Do Ethnicity and Self-Advocacy Influence Cancer Outcomes?

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Topics include: Treatments and Self-Advocacy and Empowerment

Live on location on Capitol Hill, Patient Power Host, Carol Preston, interviews surgical oncologist, Dr. Jose Trevino of University of Florida College of Medicine, following the AACR Conference and Vice President Biden’s Cancer Moonshot Summit.  Dr. Trevino is passionate about leveling the playfield for every cancer patient.  No patient should ever lack access to top care, and Dr. Trevino and his colleagues are working hard to empower patients and to increase provider outreach.  As VP Biden says, “No more working in silos.”

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Carol Preston:

Hello, everyone, and welcome to Patient Power. I'm Carol Preston. Standing in the Dirksen Senate Office Building on Capitol Hill, just having wrapped up with an AACR conference, American Association of Cancer Research, with a focus on where research is headed as well as the need for continued funding in basic science.

And I'm standing here with Dr. Jose Trevino… 

Dr. Trevino:

Yes, ma'am. 

Carol Preston:

…from? 

Dr. Trevino:

The University of Florida.  

Carol Preston:

Right, surgical oncologist.  And one of the emphasis from you, Dr. Trevino, was this issue of diversity and how cancers—the same cancer in different people, depending on their background, their ethnicity and race really can have an influence on outcomes.  

Dr. Trevino:

So when you look at cancer, what we started to recognize more and more every day is not only just a matter of different people developing different types of cancer but that the same cancer in a different person is going to act differently. And what we've really started to recognize when you start to break this down even further is that race seems to play a role. 

There are people of different races and ethnicities that have the same type of cancer with other—other races, and, unfortunately, they develop worsening disease.  They get larger tumors, or they get a poor outcome.  Their morbidity and their mortality is much higher.

Carol Preston:

One of the things that you mentioned was the fact that so many of these patients, potential patients, are not getting to centers where they can get an efficient, quick, precise diagnosis. 

Dr. Trevino:

Right, and that's true.  And so one of the things that we kind of try to investigate is what are the barriers?  Is it biological barrier?  Is the patient's tumor just so much aggressive that it's never really going to get to a point of getting the best therapies?  Or is it—are there socioeconomic barriers?  Are people just not coming because they don't trust the institutions because they don't have the money to get into the institutions, or they don't have the—or they just don't believe that a tertiary care center that has a big approach with multiple different doctors, which we call a multidisciplinary approach, is going to help them?

Carol Preston:

Well, one of the things that just I've learned as a cancer survivor is that we tend to trust sometimes the first doctor we see, the oncologist, and it's such an overwhelming diagnosis that to go beyond that first physician sometimes is tough. 

Dr. Trevino:

It is.  And that's why we open our doors to that.  And not only do we try to educate the patients, we also try to educate the physicians as well.  You mention a very important point that when the patient gets to their first primary care doctor, which they trust, they trust that that primary care doctor is going to know how to get them into the door to a big center that is going to help them. 

We see a lot of patients that go see their primary care doctor, and they tell them that they need to, quote, unquote, get their affairs in order, and that's just not the way we treat cancer these days. We are very aggressive, and we know that we can increase someone's lifespan if they can come to us, even in the cases where the primary care physician says there's no way. 

Carol Preston:

Do you think then that specialists like yourself need to maybe reach out more to the community oncologists?  

Dr. Trevino:

So Dr. Sylvia Lee from the University of Pennsylvania mentioned a really good point, and it's actually something we do a lot at the University of Florida, we do outreach.  I go to churches, and I'll go on Sunday mornings, and I will speak to all the people in the room. I'll go to group meetings, and I will speak on a Sunday, an a Saturday, on a Friday, it doesn't matter, because that's how we really try to empower the people and say, hey, listen, you have a problem. And even though your primary care physician, the first physician you saw tells you that there's nothing you can do, there is something you can do. There's always something you can do.

And so we try to empower the people to be able to become their own advocates to get through the door.  And it's funny, because I actually give out my cell phone number, and they will call me and say, you know, my mother has this cancer. Can you see my—can you see her? Can you try to help her? Absolutely.  And it's something that we really pride ourselves as a Department of Surgery at the University of Florida is that we will see anybody. We'll get them in the door. Cancer is something that we don't take lightly. And because you don't have the finances to get in the door, that's not an excuse.  You can get in the door.

Carol Preston:

So, Dr. Trevino, just to wrap up then, you see tremendous hope even for the toughest cancers like pancreatic cancer.

Dr. Trevino:

I do.

Carol Preston:

There is hope if patients are willing and doctors are willing to get together, specialists to take the extra step…

Dr. Trevino:

Absolutely.

Carol Preston:

…to meet up with each other.  

Dr. Trevino:

And so it becomes the patient becoming their own advocate, the primary physician who sees them to become empowered to get them to us, it's us getting together with them. It's you know Dr.—I'm sorry, Vice President Biden mentioned that we were practicing wrong in the fact that we were practicing in silos, and we want to break that apart. We want to bring us all together. 

So it's the patient.  It's the patient advocate.  It's the patient's family.  It's the surgeon.  It's the medical oncologist.  It's the radiation oncologists. It's everybody needs to be in that room, and that's what we try to do.  And I think that's the only way we're going to make the big advance that we need to make in cancers. 

Carol Preston:

Dr. Trevino, thank you so much. From the University of Florida, appreciate your time.  I'm Carol Preston on Capitol Hill. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on July 19, 2016