After surviving two cancers in two years, I'm gratefully celebrating National Cancer Survivors Day today with a wish for continued clear scans, good health, and longevity, not just for myself, but for the more than 18 million cancer survivors in the US.
The overall five-year cancer survival rate has improved considerably in the last few decades and the number of survivors is projected to jump to 22.5 million by 2032 thanks to better screening, novel therapies, and other medical advances.
That’s welcome news and as Artificial Intelligence (AI) promises to further transform cancer prevention, detection, research and treatment, there will be even more of us who will stare down and conquer cancer.
Next generation medicine will likely be more personalized and pricier, so unless we do more to eliminate persistent cancer disparities, a disproportionate number of survivors will continue to look like me - a white, straight, middle class, middle-aged, educated, and insured man, living in suburbia.
I’m surviving because, in part, once diagnosed, I didn’t have to battle Medicaid, Medicare, or my insurer to pay for surgery, radiation or chemotherapy. I didn’t face sexism, racism, homophobia, or language barriers at my oncologist’s office. I didn’t have to wait weeks for appointments, take three buses to get there or contemplate whether to pick up my prescriptions or pay the mortgage. I had childcare, rested safely and comfortably at home after each grueling treatment and never went hungry.
Battling cancer is tough enough without also struggling with nonmedical factors that give the relentless disease an unfair advantage.
The social, economic, and environmental conditions in places where people live, learn, work, play and pray often reinforce profound inequities in who gets cancer, when it’s discovered, how it’s treated and monitored, and ultimately, who lives and dies.
Of course, behavior, biology and genetics play a role, but federal health officials say that social determinants of health (SDOH) account for up to 50 percent of the variation in health outcomes.
Diagnosed with prostate cancer in 2022 after a routine physical exam, the disease didn’t kill me, but Black men in America are twice as likely as their White counterparts to die of the disease and continue to have the highest rates of prostate cancer in US.
Though their risk varies based on their country of origin, Hispanic patients with localized prostate cancer are nearly 20 percent more likely than white men to have aggressive disease, compared to White men, with only approximately 60 percent receiving appropriate treatment.
I recently completed six months of radiation and chemotherapy for Stage 3B colorectal cancer and, in that instance, too, I had no symptoms, and was diagnosed during a routine exam.
Studies show that less than half of Hispanic men are current on their colorectal screenings and not surprisingly, people of all races without insurance, those who are poor and those with less than a high school education have the lowest screening rates African Americans are about 20 percent more likely to get colorectal cancer and about 40 percent more likely to die from it than most other groups, largely due to screening disparities.
While I was lucky enough to be enrolled in a clinical trial, people of color, women and other underserved populations have been underrepresented in research in a way that slows advancements in cancer care for everyone.
Breast cancer is the most common cancer in the US and Black women here are 40 percent more likely to die from breast cancer than non-Hispanic White women. Black women under 50 with aggressive cancers suffer a mortality rate that’s double that of White women.
The National Cancer Institute (NCI) points out that Black, Hispanic, and American Indian/Native Alaskan women are diagnosed with cervical cancer more often than other women and again, Black women have the highest rates of disease.
Ultimately, the most powerful social determinant of health is money and while addressing persistent poverty or income inequality won’t cure cancer, closing those gaps would give the 2 million Americans who will hear the words, “you have cancer” this year a fighting chance to celebrate with me.