A renowned breast surgeon, Kathie-Ann Joseph, MD, MPH, professor in the Departments of Surgery and Population Health, treats patients with breast cancer and benign breast tumors and people with a family history of breast cancer who are at high risk of developing the disease. At NYU Langone Health’s Perlmutter Cancer Center, she co-directs the Beatrice W. Welters Breast Health Outreach & Navigation Program, which educates women about breast cancer and the critical importance of screening.
Dr. Joseph recently became a full professor in the Department of Population Health and the first Black woman to be promoted to the rank of full professor in the Department of Surgery. She was also named NYU Langone’s first-ever vice chair for diversity and health equity for the Department of Surgery and the NYU Langone Transplant Institute. She discusses her commitment to cancer health equity, improving cancer care for underrepresented populations, what inspires her, and more.
How do your recent promotions fit in with Perlmutter Cancer Center’s initiative to improve cancer health equity?
The roles all overlap and intersect with equity. The main thing that I’m focusing on is how do we provide quality care for our patients, whether it’s for the Department of Surgery and Transplant Institute or for the entire NYU Langone Health system. Working with colleagues in my department, and for the NYU Langone Health system, I am trying to integrate health equity into the way we manage our patients’ care. I look at health equity as a foundation of quality—and quality has always been a priority for NYU Langone—and we cannot continue to provide the utmost quality as an institution if we don’t focus on health equity.
By that, I mean we need to know where we are doing well and where we are not doing well. That means looking at equity in all aspects of healthcare. I am not only talking about Manhattan, but also the entire NYU Langone Health system, because then the patients that come to us will know that they really matter. All our patients matter.
That’s the entire scope, and by looking at it broadly, we are not leaving patients behind. We can also reach out to populations that we may not have considered before.
As a cancer surgeon who treats underrepresented patient populations, what do you think needs to be done to bring improvements for these patients?
There is still a need, I believe, for patients in underrepresented populations to have access to National Cancer Institute (NCI)–designated Comprehensive Cancer Centers like Perlmutter Cancer Center when they get a cancer diagnosis. At that type of center, the patient’s case is going to be discussed in a tumor board, and they will have access to multidisciplinary care. Patients need to know that it is OK to get second opinions, that they are being treated by fellowship-trained physicians, surgeons, and oncologists, and that they are part of a team. Now, patients may not be aware of this because of lack of education or knowledge or because of insurance issues.
There are barriers that may prevent patients from getting to academic cancer centers. These are some of the issues that I, in my career, have been trying to address. The Beatrice W. Welters Breast Health and Navigation Program that I co-direct (with Joseph E. Ravenell, MD, associate professor in the Departments of Population Health and Medicine and co-leader of Perlmutter Cancer Center’s Community Outreach and Engagement Program) is helping to get these patients into cancer centers.
This is so important because a patient’s initial treatment is really going to dictate their outcome. And it is important that patients understand that although it might be fine to see a general surgeon in a non–NCI-designated Comprehensive Cancer Center that treats a lot of breast cancers, it may be helpful to find a surgeon that has specific training in that area. For example, someone who receives a diagnosis of pancreatic cancer should go to a surgeon or a specialist who sees a high volume of that type of cancer, rather than someone who manages a small number of patients a year.
What can a person who is seeking care at Perlmutter Cancer Center expect?
They should know that the minute they step inside Perlmutter Cancer Center, that they are receiving the best care that they can get anywhere in New York City, if not the country. They will be treated by the top specialist for their cancer, who will be part of a highly skilled multidisciplinary team.
Your mother died of cancer when you were an undergraduate. How has this experience informed your career and how you interact with patients with cancer?
My mother was a nurse, and she worked nights so that she could be home during the day to make sure that we were home after school and did our homework. She always had dinner ready for us. I’m grateful for that, and I think that played a large part in our success as adults.
However, she didn’t put her own health first, and I think a lot of women do that. My mother couldn’t afford childcare, but she attended all of our parent–teacher conferences and all of our afterschool activities. And that took a toll on her health.
I wasn’t necessarily consciously thinking about it as it happened, but I think about it a lot when I think about my own patients who are immigrants like my mom. I often ask them about what other factors are involved at home for them, their kids, and their jobs. I think it is important to look at the patients as people and what is going on and see how we can help them as they’re going through their treatment. For people who might not want to get help when they get a diagnosis, we need to find out why and determine how we can help them, rather than assuming that they’re just “non-compliant.” They may have barriers preventing them from starting treatment because they’re worried about their families or other responsibilities.
My mom went through all her treatments, and my family was totally supportive, but I can see how not having that support could make it very difficult for someone to go through cancer treatment because I’ve watched it myself as a child.
Can you reflect on your relationship with patients that you have successfully treated?
That is the part I love about my job. With breast cancer, our patients generally do well, and we see our patients for a long time and develop relationships with many of them. They are just some of the most awesome people you’ll meet. I think they will tell you that cancer can really transform their lives for the better. And that’s what I tell many of my patients with a new diagnosis. No one wants to get a cancer diagnosis, but any challenge in life can really force you to reassess what you’re doing in your life and you reprioritize what’s important. For example, one of my patients, LaToya Williams, is a young cancer survivor and now works for the American Cancer Society (ACS). She has done so much to improve the lives of other cancer survivors here in the New York area through her programmatic efforts with ACS over the years.
I see that time and time again. I am amazed at my patients’ resilience and humbled by what they have overcome and how much they have gone through in their treatment. They are then able to give back in some way, shape, or form to help others. I think they are the true heroes, honestly. They help other patients, they are willing to talk to some of my patients with new diagnoses, or they volunteer to participate in group sessions. It inspires me to continue to do my best.