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Friday, April 18, 2014

Understanding Barriers in Health Care Among Minority Populations

This week is National Minority Cancer Awareness Week, which draws particular focus to the inequalities and disparities that affect minority populations, when seeking or receiving care for cancer.

This year, nearly 1.6 million people will be diagnosed with cancer. Those numbers will disproportionately affect minority populations. Although complex social, economic and cultural factors play a role, these disparities demonstrate the need for greater outreach, support and commitment throughout the year.

The Abramson Cancer Center Office of Diversity was established in 2013 by the Abramson Cancer Center director, Dr. Chi Van Dang. And, at Penn, researchers at Penn Medicine are trying to collectively study and understand the barriers to screening, healthcare access, diagnosis, treatment, and care. A few such researchers addressing cancer health disparities are highlighted below.

Carmen Guerra, MD, MSCE

Dr. Guerra is the Director of the Abramson Cancer Center’s Office of Diversity. The Office of Diversity supports education, outreach and programs focused on reducing racial and ethnic disparities in the prevention, screening and treatment of cancer. Dr. Guerra’s research focuses on programs that overcome the barriers to accessing cancer screening in minority communities, particularly those that are underrepresented. Along with Dr. Michael Kochman and patient navigator, Alicia Lamanna, Dr. Guerra established the Penn Medicine Colorectal Cancer Screening Navigation Program for West Philadelphia Residents and the newly created Healthy Woman Program. Both programs focus on vulnerable communities and reduce barriers to accessing life-saving cancer screening tests.

Chyke Doubeni, MD, FRCS, MPH

Dr. Doubeni is an Associate Professor and Vice Chair for Research in the Department of Family Medicine and Community Health. He is also a Senior Scholar in the Penn Center for Clinical Epidemiology and Biostatistics, and a Senior Fellow in both the Leonard Davis Institute of Health Economics and the Center for Public Health Initiatives. Dr. Doubeni's research is on colorectal cancer, focusing on racial and socioeconomic disparities in mortality and on the effectiveness of screening.

He currently leads NIH-funded multi-site studies of the comparative effectiveness of colorectal cancer screening. He is also  a co-principal investigator in one of three colorectal cancer research centers of the PROSPR (Population-Based Research Optimizing Screening through Personalized Regimens) network, examining critical questions about factors that limit the optimal performance or effectiveness of colorectal cancer screening in order to remediate avoidable failures in the process of screening.

Learn more about Dr. Doubeni here.

Timothy Rebbeck, PhD

Dr. Rebbeck is a Professor of Epidemiology in the Department of Biostatistics and Epidemiology, as well as Associate Director for Population Science at the Abramson Cancer Center. He leads molecular epidemiologic studies to identify and characterize cancer genes and their relationship with cancer occurrence and cancer outcomes in the context of the demographic, biochemical, environmental, and physiological risk factors.

He has focused this research to address the following questions:
  1) Why do men of African descent have higher incidence and
       poorer prognosis for prostate cancer compared to other
       groups?
  2) How do we refine our understanding of cancer risk and
       prevention in women who have inherited BRCA1 or BRCA2 mutations? 3) How do genes,
       environments, and other contextual factors interact in the etiology of commonly
       occurring cancers?

Curtiland Deville, MD

Dr. Deville is an Assistant Professor and Chief of the Genitourinary and Sarcoma Services in the Department of Radiation Oncology. He serves on the American College of Radiology Commission for Women and General Diversity and is the incoming Vice Chair for the American Society of Radiation Oncology Health Access & Training Subcommittee, both charged with improving physician workforce diversity. He has a research interest in assessing and improving diversity in the cancer physician workforce as a means to addressing health disparities. His research has demonstrated that, in the United States, there is currently a relative lack of minority physicians involved in cancer care compared to other medical fields, and seeks methods to increase Black, Hispanic, and Native American physician training in cancer specialties. Minority providers are more likely to care for underserved and minority populations and physicians that train with racially and ethnically diverse colleagues feel more comfortable seeing culturally diverse patient populations. The American Society of Clinical Oncology set the objective of diversifying the clinical oncology workforce as a “requisite to improving cancer care for the underserved” in their 2009 Disparities in Cancer Care policy statement to ensure that the medical field is well-equipped to meet the needs of our ever-increasingly diverse population.

Jeffrey Silber, MD, PhD

Dr. Jeffrey Silber is the Nancy Abramson Wolfson Endowed Chair in Health Services Research at The Children’s Hospital of Philadelphia and Professor of Pediatrics, Health Care Management, and Anesthesiology & Critical Care at University of Pennsylvania and directs the Center for Outcomes Research at The Children’s Hospital of Philadelphia.

In a recently published paper in JAMA, Dr. Silber examined whether the lower survival rates observed in African American women with breast cancer, compared to white women, were due to differences in biology, presentation, or treatment. Dr. Silber and his colleagues reported that white and black patients present very differently at the time of diagnosis of breast cancer, in terms of variables like tumor size, stage, and health conditions like diabetes and heart failure.

In a large study of more than 100,000 Medicare patients, he found that the percent of blacks with tumors greater than 4 cm is almost double that of whites matched for demographics (21.6% vs. 11.7%). Similarly, 9.2% of blacks present with Stage IV, compared to 5.1% of the demographics-matched whites. Treatment differences accounted for less than 1% of the nearly 13% difference in 5-year survival, whereas presentation differences accounted for over two-thirds of the disparity in survival.

The Abramson Cancer Office of Diversity

The Abramson Cancer Center Office of Diversity supports the Abramson Cancer Center’s mission, vision and values by promoting diversity and inclusion as an integral part of the Center’s goals to understand, prevent, treat and cure cancer.

The Abramson Cancer Center Office of Diversity supports initiatives like the Minority Cancer Health Awareness Week seeking to raise the awareness of cancer health disparities.

Thursday, April 17, 2014

New Stress Management Programs at Penn

Spring is a great time to find new balance, and take moments to get on track with work, home life and fun with your family.

The Penn Program for Mindfulness is a mindfulness-based stress management program that teaches you how to use meditation as the primary tool for long-term stress management. Mindfulness meditation is taught in a completely practical way as a powerful tool to manage the physical, psychological, and behavioral symptoms of stress.

Below are some of the classes offered from the Penn Program for Mindfulness this spring.

Mindfulness-Based Stress Management

This highly acclaimed eight-week program course will teach you a variety of meditation techniques to help you to cultivate relaxation, clarity and stillness in your day-to-day life. You will learn to recognize your unique reactions to stress, to find more effective ways to respond to stressful situations, and discover how to use your own inner resources to find greater health and well-being.
  • Eight 2-½ hour weekly classes and one full day Saturday on June 7. (CE Credits available)
  • Eight-week courses start week of April 28, 2014.
  • Nine classes in eight locations in PA and NJ.
Mindfulness-based stress management is perfect for anyone hoping to maintain focus and learn positive ways to manage stress.

Penn Mindfulness Programs begin week of April 28 – registration deadline, April 24.

Learn more or register here. 

The Neuroscience of Meditation

In recent years, scientists have learned a lot about the brains and lives of people who meditate. We have learned that meditation affects multiple aspects of brain function and structure, including metabolic activity, neural communication, and even the composition of brain tissue itself. Several recent discoveries, such as the influence of meditation on neuroplasticity and how it leads to synchronization between left and right sides of the brain, provide us with a deeper understanding of how embodied meditation supports personal integration and psychological growth.


Join us on Wednesday, April 23 from 7 to 9 pm for a special presentation reviewing some of these most interesting and important new discoveries in the neuroscience of meditation. This presentation, suitable for the lay public as well as scientists and clinicians, will review of some of these most interesting and important new discoveries in the neuroscience of meditation.

Learn more or register here. 

Healing the Heart and Mind: Mindfulness Meditation for Health Care Professionals

Annual eight-week mindfulness based stress program for health care providers. CME, CEU, CE credits available. Discount for Penn Medicine employees.

Class starts May 1, 2014.
Learn more or register here.

Penn Program for Mindfulness Welcomes Back Sharon Salzberg

The Penn Program for Mindfulness is delighted to welcome Sharon Salzberg back to Philadelphia for two special events on May 20-31, 2014. May 30 will feature an evening lecture titled “Real Happiness at Work." Saturday, May 31 will feature a 3-hour workshop focused on “Loving kindness in the Face of Adversity”.

Learn more or register here.

Tuesday, April 15, 2014

Office of Diversity Recognizes National Minority Cancer Awareness Week

Curtiland Deville, MD, is an Assistant Professor and Chief of the Genitourinary and Sarcoma Services in the Department of Radiation Oncology. He has a research interest in assessing and improving diversity in the cancer physician workforce as a means to addressing health disparities. In this article, he discusses National Minority Cancer Awareness Week.

On April 8, 1987, the U.S. House of Representatives' Joint Resolution 119 designated the full third week in April as National Minority Cancer Awareness Week. As explained in the Congressional Record, Resolution 119 drew attention to "an unfortunate, but extremely important fact about cancer. While cancer affects men and women of every age, race, ethnic background and economic class, the disease has a disproportionately severe impact on minorities and the economically disadvantaged."

Why Diversity and Disparities Matter

Each year in the United States more than 1.6 million* people are diagnosed with cancer. Of those, racial and ethnic minorities are disproportionately affected. Although complex social, economic, and cultural factors may play a role, ultimately when considering and controlling for all of the above, racial and ethnic differences in outcomes still exist across the majority of cancers.

Source: American Cancer Society:*

  • Although white women are more likely to be diagnosed with breast cancer, black women are more likely to die from breast cancer.
  • Blacks are less likely to be screened for colorectal cancer and more likely to die from it.
  • Hispanic women are less likely to be screened for and more likely to be diagnosed with and die from cervical cancer.
  • Blacks are less likely to be diagnosed with lung cancer, but more likely to die from it, if diagnosed.
  • Black men are more likely to be diagnosed with prostate cancer and twice as likely to die from it compared to white men.

The Abramson Cancer Center's Office of Diversity

The Abramson Cancer Center joined CityLights Network and American Cancer Society at the Ezekiel Baptist Church in southwest Philadelphia for a free community education program about prostate and breast cancer. Left: Carey Davis, director of CityLights Network, Tom Henry, Brenda Bryant, senior research / outreach coordinator for the ACC Office of Diversity, Curtiland Deville, Jr., MD radiation oncologist and Carmen Guerra, MD, Penn physician.
The Abramson Cancer Center Office of Diversity was established in 2013 by the Abramson Cancer Center director, Dr. Chi Van Dang. The Abramson Cancer Center Office of Diversity supports the Abramson Cancer Center’s mission, vision and values by promoting diversity and inclusion as an integral part of the Center’s goals to understand, prevent, treat and cure cancer.

The Abramson Cancer Center's Office of Diversity supports initiatives like the Minority Cancer Health Awareness Week seeking to raise the awareness of cancer health disparities.

Be sure to subscribe to our blog to learn more about cancer disparities research happening at Penn.

For more resources and information:

Thursday, April 10, 2014

Amyloidosis Support Group - This Saturday 4/12

The Biannual Amyloidosis Support Group Comes to Penn Medicine

In partnership with the Amyloidosis Support Group, Penn Medicine's Amyloidosis Program will be hosting this year's Biannual Amyloidosis Support Group event.

The event will featue a questions and answers segment with guest speaker Dr. Vaishali Sanchorawala as well as the Penn Medicine doctors and staff of the Abramson Cancer Center Amyloidosis Program.


Topics to be discussed throughout the event include:
  • Announcements of new clinical trials and treatments
  • Questions read and answered Amyloidosis Support Group doctors
  • How LLS can help AL amyloidosis patients
  • An informal discussion over lunch with speakers and participants
  • Nutrition and Physical Therapy for amyloidosis patients
  • Raising awareness and other ways to help 

RSVP and join us Saturday April 12th, 2014 
from 9:00am - 2:30pm
Perelman Center for Advanced Medicine
3400 Civic Center Blvd, Philadelphia, PA 19104
Main Lobby of the Translational Research Center
PARKING IN PENN TOWER IS FREE / WILL BE VALIDATED
Follow Signage - Complimentary Food Served -
RSVP for the Biannual Amyloidosis Support Group 

Tuesday, April 8, 2014

Twenty Years Later: How Breast Cancer Risk Genes are Changing Patient Care

BRCA1 and BRCA2, the genes implicated in hereditary breast and ovarian cancer, have become common parlance, especially since Angela Jolie’s May 2013 disclosure of her genetic mutation and subsequent mastectomy. This has not always been the case - just twenty years ago, these genes were being discovered.

In a “Perspective” article featured in Science Magazine, Dr. Katherine L. Nathanson, MD, Director of Genetics and a funded investigator at the Basser Research Center for BRCA, explains how far we have come in respect to genetic assessment of risk for breast cancer.

“A woman’s risk of breast cancer is still very much tied to family history, but it’s not just about their mother or grandmother; it’s about their father and his family history, too, and the population groups an individual’s family belongs to,” said Dr. Nathanson.

"Twenty years of research has provided a lot more information about these risk factors, which helps us to more effectively counsel patients about their own cancer risk and possible preventative strategies.”

Read about the past, present and furture of BRCA research in a Penn Medicine Press Release covering Dr. Nathanson’s article.

Thursday, April 3, 2014

Modern Healthcare Features the Basser Center’s Sculpture, Homologous Hope

Modern Healthcare, a leading source of healthcare business and policy news, research and information reports on the Homologous Hope sculpture, designed to honor the Basser Research Center for BRCA of Penn Medicine’s Abramson Cancer Center.

Highlighting the sheer size of the sculpture—900 pounds—and it’s fidelity to the actual form and function of the BRCA2 protein, Modern Healthcare emphasized artist Mara G. Haseltine’s desire to spin hope from science in article entitled Outliers: “The really BIG picture on cell repair.”

Read the full article here.

Wednesday, April 2, 2014

Double Mastectomies: What Price for Peace of Mind?

More magazine recently reported on the trend towards increased rates of double mastectomy, featuring an eye-catching image of a female torso with open circles dotting the bare chest instead of breasts which had been hollowed out from the statue. Investigating this trend towards mastectomy, the article extensively quotes Susan Domchek, MD, director of the Basser Research Center for BRCA at Penn Medicine’s Abramson Cancer Center.

While a proven method of decreasing breast cancer risk, mastectomy is not the only option for women at high risk for breast cancer who can also consider more rigorous breast cancer surveillance, medications to reduce risk, and oophorectomy, which if done pre-menopausally decreases breast cancer risk by 50 percent.

Read more and learn what else Dr. Domchek has to say.

Learn more about the Basser Research Center for BRCA.
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