Giving African-American women a voice

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Desiree Walker has changed her look – or that's what she tells her friends when they want to know what happened to the dreads that fell to the middle of her back for so long. Now the former Wall Street administrator spends little time on her hair and even less time travelling from her home in Harlem to Wall Street where she spent her career. After the lumpectomy, radiation and hormonal therapy, it was business as usual as mother, wife, sister, aunt, friend and employee. But to her already busy schedule Walker added working to empower African-American women in Harlem. It was the second diagnosis in the same breast in 2009 that gave her a literal wake up call to her mission in life. "I woke up one morning and a voice said to check my breast, and when I looked in the mirror, I saw a lump that didn't feel right," Walker recalls. She emailed her surgeon who got her in within days. The tumor was large, and this time it was HER2 positive. She had a bilateral mastectomy, followed by chemotherapy and Herceptin. Her dreads were gone. She had been laid off and decided to focus on educating African-American and Hispanic women in Harlem. The Witness Project of Harlem (WPH) pairs a witness role model breast cancer survivor and a lay health advisor to talk with African-American women in their churches and senior centers about early detection of breast and cervical cancers. "African-American women are caregivers and usually don't put their health first," Walker says, "because they are juggling too many responsibilities or they fear bad news and the stigma of cancer. They are taking care of their spouse or partner, the children, the grandchildren and aging parents." "When the doctor says to come back in, they often delay. They have so much to do that they would rather not know, so when the doctor says to come back in, they don't go," she says. Recently Walker had a woman tell her that the doctor wanted a follow up after a mammogram. However, she didn't want to go because she didn't want to know if she had cancer. And the fear of dying created anxiety about who would take care of the family. Some women also believe that God will heal them and Western medicine isn't necessary, she says.She also works with SHARE to educate and empower African-American and Latina women. In addition, she facilitates a support group for women of African, African-American and Caribbean heritage. She also works with SHARE's Side by Side program where she meets with medical students and doctors to discuss communication and how to deliver bad news. She works as a peer reviewer with the Department of Defense Breast Cancer Research Program."My objective is to address health disparities and be present anywhere that the voice of African-American women is not being heard. I want to be that voice."

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
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