[ad_1]
Selwyn M. Vickers, M.D., FACS, president and CEO of Memorial Sloan Kettering Cancer Center (MSK), spoke with the Amsterdam News for a Q & A about the MSK, cancer care globally, and what he hopes to achieve at the hospital. This conversation has been edited and condensed for clarity.
AmNews: Please tell us about your background.
Vickers: I grew up in rural Alabama, in an area called the Black Belt. My family were educators in the 1920s and ’40s and ’50s. I grew up with a tremendous value of education being the great equalizer in life.
We moved to a town in Alabama called Tuscaloosa, where my dad got his Ph.D. in the ’70s and I gained insight into higher education. He was one of the first four or five African Americans to get a Ph.D. from the University of Alabama, and then we moved to a town called Huntsville, where he taught at a historically Black college. Huntsville is driven by two historically Black colleges, but mostly by a federal installation called the Marshall Space Flight Center, a NASA installation where all of the rockets for NASA are made.
As a kid growing up, I lived on a street with Japanese and German engineers, African American families who were Ph.D.s—70% of the people of the town were from across the world or the country, so it was a unique environment that was integrated with those who had a significant amount of achievement.
I think fundamentally, out of all of those influences, the biggest may have been my grandmother, who in the 1920s traveled over 200 miles to get a high school degree and then [took courses for] 10 summers in the 1930s and 1940s to get a bachelor’s degree. She was a huge influence on me and how I pursued education. My grandfather on my father’s side taught himself how to write and read at 44, and became mayor of his town. Those individuals were fundamental, along with my parents.
I left Alabama, went to school at Johns Hopkins, and stayed there for 16 years, for undergraduate and medical school, and eight years of surgical training.
I’m a surgical oncologist with a focus on pancreatic cancer. I went to a fairly unique place in the south, the University of Alabama Birmingham School of Medicine, then to the University of Minnesota as the head of surgery, then back to University of Alabama School of Medicine as the dean. After about 91/2 years I had become the CEO of the health system there, but took the job for this opportunity to lead MSK.
AmNews: How do you see the role of MSK in fostering more of a sense of trust in medical research in more Black and brown communities?
Vickers: I think a lot of the history that we have builds on a skewed or inappropriate value for human life in certain communities, and that often carries over into how we treat people for their diseases or how we use investigational studies to include them. I think in the bigger picture of society, we have to continually push the message that the issue of diversity—inclusion of people from all walks of life—is actually in pursuit of excellence. Anything short of that, you’re probably less than your best.
From the point of view of research, it’s not as good as it can be if it doesn’t include representation of people from all walks of life that make up America. A lot of the research we have, as effective as it is, could be better if it were inclusive of people of color. I think MSK clearly plays a significant role in doing all that it can to increase exposure, enrollment, and engagement from people from different walks of life.
If you’re on a clinical trial, you get the most attention, the most detail, the most monitoring. People of color sometimes think that being in a trial gives us something less than standard care, but it’s typically better than standard. However, places like MSK that are large academic centers don’t often have a ton of people who are in white coats looking like people of diverse backgrounds, so you don’t necessarily feel comfortable.
We clearly have to work on both our internal environment and partnerships that allow us to expand our influence and connectivity to build trust and familiarity in those communities. That trust factor is significant because we often haven’t done a lot of work to dispel those issues.
AmNews: Can you speak to later-stage cancer diagnoses in Black and brown communities?
Vickers: I do think that because of many factors in life that affect our daily activities, whether it’s our income, our housing, the economic environment, healthcare doesn’t often rise to the top of everybody’s interest. Clearly, screening does not. It does arise when I have a symptom and I don’t feel good. Yes, I go to the doctor, but for many people dealing with the daily struggles of life, the idea of getting a screening exam is a novelty.
What can and often does happen is people come to their own ideas, often from local communication and conclusions that lead them to not show up until something has gotten really bad. The idea of prostate cancer—we’ve done a reasonable job of getting African American men aware that although PSA examinations may not work for everybody, it is still vital for African Americans to know what the risks are, get an early diagnosis, and then have the ability to try to gain information.
For breast cancer for women, we have a greater propensity for triple negative disease. The tumor is more aggressive, and although the incidence of breast cancer is not any greater in Black women, the death rate is more significant in Black women, largely because of the fact of late presentation and presenting with a highly aggressive subtype of tumor.
Invariably, whenever we address care and outcomes for people of color, we improve it for everybody. There’s a halo effect.
AmNews: Where can individuals get MSK care beyond the upper East Side?
Vickers: We have a new clinic in Brooklyn, we’re in Long Island, we’re all over. We understood that Manhattan couldn’t be the only place that people should get access to us. We have partnerships with other hospitals where people of color find themselves as their community place and we’re growing those relationships as well.
AmNews: Could you talk about factors that link to cancers and work MSK is doing regarding preventive measures for individuals?
Vickers: Our doctor Francesca Gany is working in the space of health disparities and has a significant amount of work that looks at those determinants that affect people accessing healthcare and how they are affected by both economics and education. She had a very nice study that demonstrated the impact of food insecurity on individuals’ ability to stay in clinical trials. Those are factors we don’t often think about. Can you get a meal if you’re late to the clinic? If you’re going to miss a meal, are you going to be willing to stay to get your infusion? Transportation is an important factor for people as well.
The challenge is, academic medical centers aren’t naturally geared to deal with all of those determinants and yet we do have to partner and stretch ourselves, because a lot of these services are available in the community—we have to work to connect patients to them.
We don’t have great infrastructure to foster new schools and education. We don’t have great infrastructure to provide access to fresh vegetables and fruits in areas that are food deserts. We don’t have great infrastructure to affect community parks and sidewalks.
All of these things effectively affect a person’s ability to get to healthcare, to sustain their treatment, and actually have a good outcome. It takes the effort of bringing different parts of our organization and community together to create the support and wraparound services that would allow an individual to complete their journey when it means they’ve had a diagnosis of cancer and there’s going to be that three-, four-, five-month journey to get their cancer treated.
AmNews: What changes do you want to implement and what do you want your legacy to be at MSK?
Vickers: I said I wanted Memorial Sloan Kettering to be the cancer hospital of the world, and that means culturally and geographically. I can go to Harlem and my barber has never heard of us. I want to expand individuals’ beliefs that in their own backyard is the world’s best care. We can be partners.
I want to sustain and build on the pillars of excellence in science and discovery. I want us to grow to be a global organization, and even more so clinically. I want our science to remain best in class, and I want to create a world where care and access for people is what we are proud of and we know our outcomes are good and some of the best in the country, and I want to make sure those are broadly known.
At the end of the day, any leader wants to leave a legacy of added value.
Cancer resources
Cancer screenings at the Ralph Lauren Center (Harlem):
Melanoma screening:
https://www.mskcc.org/cancer-care/types/melanoma/screening
New York State Cancer Services Program:
https://www.health.ny.gov/diseases/cancer/services/
Prostate cancer screening:
https://www.mskcc.org/cancer-care/risk-assessment-screening/screening/prostate-diagnostic
Breast Cancer Screening Program: https://www.mskcc.org/cuidadosenmsk/cancer-care/risk-assessment-screening/screening/breast-cancer-screening-programs
Lung Cancer Screening Program:
https://www.mskcc.org/cancer-care/risk-assessment-screening/screening/lung
Related
[ad_2]
Source link
