Cancer health disparities program meetings 2012

The exposome: A systematic analysis of the environmental drivers of cancer health disparities Gary W. Uncovering exposome-phenome associations from zip codes to molecules Chirag J. Exposomics in precision medicine and precision prevention: The time is now! Rosalind J. Plasma exosomes as drivers of prostate cancer progression in men with comorbid metabolic disease Gerald V. Obesity and neighborhood redlining: Potential synergism in understanding breast cancer mortality disparities Lauren E.

Fragmentation of care among Black women who have breast cancer and multiple comorbidities Michelle Doose, National Cancer Institute, Rockville, Maryland. Characterization of pseudogene expression and immune infiltration in breast cancer subtypes for African American and Caucasian patients Eric W.

Li, Lakeside School, Seattle, Washington. Worsening disparities of racial minority participation in phase 1 early drug development trials in the United States, Hayley M. Examining disparities in incidence of colorectal cancer by race, ethnicity, sex, and site Andrea Joyce M. Eligibility criteria perpetuate disparities in enrollment and participation in pancreatic cancer clinical trials Andrea N. Riner, University of Florida, Gainesville, Florida.

Keynote Speaker Victoria L. A pancreatic cancer multidisciplinary clinic reduces socioeconomic disparities in treatment and improves survival Amer H.

Designing individual-level and structural interventions to reduce and eliminate racial disparities in liver cancer Patricia D. Striving for digital health equity Jorge A. Facilitators and barriers to implementing low-dose CT screening for lung cancer in a tribal health system Zsolt J.

A synergy between the vaginal microbiome and HPV may have explanatory value for racial disparities in risk of pre-cervical cancer Katherine Y. Impact of a cancer health education curriculum among Milwaukee public high school students Abigail Kerschner, Medical College of Wisconsin, Wauwatosa, Wisconsin.

If not now, then when? Tackling barriers to clinical trials to ensure inclusion of underrepresented minorities Vanessa B. After surgery, an assessment of risks and benefits using Adjuvant Online revealed patient chances of survival without chemotherapy is 1 out of and with chemotherapy 22 out of The new tumor diagnosis revealed TNBC, 1.

Completely cured, this patient is an unusual case of TNBC. A positron emission tomography PET scan in breast, axillary and subclavian nodes showed no evidence of metastatic disease. The patient had a family history of breast cancer, two live births, one at the age of The classical TNBC case, this patient's time to disease progression was 3 months.

For TNBC patients, a long-term disease free survival is the best to hope for. While our knowledge on the nature of TNBC increases with time, there is still a lot to learn. At present, there is a critical need to identify markers to sub-classify TNBC patients. Identification of reliable markers can give lead to effective targeted therapies that will be suited for different subtypes of TNBC.

Robert Clarke Georgetown University Medical Center, Washington, DC addressed the concept of systems biology and their complexity and the components of these systems of biology under the stress of endocrine therapy. These breast cancers are generally administered antiestrogens such as Tamoxifen, Fulvestran, or Aromatase inhibitors such as Letrozole. A look at the 10 years recurrence and mortality rates by ER status indicate that while recent advances have been made in endocrine therapies, there is room for improvement.

To understand the biology behind failed Tamoxifen therapies, a systems biology approach is applied to cancer research. This approach consists of integrating high-throughput multi-omics data proteomics, metabolomics, genomics, and bioinformatics to model a network of dynamic interactions between biological components.

A predictive model of ER-a signaling network constructed on breast tumor microarray data revealed a number of molecules interconnected, relatively different from the ordered signaling pathways.

Molecules like NFkB and BCL-2 were shown to be key modulators in endocrine resistance by regulating processes like apoptosis, autophagy and necrosis. Changing trends in presentation from cancer systems biology to a single gene alteration, Khandan Keyomarsi M. Anderson Cancer Center, Houston, TX described the deregulation of the cell cycle in breast cancer and the regulators as relevant markers for prognosis and novel targets for therapy.

Cell cycle progression is monitored by a set of checkpoints, controlled by cell cycle regulators. Of the cell cycle regulators, cyclin E has gained increasing interest as several studies showed that its alterations are relevant to breast cancer. The cyclin E gene is amplified in some breast cancer cell lines and this amplification results in mRNA overexpression; allowing its constitutive expression across all phases of the cell cycle.

Posttranslationally modified by elastase, cyclin E is cleaved at the N-terminus to generate low molecular weights forms. Western blotting analysis showed the presence of low molecular weight forms of cyclin E LMW-E in tumor cells vs normal cells.

An accumulation of LMW-E correlate with advanced stage of disease. Translating these findings to animal models, the prognostic and oncogenic relevance of LMW-E overexpression were assessed. Results showed that LMW-E cooperate with mutated p53 pathway to induce metastatic mammary tumors.

Complex formation experiments and kinase assays demonstrated that LMW-E in breast cancer are resistant to inhibition of p21 and p27, allowing a bypass of antiestrogen induced G1 arrest. The presence of LMW-E in breast tumors causes a genomic instability correlating with polyploidy and lack of response to antiestrogen therapy. Immunohistochemistry analyses of LMW-E in breast tumors tissues revealed a cytoplasmic localization and association with phosphorylated CDK2 compared to a nuclear localization of the full length protein.

For Keyomarsi et al. TNBC metastases however tend to be associated with aggressiveness and shorter time to relapse and recurrence. The conference highlighted the importance of the complexity and heterogeneity of breast cancer and pointed to the challenges ahead. The 7th Annual Texas Conference on Health Disparities provided a forum for discussion between attendees, clinicians, scientists and patients. Fort Worth, TX The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.

The authors acknowledge with thanks the editorial help of Dr. Anindita Mukerjee and Dr. Sanjay Thamake. In adherence to the grant requirement, residents in the CPCT submit a final report summarizing their academic and practicum activities in the track to the funding agency. Third, residents record their experiences quarterly in learning portfolios, which are reviewed by each resident's advisor as well as the residency program director and associate director and are discussed with the resident after each review.

Residents have acquired comprehensive cancer prevention and control training with an emphasis in community engagement, service, and research. The major limitation of the CPCT is the small number of residents in the track. This necessitates that the cancer prevention and control is often taught as directed study courses. This problem will be alleviated with the implementation of a newly funded cancer prevention and control focus within the MSM MPH program.

CPCT resident experiences have been strengthened through a strong, longitudinal affiliation with the local ACS unit and national headquarters. It is expected that residents' experiences will translate into a life-long commitment to cancer prevention and control.

This program serves as a model for other residency and fellowship programs that may have an interest in developing specialized training through cancer prevention and control tracks or rotations. All authors are at the Morehouse School of Medicine. Beverly D. The authors also wish to thank the faculty and staff who participated in training residents in the Cancer Prevention and Control Track. National Center for Biotechnology Information , U. J Grad Med Educ. Taylor , MD, Ayanna V. Buckner , MD.

Author information Article notes Copyright and License information Disclaimer. Abstract Introduction Cancer is the source of significant morbidity and mortality in the United States, and eliminating cancer-related racial and ethnic disparities has become an ever-increasing focus of public health efforts.

Results Since the development of the track in , there have been 3 graduates, and 2 residents are currently enrolled. Conclusion The CPCT provides residents with comprehensive cancer prevention and control training with emphasis in community engagement, service, and research. What was known Racial and ethnic minorities have a higher incidence of cancer and lower survival rates that non-Hispanic whites.

Limitations A small number of residents in the program, necessitating the teaching of much of the curriculum as study courses. Bottom line The intervention educates residents in cancer prevention and control, with an emphasis in community engagement. Curriculum Design The CPCT is designed to follow the pattern of the existing preventive medicine residency program structure, with specific emphasis on cancer prevention and control in each phase.

Open in a separate window. Occupational Medicine The rotation at Caduceus Occupational Medicine provided the resident with an overview of the dynamic between the workplace and workers' health. Health Administration The resident worked with the Georgia Department of Human Resources in the Division of Public Health, Office of Health Behaviors where the resident evaluated the state's readiness for statewide colorectal cancer screening of adults 50—64 years of age.

Practicum Phase Residents complete competency-based objectives designed for the preventive medicine residency program that reflect the cancer prevention and control focus. Results Since receiving the grant in , the program has successfully recruited 5 residents for the CPCT.

Footnotes All authors are at the Morehouse School of Medicine. References 1. Deaths: final data for Natl Vital Stat Rep. Goldman L, Ausiello D, editors. Cecil Medicine.