Bridging Cancer Care Gaps and Overcoming Medical Mistrust

Oscar B. Lahoud, MD, cochair of a recent Institute for Value-Based Medicine^® event hosted with NYU Langone Health, knows the importance of community oncologists and academic medical systems coexisting and partnering to enhance community cancer care programs and smoothly transition patients between these settings.

Especially for medically underrepresented communities—who consequently may be underserved and underresourced—medical mistrust can be a significant issue to overcome. Here, Lahoud, clinical associate professor at NYU School of Medicine, section chief of Hematology at NYU Langone Health in Brooklyn, and director for strategy and network operations for Hematology/Oncology at the Perlmutter Cancer Center, discusses how NYU Langone works to overcome this and the success it has seen enrolling underrepresented minorities in clinical trials.

This transcript has been lightly edited for clarity.

Transcript

How can clinicians and researchers best communicate their academic research goals to overcome medical mistrust?

That's a very good question, and something that's very dear to me. I actually moved to NYU with a focus on NYU Brooklyn exactly for that purpose.

Just to give you an idea of the kind of patients we're seeing here in Brooklyn, Sunset Park, 82% of our patients have insurance that's government funded, mostly Medicaid. And we understand the challenges for many of our often underserved but also underresourced patients to be able to travel to an academic center to have access to novel therapies. So, ways that academic centers have now begun to come up with in order to bridge the gap between these patients and the care they want to be able to provide to them is by bringing academic centers to the community directly.

NYU is spread across almost all of the New York boroughs, but also across Long Island, and the thought is that we would have sites close enough to the community with a hospital hub. We have 1 full hospital in Brooklyn, 1 on Long Island—soon another one—and 1 in Manhattan, and this way patient can travel easily. So proximity, having the academicians come and meet patients in the community, is one way.

In terms of underrepresented minorities, that's essential because historically research was used in these populations…there's basically bad blood there. I don't want to go back to the Tuskegee experiments and all of that, but there's mistrust that has been there, and whenever historically they had been presented with clinical trials, they thought that they were the guinea pig for something that really there was no knowledge of.

So one key is to change the narrative around that. Now, we no longer have our patients feel like they're guinea pigs. We rather offer them the opportunity to have access to potential novel therapy ahead of the rest of the community—before it's even approved—while we believe it will have an effective role in their disease management. And we've been pretty successful with that.

Just at the cancer center at NYU in Brooklyn, 100% of the patients who were able to enroll on cancer clinical trials were all non-White, all from underrepresented minorities. That’s probably what I've been the most proud of from the team here: really being able to engage with these minorities and make them understand the value of academic medicine and those clinical trials.

We have other things that are helping directly navigating patients from primary care all the way to cancer screening to quick referral to their specialists whenever cancer is detected to the comprehensive care. A fully integrated structure to help patients along their journey is what has also helped bridge much of this gap.