Cancer doesn’t have a color. Neither should cancer research
With Bristol Myers Squibb and other partners, the V Foundation is determined to move the needle on racial disparities in cancer care and research.
It wasn’t until several years after she started raising concerns with her doctor about strange bruises, brittle nails, hair loss and unexplained weight gain that Megan-Claire Chase finally got her diagnosis: invasive lobular breast cancer. It’s the second most common type of breast cancer, but when Chase sought help at a local cancer support center, the intake coordinator wasn’t convinced. She asked if Chase was certain about that diagnosis, because, “well, triple-negative [breast cancer] is way more prevalent in the African-American community.”
“Right then, I felt like a Black cancer patient, not a cancer patient. I’d been labeled,” Chase recalls. Five years later, that moment still stings, but it’s one among a whole pile of moments throughout her cancer journey—moments when she didn’t feel listened to, respected or taken seriously. “Race is part of my cancer experience and how I’m being treated. I have been talked down to by so many white doctors. Medical racism runs so deep, and it’s been going on for a long, long time.”
Chase’s experience isn’t an isolated story. Black and other minority patients are more likely to get many types of cancer, have more advanced disease at the time of diagnosis, have more aggressive forms of the disease and die from their cancer than white patients. Researchers are investigating the potential biological and environmental drivers behind these disparities, but it’s clear that systemic racism plays a role.
“I want people to recognize that racism spills over into every situation, including the medical system,” says Chase. And, she wants it to change.
Research and racism
The relationship between race and cancer isn’t just about the interactions between doctors and patients. It goes back to which types of cancer (and patients) get studied, how clinical trials are conducted and who is included in testing new therapies. And it goes back to which research questions—and which researchers—get funded.
Recognizing the urgent need to close racial gaps in cancer outcomes, the V Foundation established the Stuart Scott Memorial Cancer Research Fund, which has made $12.7 million in research grants aimed at overcoming racism, unconscious bias and disparities in cancer. The program, with generous support from Bristol Myers Squibb and other partners, supports research projects investigating the factors behind cancer disparities, including projects led by scientists who are themselves members of minority groups.
“The V Foundation’s impact on cancer research inspires us at Bristol Myers Squibb to work even harder, even more urgently and with a commitment to inclusive research and equity, so that more patients are victorious over cancer,” says Patti Doykos, Ph.D., executive director for health equity at Bristol Myers Squibb. “Across the board, partners in the cancer space are making [health equity] a priority, and we’re doing it in a way that brings sustained organizational change.”
Sorbarikor Piawah, M.D., of the University of California, San Francisco was recently awarded a V Scholar grant through the Stuart Scott Fund. To uncover why colorectal cancer has been skyrocketing in younger age groups, particularly among Latinx communities, she is recruiting 90 Latinx patients in California and Mexico City to investigate the role of diet and the gut microbiome in cancer risk. While many cancer studies of the past were dominated by white patients, Piawah sees her work as part of a broader movement to bring the research to the populations who are suffering the heaviest disease burden.
“The V Foundation is playing a huge role by helping to support the careers of researchers who are invested in disparities research and helping to diversify the patient populations that we study and recruit to our trials,” she says. “As a scientific community, we really need to do a better job of engaging diverse and understudied populations in our research.”
In addition to supporting inclusive and culturally relevant studies, Doykos says cultivating a diverse biomedical workforce is key to driving and sustaining inclusivity in cancer research and clinical trials.
“Supporting these incredible investigators is important for allowing them to pursue their research passions, and it’s also very important for their leadership journeys,” says Doykos. “With these grants, we can help to support both diversity in the scientific workforce and diversity in the leadership within cancer research.”
Toward a more equitable future
Cancer disparities won’t be solved easily. There is a need for both knowledge and action. We need knowledge about the nature of the problem, how genetic and biological factors might affect tumor biology and a person’s response to treatment, and how a person’s social and physical environment impact their risk of cancer and their outlook once diagnosed. And we need action to ensure everyone has access to high-quality, culturally sensitive health care, and to address systemic racism and other factors—both inside and outside of the medical clinic—that affect a person’s cancer journey.
Science has brought incredible achievements in the fight against cancer, and many more are on the horizon. But with each new advance, there is also a risk. Unless we actively work to ensure equity in research and health care, the gaps could widen further.
“There are a lot of new technologies and knowledge that we’re generating, but if these technologies and knowledge aren’t being disseminated equally or equitably, we could be continuing to contribute to these disparities,” Piawah notes.
For her part, Chase has remained active in advocating for cancer patients and survivors. She shares her story on her blog, Life on the Cancer Train, and also participates directly in the scientific pipeline by reviewing grant proposals from a patient perspective. In all of this work, she’s careful to keep health equity front and center.
“When I’m looking at these abstracts, I’m thinking about what’s in the scientist’s mind when they are coming up with these new medications or treatments,” says Chase.
When they think of the patients, is it all patients, is it inclusive of Black bodies? They need to recognize what the need is in the Black community – especially where things are failing.