Tag Archive for: Asians

Addressing Elevated Gastric Cancer Risks in Asian and Hispanic Communities

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Addressing Elevated Gastric Cancer Risks in Asian and Hispanic Communities from Patient Empowerment Network on Vimeo.

 How can higher gastric cancer risks for Asian and Hispanic populations be overcome? Expert Dr. Jun Gong from Cedar-Sinai Medical Center discusses H. pylori risk and screening and advice to patients to be proactive in their care.

[ACT]IVATION Tip

“…for the risk factors that are specific to the Asian and Hispanic populations is to understand the symptoms of H. pylori, which is one of the most common causes of stomach cancer, because they can be very effectively treated with antibiotics over a period of two weeks, oftentimes, and they’re very effective. This can be done at multiple provider levels from the primary care setting to the subspecialist setting. And also to know that symptoms, if they occur in family members that reside with the patient that is infected with h pylori or has stomach cancer, for them to be tested and the importance for their treatment as well.”

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See More from [ACT]IVATED Gastric Cancer

Related Resources:

How Does Gastric Cancer Screening Differ for High-Risk Groups?

 What Gastric Cancer Challenges Do Asian and Hispanic Groups Face?

 How Can Gastric Cancer Patients in Rural Areas Access Specialists?

Transcript:

Lisa:

Dr. Gong, what can be done on an individual and systemic level to address the elevated risk for gastric cancer in the Asian and Hispanic populations?

Dr. Jun Gong:

To address the elevated risks for gastric cancer in Asian and Hispanic populations, I think it’s very important to understand what are probably some of the universal risks to both groups. And here, there’s been growing evidence that H. pylori infection affects both Asians and Hispanics and is one of the more pivotal risk factors to address on a systematic level. Here, there have been ongoing research where they’re just identifying H. pylori as a procedure and eradicating it with treatment.

This is usually with antibiotic containing treatment for about two weeks. And this imposes what we call a primary prevention method if we can actually eradicate one of the primary causes of stomach cancer. Is this the best way to address the greatest risk factor on a systematic level for Asians and Hispanics and other ethnic groups at high risk? On an individual level, I think again, this comes to tailoring what the diagnosis is with the respect of ethnicity of the patient and their cultural and their background as well as their familial background. Here, H. pylori, dietary lifestyle, hereditary causes are important to address, to minimize risk for stomach cancer.

And it’s also important to know that on the individual level, that family members that are living with patients with stomach cancer may also have what we call H. pylori incidence around the entire family. So it’s important to advise that sometimes your family members, because of the close living facilities and the shared utilities and restroom and how we dine together, that this shares a familial risk. And oftentimes it may need to be that your family needs to be treated if H. pylori is detected within the family as well.

Lisa:

So if a patient comes in and their family members are concerned, would it be advised that maybe their family members can go see their primary care provider and say, “Hey, my family member has gastric cancer. Will you test me for H. pylori? Is that…would that be a valuable question to ask?

Dr. Jun Gong:

So I think that raises the big question about should we systematically test all high-risk subgroups for H. pylori? And I think the jury is still out on that. There has to be formalized guidelines. What I recommend is family members who are with another family member that’s diagnosed with H. pylori and/or stomach cancer, if they are having any concerning symptoms of H. pylori infection, this is usually abdominal discomfort. It can actually be gastritis type symptoms of acid reflux. If you have any of those symptoms, then those are certainly indications for you to be tested either at the primary care level for H. pylori.

My activation tip for the risk factors that are specific to the Asian and Hispanic populations is to understand the symptoms of H. pylori, which is one of the most common causes of stomach cancer, because they can be very effectively treated with antibiotics over a period of two weeks, oftentimes, and they’re very effective. This can be done at multiple provider levels from the primary care setting to the subspecialist setting. And also to know that symptoms, if they occur in family members that reside with the patient that is infected with h pylori or has stomach cancer, for them to be tested and the importance for their treatment as well.

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How Is Gastric Cancer Screening and Care Impacted by Culture?

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How Is Gastric Cancer Screening and Care Impacted by Culture? from Patient Empowerment Network on Vimeo. 

How can culture impact gastric cancer screening and care? Expert Dr. Jun Gong from Cedar-Sinai Medical Center discusses solutions for improving screening rates and patient advice for reducing barriers.

[ACT]IVATION Tip

“I think one of the most important things is always for providers to be culturally aware that certain ethnic groups may have certain preferences with how news is delivered, how news is handled, how treatment is decided upon.”

Download Resource Guide | Descargar guía de recursos

See More from [ACT]IVATED Gastric Cancer

Related Resources:

What Early Phase Gastric Cancer Trials Are Showing Promise?

 Expert Guidance: Stomach Cancer Basics for Newly Diagnosed Patients

 Do Gastric Cancer Risk Factors Differ Among Hispanic Communities?

Do Gastric Cancer Risk Factors Differ Among Hispanic Communities?

Transcript:

Lisa:

Dr. Gong, how do cultural beliefs and practices impact the prevention, diagnosis, and treatment seeking behavior of individuals with stomach cancer? And how can healthcare providers better address the cultural barriers to care?

Dr. Jun Gong:

Cultural beliefs have a huge impact on access to care in stomach cancer, and I think we can do better with addressing cultural barriers to care. I think one of the innovations here at our center is that we have a center of community outreach and a disparities core here where we recognize that certain cultures and this can expand beyond Asians and Hispanics into all racial groups, that there’s a heavily…there’s an important influence of church in this sector here.

And so what we do is we actively engage leaders in the churches, in the local churches for Asians, Hispanics, and a lot of different other subgroups. And we find this a great, great relationship and partnership to have for promoting awareness and educating patients about resources that we have within a culturally specific location where patients and family members find a great deal of trust in the church.

And we also have other innovations as well. So this is more from…more of a day-to-day lifestyle from a clinical trial, a research perspective here at Cedars, we also have a designated specialist from a diversity and inclusion research group where we actually move along the disease groups from stomach cancer to colon cancer to other cancer types.

And we have this specialist sit in, usually in our weekly meetings. And whenever there is a new study, a new clinical trial, this diversity inclusion specialist will raise the question, what racial groups, ethnic groups will be of interest to hear? And how can we expand outreach and participation in these clinical trials? So these are some of the innovations that I think we can do to address cultural barriers to care.

Lisa:

Dr. Gong, do you have an activation tip?

Dr. Jun Gong:

So, my activation tip is that yes, there are growing and emerging concepts to address cultural barriers. I think one of the most important things is always for providers to be culturally aware that certain ethnic groups may have certain preferences with how news is delivered, how news is handled, how treatment is decided upon.

And additionally, I think it’s important for patients and providers to promote awareness and education in a setting where patients and family members are very comfortable with. This can be the church setting as we recognize the importance of this in the day-to-day lives of many patients and family members across multiple cultures.

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Are There Disparities in Stem Cell Transplant Outcomes?

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Are There Disparities in Stem Cell Transplant Outcomes? from Patient Empowerment Network on Vimeo.

What do myeloproliferative neoplasm (MPN) patients need to know about disparities in stem cell transplant outcomes? Expert Dr. Idoroenyi Amanam from City of Hope explains key factors that impact the outcomes of stem cell transplants and the importance of finding fully matched donors.

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Are There Any MPN Disparities in Subtypes and Genetics?

 Understanding MPN Treatment Goals and Shared Decision-Making

Understanding MPN Treatment Goals and Shared Decision-Making

 Emerging MPN Therapies in the Research Pipeline

Emerging MPN Therapies in the Research Pipeline

Transcript:

Lisa Hatfield:

Dr. Amanam, does race or ethnicity play a role in outcomes of stem cell transplantation?

Dr. Indoroenyi Amanam:

Yes. There have been some really great studies looking at this. And I think in general, we know that health disparities are a major issue for racial, ethnic, and socioeconomic disadvantaged groups. Stem cell transplant is a curative therapy for blood disorders. And we’ve looked at a variety of different, there have been multiple approaches to assess like where these disparities come from or if there are disparities from specific groups. And I think the Affordable Care Act was great in allowing expansion and insurance coverage to multiple groups and increased access to care. But that hasn’t solved the problem.

And so, one of the issues we’ve seen is that providers themselves do not refer patients proportionately. So from proportion if you’re African American, Hispanic, if you are coming from a ZIP code that your meaning income is lower, that there are some instances where referrals for transplant don’t occur in equal rates.

And we’ve also seen that even if you’re insured and you’re African American or Hispanic, referral rates are still lower. And so that’s something that, it’s something that we have to work to improve. And you know, one big thing for transplant is that you have to have donors. You have to have donors who are matches for these patients who have these disorders who need a transplant. And we do know that African Americans, Hispanics, and Asians have lower chances of finding a fully matched donor compared to white Americans. And so, why that’s really important is that when you look at rates of complications after transplant, we do know that the level of match of the donor does play a part in that. Namely the chances of the patient relapsing after the bone marrow transplant and the rates of graft-versus-host disease are significantly higher.

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How Do Non-Melanoma Skin Cancers Impact Non-White Populations?

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How Do Non-Melanoma Skin Cancers Impact Non-White Populations? from Patient Empowerment Network on Vimeo.

Do non-melanoma skin cancers occur differently in non-white populations? Expert Dr. Silvina Pugliese explains how the appearance and location of squamous cell cancer and basal cell cancer can vary in non-white patients.

Silvina Pugliese, M.D., is a Clinical Assistant Professor of Dermatology and Attending Physician at the Stanford Medicine Outpatient Center and Stanford Cancer Institute. Learn more about Dr. Pugliese.

[ACT]IVATION TIP

“…recognize the disparate presentations of non-melanoma skin cancers in patients who are not white. So this includes pigmented basal cell cancers. So looking out not just for shiny red bumps, but also blue or purple bumps on the skin, making sure that patients know and also doctors know how to look within areas of wounds, chronic non-healing wounds and also scars and in different locations such as just…such as the genital skin and the perianal skin, as well as the lower legs where we might see squamous cell cancer in skin of color patients.”

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See More from [ACT]IVATED Non-Melanoma Skin Cancer

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Transcript:

Mary Leer:

In more recent years, the incidence of cutaneous squamous cell carcinoma is increasing not only in non-Hispanic whites, but also in Hispanics and Asians. What are we learning about how non-melanoma skin cancers impact non-white populations?

Dr. Silvina Pugliese:

In dermatology, we’re certainly making a more concerted effort in recent years in studying squamous cell carcinoma in patients of all skin types. Most of our studies in the past were in white patients or lighter skin patients, but in recent years we’ve realized how important it’s to make sure that we know how non-melanoma skin cancers impact all patients, including our skin of color patients.

A few examples of how squamous cell cancer may impact non-white populations differently include where these skin cancers present. So, for example, squamous cell cancers may present in different locations on the body. So when we think about common squamous cell cancer locations, we think about areas exposed to a lot of UV, tops of the ears, the nose, et cetera.

We know that in skin of color patients we might see more of these skin cancers on the lower legs or on the feet or in genital or perianal skin. And that’s important, because we as dermatologists need to make sure that we’re examining all of these areas when we’re doing a full body skin exam.

In addition, about 20 to 40 percent of all squamous cell cancers diagnosed in Black patients are occurring within scars or areas of chronic inflammation such as wounds. It’s, therefore, really important for us to educate patients on the fact that these are areas that could be problematic in the future and need to be evaluated.

Other ways that squamous cell cancer impacts non-white populations is that patients may present…skin of color patients may present with more aggressive disease. There was one study looking at Mohs defect sizes, meaning when surgical procedures are done to remove a skin cancer, what’s left behind after skin cancer is moved is called the defect.

And because some of these skin cancers are more advanced, some of these squamous cell cancers, for example, are more advanced, they will have a larger area of skin removed, which as you can imagine really does impact how the skin heals the risk of scarring, the risk of having any longer term complications from that procedure.

There are a number of things that we can do better on the dermatology side in terms of educating patients about what to look for on their skin and also things that we can do about educating each other. And I’m talking about medical school and residency education in identifying skin cancer in skin of color patients.

Another thing I did want to mention is that basal cell cancer, which is our most common type of skin cancer, has a very different look in patients with skin of color. So it might have more of a purple or blue appearance than the classic pink shiny bump that we talk about. And then finally there is a rare tumor that we call DFSP that is actually more likely to occur in Black patients and can often have a scar-like appearance. This is a rare soft tissue tumor that can involve the deeper skin sometimes into the fat and even muscle.

And patients with skin of color are more likely to present with larger tumors.  So my activation tip for this question is to recognize the disparate presentations of non-melanoma skin cancers in patients who are not white. So this includes pigmented basal cell cancers.

So looking out not just for shiny red bumps, but also blue or purple bumps on the skin, making sure that patients know and also doctors know how to look within areas of wounds, chronic non-healing wounds and also scars and in different locations such as just…such as the genital skin and the perianal skin, as well as the lower legs where we might see squamous cell cancer in skin of color patients. So overall I think education all around for our doctors and our patients will help our skin of color patients have their skin cancers, their non-melanoma skin cancers diagnosed more properly. 

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