Making cancer care and support more equitable for everyone
College of Health researchers led by Jessica Gorman are creating inclusive cancer care programs that address barriers faced by LGBTQ+ survivors, young adults, and underserved communities to improve outcomes for all.
The premise of public health is that everyone deserves safe and healthy places to live, learn, work and play. If this were true, all 18 million cancer survivors in the U.S. would have equitable access to treatment services and support.
But barriers exist that lead to health disparities. So, researchers at Oregon State University are designing inclusive approaches to health promotion that improve cancer care and outcomes.
“Cancer affects all of us,” says Jessica Gorman, an associate professor in the College of Health. “Almost everybody knows somebody who has had cancer. If they haven't had it themselves, they’ve likely helped someone through cancer.”
Gorman’s first brush with the disease came when her aunt was diagnosed with late-stage cancer at a young age and died.
“That was a pretty impactful thing in my life,” she recalls.
It motivated her to focus her public health research on improving the lives of people with cancer. Her research team is helping present a clearer picture of cancer survivorship.
Gorman says there are significant gaps in research. Her team creates programs to reduce the negative impacts of cancer and its treatment, focusing on younger adults, LGBTQ+ people and people who live far from care.
Gorman works with affected communities, starting by listening to people’s personal stories to better understand their challenges and priorities.
When she was a doctoral student, Gorman heard from young breast cancer survivors about how treatment was affecting their fertility. Many were frustrated by not being offered options for fertility preservation.
“They are dealing with all of the emotional challenges of cancer and not being able to have a family the way they envisioned it,” Gorman says.
Gorman’s focus expanded to include partners of cancer survivors as she heard how relationships are affected. Survivor services for patients are more often available than support for partners, especially for younger couples.
“Couples are dealing with lots of emotions, changes in their relationship, financial burdens and changes in life trajectory,” Gorman says.
In her more recent work, Gorman hears stories of mistrust and discrimination leading to avoidance of care for LGBTQ+ people.
“People talk about feeling like they are not welcome in support groups and not having affirming care available,” Gorman says.
LGBTQ+ people also face many barriers to cancer screenings, cancer care and supportive services.
“We don’t fully know what these disparities are or how we can improve outcomes, particularly for transgender and gender-diverse people,” Gorman says. “This is an area where more research is needed.”
Previous studies of cancer survivorship are limited because researchers did not always ask people about their sexual orientation or gender identity, used gendered language or made assumptions. Asking people to check a box on an intake form isn’t enough, Gorman says.
“People won’t participate in research unless they feel safe and there’s a sense of trust,” she says. “We’ve tried to emphasize and figure out how to build trust with populations so they will be a part of our research, so we can build our knowledge and understanding of the barriers to care that people are experiencing.”
In a study that’s concluding, Gorman’s team developed introductory material to share with research participants to make it clear their personal information will be kept confidential. Her newest research addresses the physical, social and psychological aspects of health and aims to provide equitable access to sexual health services for survivors of breast and gynecological cancer.
“I want it to feel like a safe space for everybody to be a part of, that they can see themselves and that it is relevant for them,” Gorman says.
Systems of care may not always be welcoming and supportive. Through Gorman’s research, Oregon State is addressing health disparities so that everyone can receive the treatment, services and support they need to thrive after cancer.
Inclusive Cancer Care
The premise of public health is that everyone deserves safe and healthy places to live, learn, work and play. If this were true, all 18 million cancer survivors in the U.S. would have equitable access to treatment services and support, but barriers exist that lead to health disparities. Researchers at Oregon State University are designing inclusive approaches to health promotion that improve cancer care and outcomes.
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