This panel was moderated by Dr . Leif Ellisen , program director and professor of medicine at Mass General Malignancy Center, and included Dr. Dejan Juric , movie director of the Termeer Center for Targeted Therapies at Massachusetts General Hospital, Doctor Beverly Moy , associate teacher of medication at Harvard Medical School, and Natasha Mmeje , director of community health & outreach at Susan G. Komen.
Ellisen: So it looks like the first question is for Natasha. Natasha, can you talk about some of the efforts Leslie G. Komen has implemented to address the particular disparities that Dr . Moy has talked about? And are there resources from Susan G. Komen you can recommend with regard to our audience today?
Mmeje: Absolutely, I’d like to just first start off simply by saying thank you, Doctor Moy, regarding setting the stage so beautifully to talk about health disparities in this country plus what it means around breast cancer. So Leslie G. Komen in 2021, sent out a report called “Closing the particular Breast Cancer Gap, a Roadmap To Save Lives of Black Women in America, ” which really exemplifies the points that will Dr. Moy mentioned. And we focused on systemic and social determinants of wellness and, in particular, 10 metropolitan cities or areas that experienced the largest gaps in mortality rates between Black and White women. Dr . Moy talks about those staggering statistics. And according to that report, we found that Dark women were often ignored by their health care providers, and they faced significant barriers in order to receiving the particular care that will they needed due to the legacy of systemic racism that we’ve talked about earlier, as well as implicit bias and below standard care.
So in response to that, Komen has launched our “Stand For Her, a Health Equity Revolution, ” which is a bold program that’s set to decrease breast cancer disparities through very focused intervention that will bring down barriers. The obstacles that actually created these inequities in the first place intended for black people, some of those things include education that equips Black individuals with the knowledge about breast health, providing education upon things like breast health assessment, screening guidelines plus the importance of family wellness history, in their breast malignancy risk, as well as treatment options and how in order to advocate to get their own care. Also creating plus amplifying conversations about these resources in the Black community through faith-based organizations via our worship and paint program. And then also supporting patients or even patient support that ensures connections to timely health care and quality health treatment as well.
The other pieces of this are removing barriers to screening and diagnostic services, such as Dr. Moy mentioned, pertaining to uninsured and underinsured individuals, easing financial burden meant for treatment designed for Black cancer of the breast patients, and also increasing access to genetic counseling and testing services just for Black families. We spoken a bit about that while well today, serving as a trusted healthcare partner by means of our patient navigation program through Susan G. Komen. And then also for the purpose of medical care companies, workforce development that improves diversity plus cultural sensitivity of those health care workers. I think that’s very, very important. Plus then developing, trained Black patient navigators across the nation who will deliver best within class culturally responsive navigation services. Because the health care system may be really challenging in order to navigate, that patient navigator can really bridge that gap between wellness care suppliers and patients.
So those are the particular pieces that will we’re doing for the Black color community to address health disparities and inequities. But I would also echo what Doctor. Moy mentioned, which is, consider becoming an advocate in science, or a member of our steering committee or NBC steering panel, becoming a good advocate with our Center for Public Policy. Doctor Moy pointed out that it’s really important. And we see the change that when we go to advocate for bills that we need in order to get passed for breast cancer care, or even whatever those health related issues are usually, they don’t listen to us. They do listen to individuals, and it is extremely important with regard to patients to be in the room.
Ellisen: Thank you quite much, Natasha. And there are a couple associated with questions regarding Dr . Juric and I’ll put them together on the issue of beyond medical therapy. And one question is, when we think about METAvivor, because those surviving metastatic cancer of the breast, how can we integrate survivorship treatment into the state-of-the-art clinical trial and experimental approaches that you’ve discussed? And related to that, have you heard of Thomas Seyfried ‘s book around the metabolic basis of cancer and the keto diet and what might you say about all those kinds of approaches inside parallel along with the sort of medical approaches that you’ve discussed?
Juric: Thank you therefore much for this question, it is really critically important. Actually, one of the patients bought me that will book, when they heard that I’m studying Pi3 kinase inhibitors. It turns out that the particular Pi3 kinase pathway is important intended for insulin signaling. So whenever we’re trying to attack the malignancy using Pi3 kinase inhibitors, almost universally, we cause insulin resistance, which may have both negative metabolic effects plus also drive potentially even resistance to therapy. So this is really fascinating. You’re trying in order to interfere with the cancer cell. But at the same time, you’re changing metabolic setup of a patient, which can negatively impact the treatment itself. Plus it turns out that keto diet in that context synergizes with the particular treatment itself, there’s a beautiful paper by Luke Cantlie, that showed that of all the points that people can do to that cancer, giving the pediatric kinase inhibitor is actually not sufficient unless we change that will metabolic aspect too. And the dietary intervention, plus the targeted treatment can have massive synergy. So absolutely, you can find better examples where this question would be more suitable than the story that I just told you about the PI3 kinase inhibitors. For that reason within the Termeer center, and National Cancer Center in large all of us started a whole program that’s led simply by one associated with our nurse scientists, PhD trained nurses, called Point Program phase 1 outcomes research, exactly where we are learning how taking care of patients’ symptoms, diet impacts, hardcore clinical trial results that individuals usually wouldn’t necessarily come to connect with. Therefore paying attention to the particular well-being of the patient plus managing many aspects associated with survivorship. I’m talking about DLP rates, really technical terms in a clinical trial that often we look in isolation. Yet this Stage Program, and a nurse scientist driven research, we all learn that truly, we may measure hope, we can see what how wish impacts final results in a clinical trial, we can see what interventions we have been not offering sufferers. And what all of us should offer, we can stratify patients based on objective criteria, plus engage the entire supportive services ecosystem that the particular hospital offers or their community to improve their own outcomes. So I couldn’t agree more this particular aspect of caring for the patient is really important. It’s not really sufficient just to look at the molecular features of disease, we have to look from the whole patient.
Ellisen: Many thanks very much, doctor, your time will be running short. But I’d like to ask a person one a lot more question to get those in the audience today who might be living with metastatic breasts cancer or their family members and friends? Where would certainly you suggest they go to learn about these medical trials in order to learn regarding potential options for involvement inside research and access to innovative care?
Juric: I apologize. Honestly, the number of sources out there is massive. And I think the priority, it can fascinating how much information you can actually get very good information from social media for various patient assistance groups where some associated with the first insights even on scientific trials are shared. You just have in order to be careful to take all the points of view and levels of evidence. But I think the critical aspect of taking care of a patient or even looking pertaining to these innovative therapies to improve the relationship between the particular patient plus physician, We emphasize how important it is not to perform things to the patient. This particular really has to be a partnership. The patient should ask why. As many times as possible, and get some sort of question, why the therapy didn’t work, what can be done about it. After which together along with the individual, look with the local availability associated with clinical trials, ask the particular physician to reach out in order to their colleagues to find options. So that should be actually an active process, since opposed to thinking of kind of treatments as just the recipe which implemented. Step by step, it is usually not that it’s actually tapping in the dark often. And you need a lot of thought, a lot of humble inquiry as you move from one treatment to another, as opposed to simply throwing darts in the particular wall. So I think, luckily, there are a lot of resources out there. But really to make those assets actionable, the relationship between a physician and affected person needs to be very active, full of questions and wise, not just what can we all do next? Yes, this didn’t function. But exactly what can we do following? I believe we need to learn a great deal from aviation industry, exactly where every failure is studied to the particular last detail to really try to prevent the next failure. We need to be as detailed in oncology as we are some of these other aspects associated with our life.
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