Improving Equitable Cancer Care: A Q&A with Dr. Lionel Kankeu Fonkoua
Lionel Aurelien Kankeu Fonkoua, MD, dedicates his research to improving treatment for patients with gastrointestinal (GI) cancers. He honors the life of his late grandmother, who passed due to gastric cancer and is one of his inspirations for conquering cancer.
In this Q&A, Dr. Kankeu Fonkoua unpacks some structural inequities in cancer research and shares why he's driven to improve equitable care for patients everywhere.
Why does improving care for patients with gastrointestinal cancers matter to you?
While we have recently marked major progress with the incorporation of novel therapies into the treatment landscape of most GI cancers, we are lagging behind other cancer types in terms of survival outcomes. There’s much room for improvement to move the needle forward and make a difference for patients with GI cancers.
How does investing in early-career researchers ultimately help patients?
Solving the cancer problem requires an army of seasoned clinicians and experienced investigators. Investing in early-career researchers creates a path to research independence and ensures that the next generation of cancer researchers is equipped to tackle the multiple challenges cancer brings.
What is one change you’d like to see in cancer research 10 years from today?
If the vision is to achieve high-quality, equitable cancer care for all patients, then I would like to see our clinical and translational research efforts be more reflective of the diversity of patients affected by cancer, with particular attention to underrepresented populations.
What are some challenges you’ve personally experienced with structural and institutional racism in oncology and healthcare? How do you overcome these obstacles?
As a budding Black GI oncologist, it saddens me, for instance, to see that despite the recent progress made and considerable decline in deaths due to colorectal cancers following the adoption of national screening guidelines, Black populations continue to have the highest incidence of advanced disease and the lowest overall survival. Even more disturbing is that Black communities represent about 15% of all cancer patients, yet only comprise 3% of clinical trial participants. I often witness a reluctance from providers to consider Black patients for clinical trials due to implicit biases and perceptions that they may be less inclined to participate or comply with study requirements. If a patient is not made aware of - or invited to join - a clinical trial, they will not participate. This, combined with strict criteria that typically exclude Black patients due to their comorbidities, creates significant research gaps and increases disparities in outcomes for these populations.
I think the first step in overcoming this problem, is by training providers to improve cultural sensitivity and reduce the impact of implicit bias in clinical interactions. More importantly, and at an organizational level, we need to broaden eligibility criteria that disproportionately exclude patients with higher inequities in comorbidities.
Can you share a story about a time you experienced a meaningful moment with a patient?
I had a patient with acute lymphoblastic leukemia (ALL) whom I began caring for early in my first year of fellowship. She successfully underwent transplant and for a few months slowly began recovering, returning to doing things she had on her bucket list. Unfortunately, she relapsed and suffered multiple complications that landed her in the hospital, culminating in a decision to halt aggressive treatment. Prior to leaving the hospital and transitioning to hospice, the patient and her family requested I be paged to her room.
When I got to her room, she said: "Thank you! Thank you for holding my hand throughout this journey and helping me assign a different meaning to my illness."
She remains in my thoughts and I am thankful for having had the opportunity to care for her and help her in the small ways that I could.
It is those demonstrations of gratitude from patients that give me the strength to pick up my stethoscope one more time; to enter a patient’s room with the hope of making a difference, to show up to work believing I can make a positive impact in the lives of my patients.
The RTA, now called the Annual Meeting Research Award, provides non-oncology physician-residents from populations underrepresented in medicine who are interested in a career in oncology to attend the ASCO Annual Meeting. While at the Annual Meeting, they present their research at the Abstract Forum for medical students and residents, network with leading oncologists, and discover more about career options in their field. A travel stipend and complimentary Annual Meeting registration are included.