Healthy Tips – September/October 2018


Topics This Issue:

Breast Cancer: What’s the Risk?

Breast cancer remains the second-deadliest cancer in women (after lung cancer). It is important to know your personal risk factors, so you can reduce your risk through lifestyle changes and receive a breast-cancer screening that is tailored to you.

Learn Your Risk Factors

How often should you have a screening? What should your prevention strategy be? It all depends on your personal risk factors. Talk with your primary care provider about your situation.

Being female and getting older are your biggest risk factors. You are at higher risk if there’s a history of breast cancer in your family or if you have a BRCA1 or BRCA2 genetic mutation. But keep in mind: approximately 85 percent of breast cancers occur in women who have no family history of breast cancer. Other risk factors include starting periods at a young age, having your first baby after the age of 30 or never having children, being obese, and having dense breasts.

Make Lifestyle Changes

You can take positive steps to reduce your risk for many cancers. Some areas to explore: Are you getting enough exercise? Are you at a good weight? Do you smoke? Finally, how healthy is your diet? Are you eating more vegetables, fruits, beans and whole grains? How much your red meat, sugar and alcohol do you consume?

Your health care team can help you with all these lifestyle factors. For dietary inspiration, explore the recipes and ideas offered by the American Institute for Cancer Research.

Get Screened

Despite the value of knowing your risks, many breast-cancer cases develop without obvious risk factors. This is why age-appropriate breast-cancer screenings are essential for all women. The best approach to breast cancer detection is regular mammograms.

  • Mammograms should be performed every 1-2 years beginning at age 40, based upon discussion with your health care provider.
  • If you’re over age 75, the benefits of mammograms are less certain.
  • Knowing how your breasts normally look and feel can help you be aware of changes, which you can share with your provider.

Not Sure Where to Start? Ask the Right Questions

Here are some questions to ask your primary care provider at your next visit:

  • What testing should I get at my age?
  • What do I need to know about my family history that could put me at higher risk for breast cancer?
  • What can I do to prevent breast cancer or decrease my risk?

PacMed offers several options for primary care providers, an excellent place to begin a conversation about breast cancer prevention. Learn about our Primary Care team. We also invite you to explore our Women’s Health offerings and our Oncology department.

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Breast Cancer in Men

Yes, it’s much rarer for a man to get breast cancer. For US men, there’s a lifetime risk of about 1 in 1,000. Breast cancer in men is often diagnosed at a later stage. One reason for this may be that men are less likely than women to recognize or report symptoms to their doctor.

The Susan G. Komen Foundation offers these warning signs for men:

  • Lump, hard knot or thickening in the breast, chest or underarm area
  • Change in the size or shape of the breast
  • Puckering, dimpling or redness
  • Itchy, scaly sore or rash on the nipple
  • Inverted nipple or pulling in of other parts of the breast

If you have any concerns, contact your health care provider for a consultation.

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All About Flu Shots—Get Yours Soon!

Here comes flu season! Autumn is the best time to get your flu shot if you haven’t already. It takes about two weeks for the flu vaccine to give you protection. Make sure you understand what the flu is and how the flu vaccine works.

What is the flu?

The flu, also known as influenza, is an acute respiratory illness caused by influenza A or B viruses. These are found worldwide and are spread through sneezing and coughing. Typically, it takes one to four days from the time of exposure to the viruses to the onset of illness.

Symptoms include a fever higher than 100⁰ F, headache, muscle aches and weakness. Usually, flu symptoms come on abruptly. By comparison, with a cold you can often feel the symptoms coming on before you start feeling really lousy.

How does the flu vaccine work?

The flu vaccine introduces inactivated strains of the flu virus, which prompts your body to make antibodies to fight it. This means that when you are exposed to the live flu virus, your immune system recognizes it as an invader and goes to work on eliminating it from your body.

Who should get the flu vaccine?

Everyone older than 6 months should get the flu shot, especially those who have chronic illnesses like asthma, COPD, diabetes, heart disease or weakened immune systems.

Some people, however, should not get the flu vaccine. If you have any severe allergies to any part of the vaccine or have a history of Guillain-Barré syndrome, speak with your primary care provider before getting the shot.

Can I catch the flu from the flu vaccine?

The flu shot does not contain any live flu virus, so it cannot cause the flu. Some people do get a sore arm or redness where they got the shot. Sometimes, low-grade fever, headache or muscle aches can occur for a day or two.

Also, it takes about two weeks for the flu vaccine to give you protection. So, if you were exposed to the flu right before you got the vaccine, you may still get sick.

Learn about PacMed Flu Clinics in your area. Looking for a primary care provider? The PacMed primary care team offers a wide range of options, from pediatricians to family medicine and internal medicine providers

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PacMed Flu Shot Clinics

Our drop-in clinic for flu shots is the quick and easy way to get you and your family vaccinated. PacMed will bill your insurance company, or you can pay cash.

>>>>> Visit our Flu Clinic page to learn times, locations and other details. <<<<<

The flu shot helps protect you, your family and your community from getting the flu. It’s the smart thing to do! For more information, please call PacMed’s flu line at 206.621.4015

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Flu Prevention with Handwashing

We have all watched someone quickly rinse their hands in a restroom and rush out the door—or skip the sink altogether. Body fluids and viruses are invisible to the naked eye, but these germs are everywhere. They contaminate commonly touched surfaces like handles, doors, walls, counters and paper dispensers.

To help your family avoid the flu, there is no substitute for handwashing. Disposable hand wipes or gel sanitizers also work well, although they don’t remove dirt and grime.

Handwashing is one of the most effective ways to stop disease.

Wash your hands often: always before eating or preparing food, and always after using the bathroom or changing a diaper.

  1. Soap and water work well to kill germs. Rub your hands briskly.
  2. How long? At least 20 seconds—try humming “Happy Birthday” through twice.
  3. Most people miss the backs of the fingers and thumbs … fingertips … the creases in the palms.
  4. Use a paper towel to turn off faucets and to open the door.

With flu season here, give your hands the soapy wash they deserve. Take two minutes to safeguard your health—and wash your hands

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Nutrition for Cancer Prevention

By Kathleen Bradley, RD, CD, PacMed

Western countries have diets statistically high in fat, sugar and animal products—and also have high rates of colorectal, breast and prostate cancers, according to the National Institutes of Health. Being overweight also can increase the risk for several common cancers.

Fortunately, what you eat is one of the cancer risk factors you have the power to alter. Here are four dietary factors to prompt you to eat more healthily.

  1. Fiber and other cancer-fighting nutrients. Studies show that fiber may protect against cancer. Fiber is found in vegetables, fruits, whole grains and legumes. But the average US citizen consumes only half of the recommended 25-30 grams of fiber per day. To get more, aim to fill half your plate with fruits and vegetables, and make at least half your grains whole grains.
  2. Fat intake. Recent studies show that consuming too much fat affects cancer risks. The average US diet contains about 37 percent fat. The National Cancer Institute suggests lowering your intake to 30 percent—and other studies find that going well below 30 percent may have an anti-cancer effect. To make a change in fat intake, cut back on saturated fat sources like meats, processed snack foods and desserts. These foods have lots of calories from added sugars and solid fats, but few nutrients.
  3. Meat. Smoking, salting, adding nitrates and cooking at high temperatures can convert meats into cancer-causing compounds within the colon. Your best bet is to limit processed meats and instead eat a variety of fish, skinless poultry and lean cuts of pork and beef. Also consider eating plant-based sources of protein such as beans, nuts and soybeans more often.
  4. Alcohol. Excessive intake of alcohol raises one’s risks for cancers of the breast, mouth, pharynx and esophagus, as well as potential stomach, liver and colon cancers. Alcohol is considered more harmful when combined with smoking. The Academy of Nutrition and Dietetics recommends limiting alcoholic drinks—if consumed at all—to one serving daily for women and two for men. (A serving of alcohol is 1½ fluid ounces of hard liquor, 5 fluid ounces of wine or 12 fluid ounces of beer.)

Nutrition guidelines for cancer prevention are similar to those for preventing other diseases such as heart disease and diabetes. Work with your primary care provider or a dietitian to gage your overall dietary health or take this quick survey.

For more information about PacMed and our dietitian services, please visit our PacMed Dietitian page or call 206.505.1300

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Pomegranate Salsa with Salmon

This cancer-fighting recipe includes healthy fats, antioxidants and lots of flavor. Never had pomegranate molasses before? It’s a unique combination of sweet, sour and salty that can be used in other Mediterranean-style dishes like dips, salad dressings, cocktails and sauces.

Note: Prepare quick pickled onions and salsa 1 hour to 1 day in advance. This allows these condiments to get good flavor, and it makes dinner preparation go very quickly! If you’re short on time, use raw red onion in place of the quick pickled onions described below.


  • 1 lb. salmon filet
  • 1 lemon, thinly sliced

Quick pickled red onions:

  • 1 red onion
  • 2 cups very hot (but not boiling) water
  • ½ cup rice or white-wine vinegar
  • 1 cup cold water
  • 2-3 tablespoons white sugar
  • 5 peppercorns
  • ¼ teaspoon red pepper flakes
  • ¼ teaspoon salt

Pomegranate salsa

  • 1 cup pomegranate arils (seeds), fresh or frozen
  • ½ apple, finely chopped
  • 1 tablespoon pickled red onion (see below), chopped
  • 2 teaspoons jalapeno pepper, finely chopped
  • 2 teaspoons pomegranate molasses* or 2 tablespoon pomegranate juice
  • ¼ teaspoon salt
  • Freshly ground black pepper
  • ¼ cup chopped cilantro


  1. Prepare quick pickled onions 1 hour (or up to a few days) in advance. Cut onion in half, remove peel and slice into very thin half-moons. Place in a bowl, add hot water and let sit 1 minute. Drain onions. Add vinegar, cold water, sugar, peppercorns, pepper flakes and salt, and stir to dissolve sugar. Cover and chill for at least one hour.
  2. Preheat oven to 350 degrees F.
  3. Prepare salsa. In medium bowl, use fork to combine pomegranate arils, apple, onion, jalapeno, pomegranate molasses and 3-4 grinds pepper. Mix in cilantro. Let salsa sit for 10 minutes so flavors can meld. Here’s the easy way to remove pomegranate arils.
  4. Place salmon on a baking sheet and top with lemon slices. Bake fish for 10-15 minutes, depending on the filet’s thickness, until internal temperature reaches at least 145 degrees F.
  5. Serve salmon with salsa and pickled onions.

Salsa keeps for 2 days, tightly covered in refrigerator. It also goes well with chicken, turkey, pork chops or grilled shrimp. Sprinkle over green salad, combine with cooked quinoa or add a spoonful to garnish a bowl of butternut squash soup.

*You can buy pomegranate molasses online or in specialty stores like Whole Foods or PCC Markets.

Recipe adapted from the American Institute for Cancer Research; Dec. 30, 2014, Issue 537.

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From the Living Well Alliance—Don’t Let Autumn Stall You! Keep Moving at Work

Autumn exercise can seem like such a challenge because of the cooler weather and darkness outside. Children are heading back to school. Our schedules feel busier. And yet, physical activity helps not only the body, but also the mind. When we are active, we are better able to focus and be productive at work. We also feel happier and less stressed, and we tend to get more quality sleep at night.

So how can you stay active this fall? Try these tips for moving more at work.

Minimize the time you spend sitting. The average time sitting at work is 6.2 hours. Researchers say these long hours of sitting correlate to greater risk for heart disease and diabetes. And unfortunately you can’t undo these periods of sitting with one longer workout after work. So, it’s important to interrupt long periods of sitting with consistent movement.

Get up and move. To keep your muscles, joints and mind’s productivity at their best, sit for no more than 30 minutes at a time. Take a two-minute moving break at least twice an hour to stretch or walk around. Stand up, move about, try some stretches. Try these resources on Stretches and Walking Your Way to Health.

Find exercise you like to do! Whatever you choose, you have to enjoy it to keep up a routine. For example, if you hate squats, use the same muscles by taking a walk up a slight hill instead. Don’t want to get out your biking gear? Maybe a jump rope would be quicker and easier workout for you.

Get a friend or colleague to join you. Peer pressure isn’t always bad, especially around exercise. Have a friend join you on a morning walk for a chance to catch up on each other’s lives.

Work different muscles throughout the day. We often forget about our upper body (think T-Rex arms), so try some of these exercises using a resistance band. These bands are easy to store at work and are affordable.

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