Lesbians and bisexual women at higher risk for cancer and substandard care

Lesbians and bisexual women at higher risk for cancer and substandard care

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Center City is awash in pink, from the lit tops of the Rouse buildings to the fountains at Logan Circle, highlighting that October is Breast Cancer Awareness Month. But women who identify as lesbian and bisexual are both at higher risk from breast cancer and have a lower likelihood of getting the same standard of care as their heterosexual peers.

Two years ago, Dani Simmons was diagnosed with stage two breast cancer. “No one thinks of ‘luck’ when it comes to cancer,” Simmons explained. “But I was lucky.” Simmons had been shopping for sports bras with a friend, and the saleswoman discovered a small lump at the side of Simmons’ breast while fitting her. “It was devastating,” she said. “The saleswoman was so apologetic. I told her: ‘Hey, you probably just saved my life.’”

Simmons said she never did breast self-exams. “I just never really thought about it,” she admitted. Simmons also rarely saw a doctor because she felt uncomfortable with sharing her sexual orientation with each new provider. “The questions on the forms all presume you are straight — they always lead with birth control and could you be pregnant. I just don’t feel like I should have to educate people in healthcare that lesbians exist, too.”

Yet lesbians like Simmons are at greater risk for breast cancer than their heterosexual counterparts, according to the American Cancer Society. The ACS cites fear of discrimination, low rates of health insurance and negative experiences with healthcare providers among the risk factors for lesbian and bisexual women. Also cited are fewer early pregnancies, higher levels of substance abuse and fewer annual check-ups and cancer screenings.

A new study published in the Journal of Clinical Oncology details the results of a survey of oncologists at the National Cancer Institute and their attitudes about LGBTQ patients with cancer. Fewer than 40 percent of the 450 oncologists surveyed said they were adequately equipped or informed to treat a cancer patient who identifies as LGBTQ. While two-thirds thought knowing a patient’s gender identity was important, fewer than a third thought knowing their sexual orientation was.

Dr. Penelope Damaskos, director of social work at Memorial Sloan Kettering Cancer Center, said there isn’t adequate explanation of how “such a diverse group of people as lesbians” is at higher cancer risk, but that, “a real problem is how we outreach to the LGBT population about cancer risk, especially images displayed at walks, awareness activities and so forth. It is a very heteronormative type of imagery.”

Damaskos said, “Many lesbians don’t see themselves reflected in those images and, in turn, might not see themselves at risk. If they do not perceive themselves at risk, and it is not being reflected back to them, they may opt out of these services. “

A study by Ulrike Boehmer, a Boston University School of Public Health researcher who studies health disparities in LGBT people, revealed that women who identify as lesbian, gay, or bisexual also have less access to care after cancer treatment compared to heterosexual women. Published in the medical journal Cancer, Boehmer’s study explains that care patients receive post-cancer is critical to prevent recurrences, detect early warning signs and screen for long-term effects of cancer treatments. As a consequence, the study found LGB women have a reduced physical and mental quality of life post-cancer.

“LGB women were the most disadvantaged,” Boehmer said. She also said the lack of enough data about LGBTQ people with cancer means “There might be an epidemic going on that we’re not aware of.”

Data collection and LGBTQ health assessments are essential to understanding the breadth of cancer in the LGBTQ community. On Oct. 7, Pennsylvania’s Bradbury-Sullivan LGBT Community Center received the 2019 Breast Cancer Community Partner Award from the Pennsylvania Commission on Women for its work assessing cancer needs in the LGBTQ community. Pennsylvania Secretary of Health Rachel Levine recognized the Center, a hopeful sign for Pennsylvania’s LGBT community in this battle for competent cancer care.

Renowned breast cancer expert and lesbian healthcare advocate Dr. Susan Love, has been working toward locating the causes of breast cancer for many years through the Dr. Susan Love Research Foundation. For Love, the message is simple: “Breast cancer should be a concern of everyone.”

Love said the disease cuts across the community and that “Breast cancer is not only common in lesbians who have not been pregnant, but also in trans people on hormones. It is time to figure out the cause and prevent it once and for all.” 

ACS Cancer helpline: 1-800-227-2345

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