Saturday, February 28, 2015

Army of Women

I am a big believer in women's rights.  Heck, I might even go so far as to describe myself as a feminist.  Which is why it pains me a little to write the following statement:  Men and women are not created equal.  At least not where medicine is concerned.  In fact, I believe the treatment of women and men as equals is a dangerous practice and must be stopped.

Ladies, before you speed dial Emma Watson to notify her there is traitor in the camp - hear me out.  Women are not the same as men because - biology.

Now, unless you happen to be a Republican lawmaker in the news these days, I'm betting the average reader has a fairly strong understanding of female anatomy.  But, should a refresher course be in order, please allow me to summarize the finer points: our junk is just - different.


In addition to being unable to accurately portray the SNL classic D*** in the Box, women's bodies are generally smaller and have a higher fat composition than our male counterparts.  And as most men, PMS memes and sitcom episodes will gleefully confirm - women have higher estrogen, progesterone and other hormone levels which fluctuate throughout the month.

Women's bodies function differently than men's because they are.  So it shouldn't take that big of a leap to make the assumption that medications and medical treatments would also affect women differently.

It turns out that's true.  Studies have shown women may have an altered response to treatments ranging from aspirin to anesthesia due to variations in metabolism and absorption rates. Some treatments currently in use today may not be as effective for women.  Others may require dose changes to avoid potentially toxic side effects.

But here's the kicker - we don't really have a lot of information about that.

Until the year 1993, women of childbearing age were actually banned from participating in any clinical trial.  This means there were essentially no studies which involved women of childbearing age for any medication, device or procedure approved prior to not-very-long-ago.

If you are a woman and this statement doesn't concern you - you're not paying attention.
Do your part!

Underrepresentation is scary stuff.  And although the FDA has since lifted the "no baby-makers" regulation and encourages both male and female participants in trials, currently less than one in three clinical research subjects is a woman.

So why the perpetual clinical sausage fest?  As a research coordinator in charge of enrolling patients for trials, I can tell you "enroll more women" is not as simple as it sounds.

Women are often caregivers of children or other dependents and may be unable to schedule appointments around their other obligations.  We are also less likely to have quality insurance benefits or jobs which allow time off for medical appointments.  And there are other enrollment obstacles to contend with such as pregnancy or lack of transportation in rural communities which limit trial participation.

But instead of shrugging shoulders at the obvious gender disparity in research, oncology guru Dr. Susan Love decided to do something about it.  Namely, she found a way to connect women to oncology research trials across the country through a novel program called Army of Women.

Here's how it works:  1.  Determine that you are, in fact, a woman.  2.  Go to www.armyofwomen.org and fill out a short questionnaire.  3.  Wait for researchers will contact you about research trials you may be a candidate for.

Boom.  Science - it's that easy.

Some of these trials require a history or family history of cancer.  Others do not.  Most require some sort of tissue or blood sample which can be drawn the next time you are at the doctor's office and shipped to the corresponding research lab to evaluate for genetic markers.  (There is a particularly fascinating trial going on right now which is enrolling pregnant women with no history of cancer that will evaluate potentially protective biomarkers found in breast milk.)

Participation in any of these trials is the most effective way to "donate to research".  In the process, your contribution will also help to end gender disparity in medicine and may even help lead to the scientific breakthroughs of the future.  Not a bad way to spend the morning, if I do say so myself.

So sign up today.  Let me know when you do. Heck, while you are at it, sign up your mother, your sisters, your grandmother and aunts.  Share this with every woman on your Facebook friend list.  Because the only way to secure a seat at the decision-making table - in medicine or otherwise - is to drag it there our damn selves.