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Racial Discrimination and TNBC

Republished from Psychology Today

Racial discrimination adds an extra layer of stress that increases the aging process for African-American cancer patients, according to a study published in the journal Cancer. Respondents who reported higher incidences of discrimination were more likely to show signs of premature aging and frailty. This was true despite educational level, employment, or insurance coverage.

Whether rich or poor, cancer survivors who experienced more discrimination reported greater levels of frailty, said lead author Jeanne Mandelblatt, MD, MPH, director of the Institute for Cancer and Aging Research at Georgetown University’s Lombardi Comprehensive Cancer Center in Washington, D.C.

The stress of discrimination can throw the body off balance, increasing rates of aging and leading to a greater risk of frailty, Mandelblatt said. She and her colleagues surveyed 2,232 African American adult cancer survivors diagnosed with breast, colorectal, lung, or prostate cancer within the previous five years. The research was part of the Detroit Research on Cancer Survivors (ROCS) Study.

The study uniquely focuses on the relationships between discrimination and aging in cancer survivors.

Measurements of Aging and Discrimination

Discrimination was measured by reported instances of being unfairly fired, denied a promotion, or not being hired for a job; being unfairly stopped, searched, questioned, physically threatened, or abused by the police; being unfairly discouraged by a teacher or advisor from continuing education; receiving inferior medical care; being prevented from moving into a neighborhood because the landlord or a realtor refused to sell or rent a house or apartment; and moving into a neighborhood where neighbors made life difficult.

Aging frailty was determined by cardiovascular and metabolic health; the number of medical prescriptions; activity level, including time spent in bed; social support; body mass index and unintentional weight loss; physical, emotional, and functional well-being; depressionanxiety; and fatigue.

Three-quarters of respondents showed signs of aging-related frailty. Most of these experienced major discrimination in their lives. Those with four to seven types of discrimination events had the largest increase in frailty, despite age, time from diagnosis, cancer type, stage, therapy, and sociodemographic variables.

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Effects of Treatments

The authors noted that cancer treatments such as chemotherapy and radiation can age patients because they shock and destabilize the body, in contrast to treatments for other chronic diseases that stabilize systems, such as controlling blood pressure or blood sugar.

The highest rates of accelerated aging were among breast and lung cancer patients. Radiation treatments were most strongly associated with frailty.

Some aggressive cancers with aggressive treatment may have more effect on aging, Mandelblatt said, although that was not a focus of this research. For example. triple-negative breast cancer disproportionately affects African-American women, and it can be aggressive, requiring chemotherapy, radiation, and surgery.

“In other studies, persons with aggressive cancer generally receive more treatment, and that treatment causes damage to cells that lead to increases in aging,” she said.

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