Did you know in the African-American community 95,000 men and 82,000 women are predicted to be diagnosed with cancer this year? Statistics also show that African Americans have the highest mortality rate of any racial and ethnic group for all cancers combined and for most major cancers.” When compared to Whites, African American women are 40% more likely to die from breast cancer and African American men are 2.5 times more likely to die from prostate cancer.
To address the issue of cancer among African Americans, BFT spoke with Dr. Joycelyn L. Speight, a board certified Radiation Oncologist and Palliative Care specialist, and since 2008, is considered one of the “Best Doctors in America” – a prestigious peer-voted group – for her leadership in the study and treatment of cancers. Read our interview as Dr. Speight discusses cancer in the African-American community, advice on treatment options and the role personal fitness can play in preventing the deadly disease.
BFT: It’s no secret, entering the medical field requires years of schooling and hands-on training, which cannot be accomplished without dedication, passion and determination – what influenced you to make Oncology, the study of [and treatment of] cancer, a career?
Dr. Speight: I think it will come as no surprise that my parents and my community had a huge impact and influence on my decision to enter medicine. My parents and their contemporaries embodied “the greatest generation”. Each of them were pioneers. They, moved across the states to set up medical practices in unknown cities to serve populations who otherwise would have had little to no care. The relationships they forged, and sense of pride they took in what they contributed, and the real benefit they brought made a huge impression on me and many of my contemporaries who also followed their parents into the medical profession. That fact that I loved math and science and felt compelled to bring home every sick stray animal to try to nurse back to health were “value adds.”
BFT: Do you believe there is a lack of cancer awareness in the African-American community? In your opinion, what needs to be done to improve the absorption of cancer prevention messaging in the community?
Dr. Speight: There is good data that suggests that the way in which information is communicated to a person, impacts how it is received and understood. This is true not only by African-Americans, but for a host of groups when looked at by race, ethnicity, gender, age, geography and socio-economics. I don’t think I would say there is a lack of awareness across the board. For example I think that many people are aware of breast cancer, & prostate cancer, but perhaps not the importance of screening, what their individual risk factors may be, how to reduce their risk of getting the cancer, etc. To me this translates to a lack of opportunity to live the healthiest life possible. This problem is compounded by access to care issues, patient compliance, among many other variables, not to mention the confusing and conflicting information on the web, that comes out in sound bites on the news With regards to prevention there are many avenues that can be taken, some of which are in the works. One thing that is very important in my opinion is to recognize that “true” prevention starts at the very beginning. What I mean by that is that we have to educate and promote living a healthful life style from childhood.
BFT: What cancers are predominately affecting African Americans? Is there an explanation as to why?
Dr. Speight: The most common cancers in African American men are cancers of the prostate, lung and colon & rectum, and in African American women breast, lung, and colon & rectum. These same three types of cancer are the most frequently diagnosed in Caucasian populations, as well. The critical difference is that African Americans have the higher death rates and lower survival rates for most cancers. Although the overall disparity in cancer death rates is decreasing, the death rate for all cancers combined continue to be higher in African American men and women. The reasons for these differences are multi-factorial, complex and not completely known. Without question, individual patient behaviors (diet and activity level, smoking), physician behaviors (screening and treatment recommendations) and decision making, access to and utilization of health care services play a role. However there appears to be “biologic factors” meaning, differences in the characteristics of the “type” of tumor that influence outcomes.
BFT: What are the differences between the various oncology disciplines – ‘medical,’ ‘surgical,’ and your field, ‘radiation’? How is it determined as to which treatment will work best?
Dr. Speight: Surgical Oncologists treat cancer with surgery, ie cutting out the tumor. Medical Oncologists use chemotherapy and other drugs to treat cancer and Radiation Oncologists use high energy x-rays and nuclear materials to treat cancer. Most cancers are best treated by a combination of two or all three modalities.
BFT: As a professional not only providing treatment to patients but also providing support to their families – how can families best support their loved ones during the cancer treatment process?
Dr. Speight: That is a very complex and difficult question to answer as each situation is different and families and family dynamics are different. The simplest answer I suppose is for the family member to be present and participate throughout the journey of diagnosis, treatment and recovery. And for the family members to remember that in order to be supportive, they need to take care of themselves as well as the person undergoing treatment.
BFT: Many times health care professionals are so busy taking care of others that they fail to schedule time to take care of themselves – what do you do to ensure that you remain healthy while helping to restore the health of your patients?
Dr. Speight: Doctors often make terrible patients, so I have to make a concerted effort to eat well, get rest and exercise, too. I’m not as disciplined as I should be as far as exercise and rest, but I have migrated to a more vegetable and fish based diet.
BFT: The health field is mostly considered reactive care, and the debate on whether preventive care is getting enough focus in the medical industry has come into play more recently. For example, a study in the British Journal of Sports Medicine surveyed 31 UK medical schools and resulted in only 13% of the school including curriculum on exercise and physical activity at or above the national guidelines during each year of the program, whereas 16% included none. What is your position on medical doctors possibly not knowing enough about physical exercise, which in some cases could possibly be the best answer as opposed to a prescription.
Dr. Speight: I haven’t read this particular journal article, and don’t know how it relates to the US, which likely has different behaviors and different habits than the UK. I also can’t speak to how the medical curriculum in the US has changed since I was in medical school, but my sense is that there has been an ever increasing emphasis on prevention and overall wellness, in which exercise plays a large role. I don’t agree that in general, medical doctors don’t know enough about physical exercise. It is standard practice in the treatment of conditions such as osteoarthritis, diabetes, heart disease and high blood pressure to include weight loss and diet as part of the treatment plan. For some people it works, for others it does not. Also, remember, the doctor can recommend, but the individual has to take the action. I think it is an oversimplification to say that physical exercise could be the best answer as opposed to a prescription, though I do feel strongly that exercise should be part of one’s overall health and wellness promotion and maintenance plan, so perhaps in some cases the prescription may not be needed.
BFT: From your years of experience what advice do you offer to a person or a family member of someone who has recently been diagnosed with cancer?
Dr. Speight: Ask questions, be informed and an active participant in one’s own health care
BFT:As a doctor who is consistently voted as one of the ‘Best Doctors in America’, how do you plan on using your influence to further progress the field of cancer treatment and research?
Dr. Speight: Wow, there are so many different answers to that question. I want to continue to be involved in teaching and patient outreach and education. I want to continue to try to make every interaction and encounter I have be one in which the person leaving my office feels more informed, empowered and less afraid and has the knowledge that we are going to walk this journey together.
Dr. Speight: I am in the process of opening a practice that is focused on what I call “whole-person” care, meaning that we address not only the illness and the specific medical treatment, but also the physical, emotional and spiritual impact that the treatment has before during and after active treatment is concluded, to help patient’s re-establish or find their new normal.
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