By Aaron Allen
When dealing with health issues, nothing can be more frustrating for a patient than not being able to get answers from health care providers when you are in pain. For Patricia Cosby that frustration topped out when she sought the advice of a third caregiver when she was experiencing pain around a lump in her breast.
After her initial doctor failed to offer advice to her satisfaction, Cosby sought out a second opinion only to have the provider recommend “staying away from nuts and bananas for six weeks until the pain improves.” According to Cosby, the exams were hand examinations that did not include additional lab testing or a mammogram.
Cosby then sought out a third opinion from her primary caregiver to hopefully get more in-depth and detailed answers. However, Cosby claims that after a hand examination the doctor said to her “you must like surgeries.”
“No one told me to pursue anything in regard to my concerns over the pain and lump in my breast,” says Cosby. “I went in there not thinking much of it and during the exam, when they came back with the results, they told me it was just a cyst.”
“In the same appointment, another doctor, who was in there during my exam, mentioned to me, ‘that some women just let them grow.’ They did not say anything about follow up, absolutely nothing, although they did say come back next February and I thought to myself, ‘this is odd.’”
Unfortunately, Cosby is not alone in feeling frustrated and alone in her attempts to take control of her health.
Bridgette Hempstead, a breast cancer survivor and founder/president of the Cierra Sisters, a non-profit, breast cancer awareness organization whose mission is to break the cycle of fear and increase knowledge concerning breast cancer in the African-American and underserved communities, says that it is important for Black women to not only advocate for themselves when it comes to their health, but it is equally important to have support mechanisms in place to provide resources and to help fill the gaps that can be left unfulfilled by the medical field.
“I started [Cierra Sisters] because when I started thinking about getting a screening, just a baseline mammogram, my doctor told me to come in and had a very serious talk with me and began to give me a laundry list of reasons why I didn’t need to get a mammogram,” Hempstead recalls. “For one you are a Black woman, and this doesn’t affect your community, it doesn’t affect Black women like it does white women and she told me to come back in 10 years.”
“Well immediately I had to push back,” Hempstead continued. “And I told her that, ‘I demanded a mammogram’. And so that is the reason why, or the basic background, to why I started the Cierra Sisters. It is because in the 1990s Black women were told that breast cancer was something we didn’t have to worry about. But on the statistical side Black women were dying at an alarming rate due to breast cancer and it was not being addressed by researchers, nor the doctors. It was actually being ignored, signs and symptoms were being ignored and they [Black women] were told if they were presented with a lump to just wait and see.”
According to medical experts, breast cancer currently affects more than one in ten women worldwide and is the most common form of cancer affecting women in the U.S. While the rate of getting and dying from breast cancer differs among ethnic groups, statistics show that African American women are more likely to die from breast cancer at every age.
In the United States, the age-adjusted breast-cancer mortality rate for Black women is about 40% higher than the rate for non-Hispanic White women, notwithstanding a lower incidence rate among Black women than white women.
According to research and statistics, poverty, systemic racism and lack of empathy can all play a role in many of the health disparities that exist in America. Women in lower income brackets face significantly lower rates of breast cancer screenings, greater probability for late-stage diagnosis, and can often receive inadequate and disparate treatment, resulting in higher mortality rates from breast cancer.
Poverty has also been linked to the lack of education and information about breast cancer prevention and the importance of early detection, which can lead to increased survival rates.
Yet as health care providers seek to close the breast cancer screening gap caused by the COVID-19 pandemic, experts also believe that now is the time to address inequities in access to quality health care and health care in general that still exist in America.
Advocates claim that new approaches and strategies are needed to improve survival rates, reduce breast cancer mortality, promote breast cancer prevention, and improve the overall health outcomes of Black women. They also believe that representation is vital, and that medical professionals and leaders from underserved and minority communities must be involved in the decision-making process for research studies so that racial disparities related to breast cancer can be fully addressed, studied and ultimately eliminated.
“There has always been racism and injustice in medicine,” says Hempstead. “Unfortunately, it has been overlooked but we are calling it out. Because we have seen such a huge difference in the past 27 years, we are seeing that some white doctors are still ignoring Black women symptoms.”
Cosby agrees and says that her experience with her health care providers at the time was disheartening and disturbing.
“For a doctor to say, ‘you must like surgery’ my mind descended into a place where I couldn’t believe what I was hearing,” says Cosby. “To say something like that, to even think it was so unprofessional. To say, ‘I must like surgery’, no I just believe if something is broken, you need to fix it and they haven’t suggested or fixed anything since I came in to see them.”