Sponsored by AbbVie
Multiple myeloma—a cancer of the plasma cells in the bone marrow—poses unique challenges, particularly for Black Americans, who are disproportionately affected by the disease. Black individuals are twice as likely to develop multiple myeloma compared to white individuals and often receive a diagnosis at a younger age, contributing to disparities in outcomes. Despite being the second most common blood cancer, multiple myeloma remains relatively rare, with an estimated 35,780 new cases expected in the U.S. in 2024 and nearly 170,000 people currently living with the disease, according to the Leukemia & Lymphoma Society and the National Cancer Institute SEER program. By examining the biological nature of the disease, the disparities in care, and the critical need for diversity in clinical trials, we can better understand the profound impact of multiple myeloma on the Black community and identify actionable solutions.
Disparities in Incidence and Diagnosis
Multiple myeloma affects Black Americans at a rate twice that of other populations. Anne Quinn Young, Chief Mission Officer at the Multiple Myeloma Research Foundation (MMRF), highlights this disparity: “About 22% of multiple myeloma patients are Black, compared to 13% in the general population. Black patients are also [more likely to be diagnosed at an earlier age], often up to five years earlier than other groups.”
You May Also Like
While this earlier diagnosis might seem advantageous, systemic inequities in healthcare often mean Black patients face barriers to timely and appropriate treatment. Many Black patients are treated in community settings without access to specialists, which negatively impacts outcomes. Research from MMRF’s CoMMpass study found that when Black patients receive care from myeloma specialists, their outcomes match or even exceed those of other groups. However, without equitable access, the benefits of advanced care are lost.
Unique Challenges in Diagnosis
Dr. Craig Emmitt Cole, Associate Professor at Wayne State School of Medicine and a member of the Multiple Myeloma Multidisciplinary Team at Karmanos Cancer Institute, explains the biological basis of the disease.
“Multiple myeloma is a cancer of the plasma cells, which are a type of white blood cell found in the bone marrow. These cells play a critical role in producing antibodies to fight infection,” he says. “However, the symptoms of multiple myeloma—fatigue, bone pain, high calcium levels, kidney dysfunction, and frequent infections—are often vague and can mimic other conditions, leading to delays in diagnosis.”
You May Also Like
This delay is especially concerning for Black patients, who already face systemic barriers to healthcare. Misdiagnosis or late diagnosis exacerbates disparities in outcomes, making early detection and equitable access to care even more critical.
The Role of Education and Advocacy
Empowering Black patients with knowledge and resources is a key strategy for addressing disparities. Reggie Ware, CEO of BlackDoctor.org, emphasizes the importance of culturally relevant education.
“When patients are equipped with the right information, they can actively participate in their care,” says Ware. “For Black patients, this shared decision-making with doctors ensures that visits are more productive and focused on the best possible outcomes.”
BlackDoctor.org focuses on creating accessible, community-centered information tailored to the needs of Black Americans. By fostering patient advocacy, the organization helps individuals navigate the healthcare system and overcome barriers to care.
Similarly, MMRF’s Right Track framework guides newly diagnosed patients through the complex landscape of multiple myeloma care. The program focuses on the “Three T’s”: building the right team, having the right diagnostic tests, and starting the right treatment plan. The foundation also operates a patient navigation center staffed by experienced oncology nurses who provide personalized support to patients and caregivers.
Underrepresentation in Clinical Trials
Clinical trials are essential for advancing cancer treatments, yet Black Americans are significantly underrepresented in these studies. Non-white Americans comprise only 10-15% of participants in multiple myeloma trials, despite the higher incidence of the disease in Black communities.
“We conduct clinical trials to improve treatments and find cures,” says Dr. Cole. “But without diverse participation, we risk perpetuating inequities in healthcare.”
One of the most significant barriers to participation is simply that Black patients are not asked. Ware shares insights from a survey conducted by BlackDoctor.org: “We found that the number one reason Black patients don’t participate in clinical trials is that they’ve never been invited. Post-COVID, we’re seeing more openness to clinical trials, but we need to take a culturally sensitive approach to reach underserved populations.”
Improving Representation in Research
Addressing the underrepresentation of Black Americans in clinical trials requires intentional action. MMRF has implemented several initiatives, including providing lodging and transportation support for patients who face logistical challenges. Additionally, their new platform trial for relapsed or refractory patients prioritizes enrolling a diverse patient population by selecting trial sites with proven records of engaging Black participants and requiring diversity plans from each site.
Involving Black patients and caregivers in advisory roles is another critical step. “Listening to the experiences and perspectives of Black patients is crucial,” says Ware. “We need to meet people where they are and communicate opportunities in a way that resonates with their unique challenges and priorities.”
Dr. Cole highlights the importance of diversity training for healthcare providers. “Hidden biases can prevent doctors from discussing clinical trials with patients,” he explains. “Building awareness and fostering open communication can empower patients and improve physician engagement.”
Breaking Down Systemic Barriers
The disparities in multiple myeloma outcomes go beyond clinical trials to broader issues of access to care. Black patients are disproportionately affected by barriers to specialized treatment, even though studies show they have a lower incidence of high-risk disease and should, in theory, have better outcomes.
“The reality is that systemic barriers often prevent Black patients from benefiting equally from advances in care,” says Young. “Without equitable access to specialists and timely treatment, these patients remain at a disadvantage.”
Collaborative efforts are essential to breaking down these barriers. Advocacy organizations, healthcare providers, and research institutions must work together to build an infrastructure that ensures every patient has access to high-quality care.
Empowering the Black Community
The path forward requires a collective commitment to addressing disparities and empowering Black patients. By focusing on education, representation, and systemic change, we can improve outcomes for those disproportionately affected by multiple myeloma.
“When patients are informed, when providers listen, and when healthcare systems are held accountable, there’s no limit to what we can achieve,” says Dr. Cole. With continued collaboration and dedication, the future of multiple myeloma care can be more equitable and inclusive, offering hope to all patients, especially those in the Black community.
