Joey Wahler (Host): It provides treatment for cancer patient's, so we're discussed. Oncology Care. Our guest is Dr. Jason Sue. He's an oncologist with Jefferson Healthcare. This is To Your Health, the podcast from Jefferson Healthcare. Thanks so much for joining us. I'm Joey Wahler. Hi there, doctor. Welcome. Great to have you board.

We appreciate the time. So first, in a nutshell, doc, what would you say initially drew you to both healthcare and specifically oncology?

Jason Suh, MD: Yeah, it's a long story. I grew up in South Korea, right? So when I was young, I could not find, my purpose of, my life. So I wandered around, the world for almost two years. Then I landed in New York where I had, training. during that time I fell in love with a cancer patient.

So that's why I became an oncologist.

Joey Wahler (Host): That's awesome. And so you're actually one of two new medical oncologists at Jefferson Healthcare. What drew you to Jefferson?

Jason Suh, MD: it's also a long story, but, I used to practice in Chicago for almost 20 years and I was looking for some. Place where, nature I really enjoy hiking, right? So where there are a lot of trees And that This is where it is, right? Originally I had the option of, working at the Fred Hutchinson, And also I was offered, some directorship at, MultiCare, which is a big practice and, Tacoma, but ultimately I decide to really enjoy the small town And serve the community.

That's why I came to here, port Townsend, it's a very small town. Hospital is a 25 bed And the population is 10,000. Yeah. So I, I really enjoy being here.

Joey Wahler (Host): I can tell. So that being said, what do you specialize in? What kinds of patient's do you normally see?

Jason Suh, MD: So I told you I had, seven years of training. So I had a training in hematology. I had a training in, oncology. Then I had a training in. Bone marrow transplantation, right? So I see both, kind of patient. One is a oncology patient means a cancer patient, right? The other one is a hematology patient, which has, mainly the blood problem, like anemia or, blood counts problem And the coagulation.

So. When I was young, I did, transplantation, but I don't do it anymore. So I'm just doing a hematology and oncology, rural, the general population care.

Joey Wahler (Host): Since you deal with both cancer and blood, can you discuss the importance of having blood tests regularly as we get older, especially for those that may be considered at higher risk for blood cancers?

Jason Suh, MD: Yes. Well, I see a lot of times, patient, never had the CV for five, 10 years. Right. Then all of a sudden, develop major problem like leukemia, then the blood counts gonna be completely, Abnormal. Right? So that's why generally speaking, at least once a year, I think it's better to do a blood test out.

There are a lot of, bladder problem as you get older. it's called the bone marrow disorder. Okay? Medical terms called myelo, dysplastic syndrome. These are coming on very slowly, so that's why it's a very important, to do C, B, C. This is a complete blood count, right? At least once a year.

Make sure all your blood counts are okay.

Joey Wahler (Host): Absolutely. And so when we talk about blood cancer doctor, what patient's are at higher risk?

Jason Suh, MD: well actually age is the highest risk, right? So if you look at the blood accounts problem, it's the most common. It is called the myelodysplastic syndrome, which is a bone marrow disorder. Your bone marrow is organ too, right? And it just, doesn't function well. So. Over ages 70, right?

There is, instances about 2% means, one out of a 50 general population has, low blood cancers because of the bone marrow problem called, myelodysplastic syndrome. So I see a lot of those cases here.

Joey Wahler (Host): And so what's typically done to address that?

Jason Suh, MD: Right. So mainly when you have anemia, we'll give a injection called the ate, And also there is a new injection called the, these are the injection that, we can improve the anemia. Then when you have a low white blood cell And the low platelet count, you end up giving, bone marrow or modifying drug, which is called uh, zaine.

so there are many different treatment. Also depend on your gene abnormalities. Sometimes we use a pill called, so there are a lot of different treatment.

Joey Wahler (Host): Gotcha. Now, obviously your cancer patient's doctor are often going through a very challenging time, to say the least. And I know you've said you try to treat your parents like they're part of your family. So what do you mean by that?

Jason Suh, MD: Well. as I told you, I was in New York, right? I was doing internal medicine training. Then, I really fell in love with the cancer patient, right? So. Whenever you face a mortality, right, you just become true yourself. Right? So I really enjoy guiding those patient's and, generally speaking, right?

Generally speaking, I really treat my patient like my friend, right? I really will try to guide them, help them, right? And also like my family, right? Really. There is really no other agenda that, I truly enjoy because, I think I'm, my job is a job that I can truly influence my patient And that truly improve their qualitative living.

there are a lot of, Oncologists, just don't pay attention at the end of the life care, and they just give a chemotherapy almost until the patient is dead. Right? So my practice, I really look at the patient individually like my friend, right? A lot of my patient's are really my friend, right?

I really try to decide that, any kind of chemotherapy when I give it to them. Can it really increase the quality of living? Right? This is most important because I have a lot of elderly population. This is retirement time, okay? 75% of our PPAR populations are the retiree. So there are a lot of 80, 85, 90, 90 3-year-old male.

These are really, really fragile people, right? So unless you can, you are convinced that you can really improve their quality of living means some. we have to make sure that, treatment side effect really does not affect them, right? So what is the point of you living longer when you cannot function well and to truly enjoy the life?

Right? So as soon as I decide that, whatever I do, I cannot really improve the quality of living. I tend to refer those patient's to the hospice because, the most important thing is that all of us are gonna die right when you die. what I try most is a decreased suffering.

Decreased suffering, right? There are some situations that I cannot cure the patient. Then, I really don't try to give them any kind of a treatment because if I give them some treatment, they gonna just, a little bit longer with a miserable condition. So. Whenever there's no possibility of a cure, especially with the older patient, right, it's better not to treat them And the concentrate on the hospice care, so their lifespan can be shorter And that they suffer less that way.

So This is my, This is where I put, most of my emphasis. So. Sometimes it's a very difficult decision. So I, do a lot of a difficult discussion with the patient, mainly 'cause, a lot of people just don't expect, that they're gonna eventually die. They pretend, uh, they're gonna live forever, right?

But there is no such a thing, you know, we all die at some point. So, as I said, When you die, you wanna suffer at least, right? That's, where I really guide the patient that really serve them as much as I can.

Joey Wahler (Host): That's very comforting for people to hear. So, switching gears just a little bit, Dr. Jefferson Healthcare, as you well know, recently opened its Castle View Wing, including a radiation-oncology clinic. So why is it so important that Jefferson now offers both radiation-oncology and medical oncology?

Jason Suh, MD: So what happened is, I know for all this time here, we didn't have a radiation facility, so patient has to travel almost, uh, two hours going back and forth to the either Dale or the swim, right? The problem with oncology care is that they're saying most of cancers you never cure them with a chemotherapy alone, And also you never cure them with a radiation treatment alone.

So like head And the cancer, lung cancer, blood cancer, what have you. Muscle of cancer, we do both. So when we give a chemotherapy, radiation become much more effective. That's how we cure the patient. So. Most of the, a lot of cancers we have to give both the chemotherapy And the radiation treatment.

So when we don't have a radiation facility. Right. That creates a lot of logistical issues, especially the, a lot of elderly people. Right. they don't drive well. Right. So that's why, you when I came here, they just opened the radiation treatment and I was so happy. That, it's very interesting.

Jefferson is a tiny, bitty hospital with a 25 bed, right? And actually, when I was working actually in, Olympia prior to this job, I saw so many delays in care because there is not enough services, right? And surprisingly, This is tiny town, but now we have almost all services, so there's no delay in care.

So that's, Extremely important thing. So, radiation treatment is just essential. You cannot do without it. Right? So now my patient, they see me in my office. Next building is radiation-oncology, right? So we coordinate, it's really easy And that they're getting the best care, by the way.

Joey Wahler (Host): That's great. So any new technology or other treatment innovations in oncology right now that you're most excited about?

Jason Suh, MD: Well, I'll, tell you this way, right. So, I became an oncologist, after seven years of training. I, became a board-certified oncologist in 1997, right? So that's, 28 years ago. At that time, I had only two or three chemo. That's it. Right? Nowadays, the last chemotherapy approved by FDA is more than 10 years away.

So we are completely done with the chemo. Chemotherapy. Regular chemotherapy causes a lot of side effects, right? It's just, there has been mind boggling amount of new information that we are learning from the cancer. So nowadays, we routinely analyze all the cancer cells, gene information, then. We target those mutations.

So This is a just, past three years, right? It became a routine practice. Now, This is a, literally mind boggling if you think about it, right? So in the university of, Washington Term did a human genome project, it took a $1 billion to analyze all human genome, right? Guess how much it costs now?

It is about, $1,700, $1 billion shrank to 70, and still the cost is going down continuously. So because of this technology improvement, we can do a gene test much easier, much cheaper. So nowadays, literally every cancer patient I do a complete the gene test on the cancer. So we can.

Treat them more, much better way. So a lot of times we are targeting the gene mutation that caused the cancer. That's the most exciting area, And we do, better And the better now.

Joey Wahler (Host): Wow, that's, it's really something, isn't it?

Jason Suh, MD: Yes. if you think about it, right, I mean This is just, mind bargaining amount of, new information that we are constantly our. The understanding of the cancer cell, it's mind boggling how much we understand each individual cancer cells, the proliferation mechanism. So we attack all those proliferation signal. So if you look at most interesting areas, I told you we do origin test, right?

The next interesting, area is, really we call it, The chemotherapy antibody conjugate. So there are a lot of cancers, produce, some antigen, right? We develop the antibody to those antigen, right? Then we push chemo to the cancer cell only without ever damaging the regular cells. So it's called the drug antibody conjugate.

Now there are lots of 'em. And This is a major area that, regular chemo, you can literally never take more than six months because it affects all of your body and there are a lot of side effects, right? I have a patient who is on, uh, drug antibiotic more than one and a half years no problem because, this chemotherapy.

Is just pushed into the cancer cell only using by the link between cancer cells, antigen expression. We develop antibody to it and they just push the chemo to the cancer cell only. So it's a mind boggling technology if you think of it. And the first drug conjugate became available almost like, seven to eight years Now this area is exploding.

Exploding because, you are really looking at the treatment that it's so easy to the patient, we don't need to damage their body as, side effects, right? Because, chemo are go into the cancer cell only not the rest of the body. Right. So This is a major area of improvement And then we continuously now new medications coming out as we understand more it's cancer cells, we develop antibody.

Then, we link those antibody to the chemotherapy And the push chemo into the molecular level cells. Yeah, so that's the most exciting area.

Joey Wahler (Host): It certainly sounds like, and it seems like in so many different branches of medicine nowadays, that preciseness that you're talking about becomes the key ingredient. Well, folks we trust you are now more familiar with oncology Can. Dr. So keep up all your great work. A pleasure. Thanks so much again.

Absolutely. And for more information, please visit jefferson healthcare.org. If you found this podcast helpful, please do share it on your social media. Thanks so much again for being part of To Your Health. The podcast from Jefferson Healthcare.