Early Chemo Less Likely to Help Black Breast Cancer Patients: Study Finds

By Robert Preidt
Friday, December 11, 2015

FRIDAY, Dec. 11, 2015 (HealthDay News) — Early chemotherapy is less likely to benefit black women with breast cancer than those in other racial and ethnic groups, a new study finds.

Advanced breast cancer is more common among black, Hispanic and Asian women than it is in white women. As a result, black women often receive chemotherapy before surgery in an effort to improve their outcomes, the Yale University Cancer Center researchers said.

But their study of 27,300 women with stage 1 to 3 breast cancer showed that early (neoadjuvant) chemotherapy was less effective in black patients than in other women.

“Even when we controlled for the fact that minority women often present with more advanced-stage, higher-grade tumors, and more aggressive types of breast cancer overall, our team was surprised to find that black women did not respond as well to neoadjuvant chemotherapy compared to other racial groups,” study first author Brigid Killelea, an associate professor of surgery (oncology), said in a Yale news release.

It’s not clear why early chemotherapy is less effective in black women, the researchers said, but possible factors include differences in sensitivity to chemotherapy, treatment differences or social and economic factors.

More research is required, according to study senior author Dr. Donald Lannin, a professor of surgery (oncology) at Yale.

“The next step should be to determine which drugs black women respond to and which they don’t. For future studies, it will be important to have enough black women in the trials, so that we can be certain they benefit equally from new drugs as they are developed,” Lannin said.

The findings were published recently in the Journal of Clinical Oncology.

SOURCE: Yale University, news release, Nov. 30, 2015

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Health Equity

Health Equity, is defined as the opportunity for everyone to attain his or her full health potential. No one is disadvantaged from achieving this potential because of his or her social determined circumstances.  Health Equity is centered around  equal access to quality education, healthcare, housing, transportation, and other resources. Equitable pay/income, equal opportunity for employment, and absence of discrimination based upon social status and other factors all contribute to an equitable health care system. How do we achieve health equity?  According to the Health Equity Institute of San Francisco State University, to achieve health equity, we must eliminate avoidable health inequities and health disparities requiring short-and long-term actions, including:

  • Attention to the root causes of health inequities and health disparities, specifically health determinants (https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health), a principal focus of Healthy People 2020. Particular attention to groups that have experienced major obstacles to health associated with socio-economic disadvantages and historical and contemporary injustices.
  • Particular attention to groups that have experienced major obstacles to health associated with socio-economic disadvantages and historical and contemporary injustices.
  • Promotion of equal opportunities for all people to be healthy and to seek the highest level of heath possible.
  • Distribution of socio-economic resources needed to be healthy in a manner that progressively reduces health disparities and improves health for all.
  • Continuous efforts to maintain a desired state of equity after avoidable health inequities and health disparities are eliminated.

Our aim here at Williams & Associates, Inc. is to address minority health disparities. The concepts of health equity and health disparity are inseparable in their practical implementation. Policies and practices aimed at promoting the goal of health equity will not immediately eliminate all health disparities, but they will provide a foundation for moving closer to that goal.

Black Guys PrEP, Is Prep Right For You?

Deciding To Use Prep Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently.

PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.

To Prep or not to Prep, is an individual decision based on many factors, including your sexual practices, choice of sex partners, willingness to use other prevention methods, and whether you can stick to a daily regiment of pill taking. Having a strong support system, i.e., health care providers, friends, case managers, etc… It is hoped that Prep, along with condom use, can help turn the tide in terms of new HIV infections among some high risk groups, such as men who have sex with men.

Williams & Associates, Inc., currently offers up-to-date PrEP information, and linkage to PrEP medical care through partnership with other local PrEP providers. Reach out to the agency for more information, and look out for future PrEP events.

African American Health

According to the CDC (Centers For Disease Control and Prevention), African Americans are living longer. The death rate for African Americans has declined about 25% over 17 years, primarily for those aged 65 years and older. Even with these improvements, new analysis shows that younger African Americans are living with or dying of many conditions typically found in white Americans at older ages. The difference shows up in African Americans in their 20s, 30s, and 40s for diseases and causes of death. When diseases start early, they can lead to death earlier. Chronic diseases and some of their risk factors may be silent or not diagnosed during these early years. Health differences are often due to economic and social conditions that are more common among African Americans than whites. For example, African American adults are more likely to report they cannot see a doctor because of cost. All Americans should have equal opportunities to pursue a healthy lifestyle.

Public health professionals can:

  • Use proven programs to reduce disparities and barriers to create opportunities for health.
  • Work with other sectors, such as faith and community organizations, education, business, transportation, and housing, to create social and economic conditions that promote health starting in childhood.
  • Link more people to doctors, nurses, or community health centers to encourage regular and follow-up medical visits.
  • Develop and provide trainings for healthcare professionals to understand cultural differences in how patients interact with providers and the healthcare system.

St. Louis Violence: A Public Health Issue

According to the St. Louis Post Dispatch (July, 2015) St. Louis police reported 4,434 crimes to the FBI in June.

Statistics released by the St. Louis Police Department show there were 22 homicides in May, up from 15 reported in May and up from six reported in June 2014.

Homicides as of this writing, total 115, up from the first six months of 2014. Homicide numbers don’t always match completely because adjustments are made when people die later of injuries or developments change the category. What often isn’t reported is the public health impact of violence within a community. We in public health refer to such things as violence, employment, housing, and crime, among others, as “social determinants” of health. Meaning, these variables impact heath outcomes for individuals and for the community.

The impact on young people who witness, and in many cases, are victims of violence, go on to develop mental health issues that interfere with their personal growth, and world view of their environments and self-esteem. Community violence includes many events. It might be a stranger using physical threat or direct violence to take something or hurt someone. It can also be violence between family members, close partners, or peers. These events may include cruel acts such as being shot, raped, stabbed, or beaten. Most of the attention from media and research is on community violence that involves adults. However, many children and teens face violence in their neighborhoods and schools. Such violence can have effects on children.

Who is at risk?

Sadly, there is no way to make sure your child does not face community violence. However, we do know some of the factors that add to a child’s risk for coming into contact with community violence:
•Living in poor, inner-city areas.
•Being non-White.
•Being in a gang or using alcohol or drugs.
•Living in a home with domestic (family) violence.
•Males see more community violence than do females and are at more risk for physical attacks.
•Females are at more risk for sexual assault.

What are the effects of community violence?

If hurt by violence, a child may have to cope with physical or medical problems. A child may also have mental health problems, including PTSD. Some people think that young children are not harmed by community violence because they are too young to understand or remember. However, studies have found signs of PTSD in babies and young children.

Violence impacts the entire community. A public health approach is needed when it comes to addressing the impact of violence on individuals and the community.