S1: Welcome in San Diego. It's Jade Hindman. On today's show , it is Cancer Prevention Month , and doctors are spreading the word about how to be more proactive with your health. And this is KPBS Midday Edition connecting our communities through conversation. Nearly 50% of all cancer deaths are considered preventable. That's according to the American Association for Cancer Research. Still , though , there's a general lack of awareness about early detection and screening. Well , this Cancer Prevention month , doctors are spreading the word about how to be more proactive with your health. Joining me now is Doctor Swati Hari. She's a professor at San Diego State University and a member of UC San Diego's Moores Cancer Center , also a research grantee with the American Cancer Society. Doctor , welcome to Midday Edition.
S2: Thank you for having me.
S1: Glad to have you in here in studio.
S2: The easy part is that a lot of us don't want to know , because it's a scary question to ask what your cancer risk is. But also a lot of the factors that contribute to cancer risk are very complex and lifestyle associated. So if you go to someone and say you'd have less cancer if you exercised more or ate better or ate more broccoli , you're less likely to get buy in because those are hard things to do. We say them like they're easy , but you know , if you don't like broccoli , that's a tough thing to do every day. So I think it's a complex problem of why we don't want to do it or why we don't ask to do it. But there are also very real issues with the medical system and being provided that information that you need. And we know that there are disparities in who gets that information and how they receive it.
S3: Well , you.
S1: Implied it , and you pretty much said that lifestyle changes are a big key to prevention.
S2: But the question is , how many of us can do it legitimately and constantly ? Right. The other big contributors to cancer risk are or decreasing your cancer risk are things like the biggest contributor is smoking. If you don't smoke , that significantly decreases decreases your risk of cancer. But also things like vaccination decrease your risk of cancer. These are things that I think may be easier to do , or at least have been messaged more successfully to a wider audience. Mhm.
S3: Mhm.
S1: Um , and also early screening obviously plays a big role here , but there's still a lot of cancers that just can't be screened for. Right.
S2: There's definitely cancers that can't be screened for. But there are a lot of cancers that can be screened four , but there is less follow up or follow through from the medical establishment to screen people , because that's hard to do. And a lot of times you have to make sure that you're on top of your screening or you know what you need to be screened for because you might not have the time and you're seeing your GP to go through all of the things that you need to do as clearly as you would like. So there are tools that are available that you can use at home , like the American Cancer Society has a cancer 360 tool , which you can just do online , and it goes through a whole bunch of risk factors , and then it assesses your cancer risk based on the answers that you give. And then that also gives you a better idea of what you want to talk about when you go see your GP. Another issue I think with the screening is that often screening is tied to family history. And while some of us know our family history quite well , there are disparities in the communities that can follow their family history or know true causes for , um , deaths in their family. And so then that also biases against certain communities getting the screening that they need.
S1: And that brings me to health equity , because , you know , in a perfect world , everyone would have the same experience in a doctor's office. But we know that's often not true.
S2: So it's a difficult question to address systemically as of now. But I honestly believe that the answer is with us , like being proactive , knowing the inequities that exist , and then preparing what the information at hand so that when you go into the hospital or the clinic , you can advocate for yourself successfully. I know , especially for black women with breast cancer , for example , there are several advocacy organizations like touch , BBC , A , and there are excellent talking you through the sorts of things that you need to know. I think the biggest thing also is that when you're talking about things like cancer diagnosis in the clinic , when you receive your diagnosis , or when you receive information , you're given a lot of information very quickly with very little contextualization of what that might mean. And so it's hard to advocate for yourself when you're just getting this firehose of bad news , really. And so having the ability to think through it at home , or places where you're comfortable with a community that you're comfortable with , and then going back with that information when you go to the clinic again is a great way to get around it. Um , from , from the point of view of the person going to the clinic. I will say there are huge , um , attempts and interventions at the systemic level to try to address this bias. But as you know , bias is difficult to address systemically.
S1:
S2: We work on research to look at disparities in cancer outcomes and why they happen. It's disturbing to think about the fact that disparities in cancer outcome and incidents have persisted for almost a hundred years now , and if anything , the gap between white patients and other demographics keeps increasing. Um , it's when you think about the advances we've made in diagnostics and treatments , you'd think that everyone would do better. But then you need to take a step back to realize that most of the science we do , the research that we do is based around model systems that mimic white biology. And so that means that many of the advances we make with research may not be applicable across the board to all demographics. We're also finding more and more now that other lived experiences and cultural factors , including things like chronic stress because of high poverty burden , for example , disproportionately affects different demographics in the US and around the world. And we're only now beginning to understand how that affects cancer risk or cancer outcome or response to treatment. Part of the problem has been a systemic lack of data sets that represent many different demographics. So we have patient data , mainly from white patients , that tell us a lot about what's happening inside the cancer , inside a patient. But if we don't have representative data sets that look at everyone , then you're really only studying a small facet of the disease. I think the good news is we're now making those data sets , and there's people who are trying to create more holistic understanding of what cancer is doing , not as a cancer cell on its own , because that never exists , but as a cancer cell inside a person who has had many lived experiences and who has their own identity. Hmm.
S3: Hmm.
S1: I mean , gosh , well , you go to the doctor.
S2: It depends on who you are and how old you are , your gender , your family history. That's why it's a complicated question. But again , I think that the best , the best resource that most of us have is to figure out our risk on our own at home , maybe using resources like the ACS three seconds at 360 and then going armed with that information to the clinic so you know what to ask for when you get there.
S1:
S2: Most doctors are also overcommitted and don't have a lot of time for each patient. Um , so going in with that information is really useful. Advocating for yourself in our medical system , I think it is essential. Not critical , but essential because otherwise you're not going to get the care you should.
S1: You know , it's also so easy to find misinformation and conflicting advice on social media these days. How do you recommend deciphering credible information when it comes to your health ? Yeah.
S2: This is this is a really good question. I used to tell people , look for sources that you know , that you can rely on , for example , the government or institutions like ACS or ACR of late , with the kind of politicization of science and medicine , those may not necessarily still be the right answers. So I don't say that anymore as advice on how to decide. I don't know if many people have heard of flick flick , which is a way that you can identify misinformation or disinformation because it generally tends to follow a very standard pattern , which is like identifying fake experts or cherry picking data or appealing to your emotions , as opposed to appealing to science and evidence. And when you see those red flags , that gives you a good idea that this might not be the most evidence based research.
S3: Oh , that's a great resource.
S1: We'll have to link that in our web story on KPBS. Org. Um , okay. So earlier you mentioned that risk assessment tool , uh , from the American Cancer Society. What are some other simple , actionable steps someone can take today to really look into their cancer risk.
S2: I can't emphasize enough how important it is to know your family history , and I might not be easy for all of us , but making attempts to find out if people in your family have had cancer , or if indeed you are diagnosed with cancer , letting other people in your family know is a huge resource because a lot of our screening is tied to family history. Family history remains one of the most reliable predictive factors of your cancer risk , so that would be the single most important thing to do. I also highly advocate for going to community organizations that you trust. UCSD and Sdsu , for example , have a very strong community outreach and engagement exercises where they talk to the community and they make scientists and medical professionals available to the community to reach out.
S1:
S2: I don't know if I'm fully qualified to answer that. So I'll answer the part that I think I'm qualified to answer. Uh , a lot of times there are resources available , like clinical trials that you might be a great fit for , but either your doctor may not be aware of it , or they might not have the time to tell you. Or they might think that you are unlikely to participate in it and therefore not tell you about it. Um , there's no there's no guidelines for doctors that they have to tell you about a clinical trial or not. But there are resources that you can use. Acts as a good one. Acts. It's a way that you can go home and you or your family members or whoever's supporting you can phone the number there and you can talk to someone about your particular cancer. And then they give you recommendations for clinical trials that you might be eligible for. The great thing about it is you're not like guaranteeing that you're going to enter a clinical trial. You're just getting more information , and then you can go back and talk to your medical team about what they suggest , and then that can be a starting point for you to be more proactive and engaged about your own care.
S1:
S2: There's a lot of advocacy now trying to get more diverse participants into clinical trials. Obviously , in our country , there is historic mistrust from certain communities , or if the scientific and medical profession's which is very justifiable and warranted. So no finger pointing here. But definitely if you are not at the table , if your data is not being collected , then it's really hard for scientists at the back end to figure out better ways of having essentially precision oncology. For instance. A lot of times Our data sets rely on metrics like race or ethnicity. But as we live in a more complex world , race and ethnicity is not a dichotomous , um , problem , right ? It's not okay. You are this or you are that. You're often a blend of many different things that you might not even be aware of. What we also find , for instance , in my lab , where we recently created a database that had much more sophisticated annotation , including socioeconomic status , including education levels and things like that. We found that a lot of factors or biology that is attributed to race is actually due to socioeconomic factors , but because these too often conflate in our country and around the world , where people have certain demographics , are far more likely to experience high poverty burden , for instance , than others. These are hard to tease apart unless we have these very well annotated data sets , which we are just beginning to build. Wow.
S1: That is that is very , very interesting and such great information. You can actually find all of those resources we mentioned in this conversation at KPBS. I've been speaking with Doctor Swati Hariharan. She's a professor at San Diego State University and member of UC San Diego's Moores Cancer Center. She's also a research grantee with the American Cancer Society. And doctor , thank you so much for joining us.
S2: Thank you for having me.
S1: That's our show for today. I'm your host , Jade Hindman.
S4: Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
