Cancer, Community, & Caring for Each Other

How Dr. Hammad believes our community networks, activism and advocacy can influence cancer outcomes for Black people.

Dr. Nazik Hammad is a Professor at the Division of Hematology Oncology, at St Michael’s Hospital and the Department of Medicine at the University of Toronto. She is a commissioner in The Lancet Commission on  Women, Power, and Cancer, where she contributes her perspective to the table. 

On September 29, The Commission released a report detailing how to explore the intersection of social inequality, cancer risk, outcomes, and the status of women in society, just in time for Breast Cancer Awareness Month.

The report explores  how women engage with cancer in various capacities, and the multiple forms of discrimination they face that can limit their rights and opportunities in relation to cancer prevention, diagnosis, caregiving, and professional advancement. 

A report like this is just one of the ways we are seeing strides forward in the journey toward increased awareness of women’s health and cancer. The intersectional feminist  approach to these conversations ensures that Black women’s stories and challenges are heard. This is in keeping with the famous quote by bell hooks, the African American feminist, “Whenever women struggle with breast cancer and face better care than ever, that’s feminism.”

“It’s exciting times for cancer and Black people, the world is paying more attention and we are seeing more engagement of Black researchers across the globe,” said Dr. Hammad, “We still have a long way to go, but there has been progress so far.” 

The room for progress proves true as Canada still struggles to collect raced-based data that will help us make more definitive claims about health disparities. According to a study from the University of Ottawa’s Interdisciplinary Centre for Black Health, there’s no data on how the 20 most common cancers in the country affect Black people. This makes it difficult for advocates and ultimately patients, to have their specific and individual needs met with compassionate care.  

In America, we know that Black women under age 50 have a death rate that is twice as high as White women of the same age range. Black women are also more likely than White women to die of breast cancer at any age. 

These disparities are rooted in the lived experiences many Black women must navigate. Chief among those experiences: racism and the discrimination that accompanies it. These challenges on top of the challenges that come with being a woman, contribute to a psychological and physiological burden known as allostatic load

Allostatic load is an important concept that links structural racism and injustice  to biologically worse outcomes beyond the issues of access. Recent research indicates that high allostatic load, defined as a cumulative measure of physiologic damage caused by cognitive-emotional responses to socio-environmental stressors (such as low socioeconomic status) was associated with higher mortality  rates amongst breast cancer patients. Black women had higher allostatic load than White women.

Fortunately, with the increased awareness through research, commissions, and campaigns like Breast Cancer Awareness Month, we are seeing a move toward prioritizing the issue and progressing toward finding and funding solutions. 

Dr. Hammad, like many of her colleagues, emphasizes the importance of prevention. Of particular significance to her was self-care. While ‘self-care’ has become a term that has grown a bit overused, its principles for preventative health and wellness remain true. 

Decreasing stress, maintaining a nourishing diet, keeping a consistent movement plan, and cultivating a strong community of support, are just a few of the pillars of a healthy life and are proven ways to combat the dangers of allostatic overload. 

We need to be encouraging, especially young Black girls, to take care of themselves early and to advocate for themselves,” she says. “We must work together to help each other.” 

Creating a culture of self- and community-care requires that all of us begin to prioritize taking better care, for the sake of our health, the health of our community, and the health of the coming generations.  This means prioritizing doing so, even when it’s challenging, especially with the demanding careers that make up medicine. This is the work that the BPAO is mandated to help our members and supporters do. 

Dr. Hammad also serves as co-chair for BPAO’s Network for the Advancement of Black Learners (N-ABL). Through her leadership in this program, she’s able to facilitate and live out her beliefs of ensuring that Black learners (medical students, residents and fellows) have the opportunity to be supported to connect, both for personal and professional development purposes, as they constantly face anti-Black racism in medicine. 

“BPAO provides a channel to put ideas and collective work in action,” she says. This includes continued efforts of cancer screenings and events that are culturally competent and curated with community in mind. 

“It’s important that  medical students and residents get to take part in this kind of work and research and it’s awesome that we get to help students advance their careers in this way.”

Dr. Hammad looks forward to continuing the work of creating access for Black learners to be and feel supported enough to take care of themselves, and stay rooted in community while they do.

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