Tag Archive for: VA care

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

/in , , , , , , , , , , , , , /by

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.

[ACT]IVATION TIP

“…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.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

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.

Share Your Feedback

Create your own user feedback survey

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer

/in , , , , , , , , , , , , , /by

Equitable Access: Overcoming Challenges in Precision Medicine for Veterans with Lung Cancer from Patient Empowerment Network on Vimeo.

Do veterans with lung cancer face barriers to precision medicine and targeted therapies? Expert Dr. Michael Kelley from Duke University School of Medicine discusses past and current access to precision medicine, the National Precision Oncology Program, and proactive patient advice to ensure you receive essential testing and optimal care.

[ACT]IVATION TIP

“…if you have advanced lung cancer, ask your provider, what testing has been done on my tumor, what are the results, and what does that mean for my treatment?”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

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

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

 Are There Lung Cancer Clinical Trials Studying Veterans?

Are There Lung Cancer Clinical Trials Studying Veterans?

 Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Navigating Lung Cancer Clinical Trials: VA Support and Resources for Veterans

Transcript:

Lisa Hatfield:

Dr. Kelley, what specific challenges do veterans face in accessing precision medicine? And how can these challenges be mitigated to ensure equitable access to advanced treatments?

Dr. Michael Kelley:

So before 2016, the first cancer moonshot, there were major challenges in, not only in the VA, but across the country to access to precision medicine in the oncology field. We launched in that year, and if really now provide access to cutting-edge precision oncology technology, which is a lot of molecular testing and the expertise to be able to interpret the results of that test to apply it to individual patients. So I think we have advanced to the point where this should not be a barrier anywhere in the VA system, but I would say that only about half of veterans are enrolled for VA care.

And outside of VA there still are areas that have a variety of different barriers to getting the testing done on the tumor samples in a way which informs the treatment decision-making for patients. So this is very important. My activation tip for this is to be sure to ask your provider whether your tumor has been tested for molecular tests, and if so, what the results of those tests are, and how that impacts the treatment of your cancer.

Lisa Hatfield:

Dr. Kelley, can you speak to your research around barriers to prescribing targeted therapies for patients with non-small cell lung cancer with highly actionable gene variants, and what should patients and their care partners be aware of related to these barriers?

Dr. Michael Kelley:

So one of the key pieces of information that your providers need to know in order to, how to treat your advanced stage lung cancer is what are the molecular alterations in your tumor, and what types of proteins are expressed on the surface of the proteins that allows them to make good choices around immune therapy and another group of therapies called targeted therapies, and that can make major differences in your care and your outcome.

So when we first started using this type of testing, in particular the genetic testing of tumor samples, there was a lot of complexity in the results that was not well understood by the oncology providers, because it was new and very complex. So VA has instituted a program to provide that testing and the expert consultation service to be able to interpret those results.

And so when we set up that program, which is called the National Precision Oncology Program, we did a study, looking to see how many patients who should have gotten a targeted drug actually got that drug. And the results were similar to what has been reported in other healthcare systems. And that is, is that less than every patient was getting the targeted therapy, and it was about somewhere around a third of patients who did not get the therapy that would’ve been indicated by that test result.

So we wanted to know what the reasons were, and I think we’ve addressed a lot of the reasons that we came upon. A lot of it is education and making sure that the information from those tests gets to the provider and gets to the patient, and that comes with an understanding of what those test results mean. So my activation tip is, if you have advanced lung cancer, ask your provider, what testing has been done on my tumor, what are the results, and what does that mean for my treatment?

Share Your Feedback

Create your own user feedback survey

Do Veterans Face Health Disparities in Lung Cancer Care?

/in , , , , , , , , , , , , , /by

Do Veterans Face Health Disparities in Lung Cancer Care? from Patient Empowerment Network on Vimeo.

Are there any lung cancer disparities that veterans face? Expert Dr. Michael Kelley from Duke University School of Medicine discusses smoking rates of veterans, the quality of VA care versus the general population, potential environmental exposures during military service, and proactive advice for optimal lung cancer care.

[ACT]IVATION TIP

“… if you have cancer, then you should be taken care of in a way which addresses your needs regardless of what the availability is within the VA system. VA sometimes cannot take care of all patients with cancer, and in that case, VA will purchase a service in the community.”

Download Resource Guide  | Descargar guía de recursos

See More from [ACT]IVATED NSCLC Veterans

Related Resources:

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

Explaining Advanced Non-Small Cell Lung Cancer to Veterans and Their Families

 What Should Veterans Know About Lung Cancer Screening and Risk?

What Should Veterans Know About Lung Cancer Screening and Risk?

 What Impact Does the VA Have on Lung Cancer Care Coordination?

What Impact Does the VA Have on Lung Cancer Care Coordination?

Transcript:

Lisa Hatfied:

Dr. Kelley, can you discuss any disparities or differences in health outcomes among veterans compared to the general population when it comes to access to treatment? And are there systemic issues within the healthcare system that disproportionately affect veterans?

Dr. Michael Kelley:

So there are some differences between what types of cancers that veterans get and the general population, but there is not a bright line difference between those two groups. They’re really gradations, and if you have the same type of cancer and you’re in the VA versus outside the VA, the treatment approaches and prognosis should be the same.

And that’s actually what we see when you look at systematic studies of the quality of care of inside the VA compared to the rest of the country. The VA care, it looks the same or better almost routinely, and that is, I think, due to the uniform availability of services that are not only the medical care, but some wraparound services that are available to veterans.

There are some differences that we want to talk about. One is related to smoking. So military veterans have a higher rate of previous smoking. The current smoking rate is about the same as the general population, so it’s more likely that they will get smoking-related malignancies, and, of course, lung cancer is one of those cancers.

Military veterans also have exposures during their service to a lot of other physical, chemical, and other types of exposures, which can increase their risk of a variety of different types of cancers. And those can also show up in different subpopulations within the services depending on where they served. But many studies that explored some types of associations that were thought to be existent turned out not to show a difference.

So, for example, breast cancer and active duty military women is actually lower than it is in the general population. So there are some differences, but they go both ways. So I don’t want to make any general statements. But my activation tip is that, if you have cancer, then you should be taken care of in a way which addresses your needs regardless of what the availability is within the VA system. VA sometimes cannot take care of all patients with cancer, and in that case, VA will purchase a service in the community.

Share Your Feedback

Create your own user feedback survey