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Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer? from Patient Empowerment Network on Vimeo.

Do Black and Latinx veterans face lung cancer disparities? Expert Dr. Michael Kelley from Duke University School of Medicine discusses past and current health outcome disparities and comparisons of molecular genetic alterations between Black and white veterans.

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“…if you are experiencing a challenge in working with the VA healthcare system, regardless of what community you are in, please communicate that to someone at the VA. That could be your provider, that could be the patient advocate. Every VA hospital has a patient advocate or that could be someone else at the medical center. We want to know how we can help you in what problems you’re experiencing.”

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Transcript:

Lisa Hatfield:

Dr. Kelley, what specific challenges do veterans from the Black and Latinx communities face when trying to access lung cancer healthcare services?

Dr. Michael Kelley:

So in VA, there are several different ethnic and racial populations, and we’ve looked at the outcomes of Black and white veterans. Latinx veteran population is still relatively small, so we don’t have good statistical power to be able to draw strong conclusions there. But the comparison between Black and white is very clear in VA in lung cancer in terms of the outcomes.

And the result is, is that Black veterans do just as well, or better than white veterans at every stage of lung cancer. That is quite different than it is in the rest of the country. So that is one area that I think VA as an integrated healthcare system with wraparound services is able to brag about that we are able to provide all the care that is necessary to derive that outcome.

That wasn’t always the case. In the early 2000s, there was a difference in surgery rates for Black veterans with early stage lung cancer. And we were studying this, and what we saw was that, that difference went away about 2009 or 2010, and it hasn’t come back since we last looked at it. We don’t know what caused it, and we don’t know why it went away, but we’re glad to see it did go away. There are a long list of other possible challenges that veterans in Black or Latinx communities might face. These may be overlapping with those that everyone faces, but VA probably has a service to help with it.

And so my activation tip for you is, is that if you are experiencing a challenge in working with the VA healthcare system, regardless of what community you are in, please communicate that to someone at the VA. That could be your provider, that could be the patient advocate. Every VA hospital has a patient advocate or that could be someone else at the medical center. We want to know how we can help you in what problems you’re experiencing.

Lisa Hatfield:

Are there any differences in the characteristics of the cancer for these populations for the Black and Latinx communities that you have seen?

Dr. Michael Kelley:

We have looked at a lot of comparisons between Black and white groups of veterans, not so much around Latinx because of the smaller numbers. There are not a lot of differences in terms of molecular genetic alterations. And so there are some differences in the geography. So the Black African Americans veterans tend to live more in the Southeast, where actually there’s the largest collection of military veterans who are enrolled in VA care anyways.

But in terms of the outcomes, we don’t really see any outcomes. There are some other differences in medical care that are appropriate, such as a variation of normal in terms of the white blood cell count that happens in some individuals predominantly in of African descent. And those individuals might be at risk for having their chemotherapy doses reduced, because their white count goes down more than other individuals. But in general, we don’t see a lot of differences between those populations medically.

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Transcript:

Lisa Hatfield:

So a shout-out to Dr. Nyame for an outstanding article that you wrote. I’m going to read a quote from that. Worldwide Men of African Ancestry Demonstrate Worse Outcomes in Prostate Cancer, a phenomenon driven largely by social factors that inform biologic, environmental, and healthcare risks. So, Dr. Nyame, considering the disparities and taboos on prostate cancer, how can Black and Latinx men including their care partners play a role in eliminating these racial disparities surrounding prostate cancer diagnosis and survival rates?

Dr. Yaw Nyame:

I think because of the nature of what drives these disparities, there is no doubt that cancer is a biologic phenomenon, and so there is no reason to ignore biology, but a lot of inequity in the majority of inequity is rooted in structural and social inequities that really inform health, and when I look at our traditional mechanisms for providing healthcare, there is such a power differential, whether it’s in how we provide clinical care or how we do research, and so we as a research team here at the University of Washington, fundamentally believe that we have to reverse those roles that we have to hand the power back to community, so that they’re an equal partner at the table when we do the work that we do. And so we do a lot of work that is centered around engaging community and patients and partnering with community and patients, and I think that’s one way to ensure that we develop research and interventions that create equity.

My activation tip in this particular space is for Black and Latinx communities to think of ways to be partners in research and to really embrace the fact that it is their right to be at the table when we make decisions about how research is conducted, what the results of our research means and how we share those results so that they have impact in our communities, and so there are a variety of ways to be partners in research, sometimes it’s literally being part of the research team, like we do on showing up to meetings every week, and being engaged in the work in all forms, just asking to participate in the trial, being a member and a participant in the trial and making sure that your experience counts in the way we think about advancing the field of prostate cancer and making it better for everybody.

Sherea Cary:

My activation tip in this area for care partners would be encouraging communication, encouraging the patient to share with others, other men, what their experience has been. It seems to me that when you’re in community with other people and you have something in common then the person who is experiencing cancer or an illness, feel a connection, if they know that someone that they know has had it and survived it and seems to be doing well, that’s encouraging to them, and then we also want that person to pay it forward.

So what I remember about my dad is that after he had his cancer diagnosis, he would share with other men who were facing, who were having testing done and then who had been diagnosed, he talked to them about what happened with them, and they had their own sense of community.

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Do Disparities Exist for Black and Latinx Veterans Facing Lung Cancer?

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Advanced Prostate Cancer Diagnosis and Survival | Black and Latinx Disparities

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