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Next week in the United States is designated as National Minority Cancer Awareness Week. 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. National Minority Cancer Awareness Week promotes increased awareness of prevention and treatment among those segments of the populations that are at greater risk of developing cancer. The week’s emphasis gives clinicians, healthcare professionals, and researchers an opportunity to focus on high-risk populations and to develop creative approaches to battling cancer problems unique to these communities.

The Centers for Disease Control and Prevention (CDC) report that cancer death rates for women are highest among African Americans, followed by Caucasians, Hispanics, and Asian/Pacific Islanders. Cancer is the leading cause of death for female Asian Americans since 1980. Colon cancer continues to kill more African Americans than Caucasians for reasons that are not completely understood. According to the Intercultural Cancer Council, this is due in large part to delayed diagnosis coupled with less than appropriate patient care. In addition, individuals of all ethnic backgrounds who are poor, lack health insurance, or otherwise have inadequate access to quality cancer treatment experience higher cancer incidence, higher mortality rates, and lower survival rates. As a result, members of these populations may put off the expense of seeing a doctor until they are very sick and are diagnosed at a later stage, and thus have a poorer chance of survival.

Key Statistics about Cancer in Minorities from the American Cancer Society:

• African-Americans have the highest death rate and shortest survival following diagnosis of any racial and ethnic group in the U.S. for most cancers.
• It is estimated that about 169,000 new cancer cases will be diagnosed among African-Americans by year’s end. Approximately 66,000 African-Americans will die from cancer.
• The most commonly diagnosed cancers among African-American men are prostate, lung and colorectal.
• Among African-American women, the most common cancers are breast, lung and colorectal. 
• Nearly 99,000 new cancer cases in Hispanic men and women were diagnosed in 2009. Among Hispanics, there were 29,000 cancer deaths.
• Prostate cancer is the most commonly diagnosed cancer in Hispanic men, while lung cancer accounts for the largest percentage of deaths in that group.
• Breast cancer is both the most commonly diagnosed cancer and the leading cause of cancer death among Hispanic women.
• Among Asian Indian and Pakistani women, breast cancer is the most diagnosed cancer and the leading cause of cancer death. (National Cancer Institute)

For more information about how cancer affects minority populations, please visit the Intercultural Cancer Council or click HERE.

Tomorrow, April 11th, we are excited to be hosting Clarisa Gracia, MD, MSCE, Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania, for our Virtual Grand Rounds at 10 AM CDT. Her presentation entitled, Case Studies in Oncofertility, will analze indviduals who have undergone fertility preservation following a cancer diagnosis, and the developmental factors related to their decision. Dr. Gracia is also a contributing author in the Oncofertility book series, lending her clinical expertise and experience to the subfield, and she is an integral member of the Oncofertility Consortium. Click here to watch Dr. Gracia present her Virtual Grand Rounds, tomorrow at 10 AM CDT.

For those who are not aware of these special rounds, they are live videoconferences with experts in the fields of reproduction, cancer, and oncofertility. The rounds provide researchers, clinicians, and others the opportunity to hear emerging research findings from anywhere across the globe and participate through a live video chat. Virtual and in-person attendees to the rounds can also receive free continuing medical education (CME) credits by following the instructions here. Within one week of the rounds, a video recording will be posted on the Oncofertility Consortium website and CME credits will be available to online viewers. To read more about receiving education credits from the Oncofertility Consortium, read about the Oncofertility Online program.

Wouldn’t it be great if insurance companies were required to provide coverage for medically necessary expenses for standard fertility preservation services when a medical treatment may directly or indirectly cause infertility to an enrollee or insured? California Assemblywoman Sharon Quirk-Silva, thinks so too and recently introduced CA bill AB 912, which proposes to do just that.  On behalf of the Oncofertility Consortium, we support bill AB 912, and we encourage others to learn more about the positive implications of this bill as well.

AB 912 provides for insurance and HMO coverage of fertility preservation services when future fertility will be put at-risk by treatment of a disease such as cancer, sickle-cell anemia or lupus. While the numbers of people who will need the services is likely to be small, for those people facing a life-altering disease which could require chemotherapy or radiation or both with a high potential for causing infertility after treatment, this coverage could make all the difference. People who have the option for these services score much higher on quality of life measures after treatment. Probably more importantly is that by providing this coverage, the patient is able to keep focus on what would be the best therapy for their disease, without having to worry about the effect on their future fertility.

Mandating insurance coverage for fertility preservation will transform the quality of life for cancer survivors. Fortunately, the relatively small numbers of people in their reproductive years who will need this care will only minimally impact insurance premiums when spread out amongst all insured persons. Without insurance coverage, patients may forgo fertility preservation, which may result in compounded costs for the survivor years later when trying to build a family.

While the cost to preserve fertility is relatively modest, most patients are unable to afford this unexpected out-of-pocket expense, especially at a time when they may be facing other significant cost pressures surrounding the treatment. A short time frame between diagnosis and treatment that does not allow time to seek appeal when insurance companies deny fertility preservation coverage further complicates this.

As survivorship for a typical cancer improves, the ability to bear children after therapy is an understandable and expected concern. For some patients, cancer treatment options may be decided based on its risk of fertility loss rather than fully focusing on its effectiveness to cure the cancer. AB 912 will provide fertility preservation insurance coverage for patients undergoing treatments known to compromise fertility. This is an equitable and cost-effective solution to a foreseeable harm from medically necessary treatment. Please support bill AB 912, ensuring fertility preservation coverage for those who may lose their reproductive potential through no fault of their own.

By Marla Paul

A new gentler chemotherapy drug in the form of nanoparticles has been designed by Northwestern Medicine® scientists to be less toxic to a young woman’s fertility but extra tough on cancer. This is the first cancer drug tested while in development for its effect on fertility using a novel in vitro test.

The scientists designed a quick new in vitro test that predicts the toxicity of a chemotherapy drug to fertility and can be easily used to test other cancer drugs in development as well as existing ones. Currently the testing of cancer drugs for fertility toxicity is a time and resource intensive process.

“Our overall goal is to create smart drugs that kill the cancer but don’t cause sterility in young women,” said Teresa Woodruff, a co-principal investigator of the study and chief of fertility preservation at Northwestern University Feinberg School of Medicine. The paper was published March 20 in in the journal PLOS ONE.

The scientists hope their integration of drug development and reproductive toxicity testing is the beginning of a new era in which chemotherapy drugs are developed with an eye on their fertotoxity (fertility toxicity). As cancer survival rates increase, the effect of cancer treatments on fertility is critically important to many young patients.

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