No Patient Left Behind: Tracking Cancer Disparities

Veronica Reynolds' multiple myeloma is now in remission. She says Dr. Leon Bernal-Mizrachi "walked with me every step of the way. He's a great spirit. It doesn't matter who you are, you will be treated the same way."

Veronica Reynolds’ multiple myeloma is now in remission. She says Dr. Leon Bernal-Mizrachi “walked with me every step of the way. He’s a great spirit. It doesn’t matter who you are, you will be treated the same way.”

Why are some individuals more likely to develop cancer or to develop a more aggressive form of cancer? Winship clinicians and researchers confront such disparities daily – and are working to understand and change them.

Genetic research is a key to understanding how either race or ethnicity affect the incidence of different cancers and how these factors may contribute to different responses to the same treatments. Multiple myeloma, a blood cancer of the immune system’s plasma cells, occurs two to three times more often in African Americans than in Caucasians. Finding out why could lead to better therapies for all. Winship researchers couldn’t do it without people like Veronica Reynolds.

In her mid-50s, the busy realtor developed severe pain. She asked herself if she had strained her back, driving back and forth showing houses or picking up grandchildren? She told herself it would go away. It got worse. One doctor told her she looked too well to hurt as much as she claimed. Another believed her but his pills barely helped. After two years, she feared her heart would stop from pain. At Grady Memorial Hospital, imaging revealed fractured bones, due to bone destruction. Other tests provided the multiple myeloma diagnosis – and led Reynolds to Dr. Leon Bernal-Mizrachi, a Winship hematologist/oncologist who sees patients at Grady.

Reynolds credits God for sending her to Bernal-Mizrachi and to Dr. Jonathan Kaufman, director of Winship’s ambulatory infusion center, who oversaw her stem cell transplant following high dose chemotherapy. She credits herself for following the complex treatment regimens. And she’s “ecstatic,” she adds, about being part of her doctors’ research. “I hope I have enough fight in me to live to see it help many people like me.”

Reynolds – and her genes – are part of a massive multi-institutional study to sequence the entire genome (more than three billion DNA base pairs) of 1,049 African Americans with multiple myeloma and another 7,084 without the disease. The Winship component, headed by Drs. Sagar Lonial, Bernal-Mizrachi, and Ajay Nooka, has gathered almost a third of the study’s participants, thanks to the researchers’ commitment and Georgia’s high African-American population. Although still in process, the study is already producing valuable insights. Winship physicians routinely take tissue cells from multiple myeloma patients, looking for genetic variants that indicate who is at higher risk of relapse. They hope this new study will help identify why this disease occurs more frequently among African Americans and determine if there are treatments that may be specific to these patients.

The incidence of multiple myeloma in the African-American community is just one of the cancer disparities that Winship researchers are aggressively investigating. This blog is excerpted from a more comprehensive magazine article about health disparity research at Winship which can be accessed at https://winshipcancer.emory.edu/magazine/issues/2015/summer/features/no_patient_left_behind/index.html.

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