Hispanic Breast Cancer Clinic Seeks to Take Down Barriers to Care

Claudia Tellez, MD

Northwestern University Feinberg School of Medicine

A multidisciplinary clinic composed primarily of Spanish-speaking staff may help create a safe space for Hispanic patients with breast cancer and provide them with standard of care they may not otherwise receive at other academic medical centers, according to Claudia Tellez, MD.

In a conversation with CancerNetwork^®, Tellez, a clinical assistant professor of Hematology and Oncology at Northwestern University Feinberg School of Medicine, discussed the role the Lurie Cancer Center Hispanic Breast Cancer Clinic at Northwestern Memorial Hospital may play in addressing treatment access disparities among the Hispanic breast cancer population. Due to a low proportion of Hispanic patients who were receiving care at Northwestern in the past, Tellez wanted to form a Spanish-speaking team that could administer quality care to this population while addressing other barriers and patient concerns such as paying for transportation.

“I hope to elevate the care of these patients to reach a standard level,” Tellez said. “We can then use that as a model to potentially expand to treat many other groups out in the community who also potentially have the same types of limitations. I hope that this can be reproducible in other places and other cities for many other ethnic groups and other minority groups who also need to be addressed in this way.”

CancerNetwork^®: Could you talk about why the Lurie Cancer Center Hispanic Breast Cancer Clinic was launched? What do disparities look like within the Hispanic breast cancer population?

Tellez: I’ve been an oncologist at Northwestern for 15 years, and I’m a native Spanish speaker. Historically, I’ve been the person who has received the majority of the Hispanic patients who come to Northwestern. I noticed that the percentage of Hispanic patients was always pretty low—universally, I would say less than 10%. The first gap that I noticed was that being aware of the percentage of Hispanic [individuals] in the city of Chicago, which is almost a third, we were really seeing a lot less than what you would expect, given the percentages in the city.

I wondered why that was. For years, I’ve done a lot of community work, and I knew that a lot of the community organizers are aware that we have a Spanish speaker at Northwestern. It’s the issue of how to bring a person from the community to a place like Northwestern. We also have awareness that in the community, patients are not receiving the standard of care that most patients would be receiving in a place like Northwestern or [other] major academic medical centers for a variety of reasons.

Sometimes, it’s partly because the providers in the community might be taking care of multiple different cancers compared with just breast cancer. The awareness of the latest and best care is probably limited. Another reason is because there are extra resources that are needed to provide some of the standard treatments; some of the best treatments are labor-intensive to give, so there might be a lack of resources in the community to provide those types of treatments. There has been a variety of different reasons why the patients are not coming to Northwestern, and why they’re not receiving the standard that they should be receiving. We thought, ‘Okay, this is our opportunity to create something, to welcome the patients to Northwestern, make it official, and then also work on making the connections to make sure the patient is actually able to come.’

How is this clinic going to help close the gap in these disparities? What are the resources that are being utilized within the clinic?

One of the biggest barriers to having patients come to a place like Northwestern has to do with the fact that patients are really scared to come to a big academic center not knowing if anyone is going to be able to speak their language. It’s the thought of having an overwhelming diagnosis, and going to a very scary place, being probably fearful of even paying for the parking, not really knowing how you’re going to navigate the hallways, not knowing if you’re going to encounter anybody who’s going to be warm and courteous who will work with you.

Our goal was to have the entire time in the clinic be a safe space for the patients. All the people in the clinic are Spanish speakers. We’re trying to even communicate with the patients ahead of time to identify what their concerns and their worries are to address some of the issues that might be a problem for that specific patient. That might be, again, a concern about parking, maybe a concern about paying for the ride; we want to try and address those issues to just facilitate and create a better experience for the patients.

What future plans do you have for the clinic?

Hopefully, we become successful. The space of our clinic might not be enough to take care of all the patients who seek out care. I’m hoping that that will be something that we need to look in the future by expanding to some locations outside of the downtown area. We may have 2 centers, one in Brownsville and one in Sterling Park, and that should house some oncology, as well. There’s the potential of maybe opening some extra clinics in those locations if this goes well. In addition to that, there is a desire to connect the patients to clinical trials. Another important part of what we’re trying to do is make clinical trials that are available at Northwestern and potentially other places in the city. We have to create a connection for the patients to those clinical trials knowing that for some stages of cancer, a clinical trial is the best available treatment for the patient.

What is the importance of utilizing a multidisciplinary team when it comes to treating these patient populations?

The team that is currently available during our clinic is comprised of a nurse, physician, a social worker, a medical assistant, and a research assistant. Our phlebotomist who is available on Friday mornings also speaks Spanish. That’s the team that’s specifically here. We also have an active team of surgeons, a radiation oncologist, and other care providers such as nurse practitioners who are also available for our patients. Some of them are also working at the same time as our clinic. They’re just not directly participating in the clinic.

For example, if I had any immediate issue with one of my patients, and I needed a surgeon to see the patient, they would be available to reach out and see that patient at that same time. We do have meetings once a week, where we have cancer center discussions of cases. We do have the ability to present all of our patients’ cases and discuss the details to help to determine a treatment plan for our patient. I absolutely think it’s essential to have a multidisciplinary discussion regarding all the cases and all the details, just to make the best possible plan for each of our patients.

What do you hope that your colleagues take away from our conversation?

There are just so many opportunities. I feel like I’ve picked a very small area of need, but one of my hopes is that we’re successful in providing very high-quality care and education for our patients. Even if we can’t take care of some patients at Northwestern, I hope that we can provide them with a second opinion, so that they’ll at least be empowered with the knowledge of how their cancer should be treated, what the treatment paths should look like, and that they’re potentially eligible for clinical trials.

Reference

Lurie Cancer Center Hispanic Breast Cancer Clinic at Northwestern Memorial Hospital. Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Accessed December 13, 2023. https://bit.ly/45Vm0kx