Happy Flag Day. Happy FIFA World Cup Day. Happy FiERCE Day.
That last one may not ring a bell, but I hope it will one day. The Biden Cancer Initiative today announced a new program, called the FiERCE Awards, intended to honor individuals and organizations that are having “a transformative impact on the lives of cancer patients”—and it’s calling out to you, dear reader, for nominations. The prizes will be presented on September 20, on the eve of the Biden Cancer Summit in Washington, D.C.
The five awards categories are, in my view, spot on—and acknowledge the kind of typically unsung heroes who have been strengthening spirits, guiding those who are lost or afraid, steadfastly fighting inequities, and saving lives day after day after day. These are the transformative figures in the cancer realm who don’t claim the limelight at most cancer research conferences—and yet my guess is, they’ve collectively done more to improve survival rates from this freaking lousy disease—and improve the quality of life for those who do survive—than a train full of gene-jockey scientists. (No offense.)
Specifically, the Biden Cancer Initiative will honor those who are developing better tools for prevention and early detection; reducing cancer disparities and serving communities that are too often overlooked; helping patients navigate the cancer care labyrinth; helping survivors manage the near- and long-term challenges of their disease and frequently toxic treatment; and finally, those, who are leading through “exemplary and awesome purpose”—whether that be in reframing our approach to cancer research or otherwise accelerating progress against this scourge. (Okay, there may be a few gene jockeys in this list, too.)
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“In the face of one of the most frightening experiences, we can find joy, comfort, and hope in the people around us,” says Dr. Jill Biden, co-chair of the Biden Cancer Initiative. “Sometimes, it’s the smallest kindnesses that can make the biggest difference.” (And having lived through this sucker myself, I would heartily agree.)
I would urge anyone with a great U.S.–based candidate in mind to submit her or his name here by July 31.
For now, I’ll offer one nomination. It’s the person who has done more to demonstrate the power of “patient navigation”: that is, guiding newly diagnosed individuals through an often frustrating, and nearly always confusing, healthcare continuum. And that’s Dr. Harold P. Freeman.
Freeman, the chairman emeritus and founder of the Ralph Lauren Center for Cancer Care, began his work as a freshly minted cancer surgeon in Harlem, New York, during the late 1960s. As early as 1979, Harlem Hospital—where Freeman served as director of surgery for a quarter century—offered free breast cancer screening. But it wasn’t enough, he says. “Patients—who not only often lacked health insurance, but also struggled with a limited education and distrust of doctors—needed help making their way through the medical system,” he explained in a 2014 op-ed in the New York Times (“Why Black Women Die of Cancer”). Even when black women had health insurance, Freeman and others found, there were often critical delays between screening and biopsy, or between a positive biopsy and follow-up. (I wrote about some real-world effects of this disparity back in November 2016.)
So in 1990, Freeman pioneered what he called a patient navigation program, “which provided one-on-one support to patients with abnormal findings.”
The surgeon, a past president of the American Cancer Society, a long-time past chairman of the President’s Cancer Panel, and founder of the seminal Harold P. Freeman Patient Navigation Institute, is a legendary figure in cancer history. But like many legends, his message is too often forgotten.
The simple fact is, we still have a glaring gap in this country between the care that, on average, white people get and that which blacks and Hispanics/Latinos get. In the most recent year for which we have good stats (2015), for example, the U.S. cancer death rate was 14% higher in blacks than in whites. While the difference in outcomes has moderated substantially from its 1993 peak of 33%, the gap remains frighteningly wide in those under the age of 65, who aren’t covered by Medicare.
Helping cancer patients navigate the system—and get the timely care they need—can narrow the gap far more. “The fundamental benefit of patient navigation is that it saves lives,” Dr. Freeman, now 85, told me in a phone conversation this afternoon. “And the reason is, although everybody with cancer gets treated, the question is, when they get treated. Patient navigation has been the most important strategy that has been come up with so far that has changed the timing of when patients are first diagnosed.” Simply shifting that timeline, he says, increases the likelihood of survival and better outcomes across the board.
This is the kind of pioneering, life-changing work that the new FiERCE Awards is designed to recognize. “VP Biden and Dr. Biden started the Biden Cancer Initiative to address what is wrong with our current cancer research and care systems,” says Greg Simon, the Biden Cancer Initiative’s president and a longtime cancer warrior who may know more about what’s broken in the cancer system than anybody. “But we know there are people and organizations doing wonderful things across the country we don’t know about—and we hope these awards will bring attention to people in all walks of life caring for others with cancer.”