Associate Director, Community Outreach and Engagement (COE)
Associate Professor, Cancer Prevention and Control
As an expert in community-engaged research, much of my work involves studies on cancer disparities, primarily prostate cancer, and how certain risk factors influence cancer occurrence, progression, and treatment outcomes. Among some of these risk factors are race/ethnicity, neighborhood characteristics, genetic polymorphisms, inflammation biomarkers, obesity, and socioeconomic status. To address this, my team and I focus our research goals on identifying possible modes for cancer prevention in high-risk populations and providing new understanding about how contextual factors influence disease outcomes.
Neighborhood Characteristics and Prostate Cancer Disparities – One of my primary research interests involves using the characteristics of neighborhoods to determine disparities in prostate cancer. Although prostate cancer survival has improved over the years through advanced treatment options and methods of early detection, disparities still exist both socioeconomically and racially.
In our previous research, my team and I have used methods such as geospatial analysis to identify neighborhoods in Philadelphia with the highest prostate cancer burden. Through our study, Empowering Men about Prostate Cancer Together (EMPaCT), we were able to develop and test a targeted intervention that helped patients improve not only their knowledge of prostate cancer but their confidence in speaking with a physician about best options for screening.
Our work is continuing through the Pennsylvania Residential Opportunities to Improve Outcomes, Treatment, and Survival (PA-ROOTS) Study. This investigation combines geospatial analysis and mixed methods to study the role of patients’ residential histories, as well as the history of neighborhoods themselves, to determine how prostate cancer disparities are associated with structural racism as measured by historical redlining, lending bias, gentrification, and poverty. We seek to increase prostate cancer awareness in high-risk communities and encourage policies and practices that dismantle the structural barriers to health and healthcare that enable disparities to persist.
Outcomes in Prostate Cancer and Obesity – Although prostate cancer is common, it is a complex disease with strong ethnic disparities and few non-modifiable risk factors. Obesity, which is prevalent in African American populations, is a potentially modifiable risk factor and has been shown to increase the risk for advanced disease. Although obesity and advanced cancer individually have been linked to specific patient and neighborhood factors, these factors have not been studied as modifiers of obesity effects in prostate cancer patients.
Our research investigates disparities in the relationship between obesity and prostate cancer outcomes. By adjusting multilevel models for patient and neighborhood factors, we are able to determine whether significant modification by patient and neighborhood variables suggest new pathways for prostate cancer progression, identify groups of patients at highest risk for poor outcomes, and provide strategies for effective intervention to decrease disparities.
Inflammation of the Tumor Microenvironment – The tumor microenvironment, which consists of normal cells and other components that surround tumor cells, is of interest for researchers interested in uncovering how cancer develops and metastasizes.
One of the major characteristics of cancer that has been associated with disease severity is inflammation. When it occurs continuously, inflammation can cause immune cells such as T lymphocytes and macrophages in the tumor microenvironment to increase cell proliferation. The presence of these immune cells may be indicative of aggressive tumors that are likely to metastasize.
Being able to measure these changes in the tumor microenvironment under various conditions may help us identify tumor signatures that improve diagnostics of prostate cancer. The goal of this pathology-based research is to characterize differences in tumor-infiltrating lymphocytes and macrophages within the tumor microenvironment by obesity status and cancer severity.
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