Tag Archive for: gynecological cancer
How Is Gynecological Cancer Care Impacted by Social Determinants of Health?
How Is Gynecological Cancer Care Impacted by Social Determinants of Health? from Patient Empowerment Network on Vimeo.
How can social determinants of health impact gynecological cancer care? Expert Dr. Charlotte Gamble from MedStar Health explains common factors that can present barriers to care and some resulting impacts to patient care.
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Transcript:
Lisa Hatfield:
Dr. Gamble, how do social determinants of health potentially influence the quality of care received by patients with gynecologic cancers?
Dr. Charlotte Gamble:
Yeah, another really wonderful question and an area of research that people have looked at for a long time. I think when we think about social determinants of health, we have to define what they are, right? So these are going to be aspects of people’s lives that might not be specifically health related, but absolutely influence the ability to access healthcare, the ability to complete treatment regimens, the ability to be able to get support and survive these treatment regimens and continue in survivorship.
So think when we, when I specifically think about social determinants of health and gynecologic cancers and encompassing the ovarian cancers, cervical cancers, endometrial cancers and vulvar cancers. We see multiple things. So in general, these cancers are affecting people who have the female reproductive tract. So this is going to be oftentimes people that identify as women, but also can include trans men.
And so there’s also like a gender component of this and how people identify. And for the trans community, there are barriers everywhere in terms of how they can access gynecologic care and the stigma that might be associated with providing trans healthcare in general that affect them specifically. When we talk about women or people who have identified as women and who also have a female reproductive tract, there comes into place how women in general and historically have been able to access healthcare and the barriers that they might face in communities.
Women generally tend to be the providers of healthcare or the providers of childcare and have several responsibilities in taking care of their families and communities. And in so far, doing tend to downplay their own healthcare and prioritizing their own well-being to be able to care for those who they love, who surround them and are stretched thin.
And so because of that, we oftentimes see delays in seeking access to healthcare because women tend to be pulled in so many different directions by their communities. Other times what we see is things that I’ve mentioned previously in terms of insurance barriers and either not having insurance. So for patients who are undocumented immigrants, this tends to be a massive issue. I’ve had patients myself that we’ve had to work tirelessly for, to be able to get them insurance. And this is in the nation’s capital where insurance, even for undocumented people, tends to be a little bit easier to access than in other places. And it’s been a huge challenge and delay their care by months. And this directly correlates with survival and how patients do on the back end of things. But even having insurance that is, that is, doesn’t, might not cover everything that’s needed, and there might be large copays associated with visits or treatment plans.
This is an area that there’s a lot of room to improve in the United States, and a real macro issue. But when it comes to also things like transportation and living in a food desert and not having healthy groceries and nutritional options that for patients who have endometrial cancer, that oftentimes if it’s a low grade non-aggressive cancer, they’re going to do fine from a cancer standpoint, but it’s the cardiovascular issues and the possible severe obesity they might suffer from. And that is an issue that patients who live in food deserts or live in places that they can’t access sidewalks and ability to live healthy lives in their neighborhood will really suffer from not being able to have those determinants of health work in their favor.
And then we also have issues within health systems. And we see that for patients who live in conditions that are historically considered impoverished, they might not be able to make it to the beautiful National Cancer Institute designated cancer center, seeing this most subspecialist and having access to five clinical trials and a case navigator and a care navigator and a social worker to help them through the social issues that they might be seeking care with a community practice that could itself be underfunded or not linked to strong cancer institute options.
And so that’s another kind of systems level that we see where patients are seeking care that they might not be able to actually get to the subspecialists that they need, or health systems that are resourced enough to help them in their lives. So that’s a very long-winded question, [laughter] because it’s such a massive issue. But it, social determinants of health affect everything in the cancer continuum from a timely diagnosis and being able to recognize abnormal symptoms to being able to get into a doctor’s office, to be able to get to a subspecialist that is has expertise in the area to be able to complete therapies on time and to be able to eat healthy food and have a healthy lifestyle after one has gone through all these major treatments. It’s a massive issue and something that we see in every single health condition in the United States.
That is the most excellent comprehensive response to barriers, obstacles, stigmas that I’ve ever heard regarding accessing quality of care for cancer patients. Any cancer patient is going to benefit from your response to that. So thank you.
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How Can You Access Personalized Medicine for Endometrial Cancer?
How Can You Access Personalized Medicine for Endometrial Cancer? from Patient Empowerment Network on Vimeo.
How can endometrial cancer patients access the most personalized treatment approach for their individual disease? This animated video reviews key treatment considerations, the impact of biomarker test results on therapy options, and advice for engaging in care decisions.
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Endometrial Cancer Treatment Decisions | Factors That Impact Your Options |
Transcript:
Endometrial cancer research is evolving quickly, leading to targeted treatment approaches and helping patients access more personalized care.
So, what is personalized medicine? Personalized medicine – also called precision medicine – is a type of care that is based on the genetic makeup and individual characteristics of a patient’s disease.
This information is gathered using biomarker testing, which identifies key markers such as genes, proteins, or other molecules in a sample of tissue, blood, or other bodily fluid. The results of this testing can give a more detailed picture of the tumor’s type, aggressiveness, and may help predict how the cancer will behave.
The test results can also identify which treatment approach may be most effective, through the presence of certain molecular markers. For example, if biomarker testing results reveal that a tumor has either high microsatellite instability (MSI high) or mismatch repair defects (dMMR), an endometrial cancer patient may benefit from immunotherapy.
Or, if the results show the HER-2 or mTOR mutation, this could indicate that the disease may respond well to a targeted therapy. And the presence of estrogen or progesterone receptors in a patient’s tumor may suggest hormonally targeted therapies may be beneficial.
In addition to biomarker test results, other factors that physicians consider when recommending a treatment approach include:
- A patient’s age, overall health, and any pre-existing conditions.
- The type, stage, and grade of endometrial cancer.
- And the patient’s preference.
When considering treatment, patients should discuss the pros and cons of each option with their doctor. And they should review potential side effects, understand how the treatment is administered, and how the therapy may impact their lifestyle.
So, what steps can YOU take to access personalized care?
- Find out if your doctor has experience treating endometrial cancer. Consulting a specialist or getting a second opinion can help confirm your diagnosis and treatment plan.
- Next, request all essential testing, including biomarker testing, and discuss how the results may impact prognosis and therapy options.
- You should also ensure that you understand ALL of the treatments available to you – including clinical trials.
- And, make sure to have a friend or loved one present during discussions, so you can talk about the information later and feel confident in your decisions.
- Finally, don’t hesitate to share your opinion and ask questions about available options. Remember, YOU should be at the center of your endometrial cancer care.
To learn more about endometrial cancer and to access tools for self-advocacy, visit powerfulpatients.org/endometrial
The Foundation for Women’s Cancer Educational Series
The Foundation for Women’s Cancer (FWC) offers a comprehensive set of free educational courses designed to support patients and caregivers that answers the question, “What do I need to know?” for a cancer journey. From the basics of “what is cancer?” to understanding treatments, clinical trials and how genetics play a role, to lifestyle discussions on sexual health and nutrition, these courses meet you where you are to answer the questions you might have. Available in a variety of self-study and live webinar formats, these courses are available for you when you need them. Additional downloadable resources are a part of each course.