Lost in translation

By Geoff Koehler

The Banting Research Foundation recently announced funding for six Discovery Award grants. Dr. Adena Scheer, a surgical oncologist with St. Michael’s and an associate scientist with the hospital’s Li Ka Shing Knowledge Institute, was one of the six recipients funded in the 2017 competition out of 53 applications.

Dr. Scheer’s co-lead on the project is Dr. Yvonne Bombard, a scientist with the hospital’s Li Ka Shing Knowledge Institute. The pair is studying how cultural and language differences play a negative role in breast cancer outcomes for immigrant women.

“Communicating clearly and developing trust can be challenging even when the patient and surgeon share cultural backgrounds,” said Dr. Scheer. “It is not surprising then that visible minorities are less likely to be screened for or receive standard treatment for their breast cancer, compared to Canadian-born women.”

New immigrants—those who have lived in Canada for less than 10 years—are almost half as likely to undergo breast reconstruction compared to Canadian-born women. Dr. Scheer said that at the heart of these health inequities lie significant cultural and language barriers between patients and their surgeons. These barriers have been shown to negatively affect communication and trust between patients and their doctors, leading to poorer health outcomes.

“Ours is the first study to identify culture-related issues and communication needs in breast cancer treatment among Canadian immigrants,” said Dr. Bombard. “We are interviewing immigrant breast cancer patients and breast cancer clinicians to understand the cultural issues from both perspectives.

Based on results of the first study, the team will develop the first culturally sensitive decision aids for immigrant patients and their health-care providers. These aids will empower decision making for Canada’s largest cultural minority groups and may ultimately reduce health inequities among immigrant patients.

The successful Banting grant and an earlier grant received for this project were made possible by preliminary research that was funded by the St. Michael’s Foundation’s Translational Innovation Fund and Angels’ Den competition—an annual scientific competition at the hospital that provides seed funding for early-stage research and innovation projects.

“The idea of this competition is to identify the best possible new ideas and provide the initial funds to pilot the research,” said Dr. Arthur Slutsky, vice-president of Research for St. Michael’s. “If these innovations bear out, our researchers and clinicians will be able to take their initial findings to larger grant competitions and, ultimately, develop health-care solutions that can be brought to patients’ faster.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.