Addressing Racial Equity In Healthcare & What Patients Can Empower Themselves
- Mom of one Starr Shamp has just received her Master’s degree in Clinical Mental Health Counseling from Bellevue University, seven years after being diagnosed with stage 4 breast cancer at the age of 28.
- She got married, had a child, and went through her entire Master’s program while battling the disease.
- It’s important to remember that survivorship, like in Shamp’s case, isn’t just an end state – it’s a continuous journey. It begins the moment a person is diagnosed with a significant health condition and continues throughout their life. You might hear people say things like, “from the moment of diagnosis, you become a survivor.” It’s a powerful sentiment that reflects the courage and resilience involved in battling a serious illness.
- SurvivorNet experts recommend emphasizing earlier, more frequent screenings, increased access to clinical trials, and providing more access to oncologists to help Close the Gap in care.
Shamp, who is working on becoming a licensed professional counselor in Illinois, attended her graduation ceremony at Mid-America Center in Council Bluffs, Iowa—filled with resilience, determination, hope that she can help others in survivorship obtain the support they needed while battling a disease.
Read More
When Shamp turned 28, she was working full time and undergoing her first round of treatments. However, when she realized more support was needed in the survivorship community, she decided to take action and go back to school, specifically to Bellevue University’s counseling program.
Shamp, who joined the graduate program in 2021, explained, “Especially for people like me, who are stage four, I will always have treatments. So I just felt the need that there needs to be more care for people who are actually living through these diseases.”
During her studies, she got married and had a child, but the pregnancy didn’t come easy.
RELATED: Access To Good Information Is Crucial After a Breast Cancer Diagnosis
“I found like an enlarged lymph node in my throat and we could not do anything at first, we were just kind of watching it. Eventually, they were like ‘We need to do something,’ so I actually had to deliver six weeks early,” she added.
“Harrison, my son, spent about two weeks in the ICU, but he is perfectly healthy and has no issues.”
Shamp, who credits her family, friends, and community for being an incredible support system throughout the arduous times, spoke at her graduation ceremony as she was the 2025 student commencement speaker.
She told her fellow graduates, “Never quit, there is always going to be something.Things pop up, it’s hard, acknowledge them, you know, do not try to push them back in your brain and ignore them.
“Feel them, go through them and keep going.”
We’re delighted that Shamp, who will continue getting treatment every three weeks, has shared her story, as it offers a reminder to anyone battling cancer that anyone can thrive following a diagnosis.
What You Need to Know About Survivorship
Whether you’re beginning your journey into survivorship or are a seasoned survivor, you’ll quickly learn that it’s a term with many layers. At its simplest, ‘survivorship’ signifies the state of living beyond a challenging event or diagnosis, such as cancer. More specifically, it marks the period after treatment where a patient goes from merely surviving to thriving, as they navigate their newfound lease on life.
It’s important to remember that survivorship isn’t just an end state – it’s a continuous journey. It begins the moment a person is diagnosed with a significant health condition and continues throughout their life. You might hear people say things like, “from the moment of diagnosis, you become a survivor.”
It’s a powerful sentiment that reflects the courage and resilience involved in battling a serious illness.
Being a survivor also means redefining your life while coping with the aftermath of disease and its treatment. This phase might include the challenge of dealing with physical and emotional changes, attending regular check-ups, the fear of recurrence, or the need for long-term medication. Despite these hurdles, many survivors find unique strength, growth, and transformation during this time.
Survivorship is much more than just the absence of disease—it’s a new stage of life, a rite of passage. Your journey might not have been one you would have chosen, but through it, you’ll uncover a greater understanding of yourself and what you’re capable of. Each person’s survivorship journey is unique, and how you choose to travel is entirely up to you.
Remember—navigating this new terrain called ‘Survivorship’. It might be challenging, but remember, you’re not alone. There are ample resources and support systems designed to help you along the way.
Continued Medical Care
Don’t lose sight of the importance of continued medical care – always keep your follow-up appointments and adhere to any healthcare recommendations.
Remember, embracing these coping strategies can help you navigate your way into survivorship with greater ease and renewed energy. Just remember – slow and steady wins the race! You’ve overcome huge hurdles, it’s okay to take this new stage of your life at your own pace.
Resilient learning to overcome any obstacle
Additionally, health checkups are an integral part of maintaining wellness and spotting potential health issues early. This holds true for everyone, but even more so for a person who’s in the throes of survivorship.
One of the main reasons you’ll want to maintain routine health checks is to monitor for recurrence. While the hope is always for complete recovery, there’s a possibility of the disease returning—even with successful treatment. Regular checkups allow you to keep a vigilant eye on the situation, leading to early detection and treatment if any problem emerges.
Metastatic Breast Cancer and How It’s Treated
Breast cancer spreads through the bloodstream or lymphatic system. The blood carries cancer cells to different body parts, where they grow as new tumors.
Once breast cancer spreads, the cells may continue to grow slowly or stop growing and stay at equilibrium.
“Metastatic breast cancer is a treatable disease,” explains Dr. Kenneth D. Miller, medical oncologist at the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital of Baltimore.
“Fortunately, we have so many new treatments for women with recurrent breast cancer and for many women who look at this as a chronic disease that they can live with often for many years.”
When Breast Cancer Spreads to the Bones
Breast cancer is sometimes classified as either local, regional, or distant.
- Local: Cancer is located in the breast and has not spread
- Regional: Cancer spreads from the breast to nearby lymph nodes
- Distant: Cancer spreads to distant parts of the body, including bones, liver, lungs, and/or brain
Treatment for metastatic breast cancer focuses on decreasing the spread of cancer cells, as well as relieving symptoms and improving quality of life.
Expert Resources On Metastatic Breast Cancer
- Debt Collectors Are Hunting Half of Women with Metastatic Breast Cancer — Help Us, Please!
- Metastatic Breast Cancer: You Are Not a Statistic
- Metastatic Breast Cancer: Biomarkers and Mutations That Matter
- HER2-Positive Metastatic Breast Cancer Treatment Options Explained
- PARP Inhibitors Provide New Promise for Certain Metastatic Breast Cancers
- Understanding Gene Mutations in Your Metastatic Breast Cancer Diagnosis Is Crucial to Your Treatment
Women with HER2-positive breast cancer, meaning they have high levels of a protein called HER2 on the surface of their cancer cells, targeted treatments are available. The drugs trastuzumab (Herceptin) and pertuzumab (Perjeta) have transformed the outlook for some women with late-stage breast cancers. These therapies, which are often combined with chemo, are very effective at controlling breast cancer once it has spread.
Another notable treatment is for triple-negative breast cancer. This has historically been one of the most aggressive and most challenging to treat forms of the disease because it lacks any of the main drivers of breast cancer, the estrogen receptor, the progesterone receptor, and the HER2 receptor, and it doesn’t respond to treatments that target these receptors.
Now, in addition to chemotherapy, immunotherapy has been approved to treat triple-negative breast cancer.
The Outlook for Immunotherapy Treatment
Breast cancer that has spread to the bone – such was the case with Anderson’s mom – the cancer is often hormone receptor-positive, according to SurvivorNet experts. Women may think when this happens, they need aggressive chemotherapy. However, in most instances of hormone receptor-positive metastatic breast cancer to the bone, the first line of attack is hormone therapy.
Hormone therapies are often combined with other medications to improve their efficacy. For example, CD4/CD6 inhibitors are a type of oral medication that is sometimes combined with hormonal therapies to help shrink breast cancers.
Chemo Plus Immunotherapy for Metastatic Triple-Negative Breast Cancer
The Importance of Breast Cancer Screening
Screening for breast cancer is normally done through a mammogram, which looks for lumps in the breast tissue and signs of cancer.
While there is some disagreement about the exact age a woman should start getting mammograms, doctors generally agree it should happen in their 40s.
The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) now says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives
WATCH: Mammograms are still the best tool for detecting breast cancer.
The ACS also advises:
- Women aged 40-44 have the option to start screening with a mammogram every year
- Women aged 55 and older can switch to a mammogram every other year
- Women aged 55 and older could also choose to continue yearly mammograms
For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Don’t delay speaking with your doctor to make sure you are staying on top of your breast health.
Solutions to Closing the Gap
SurvivorNet’s Close the Gap initiative is committed to drawing added awareness of these disparities and providing solutions to improve the survival rates of all people diagnosed with cancer, regardless of their background. Our partners in this initiative include NYU Langone and The Perlmutter Cancer Center. We are committed to the fight for equality.
SurvivorNet experts recommend emphasizing earlier, more frequent screenings. Other focus areas to improve access to care for racially diverse groups include:
- Reviewing a patient’s family medical history
- Address income inequality. Lack of access to healthcare due to no or limited health insurance is a barrier for some low-income patients.
- Increased access to clinical trials and oncologists
- Greater overall access to healthcare
- Improve the number of oncologists from diverse backgrounds
Overcoming Cultural Barriers to Improve Healthcare for Black Women
Clinical trials and medical studies are crucial to understanding how medicine works. However, most people participating in these studies and clinical trials are white.
The American Society of Clinical Oncology (ASCO) says Black Americans are “under-represented in cancer clinical trials,” which can limit our understanding of therapeutic response to Black populations.
The Federal Drug Administration (FDA) said in a 2020 report that studied demographic data on clinical trials for drug participation 75% of participants were white, 8% were Black African Americans, 6% were Asian, and 11% were Hispanic.
WATCH: Black Americans and cancer screenings.
The federal agency noted that patient recruitment and retention were critical to understanding the effectiveness of clinical trial results.
“As it is, patient recruitment in oncology clinical trials is quite low. For Black patients, it is about 4%,” Dr. Kathie-Ann Joseph, a breast surgeon and vice chair for diversity and health equity in the Department of Surgery at NYU Langone Health Perlmutter Cancer Center tells SurvivorNet, regarding the need for more diverse participation in this critical area of medicine.
Dr. Joseph highlighted some key areas the healthcare community must address to improve Black and other racial groups’ participation in medical studies and clinical trials.
“Trust has to be built not only between the doctor and the patient but also between the hospital and the community.”
“Moreover, there should be efforts to recruit minority patients by having diverse staff and ensuring that the language used in the recruitment literature is at the appropriate reading level and translated into the languages common in the community,” Dr. Joseph explained.
Building Trust
“It all comes down to trust and familiarity,” psychologist and founder of InnoPsych Dr. Charmain Jackman tells SurvivorNet.
WATCH: Solutions to Racial Disparities in Cancer Care
“Our shared heritage engenders trust and serves as a first step to Black people trusting the medical field. However, there is still so much inherent bias in the way we are trained that if the Black professional is not doing the work of decolonizing (i.e., removing bias) their practice, my guess is that trust will be hard to keep, and the Black patient may not return for care,” Dr. Jackman adds.
Efforts to get more Black Americans to heed medical information, even from legitimate sources, become easier once past racism in medicine is fully atoned.
WATCH: Merck’s Josette Gbemudu explains how to improve outcomes for Black cancer patients.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
ANSWER QUESTIONS
