In an interview with Targeted Oncology, Zangmeister Cancer Center Medical Oncologist Jorge A. Rios, MD, discusses recent advances in non-small cell lung cancer and the role targeted and immune checkpoint inhibitor therapy has played in this progress. Read the article.
On Aug. 21, 2021, leaders in hematology and hematology malignancies will gather in Indianapolis for what has become one of the most comprehensive educational hematology conferences in the country – the 18th Annual Indy Hematology Review. I’m honored to be chair of this year’s event, which is hosted by Indy Hematology Education, Inc. and delivers to attendees a concise and practical summary of the American Society of Hematology annual meeting, including the most current hematology research and clinical practice.
It was almost two decades ago when a group of hematologists recognized a need to promote education in hematologic disorders and malignancies in the Indianapolis area. We (I was honored to be part of this group) determined that successfully meeting the needs of our community required convening a faculty that was second-to-none – regardless of where in the world they may be based. But we also wanted to ensure those experts were able to share their knowledge in an environment that made it easy for the practitioners who would most benefit from that education to integrate it into their own clinical practice.
This ultimately led to the creation of the Indy Hematology Review, where attendees hear from speakers hailing from the top universities, cancer centers and research organizations in the world, live and in-person. And, because attendance is kept relatively small compared to other meetings of this type, those physicians, nurses, and other practitioners also have the rare opportunity to interact one-on-one with these internationally renowned experts, asking questions, sharing experiences, and gaining practical tips for putting the latest research findings and clinical tools into practice.
In addition to the main Symposium, with programming for physicians, the Indy Hematology Review features a second tandem symposium for nurses and allied providers. There is even a town hall and reception at which patients can share their own case stories and ask questions of a diverse panel of experts.
The Review also offers Continuing Education – up to 8.75 Medical Knowledge Maintenance of Certification (MOC) points in the American Board of Internal Medicine’s MOC program and up to 10 Continuing Nursing Education contact hours by the American Nurses Credentialing Center’s Commission on Accreditation. Pharmacists can also earn up to 10 contact hours from the Accreditation Council for Pharmacy Education.
Among the key highlights of the 2021 Review, which features both in-person and virtual programming options, are “State of the Art: 2021 Emerging Therapies in Hematologic Malignancies,” which provides summary of all the major updates in the field, and live case reviews during the Town Hall wrap up event.
The Review will also feature “An Evening with the Experts,” an opportunity for patients, their families, friends, and caregivers to hear from nationally esteemed physicians about new scientific knowledge and advances. Among the topics to be presented are emerging therapies for blood diseases, cancers and lymphomas, stem cell transplantation and CAR therapy, surviving cancer with art therapy, emerging therapies for lymphomas, and an overview of treatments and current research in leukemia, myeloproliferative disorders, lymphoma, Waldenström’s macroglobulinemia, and myeloma. You can access more information and register here.
More information on the 18th Annual Indy Hematology Review, including the agenda, speakers and registration, can be found here.
On August 1, Messino Cancer Centers (MCC) and American Oncology Network (AON) join the Lung Cancer Foundation of America for World Lung Cancer Day, celebrating the researchers, clinicians, and patient advocates who exemplify what “Living with Lung Cancer” looks like. We’re also raising awareness of the need for ongoing and expanded lung cancer research to continue building upon the advances that have given greater hope to patients who receive this devastating diagnosis.
Lung cancer is the third most common cancer in the U.S. It also claims more lives – both men and women – than any other type of cancer. Yet there is room for optimism, thanks to the significant advances in early diagnosis and treatment.
It was not that long ago when chemotherapy was the only real option when it came to treating metastatic lung cancer. Now, we have a broader selection of treatment tools at our disposal, which has helped improve life expectancy for non-small cell lung cancer and small cell lung cancer.
At MCC, my practice centers around systemic therapy, where medications are given intravenously or orally and disseminate throughout the body to target cancer wherever it lurks. While chemotherapy – which attacks rapidly dividing cells – is still used in frontline treatment, we now have additional types of treatment including targeted therapy and immunotherapy.
With targeted therapies, we leverage the knowledge that certain types of lung cancer can have specific gene mutations, so-called driver mutations, that create hyper-activated protein products. As their name implies, these mutations drive the formation, growth, and dissemination of these cancers. Targeted therapies are designed to inhibit the production of these driver mutations. Doing so creates a catastrophic response that kills the cancer cells and shrinks the tumor.
Immunotherapies are another advancement that have completely reshaped how oncologists treat lung cancer. The idea of immunotherapy is decades-old, the premise being that our immune systems recognize cancers as foreign, but cancer cells evade attack by immune cells. Early attempts at overcoming so-called immune evasion involved deploying high dose cytokines to hyperactivate immune cells, but these are fairly toxic and have a very narrow scope of activity.
More recently, the molecular mechanisms of so-called checkpoints between tumor cells and immune cells that mediate immune evasion have been delineated by immunologists. This has directly led to the development of antibodies that block these checkpoints, allowing a patient’s immune system to bypass these checkpoints and proceed to attack and kill the cancer cells. Immunotherapies are now ubiquitously deployed in metastatic lung cancer with or without chemotherapy and tend to be more durable and less toxic than chemotherapy.
When it comes to lung cancer therapies, MCC plays an active role in their advancement by participating in clinical trials to uncover the next cutting-edge treatment. In addition to an affiliation with the Southeast Clinical Oncology Research (SCOR) Consortium, our partnership with AON paved the way for us to become a strategic research site for Sarah Cannon Research Institute. These relationships help us bring clinical trial opportunities to more of our patients than would otherwise be possible as an independent community-based practice.
For example, researchers are looking at combining standard of care immunotherapies with a new investigational drug that could potentially boost their effectiveness. Participating in these kinds of clinical trials help evaluate effectiveness of drugs or treatment routines – and give our patients the opportunity to participate in approved and exploratory therapies without need for travel to an academic center.
It’s also important to point out that, in addition to novel therapies, palliative care is now established as fundamental to frontline care of lung cancer patients. The so-called Temel study – published in the New England Journal of Medicine in 2010 – found that early palliative care not only led to significant improvements in both quality of life and mood among patients with metastatic non-small-cell lung cancer, but actually prolonged survival compared to usual care. Early palliative care is now a standard of care in non-small cell lung cancer and a motivation for MCC’s recent addition of Dr. Joshua Baru, a consummate palliative physician, to our clinical team.
There is no question that, when it comes to the diagnosis and treatment of lung cancer, research has allowed us to move the needle on both survival and quality of life. A cure has yet to be found, but the dedication of oncologists, clinical researchers, patient advocates and patients themselves has resulted in life-altering advancements that mean a lung cancer diagnosis comes with a level of hope that exceeds what we’ve seen in the past.
June is Men’s Health Month and the perfect time for a refresher on some things men can do to improve their overall health and wellness, reduce their cancer risks, and improve the odds of catching some cancers in their earliest stages.
One of the most important steps is also the easiest: see your doctor.
Annual physicals are essential to leading a healthy lifestyle. They ensure that appropriate health screenings are conducted and preventive vaccinations including the flu, shingles, HPV, and most likely COVID-19 are given. The physical is an ideal opportunity to identify potential issues and discuss concerns the patient or physician may have. It is also a good time to review factors, including family history, which can impact risk for cancers and other diseases and can guide screening decisions.
This year’s annual exam is especially important for those who put off seeing their physician during the pandemic – care delays that have driven an uptick in later-stage cancer diagnoses due to missed screenings and, in some cases, preventable advancement of the disease from delayed treatment.
One of these is colorectal cancer, which has seen a troublesome uptick among younger adults and is now the leading cause of cancer deaths in men ages 20-49. The alarming trend prompted the US Preventive Services Task Force (USPSTF) in May to change its stance and recommend screenings begin at age 45 and continue through at least age 75. Colonoscopy remains the preferred screening for colorectal cancers, particularly as any polyps that are found can be immediately removed and sent for testing. However, lab tests and other less invasive options are also available – but are likely to be followed by a colonoscopy in the case of abnormal results.
Prostate cancer is the second leading cause of cancer death (behind lung cancer) and the second most common cancer (behind skin cancer) in men. To promote early identification of prostate issues, the USPSTF recommends that men between the age of 55 and 69 decide about prostate-specific-antigen (PSA) testing in consultation with their physician. It also recommends against PSA testing in men aged 70 and over. Those who are at a higher risk of prostate cancer, including African-American men and men whose father or brother had the disease, should speak with their doctors about earlier screenings—in some cases by age 45. Currently, Medicare and many private insurance plans provide coverage for an annual PSA test for all Medicare-eligible men aged 50 and older.
Though uncommon, breast cancer should not be overlooked as about 1 in every 100 cases occurs in a man. The risk goes up for those with a family history or inherited mutations in certain genes such as BRCA1 and BRCA2. Age, a history of radiation or hormone therapy, liver disease, and conditions that affect the testicles (e.g., injury to, swelling in or surgical removal) can all increase the risk of breast cancer, as can being overweight or obese.
Screenings and annual exams are important steps, but there are other steps men can take to improve their overall health and reduce their cancer risks. Maintaining a healthy weight through proper nutrition and exercise is a big one, as are limiting alcohol, getting plenty of rest and other steps that strengthen the immune system.
But all these actions pale in comparison to the impact of quitting smoking.
Smoking is the leading cause of premature, preventable death, causing about 480,000 premature deaths each year in the U.S. It harms nearly every bodily organ and organ system and is associated with innumerable malignancies – cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia.
Smoking also causes heart disease, stroke, aortic aneurysm, chronic obstructive pulmonary disease (COPD), diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, and cataracts, and worsens asthma symptoms in adults. And smokers are at higher risk for pneumonia, tuberculosis, and other airway infections. It also causes inflammation and impairs immune function.
Simply put, the message every man should take from Men’s Health Month is to carve out just an hour each year to have that annual physical. For smokers, the primary message is equally concise: quit.
Both actions can, quite literally, save a life.
Clinical trials are essential to advancements in treating — and ultimately eradicating — cancer. And patient participation is key to ensuring their efficacy and accuracy.
However, patients aren’t as willing to enroll in trials as they have been in the past. One study conducted in 2020 found that 49% of respondents were willing to participate in trials, which was down from 85% in 2019. One reason could be patient education; that same study showed 36% of those polled didn’t understand clinical research very well or at all. That number was at 10% in 2019.
The best way to make patients feel more comfortable enrolling in trials is participation by community oncology practices, which allows them to take part in trials close to home and alongside nurses and physicians who they already know and trust.
About 90% of cancer patients are treated at community practices — yet most clinical trials are performed at academic institutions, where they can be accessed by only about 10% of patients. This not only limits the number of patients who can enroll, but it puts the additional burden of travel on those who do participate, especially those who live in rural areas.
By administering trials at community oncology practices such as those that comprise the American Oncology Network (AON), pharmaceutical companies can provide patients with access to cutting-edge and innovative therapies and medications in the comfort and familiarity of their local clinic.
This benefits scientists and oncologists too, as they can get a clearer picture of the efficacy of a certain medication or therapy when a large number of patients enrolls in a trial.
Before enrolling in a clinical trial, patients are put through a rigorous screening process to make sure it is safe for them to participate.
Once patients are cleared, scientists, oncologists and nurses outline the process, explaining why the design of a certain drug fits their particular case and how it may aid in their treatment. If a patient has any concerns — for example, many fear they will be placed in a placebo group — it is covered in that discussion.
Once those conversations take place and their fears fully addressed, patients are typically very willing and engaged in the trials — especially when they realize that their participation can help millions of others who are also fighting cancer.
Some local clinics may not have the manpower, time or resources necessary to participate in clinical trials, especially clinics located in rural areas. Partnering with a network such as AON can alleviate those issues.
Whether it’s financial support or assistance recruiting the necessary personnel, AON can help lay the groundwork for a community practice to start administering trials. The network can also assist with laboratory or tech support and the implementation of any hardware or software.
Clinical research is another way community oncology practices can take better care of their patients while contributing to the body of scientific knowledge. Through these trials, oncologists can continue to learn new and innovative ways to treat cancer and provide more optimistic and successful outcomes for their patients.
World Ovarian Cancer Day takes place May 8 — just before Mother’s Day — and marks the start of National Women’s Health Week (May 9 – 15). This confluence of events makes this an excellent time to shine a light on the symptoms of gynecological cancers and the preventative measures women can take to lessen their risk.
There aren’t many options when it comes to gynecological screenings. That is one reason why knowing the warning signs and keeping up with annual examinations is so important.
Endometrial cancer, which starts in the inner lining of the uterus, is one of the most common gynecological cancers. According to the American Cancer Society, more than 66,000 cases of endometrial cancer will be diagnosed in 2021 and nearly 13,000 women are projected to die from it. The good thing about endometrial and cervical cancers is they are often easy to identify because they present very specific symptoms such as abnormal vaginal bleeding or discharge.
Ovarian cancer, which ranks fifth in cancer deaths among women, is far more challenging to diagnose because its symptoms including bloating, diarrhea and weight gain can all be attributed to less serious conditions. Consequently, ovarian cancer is often diagnosed when it is already in an advanced — and sometimes untreatable — stage.
Vulvar cancer is exceedingly rare, accounting for less than 1% of cancers in women. However, the American Cancer Society projects more than 1,500 women will die from vulvar cancer in 2021. Symptoms of vulvar cancer include the presence of unusual moles, itching and irritation. Women, especially those 60 years or older, should see their physician if they are experiencing any of these symptoms.
The healthcare industry has made great strides in understanding the genetic components of many cancers — gynecological cancers included.
Genetic predispositions can be traced to 25% of ovarian, Fallopian tube and primary peritoneal cancers. This allows women in the high-risk category to be screened earlier with the cancer antigen 125 (CA 125) blood test. In some cases, risk-reducing surgeries can be performed.
However, while they are the best option right now for diagnosing these cancers, data has shown that these tests aren’t always effective. Because there aren’t many options in regards to screenings for these cancers, it is important that women remain proactive about their annual check-ups, including a full examination of the uterus and ovaries — especially since malignancies in these areas may go undetected during a Pap smear.
Being proactive means living a healthy lifestyle as well. Obesity can be traced back to conditions such as endometrial cancer, so eating right and getting plenty of exercise can help reduce the risk of a diagnosis. When it comes to staving off cervical cancer, physicians highly recommend the HPV vaccine that prevents the human papilloma virus — the primary cause of cervical cancer.
We are always looking at new and enhanced ways to prevent and ultimately eradicate cancer – a quest that has led to the development of medications such as PARP (poly adenosine diphosphate-ribose polymerase) inhibitors, a targeted therapy that can be taken orally and prevents cancer cells from repairing themselves. Without patient participation in clinical trials, however, advanced treatments such as PARP wouldn’t be possible, which is why patients are encouraged to participate in these trials whenever and wherever they can.
Clinical trials allow patients access to innovative and cutting-edge treatment methods while also helping the healthcare industry move forward in its quest to better treat — and ultimately eradicate — cancer.
Similar to the other community-based practices in the American Oncology Network (AON), Cancer & Blood Specialists of Arizona offers comprehensive whole-person care.
Our nurses and multidisciplinary oncologists accompany patients on every step of their journey, from initial diagnosis through chemotherapy and, if needed, surgical procedures. We also provide cancer surveillance and survivorship programs to help guard against a recurrence.
Because our patients receive treatments and follow-up in one nearby, convenient location, they are able to form trusting relationships with our nurses, physicians and staff — the greatest benefit to working with a community oncology clinic.
Cancer is one of the most challenging and scariest experiences a person can endure. Doing so in a safe and comfortable environment, however, can go a long way toward lessening some of the emotional and physical burden.
Nurses Week takes place May 6 – May 12 and spotlights the millions of nurses across the country who devote their lives to helping others in their time of physical, emotional and spiritual need.
Nurses play an essential role in oncology care, especially throughout the community-based clinics that make up American Oncology Network (AON). They forge meaningful, trusting relationships with our patients — as well as with their families and caregivers — and provide comfort and hope to those battling through some of the most difficult and scariest times of their lives.
While the role of an oncology nurse has expanded and changed over the years, one thing remains constant: the complete commitment and compassion they have for each patient they help treat.
Oncology nurses pride themselves on providing whole-person care, which encompasses nurturing the patient’s spiritual and emotional well-being while also addressing their physical needs. This begins at a patient’s very first visit to one of our practices, where they have a thorough meeting with a nurse practitioner to go over their course of care. When the patient undergoes their first chemotherapy infusion — which can be a frightening and overwhelming experience — the nurse remains by their side to guide them through it.
Unlike those at a hospital, nurses who work at community oncology clinics see the same patients several times a week, giving them a chance to earn their trust and tailor their treatment. For example, if a nurse notices one of their patients isn’t feeling particularly well, they can confer with the physician about IV hydration or perhaps delaying the patient’s treatment until they are feeling better. Most nurses get to know their patients so well that they can tell how they’re feeling just by looking at them.
Along with providing care and support, oncology nurses assess a patient’s health and, in consultation with the physician, decide which members of a multidisciplinary team should be involved with their care. To succeed in this expanded role, nurses must listen to their patients, earn their trust and provide them with the tools needed to get the most success out of their treatment.
More than 500,000 experienced registered nurses are set to retire by 2022, and the U.S. Bureau of Labor Statistics projects that an addition of 1.1 million nurses will be needed to help avoid a shortage.
While the impact of a nursing shortage will cause ripples throughout the healthcare industry, it will have a greater affect on oncology. Because our nurses deal with patients who are being treated for a potentially terminal illness, many young nurses and nursing students mistakenly believe that working each day at an oncology practice is a sad and arduous task.
This is a misconception that needs to be addressed. The truth is, because our patients rely so heavily on a nurse’s care and compassion, working as an oncology nurse is an extremely rewarding career, and the relationships nurses build with patients can last long after treatment is completed.
To help attract more nurses to oncology, many of our nursing society groups offer scholarships to nursing students with an interest in cancer care. AON practices are also very involved with their local oncology nursing societies, many of which offer free memberships to nursing students. Nurses from our clinics visit local colleges and nursing schools and meet with nursing students so they can get an entry-level view of life as an oncology nurse.
Oncology nurses who work in practices that partner with AON benefit from working with a national network.
AON offers several different opportunities for nurses to advance their careers while working directly with patients. We also provide financial assistance for nurses who choose to further their degree and also pay membership and certification fees to help nurses become certified in oncology. AON also pays membership fees for oncology nursing societies, giving our nurses the opportunity to exchange ideas and share new approaches to patient care.
At AON, our nurses take great pride in what they do and understand the role they play in providing compassionate care and support to those who need it the most. They are essential to our ability to deliver high-quality oncology care to patients right in their own community.
By Jenny Li, Clinical Oncology Pharmacist, and Camilo Rodriguez, Director of Pharmacy Operations, American Oncology Network
At American Oncology Network (AON), we take pride in providing high-quality care to cancer patients right in their own community. As an extension of that care, we offer specialty infusions throughout our clinics across the country.
Specialty infusions are not associated with a cancer diagnosis and are often used to treat a wide range of illnesses including asthma, genetic and skin disorders, rheumatoid diseases such as arthritis, and Crohn’s disease and other gastrointestinal problems.
Receiving these infusions at one of our practices will make for a convenient, cost-effective experience for oncology and non-oncology patients while they’re being treated by nurses and physicians based right in their own community.
Because the infrastructure is already in place, there are many benefits to receiving specialty infusions at our practices as opposed to a hospital or other outpatient setting.
One important distinction is that the biologic drugs that make up specialty infusions are often similar in nature to the oncology medications we prescribe and administer at AON. Consequently, our staff is already familiar with the procurement processes for these drugs, as well as the pertinent administration preparations.
Furthermore, if a patient receiving a specialty infusion starts experiencing side effects—especially when they mirror those that accompany oncology medications—our staff has the expertise and equipment to begin immediate treatment. And by receiving these treatments in a community setting, patients won’t be hit with the extra facility fees they would have to pay at a hospital. This helps ease the financial burden and enrich a patient’s physical and mental health.
For oncology patients who also need treatment for non-oncology disorders, providing specialty infusions lets us serve as a one-stop shop where they can receive comprehensive care in one convenient, familiar location. Rather than going to an infusion center or hospital to receive treatment from staff they’re not familiar with, our patients will see the AON physicians and nurses with whom they’ve already built a trusting relationship.
Joining a national network such as AON offers a whole host of benefits for independent community-based oncology practices that wish to also provide specialty infusions to their patients.
AON has contracting power that gives our practices access to a wide formulary of non-oncology medications that may not be available to smaller private practices.
Some independent practices may not have the time or manpower to research and investigate the specifics regarding specialty infusions. AON manages all that with standardized education and training, as well as a reference library our clinicians can access at any time to learn more about a medication. That includes such important information as preparation instructions and monitoring parameters under the Food and Drug Administration’s Risk Evaluation and Mitigation Strategy (REMS) program. REMS is a drug safety program required by the FDA for certain drugs to help ensure the benefits outweigh the risks.
Ultimately, supporting our practice partners in offering specialty infusions is another way AON provides top-shelf service to our patients right in their own backyard—which is precisely what community-based care is all about.
At American Oncology Network (AON), we encourage our practices to adopt a patient-centric approach and deliver exceptional care with compassion and kindness. It’s a method of care delivery that supports the value-based care model, which has revolutionized healthcare by rewarding providers based on their delivery of the highest quality patient care.
One of our practices, Oncology Hematology Associates (OHA), located in Springfield, Missouri, has long embodied this approach by embracing patient-centered care. By placing its patients first, OHA continuously earns high patient satisfaction scores of 96.1% and above.
As part of our patient-centered approach, AON practices embrace the Whole-Person Care model, which is defined as taking care of a patient’s mental and spiritual health as well as treating them physically. At OHA, whole-person care permeates every aspect of care management, including financial burdens. Battling cancer is stressful enough without patients having to concern themselves with how they are going to pay for treatment. That’s why OHA helps its patients connect with local organizations that provide financial assistance ranging from utility bills and groceries to mortgage payments and even affordable housing. Alleviating a patient of some of their financial burdens can be a great boost to their physical and mental health.
The practice also offers nutritional assistance for patients who are undergoing chemotherapy and radiation treatments by recommending which foods to eat and which they should avoid when it comes to managing side effects. OHA also works with a local organization that supplies mental and spiritual support to those recently diagnosed with cancer.
Understanding that caregiver fatigue is a very real, very serious issue, OHA includes members of a patient’s support team when it comes to nurturing mental and spiritual health. Its infusion centers are open to a patient’s caregivers, friends and family, allowing our nurses to interact and bond with whomever accompanies the patients to their treatments.
One of the many benefits of a community oncology practice is that patients often see the same physicians, nurses and other clinical team members during their visits, which leads to meaningful relationships built on trust. OHA focuses on establishing these relationships when a patient walks into the practice for the first time — regardless of where they are in their diagnosis.
Cancer patients are taking a journey, and OHA employees will be there to support them every step of the way. Because OHA’s clinics offer a variety of services, patients do not need to go anywhere else for blood work or infusions, which allows them to become more comfortable each time they walk into the office and interact with our staff. OHA wants its patients to feel like they’re visiting family — not just physicians and nurses. Part of that is encouraging patients to reach out anytime. For example, our nurse practitioners are standing by and ready to assist any patient suffering through uncomfortable side effects from treatment by sharing tips on managing symptoms and offering up a library of educational collateral to share.
Joining a national network such as AON can supply local, independent practices with the structure and resources they need to enhance a patient-centric approach to oncology care — which is the backbone of community-based care.
For those who work at OHA and in other practices across AON, oncology is more than just a job — it has become a very important part of their lives. They love the bonds they get to forge with their patients and are proud to be a part of their journey, regardless of where or how that journey ends.
February was Black History Month, making this an important time to note the racial disparities that exist in cancer care and research. Black people have higher death rates than members of all other ethnic groups for most types of cancer — specifically multiple myeloma and prostate cancer — and black women are more likely to die from breast cancer than white women despite a similar rate of diagnosis.
While there has been progress toward erasing these inequities in treatment and care, a great deal more work remains to be done. To that end, it is important to stay informed of these disparities so we can learn how to eliminate them forever.
There are many reasons why racial disparities exist in cancer care, one of which is based in socioeconomics. The reality is that a wide wealth gap remains between black and white households, even within the same income class, which can put higher quality medical care out of financial reach. This is especially true for those seeking treatment for costly cancer care.
Another reason is an inherent distrust African Americans have traditionally had with the healthcare industry. While this distrust dates back to the highly unethical Tuskegee syphilis study in 1932, more recent research has provided additional reasons why it persists: an implicit bias in healthcare that black people often receive lower quality care than their white counterparts. According to a survey conducted by Genentech and published by WebMD in partnership with the All of Us Research Program, 1 in 3 medically disenfranchised black and Hispanic people said they didn’t participate in clinical trials or receive vaccinations because of their lack of trust in the healthcare industry.
The restoration of trust in the healthcare industry would be a huge step forward in greatly reducing or eliminating racial disparities.
While social and economic barriers do play a role in higher rates of cancer in the U.S., it is also true that African Americans are more susceptible to the disease than other ethnic groups. This can be attributed to genetics, limited access to quality care and, most importantly, substandard care stemming from a lack of diversity in clinical research and drug trials.
Black people make up about 13% of the U.S. population, yet we seldom see that portion of the population represented in research. Notably, African Americans make up just 1-2% of the participants in clinical trials. This lack of diversity makes it impossible to see what effect certain drugs may have on people of African-American descent, especially when trying to treat multiple myeloma, of which African Americans account for approximately 30% of the patients.
One way to combat this is to assign a diversity officer to all research studies and clinical trials. Currently, there are data safety and monitoring boards for studies to ensure the patients and participants are being properly cared for and protected. The diversity officer can play a similar role by ensuring study populations don’t heavily skew in the direction of one race or another. This helps ensure that all patients are represented equally, making available the data that lets researchers know the effect a certain drug or treatment has on all members of the population.
Disparities and gaps in care do exist, but for the first time, we are seeing progress toward rectifying this problem. While the Food and Drug Administration cannot mandate population-based studies, it is beginning to encourage drug manufacturers and the healthcare industry to focus research on generating data applicable to African Americans. The industry seems to be listening, too, as evidenced by the creation of think tanks and advisory boards to learn how to be more inclusive.
The American Society of Clinical Oncology, which is the world’s largest cancer society that features representation from 150 different countries, recently announced the addition of a diversity and inclusion officer to its administrative structure. This role will address some of these racial disparities and work toward solutions to eliminate them.
At American Oncology Network (AON), we are in a unique position because of our diverse patient population and geographic footprint. This combination allows all patients, but especially African Americans, to participate in trials right in their own community – trials that are being conducted by physicians and doctors they know and trust.
This sort of inclusion is a significant step toward making sure patients from all walks of life are receiving the care they deserve.
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