

The eight-month pilot continues. Leaders will consider whether to expand the testing across the OSF Ministry by considering the number of people taking advantage of it, along with feedback from providers and patients.

While PRSs can identify individuals at higher risk, they have limitations for complex conditions influenced by both genetic and environmental factors. But, Dr. Meeker believes in the future, polygenic risk scoring will influence individual screening recommendations.

“The hope is, as we learn more in this area and get this more highly refined, that we can really target our screening so we can screen fewer people to find the ones that are really at risk, without having to screen everybody and spending all that money and having all that exposure, you know, the potential false positives.”

Polygenic risk scores in the future could also help identify individuals who are most likely to benefit from specific treatments, improving the efficiency and effectiveness of clinical trials. And Dr. Meeker asserts, as research continues, more targeted, personalized approaches to care and prevention can improve overall health and wellness.

Currently polygenic testing is still in an early phase of the pilot, so it is available through five select OSF Medical Group providers in Peoria, Galesburg, Kewanee, Sheffield, and Pontiac. If you have questions, talk with your primary care provider or learn more at the National Human Genome Research Institute.

Top 10 health risks included in polygenic testing:

1.    Breast cancer

2.    Colon cancer

3.    Prostate cancer

4.    Ovarian cancer

5.    Coronary artery disease

6.    Atrial fibrillation

7.    Stroke

8.    Type 1 diabetes

9.    Type 2 diabetes

10.  Alzheimer’s disease

Dr. John Rinker

Dr. Mark Meeker

B-roll of polygenic testing

The Peoria, Illinois-based hospital system has brought surgical oncologist Tamara Floyd, MD, to the care team at OSF HealthCare Saint Francis Medical Center in Peoria. Dr. Floyd performs cytoreductive and HIPEC (hyperthermic intraperitoneal chemotherapy) surgeries in Peoria, while also seeing patients in Bloomington and Galesburg.

HIPEC procedures are mostly for patients who have tumors or cancer spread in the abdominal cavity. 

Cancerous tumors are removed through cytoreductive surgery where the surgeon initially attempts to remove as much of the cancer as possible. Surgery is then followed by HIPEC, which is when a heated chemotherapy – at just over 106 degrees Fahrenheit – is administered into the abdomen. The heated chemo is then circulated around the area inside the abdomen to treat any remaining microscopic tumor cells.

HIPEC can be beneficial for several types of cancer patients. The one it benefits the most is LAMN, or low-grade appendiceal mucinous neoplasm. HIPEC is considered a standard of care for patients who have seen their cancer spread into the space in the abdomen that contains the abdominal organs.

These can be appendix, colorectal, and now more data indicates stomach cancer patients may benefit from HIPEC, Dr. Floyd says.

"Additionally with more data, pancreatic cancer is being looked at as well. Even patients with breast cancer. Another cancer that benefits from HIPEC is peritoneal mesothelioma." 

HIPEC can be a viable treatment option at any stage, Dr. Floyd says. But as some people are diagnosed with later stage disease, it can feel like no options are possible. HIPEC changes that.

"It's beneficial to have the option of doing HIPEC, or cytoreductive surgeries, for patients who have peritoneal spread of disease, which for most cancers means it is a stage 4 disease," Dr. Floyd says. "In a lot of instances, if you're talking about stage 4 disease, there aren't a lot of other options."

While HIPEC is a viable option for low-grade cancers, it's also a helpful option for later stage, more aggressive cancers. Patients with signet ring or goblet cell features, which are more aggressive subtypes, can also be treated with HIPEC. 

"Signet ring is one of the subtypes of appendiceal, colon or rectal that can be treated. There are even some subtypes of gastric or stomach cancer that are considered a signet ring or have signet ring features," Dr. Floyd says. "Cytoreductive and HIPEC can be considered for those patients."

Throughout a cancer journey, combining traditional chemotherapy that is administered through IV with HIPEC provides a "synergistic effect" Dr. Floyd says. HIPEC allows the chemotherapy to be administered directly to the cancer cells and kill them that way. 

Dr. Floyd has done one HIPEC at OSF Saint Francis so far and has another planned soon. It's anticipated that within the next year, Dr. Floyd and her team will start to do three to four HIPEC surgeries a month as OSF HealthCare Cancer Institute continues to grow as a destination center.

Patient recovery times can be one to two weeks in the hospital after HIPEC surgery, which is why having this option for Central Illinois patients is so important. It allows the patient and their families to stay close to home, instead of having to travel hours away. Dr. Floyd says the longer travel times can turn patients and their families away from pursuing care. 

Heated chemotherapy can also be used in thoracic cavities. This would then be called HITEC or HITOC, Heated IntraThoracic Chemotherapy. This is for patients who have disease spreading in the pulmonary area. 

Types of cancers that can be treated by HIPEC: 

-          LAMN (Low-grade appendiceal mucinous neoplasm)

-          Appendiceal

-          Colon

-          Rectal

-          Gastric

-          Stomach

-          Pancreatic

-          Breast

-          Mesothelioma

-          Ovarian

For more information on cancer treatment options at OSF, visit the OSF HealthCare Cancer Institute website.

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As Saturday Night Live celebrates its 50^th anniversary, one thing it has been known for over the decades is the use of comedy to make a commentary on what’s happening in the world. Recently, 
it was a skit about how the only way to get a young man to an annual physical is to pretend it’s a podcast appearance.

OSF HealthCare primary care physician, Mfowethu Langeni, DO, said he heard about the skit and then watched it with appreciation.

“So hopefully this can help encourage people to change that mindset and change the framing and letting them know that we will see you even if you have no symptoms, no issues. Preventive health is equally as important as any other aspect of health care.”

Nearly 40% of Generation Z men (age 20-29) don’t have a primary care provider and millennial men (age 29-43) make up the second-highest number of men without regular primary care according to one study.

Using comedy to tell hard truths can be an effective tool so Dr. Langeni hopes the skit breaks through the perception of many young men – a feeling they are invincible and therefore don’t need medical attention unless they experience serious symptoms.

Research from the Centers for Disease Control and Prevention also reveals young men have a misperception they are healthier than they are.

“A good portion of men between the age of 18 and 35 are actually in probably fair to poor condition as far as health is concerned. So, I think the first thing we do when you walk in the door in a primary doctor's office, we check your weight, we check your vitals, and we check blood pressure. Those are some really quick things that we can get, but it can tell a lot of information.”

For example, Dr. Langeni says Type 2 diabetes and high blood pressure don’t always have prominent symptoms right away and without an annual exam, they can go undetected for years. That poses the risk of irreversible harm. During an initial primary care visit, Dr. Langeni says he’ll also go over family history because there are some diseases, including cancer, that can be genetically linked.

“And so, if your father or mother or grandmother, uncle had a condition, you could also be predisposed to that condition as well. So, we address these things, we talk about these things, and then we come up with shared decision making and figure out what to do next.”

Research also shows men are increasingly turning to social media platforms such as Instagram and Tik Tok for their health information, often relying on influencers. That’s not all bad, says Dr. Langeni, but he says having a primary care provider as a trusted source is a great way to verify information from social media.

“I promote people getting information, but the big thing is just then take the information and then ask, ‘Hey, what's true? What's not true, or if it is, is this right for me?’ If it's not right for me, because everyone is individually different, having a primary doctor really will help to cater to your individual plan.”

With OSF MyChart, you can also easily access your primary care provider with questions about a variety of concerns, including medications, supplements, or issues that might arise between appointments. If it requires a referral to a specialist, your primary care provider can make that happen. Dr. Langeni suggests thinking of a primary care provider as someone who is a care coordinator and your advocate.

National statistics reveal other health realities men might consider. For example, men die by suicide at twice the rate of women and 40.5% of men over 20 have obesity. A primary care provider can help with lifestyle changes and medication, if necessary, to address obesity. Some mental health challenges can be managed at the primary care level, but Dr. Langeni says having a professional you trust to discuss stress, anxiety, depression or other concerns is crucial. Then, he says, your provider can recommend whether seeing a behavioral health specialist might be the best approach.

Just as you take your car in for a regular oil change, Dr. Langeni strongly suggests regular health maintenance with a primary care provider. Putting it another way, he emphasizes, “primary care is preventive care” and that’s nothing to laugh at. 

Dr. Mfowethu Langeni

Related story

Are you treating your care better than your body?

Innovative Technologies at the Forefront

Leading-edge cancer treatments like proton beam therapy, brachytherapy, genetic counseling and dietetics are all offered within the OSF Cancer Institute, providing patients with a one-stop-shop during their cancer journey.  

Proton therapy

Proton therapy was first offered on April 1, 2024.

"Proton therapy lets us offer radiation therapy to patients that maybe wouldn't have been able to tolerate side effects due to tumor location, or factors such as prior radiation treatment to the same area," says Tom Cox, the vice president of operations at OSF Cancer Institute. " This is possible because protons stop after passing through a tumor, eliminating the radiation effects on tissue often treated incidentally to photon (X-ray) therapy. The OSF Cancer Institute is on track to have treated 180 patients by April 1, 2025 – which far exceeded the original first-year target of 130 patients.

Brachytherapy

The brachytherapy suite offers a more patient-friendly way for mostly prostate and gynecological (cervical, endometrial) cancer patients to receive treatment. This option involves placement of applicators or needles directly into tumors so that very controlled, effective radiation can be delivered in discrete volumes. Since the radiation is delivered from within the tumor, there is a dramatic reduction of the dose to normal tissue, even those near the tumor itself. The dose is delivered with high-dose rate techniques so the therapy is delivered in just a few minutes time.

"Being able to bring the introduction of the applicators into the body, the treatment planning CT and the treatment all in one room, has created a much better experience. We're having some really good outcomes there, and we think we can expand what we're able to do there,” Cox says.

Intuitive Ion robot 

The OSF Cancer Institute’s pulmonology team offers state-of-the-art diagnostic tools and treatments, including minimally invasive, robotic surgeries and robotic assistive bronchoscopy. This includes the Intuitive Ion Robot, which allows care teams to get early answers and advance care for lung cancer patients.

"We're going to leverage the ability of an ion robot in the interventional pulmonary lab to really upend how we do the front end of lung cancer care," Cox says. "That robot is going to enable us to biopsy smaller lesions. It has fewer side effects than when you're getting a lung biopsy that's CT-guided. You can also do a staged EBUS (endobronchial ultrasound) exam, so you can diagnosis and stage at the same time."

Rachael Davis, MD, a pulmonologist at OSF Cancer Institute, and her team have been using the ion robot weekly. Dr. Davis and her team are training more providers, and by this summer they’re expecting to quadruple – or more – how often it’s used. 

HIPEC procedures

Hyperthermic intraperitoneal chemotherapy (HIPEC) surgeries are now offered at the OSF Cancer Institute. Tamara Floyd, MD, a surgical oncologist with OSF performs the open surgery and removes tumors from the abdomen. In the HIPEC procedure, heated chemotherapy is circulated through the body for a period of time. The first case went extremely well, and Dr. Floyd is planning her second case for mid-March. 

In addition to treatment options, the OSF Cancer Institute is increasing cancer supportive services in the Peoria region as well.

• Cancer navigation - 13% increase (Specially trained OSF Mission Partners walking you through the process of cancer care) 
• Dietetics - 64% increase
• Palliative medicine - 213% increase (Helps control symptoms, augments treatment from physicians) 
• Genetic counseling - 20% increase

Nutrition journey during cancer

Part of the dietary benefits OSF Cancer Institute offers is in the CEFCU Teaching Kitchen. Oncology dietitians work with patients on recipes to cook and are there with them step-by-step during their cancer journeys. Cox says 50% of people who come in for cancer treatment have dietary risks, while 80% of those people suffer malnutrition during treatment. Having a trained, professional dietary team walking alongside you helps fight those negative complications.

OSF Cancer Institute Culture

Cox credits the Institute’s first-year success to the culture of those who work there. The goal, he says, is to offer cancer support services across the entire spectrum of life. 

"The Mission Partners that work in this building have completely bought in to the idea that we all are advocates for cancer patients. We're always asking patients what they need, to see if we can help them," Cox says. "If we hear there's an issue with travel, or they're having trouble keeping food down, or if their children are not coping very well (with a loved one's cancer diagnosis), we know there are resources in the building, and we try very hard to line up those resources. You can feel it when you walk through the building."

Support services after cancer treatment 

"We can get you with a nurse, an exercise specialist and a dietitian to get back to your best life after cancer. Maybe you like to run a lot and ran half marathons, and you think you'll never be able to do it again. We have rehab and exercise specialists here and nutritionists. Who says you can't do that again? We're going to work with you to see you can get to the life after cancer you want to get to,” Cox says.

Services and medical professionals continue to grow

Building off the first year of OSF Cancer Institute, the administrative team continues to hire world-class medical professionals to offer cancer care in Peoria. A breast surgeon was recently brought onto the team, and a colorectal surgeon will be starting soon.

Additionally, the fourth floor of the building will be built out soon. Cox says this will give much-needed space for the surgical oncology and medical research teams. Research-focused medical oncologists are currently being recruited as well.

Leaving OSF Cancer Institute healthier, and more aware

Patients who leave OSF Cancer Institute don't just leave the building as healthier people; their awareness continues and will benefit other people. Cox admits a cancer diagnosis is not an easy thing to go through, and that the support from the OSF care team doesn’t stop when you walk out the door.

Grateful for community support

Cox says he’s been humbled throughout the years of working in oncology by the incredible commitment of the community and region to the OSF Cancer Institute.

"It is overwhelming to me, the philanthropic spirit of our community and extended community," Cox says. "I take that as, they've made a big commitment to us, and we're making a big commitment back. We're going to bring things to central Illinois that have not been here before. We are going to support you and your family members throughout your life and keep you as healthy, relative to cancer, as we possibly can."

Looking to the future

Cox says the OSF Cancer Institute is looking to bring more pediatric cancer support services to the building, the work collaboratively alongside the adult services.

The team is creating both a lung lesion clinic and a lung multidisciplinary clinic, which aims to reduce the time from finding a cancerous lesion to treatment. The lesion clinic is expected to open in late spring.

The OSF Cancer Institute intake team has been created with oncology nurses who will answer patients’ questions on the very same day, to see if services are right for you.

Cox adds that OSF is planning to put together an early detection hotline as a resource for the community to know if or when they should be screened for cancer.

To learn more about the OSF HealthCare Cancer Institute, visit its website to view the services offered and find contact information to get connected.

Video Interview Clips

Mammography remains the gold-standard imaging tool for early detection of breast cancer but some women might need additional screening. That includes women who have dense breasts.

The FDA is now recommending any facility that offers mammograms must tell women if they have dense breasts that could put the at higher risk for breast cancer. The regulation will begin being enforced next year.

Illinois and Michigan are among 38 states in the country that already require imaging centers to disclose if women have dense breasts but rules vary on how much information they require in the notification. The new federal regulation will mandate that notification in all states and standardize what must be disclosed.

Jessica Guingrich, MD, is radiologist and medical director of OSF HealthCare Center for Breast Health in Peoria. She says for women with dense breasts, it can be more difficult to detect cancer with mammography, which relies on contrast to detect cancer. She says dense tissue, which is white, can mask changes in breasts such as a tumor.

“We’re trying to see white findings (tumors) so the denser tissues means there’s more whiteness in the background and it’s harder to see those white findings,” Dr. Guingrich explained.

Having dense breasts not only makes cancer detection more challenging, it can also increase cancer risk, particularly for the roughly 10% of women over 40 that fall into the category of very dense breasts. Dr. Guingrich says a woman can’t determine her own breast density through self-exams or through a clinical exam. Radiologists use national guidelines based on the amount of fibrous tissue within the breasts.

“The density actually has nothing to do with how they feel on physical exam or the breast size. It actually has to do with that appearance on the mammogram.”

Breast density can change over time so a women who earlier was considered for advanced imaging such as a breast ultrasound or MRI might not qualify another time if the density has changed. But, the goal of the notification is to promote a discussion with medical providers about whether advanced imaging is needed to detect cancer earlier and reduce the need for aggressive treatment.

So what are the best options for women who receive the notification? Dr. Guingrich says that will depend on a woman’s risk factors. She stresses having dense breasts is a minor risk factor compared to other considerations such as family history.

“Like if one has a first-degree relative or a pre-menopausal relative diagnosed with breast cancer or if they have a personal history of breast cancer, those women are at higher risk. If a lady is a gene carrier or if a lady has had chest wall radiation.”

The American Cancer Society says breast cancer is the most common cancer diagnosed among U.S. women and is the second leading cause of death from cancer among women after lung cancer. Insurance coverage for advanced breast imaging varies from state to state and the new FDA recommendations don’t address coverage so it’s best to check with your insurance provider.  

Here are the Center for Disease Control and Prevention’s answers to frequently asked questions about dense breasts and implications for additional screening beyond a mammogram.

Video clips-Dr. Jessica Guingrich,  radiologist & medical director, OSF HealthCare Center for Breast Health  

Mammogram B-roll