I have always been interested in the relationship between race and cancer therapy. For some reason, African Americans face a higher genetic risk of getting a number of different cancers.
But my concern is the higher death rates associated with these risks. Last May I wrote an article addressing this issue titled Say It Isn’t So In 2010—African American Multiple Myeloma Patients Face Therapy Discrimination. Now there is a lung cancer study which supports the theory that African Americans aren’t always getting the quality care they need:
Cultural Factors May Skew Cancer Differences
Despite a high likelihood of death, black patients are much less inclined to have surgery for early stage lung cancer than whites, often because of a communication gulf between them and their doctors, scientists at the University of North Carolina-Chapel Hill report.
In a study published in the Journal of the American Medical Association, university researchers surveyed nearly 400 patients newly diagnosed with lung cancer to determine what factors influenced their treatment decisions.
For black patients, who have long had worse outcomes for lung cancer than whites, just 55 percent chose surgery to remove the tumor – the only lifesaving option when cancer is diagnosed early. Sixty-six percent of white patients chose surgery.
The university team found that many black patients misunderstood their prognosis, or didn’t connect well enough with their doctors to feel comfortable discussing the options.
Such insights, while specifically addressing a decision about lung cancer treatment, may help explain persistent differences between racial minorities and whites in disease interventions and outcomes.
“It’s a frustrating problem,” said Dr. Samuel Cykert of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina-Chapel Hill and lead author of the study. “It’s not just lung cancer,” he said. “It’s everything from using tooth floss to knee replacement surgeries. There are hundreds of categories where disparities systematically exist.”
Cykert said many black patients reported they didn’t connect with their doctors, and as result, didn’t ask questions or initiate a dialogue about treatment options and their potential outcomes.
“Black perceptions of physicians as uninterested and less engaging lead to fewer adherences to physician recommendations and inadequate understanding of treatment problems,” the study authors reported.
Patients often opted against surgery if they interpreted pessimistic spin in a doctor’s explanation about the difficulties of the procedure and post-operative rehabilitation.
For the doctor, that pessimism may stem from a subtle bias. Among the study participants who declined surgery, black patients tended to be older and single, and have more health problems in addition to their cancer – factors doctors might see as impediments to a strong recovery.
How unfortunate. Read the complete article by going to CancerCompass.com/Cultural Differences.
Feel good and keep smiling! Pat