Cancer Survivorship Center in Dayton, Ohio

To Senator Sherrod Brown,
NEW Member of the Appropriation Committee
Ohio.

The Coalition for the Reversal of Breast cancer Mortality in African American women (CRBCM) would like to congratulate you for a successful electoral campaign, and take this opportunity to bring your attention to the plight of Breast Cancer and its reversible devastating effect in African American Community. 
Breast Cancer is the second leading cause of cancer death. One in 8 American will be diagnosed with this disease before age 85. And Approximately 40-50,000 women and men will die of this disease.  This number will include more than  6,000 African American women!

Ohio: Breast Cancer Deaths per 100,000 Women by Race/Ethnicity, 2009

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Breast Cancer Deaths per 100,000 Women by Race/Ethnicity,
	OH	US
White	22.8	21.6
Black	30.0	30.5
Hispanic	NSD	14.8

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The above statistics points once again to the unfair burden carried by African American in the mortality rates from Breast Cancer.
As a matter of Facts, all epidemiologic studies have suggested that the incidence of breast cancer in African American communities is lower than that of white counterpart.  This well known dichotomy  is well established and even coined "Breast cancer paradox".  Significant and concerted Action against this paradox is bluntantly lacking however!   It is estimated that up to 3000 African Women could be saved YEARLY if such an action is undertaken.

The reasons for this unfair level of death are also well known:
1.  relatively poor rates of screening particularly in low income communities where lack of health education and insurance coverage are the main drivers to poor detection of the disease.   Here Vans outfitted with mammograms ("mammoVans")  have been the most successful venues to combat this problems.
2.  with poor screening and detection, comes the late stage of cancer at the time of diagnosis.  and furthermore, they appears to 
be a an increased rate of poor histology type of breast cancer in African American women.  This type is called Basal cell like Breast cancer which is triple negative, meaning lacking Hormone and Herceptin receptors, making current treatments  almost irrelevant.  New genetic studies have only now revealed this type to be closer to Ovarian cancer and new strategies are only now being devised.
3. Lack of leadership and meaningful comprehensive plan with exclusive focus on this PARADOX.   To date, this reversible fact has not been proclaimed a national emergency.  Despite our progress with Human genome, progress in radiology for early detection, expansion of our knowledge of various molecular targets, No politician has stood before the nation and asked that deaths we know to be reversible, be stopped.  It is an amazing and striking thing for a country with an ambitious incline!  Cure will not come without the Senate committment to a 10 year program.   In Texas, CPRIT is trying to do this.  Ohio should join the race! and create jobs!

The Breast Cancer Coalition, CRBCM, through our representative Amy Mccoulah, based in Greenville OH, is asking for funding to open a CANCER SURVIVORSHIP CENTER IN DAYTON OHIO.  The center is the best approach to offer a comprehensive plan to this problems because it will provide all phases of cancer preventions:

-Primary Prevention:  the Center  will conduct field investigation to detect risk factors predominant in local community and develop adjusted prevention programs to fit people of Ohio.  Reach people through Health Bus for health education.
-Secondary Prevention: have mammovans to meet people in churches, work place and civic centers.  And explore the issue of adequacy of current screening means as it is related to this rare histology (triple negative breast cancer). Is mammogram the best way forward to early detection for this population.
-Tertiary prevention:  which include treatment, patient navigation services, and survivorship programs.
The survivorship programs ultimately provide support services to survivors who are the 50-80 percent of breast cancer patients, these services include nutrition, mental health, fitness program, Lymphedema clinics, etc.   Most of these services are reimbursed by federal insurances, insuring the continuation of the center once created!   With further details of this program, it is easy to see that jobs will be created!

Dear Senator, These type of initiatives work in reducing Breast cancer mortality.   Stopping Hormone replacement therapy and work on BRCA have made a difference in mortality,  and have led to oncology practice changes. And it is in your power to make a difference.  The fiscal cliff has been averted, it is time to put Ohio back to work and this initiative will make a difference in African American communities of Ohio.  We call to your human side to act!

Sincerely,

Amy McCulah and DR Mutombo Kankonde MD, MPh (Oncologist).
The Coalition for the reversal of Breast cancer mortality in
African American Women (CRBCM)
Greenville, OH.

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