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Black Women Less Likely To Follow-Up Breast Cancer Treatments

Black breast cancer survivors exist because they often act like Wilma Rudolph, the track star many called the fastest woman on earth in the 1960s.

This does not mean the average breast cancer survivor sprinted through the disease and walked away with three gold Olympic medals like Rudolph did in the 1960s. Instead, as the nation observes Breast Cancer Awareness Month in October, women of color are triumphing over breast cancer because they are sprinting toward several hurdles and clearing them. The winners are gaining access to health care, participating in new treatments, and scheduling screenings.

Sadly, the hurdle that makes many African-American women trip is self-care, according to a new study in the Journal of the National Cancer Institute. Black women made up about 43 percent of the 1,300 women with breast cancer in the new study conducted in North Carolina from 2008 to 2013.

Lead author Stephanie B Wheeler said this new study sheds “light on the modifiable mechanisms through which multifaceted and culturally competent behavioral interventions can help women with breast cancer achieve the best outcomes.”  

Translated, it means African-American women were more likely than Caucasian women to have difficulty affording and taking endocrine therapy, a 10-year treatment prescribed for women with certain types of breast cancer. (It’s prescribed after a woman undergoes surgery, chemotherapy or radiation therapy (or some combination of these) and can help cut her risk of recurrence by half.

Researchers found that African-American and Caucasian women were equally likely to stop taking the endocrine therapy before the 10 years of treatment ended. (About 10 percent of women discontinued treatment early).
However, the point is African-American women were more likely to skip these hormone therapy treatments for breast cancer.
Black women, overall, 24 percent reported underuse of endocrine therapy drugs, compared to 16 percent of White women. Black women more often reported not taking their pills every day as prescribed (14 percent vs. 5 percent). Black and White women (10 percent) equally reported discontinuing their medication before the recommended time-period. Younger women were more often underusing endocrine therapy drugs, as were those women insured by Medicaid and those making less than $50,000/year.
The problem is women of color tend to focus on their role as caregivers so they neglect themselves, said Niasha Fray, who was diagnosed with breast cancer in 2017. She is the program director of the Duke Center for Community and Population Health Improvement.
“Black women like me have to put on the armor of self-care,” Fray said, in a recent NPR interview. . “We have to create it for ourselves and be intentional about it … No one is going to do it for us.”
Black women must practice self-care the way a runner sprints through a race. This means take it step by step. For example, learn about breast cancer’s symptoms and risks. Lose the fear and embarrassment when it comes to examining your breasts for abnormalities, undergoing cancer treatment, contemplating partner abandonment, and talking openly to health professionals.
Here is another way you can practice self-care. Launch discussions about breast cancer at church. Distribute cancer screening awareness materials. Seek help.

The FDA Office of Women’s Health launched the Pink Ribbon Sunday Mammography Awareness Program in 1998 to educate women about early detection of breast cancer through mammography. Pink Ribbon Sunday originally targeted African-American and Hispanic churches, but the program has since expanded to all types of organizations serving women from diverse ethnic, religious, and social backgrounds.
Here is another way to practice self-care. Know your medical history. Have a frank discussion about breast cancer with a healthcare provider you trust.
While African-Americans have the highest death rate and shortest survival of any racial and ethnic group in the US for most cancers, breast cancer rates stabilized among African-American women aged 50 and older during 1994-2007, while rates decreased by 0.6 percent per year from 1991-2007 among women under age 50.
Breast cancer death rates among African-American women are declining. It increased 1.5 percent annually from 1975-1992 and declined thereafter. This decrease was larger in women under 50.

By Rosaland Tyler
Associate Editor
New Journal and Guide

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