In a powerful discussion for Clinical Trials Day among healthcare professionals Keith Crawford, MD, Wendy Garvin Mayo, DNP, clinical trials editor Taylyn Washington-Harmon, and breast cancer survivor Ricki Fairley, a critical truth emerged: Black bodies are biologically different from white bodies, and this difference extends to how diseases manifest and respond to treatment.
Black biology is different
“We know now that on a cellular level, our breast cancer is different, and we now have data to prove it,” shared Fairley. “Our immune system cells are different too. And so the research has to happen for us, and we must advance the science.”
This biological difference extends beyond breast cancer. Dr. Keith Crawford, Director of Clinical Trials and Patient Education at the Prostate Health Education Network, highlighted a striking example in prostate cancer treatment where the results of combining two medications showed remarkable disparities: “When you combine the drugs together, it had no impact on white men. But when you combine it together for Black men, it doubled the life expectancy.”
These findings aren’t anomalies. They represent a broader pattern of how medications and treatments may work differently in Black patients compared to white patients.
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Stress contributes to Black diseases
The panelists emphasized how chronic stress impacts health outcomes in Black communities. Dr. Wendy Garvin Mayo, CEO & Founder of Collaborative Cancer Care, explained, “Black individuals in America specifically have higher levels of stress… related to prejudice, discrimination, which leads to a lot of these chronic illnesses such as diabetes, high blood pressure, and cancers.”
Dr. Crawford expanded on this point: “Your stress increases cortisol levels. Your cortisol levels suppress your immune system. If you’re—what people don’t recognize is your immune system is constantly fighting off cancer cells.”
This chronic stress creates a dangerous cycle where immune function is compromised, making Black bodies more vulnerable to disease development and recurrence.
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Black folks are missing from clinical trials
Despite these biological differences, Black patients remain significantly underrepresented in clinical trials. Dr. Crawford noted that in prostate cancer trials, there is “between four to seven percent participation of Black men in a clinical trial when there’s a need for 22 to 25 percent participation.”
This underrepresentation means treatments are often developed and approved based on how they perform in white bodies, potentially missing crucial insights about their effectiveness in Black patients.
How we can change this
To address these disparities, the experts offered several solutions:
- Visibility and Representation: “It starts with forums like this for people actually seeing people that look like them talk about clinical trials,” Dr. Garvin Mayo explained.
- Provider Education and Accountability: “I think organizations have to take responsibility for who they’re hiring and how passionate they are about really inclusion, diversity,” Dr. Garvin Mayo emphasized. “Many people aren’t asked. They don’t know about it.”
- Moving from Dependent to Independent: Dr. Crawford challenged the traditional patient-doctor dynamic: “It is our responsibility to advocate for ourselves, to get as much information as possible because we can’t expect doctors to do it for us.”
- Support Systems for Advocacy: When facing a cancer diagnosis, having support is crucial: “That’s why it’s important to have somebody there who can listen for you and then help you manage the stress,” said Dr. Crawford.
Clinical trials are the future of Black health
Despite the challenges, the experts emphasized that clinical trials offer hope. “When the doctor says you have cancer, you’re not gonna die in two months,” Dr. Crawford assured. “The treatment options that are out there, we have men who were diagnosed with metastatic prostate cancer that I can put you on the line with that are eight years out.”
Ultimately, as Dr. Crawford stated, “We’re moving towards making cancer a chronic disease.” But achieving this future requires ensuring Black patients have equal access to cutting-edge treatments through clinical trials that account for their unique biology.
For Black Americans facing health challenges, the message is clear: clinical trials aren’t just important for future generations—they may provide life-extending options today.
