Clinical trials, mental health, and digital therapies

In the treatment paradigm breast cancerPrecision medicine and new therapies have created new opportunities to deal with the physical burden of illness. However, the issue of access to these innovative therapies and interventions for the psychological aspects of diagnosis continues to prove to be significantly unsatisfied, especially in poorly serviced communities across the country. American Journal of Managed Care^® ((((AJMC^®).

Despite the universal decline in breast cancer mortality, black women experience Mortality rates at 5 and 10 years are doubled compared to white women. In closing these prominent disparities, issues related to insurance status, financial well-being, and other social determinants of health have long been cited as the cause of the detrimental consequences of breast cancer minorities.

However, biology has also been shown as a potential reason for these disparities, indicating that research is on the rise. Link Between black women and aggressive subtypes such as triple-negative breast cancer and inflammatory breast cancer.

Black women are also more likely to be diagnosed at a younger age or at a more advanced stage of the disease and have the following precautions: SiftingAdoption to these populations has long been delayed to explain the difference in risk. In addition, clinical trials conducted to evaluate these therapies largely excluded these populations, raising concerns about the applicability of new tumor therapies in the minority group.

Recent articles by American Society of Clinical Oncology (ASCO) Black patients make up less than 4% of all patients enrolled in multiple trials, demonstrating support for approval of immune checkpoint inhibitor treatment. lung cancer, A similar underestimation referenced in trials performed on renal cell carcinoma and other tumor types.

Barriers to minority access / uptake to breast cancer clinical trials

In addressing the lack of minority representation in clinical trials, GRYTHealth Partnership Director Megan-Claire Chase AJMC^® About patient and clinician-specific barriers that contribute to these disparities.

As a black woman and a survivor of breast cancer, Chase emphasized the stigma associated with clinical trials in diverse communities based on her past experience with. Henrietta Lacks Syphilis experiment Tuskegee black man From 1932 to 1972.

“There are many other atrocities like this. They are the stains that remain at the forefront of all black minds when they hear the words. Clinical trials, “She said.

As these questions are already of paramount importance to the minority when considering enrollment in clinical trials, Chase will seek help from clinician management during breast cancer diagnosis, especially during aggressive treatment. He added that it was a traumatic experience and contributed further to her distrust. Clinical trials and medical system.

“I wasn’t the most prevalent triple-negative in the black community, so I’ve been consistently asked about the types of breast cancer I had. We’re not all the same. Racism and prejudice It was a bitter discovery to see it occurring in the area of ​​cancer as well. “

Initially not aimed at becoming a patient advocate, these experiences helped Chase start blogging, highlighting the struggles to become a cancer survivor for young adults, and attracting people from diverse communities. We have made it possible to know that we and our voice are important.

Specifically, Chase listed five things that he felt needed to build trust, from the moment he met the medical community to diverse patients to conversations about participating in clinical trials.

• See us Chase said doctors need to learn how to speak silently, especially when using medical terms. “If you don’t understand what you’re saying, some of us ask you to explain it in another way, but because of lack of education, language barriers, or pure nerves. , Not all blacks or people of color speak. “
• Listen to us Chase noted the progress of breast cancer diagnosis two years after he overlooked his concerns and said it was because he did not have the typical breast cancer symptoms seen in white women. “Therefore, not all of us have the same symptoms, so clinical trials need diversity.”
• Be with us. Chase emphasized that at that point, doctors need to pay close attention to each patient, regardless of color. “We notice a lack of their body language and eye contact. Many of us feel rushed and won’t say what we wanted to say. This is what doctors want to say within these diverse populations. I missed the opportunity to build trust. “
• Believe us Chase talked about his lack of belief in pain and emphasized that “not all of us are drug seekers.” I want to find out the root cause of the pain. “
• Including us. When considering clinical trials, Chase said patients are seeking recommendations from their doctors and it should not always be the patient’s decision. “Many of us don’t understand when to consider an exam, what it means for our quality of life, or even what you are doing with our information. “

Raising the unprecedented voice of a diverse community is the focus of a recent collaboration between the chase organization GRYTHealth and Bristol Myers Squibb. Oncology Diversity..

More than 281,550 new cases of invasive breast cancer and more than 49,290 new cases of non-invasive breast cancer Estimated To influence women in the United States this year, she listened to diverse communities and emphasized the need to include hopes for improving the health inequalities of individuals who are forced to live every day.

“Although it’s only recently that we recognize and take action to address health inequalities, we are currently taking the highest level of serious and systematic efforts,” she said. “We believe that by having these necessary and courageous conversations on the issue of health inequalities and working with those who live in them, we can co-create structural changes together.”

Mental health solutions for breast cancer patients

As health inequalities widen in public conversations in a pandemic, unsatisfied gaps in mental health care are also in the limelight. For breast cancer patients, these problems are often Mental and emotional tension Caused by diagnosis and subsequent care.

“I hadn’t heard of my first symptoms before getting an official breast cancer diagnosis for more than two years. It’s been two years since I was consistently dismissed and I need to lose weight and reduce stress. I was told, “Chase said. “When I was finally diagnosed with stage 2A invasive lobular breast cancer in September 2015, I was justified because no one took my symptoms seriously until I felt the thickness of my left breast. I felt crushed. “

Pandemics that fuel emotions of stress, anxiety, and depression have exacerbated the emotional burden affecting breast cancer patients who have been newly diagnosed or who are afraid of possible recurrence.

In managing these mental health concerns, survival-critical emotional and well-being support services are often and generally nonexistent, not affordable, inaccessible, and / or common. Betty Sanchez, MSc, said it is not part of the treatment of tumors in the population. , MA, Advocate and Patient Advisor, Blue Note Therapeutics, Email Exchange AJMC^®..

Sanchez received face-to-face on-site mental health services from a local nonprofit organization that worked with oncologists and hospital care systems prior to the pandemic when discussing his experience as a survivor of metastatic breast cancer. He said he was lucky. However, when COVID-19 overturned all selective treatment and care, her depression and anxiety were suppressed, but she was back.

As seen during the pandemic, Expansion of telemedicine It has opened up access and care delivery possibilities to millions of patients across the US healthcare system. Unique to breast cancer Postponed care Sanchez’s organization Blue Note Therapeutics can recently lead to worse treatment outcomes Presentation In collaboration with the Memorial Sloan Kettering Cancer Center, we have developed an app that provides accessible on-demand care for people with cancer to treat their risk of recurrence.

“Patients’ self-awareness that mental health, emotional, and well-being treatment services are important and respectfully and easily available for digital treatment of cancer-related distress after breast cancer diagnosis, and what follows. It is accessible, which can have a strong impact on boosting your health, “says Sanchez.

Sanchez looks at the potential of digital therapies to remove barriers that cause health inequalities such as transportation and access, adding that voice instruction and reminders available through the app can provide culturally sensitive care. I did. Relax, think about sleep quality, and identify the difference between stressors and anxiety.

“With the introduction of prescription digital therapies to treat comorbidities in the mental health of cancer, healthcare providers have the opportunity to meet the patient’s holistic and home-based needs,” Blue Note Therapeutics said in a statement. AJMC^®..

Blue Note is a diverse patient advisor, partner, designed to represent the entire U.S. community, with particular attention to the barriers to equitable access to psychotumor treatment in the development of digital medicine. And said that clinical trials are included.

“Our digital therapies are needed to provide tools for managing the pain of associated cancers, while at the same time considering future medical decisions and ultimately enhancing overall treatment success. We provide a problem-focused approach. “