Unequal access to cancer breakthrough | Philly Health Insider
Plus, how quiet is your hospital?
Good morning. This week, we have a deep dive into racial disparities in the Penn-developed cancer treatment CAR-T and news on a nursing contract at Cooper University Hospital with workload restrictions aimed at curbing burnout. Plus, we look at how quiet hospitals in the Philly region are — read on to find out where yours ranks!
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— Aubrey Whelan and Abraham Gutman, Inquirer health reporters, @aubreywhelan and @abrahamgutman.
Penn researchers are sounding alarms about a disturbing trend in the CAR-T cancer treatments developed and delivered at their own institution: Patients of color are much less likely to receive them.
CAR-T is something of a wonder therapy, “the ultimate in personalized medicine,” as our colleague Sarah Gantz writes: It removes and genetically modifies a patient’s own white blood cells to target their specific cancer profile. The novel gene therapy is already being hailed as a cure for some blood cancers, and more than 1,600 clinical trials are studying its potential for other cancers.
But, as in so many other aspects of medicine, people of color access this treatment at far lower rates than their white counterparts. Between 2018 and 2022, nonwhite patients made up 16% of lymphoma patients at Penn’s Abramson Cancer Center. But they only made up 7% of those receiving CAR-T therapy. Meanwhile, white patients made up 84% of the cancer center’s patients, but accounted for 94% of its CAR-T patients. (The percentages do not equal 100 due to rounding.)
The study didn’t examine why fewer Penn patients of color received CAR-T, but Sarah spoke to researchers who have some ideas about what could be driving these disparities and how to alleviate them.
The latest news to pay attention to
Temple’s Episcopal Hospital will expand its emergency department and crisis response center in a $12.6 million construction project — a needed update in a city whose EDs and mental health services are often swamped with people with complex needs.
Nurses at Cooper have signed a new contract with one of the strongest workload-limiting provisions in the region. Under the new contract, a registered nurse can care for no more than five patients apiece (and no more than two in critical-care units.) Abraham broke down what this means for Cooper nurses.
Avian flu has infected dairy cattle in at least nine states, turned up in at least three humans, and been found to contaminate unpasteurized milk. But despite all this, raw milk is having a bit of a moment. Our colleague Jason Nark visited local farmers selling raw milk to learn more about its increasing popularity — and the health concerns it poses.
This week’s number: 54%.
That’s the percent of Philly-area hospital patients who called the area around their room “always” quiet during the stay — 8% lower than the national average.
As health reporters, we hear a lot about noise reduction from hospitals. Every time we visit a recently renovated or new unit, someone will point out features like a floor covered with material to dull the sound of steps, or how areas where staff talk are far from patient rooms.
Federal regulators care, too. A CMS survey asks patients how often the area around their room was always quiet. (That’s because, just like Grandma says, rest is important for healing.)
The quietest hospitals: Inspira Medical Center at Elmer, N.J. (69%), Penn’s Chester County Hospital (64%), and Main Line Health’s Bryn Mawr Hospital (62%).
The loudest was Riddle Hospital in Delaware County, where a quarter of patients said the area around their rooms was “sometimes” or “never” quiet.
Check out how patients ranked your hospital.
Each week, we highlight the results of various hospital inspections in the region. Up this week: Riddle Hospital. State inspectors did not conduct an on-site investigation for safety violations at the Main Line Health-owned hospital in Delaware County between September 2023 and February 2024.
Camille Ragin, an epidemiologist and associate diversity, equity, and inclusion director at Fox Chase Cancer Center, spoke to Sarah about another disparity in the world of cancer treatment: underrepresentation in clinical trials.
Trials for years have mostly enrolled white patients, Ragin says, limiting what doctors know about how these treatments will work for patients from different backgrounds.
“Whatever answer we get from our scientific studies, we want that answer to be applied to everyone, despite the fact that we know there is heterogeneity. One solution to that is to make sure there’s appropriate representation — then the findings will be relevant,” she said. “If you don’t, the findings are only relevant to the group you are studying.”
Making moves
Binita M. Kamath, a physician who specializes in pediatric liver disease, has been appointed the new chief of CHOP’s Division of Gastroenterology, Hepatology, and Nutrition, the hospital announced last week.
Kamath was an attending physician in the same department at the Hospital for Sick Children in Toronto for 15 years and its interim division head for the last two years. She previously did her clinical fellowship and residency training at CHOP, and was also a junior faculty member there, the hospital said in a news release.
Many liquid medicines taste bad. (With the exception, perhaps, of that delicious bubblegum-flavored amoxicillin that millennials still pine after.) But the alternative — swallowing pills — can be hard, especially for children and the elderly, to the point many do not finish a course of medication.
That’s why scientists have been working for years to create a “bitter blocker” that makes it easier for the medicine to go down. This week, the Philly-based Monell Chemical Senses Center announced that they’ve found a compound that does so.
Interestingly, it doesn’t affect a person’s taste buds. Instead, it blocks the nerve receptor that sends “taste” signals to the brain for about 60 to 90 minutes. Aubrey interviewed Monell scientists about the breakthrough and what it means for public health.
Here’s some good news to send you off: Our exceptionally talented colleague Wendy Ruderman has won a prestigious Association of Health Care Journalists Award for Excellence in Health Care Journalism for her health-care accountability reporting.
Wendy writes: “Health is a topic that touches each of us. I find the health beat challenging, inspiring and at times, heartbreaking. I love learning from the people I interview, and I’m fortunate to have a job in which I can elevate their voices and hopefully illuminate the triumphs and foibles of our health care system for Inquirer readers.” We are all very lucky to work with her!
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