Bridging the Gap: Inclusive Cancer Care for the LGBTQ+ Community

Cancer care is most effective when tailored to meet the unique needs of each patient. Unfortunately, systemic barriers and discrimination have led to poorer outcomes for LGBTQ+ individuals. At Mayo Clinic, Elizabeth Cathcart-Rake, M.D., a medical oncologist specializing in breast cancer, is addressing these disparities through the Rainbows Breast Cancer Clinic, an LGBTQ-focused breast cancer clinic in Rochester, Minnesota.

This groundbreaking clinic is redefining cancer care for LGBTQ+ patients by focusing on three critical areas:

Creating a Safe and Affirming Environment

Many LGBTQ+ individuals face significant discrimination in healthcare, leading some to delay or avoid cancer screenings entirely. A survey from the American Association for Cancer Research revealed that 16% of LGBTQ+ individuals experienced discrimination when seeking healthcare, and nearly 20% avoided care out of fear.

Dr. Cathcart-Rake emphasizes the importance of safety, noting that "thinking about cancer prevention and screening is a luxury" for many. To address this, the Rainbows Breast Cancer Clinic fosters a welcoming atmosphere with inclusive language, gender-neutral restrooms, LGBTQ+ signage, and staff trained in cultural sensitivity.

Delivering Personalized Cancer Expertise

Cancer care isn’t one-size-fits-all, particularly for the diverse LGBTQ+ community. The clinic tailors care to each patient’s unique needs, factoring in gender-affirming hormones, surgical history, and past healthcare experiences.

• Hormone Therapy and Risk: While research is mixed, gender-affirming hormone therapy must be considered alongside other cancer risk factors during screenings.
• Gender Dysphoria: Procedures like mammograms can trigger gender dysphoria especially for trans men. The clinic adjusts screening recommendations to balance medical necessity with patient comfort.

Dr. Cathcart-Rake highlights lifestyle interventions like reducing smoking and alcohol use, recognizing these behaviors are often linked to the stigma and stress LGBTQ+ individuals face.

Advancing Research for Better Outcomes

Research on cancer in LGBTQ+ populations remains sparse. Data shows trans and gender-diverse individuals face higher risks for late-stage cancer diagnoses and poorer outcomes. For example, trans individuals with non-Hodgkin lymphoma are twice as likely to die compared to cisgender patients.

Dr. Cathcart-Rake’s research focuses on early detection, access to care, and the interactions between gender-affirming hormones and cancer treatments. “We need to act and be proactive to ensure good cancer outcomes despite someone’s identity,” she says.

A Safe Haven for LGBTQ+ Patients

The clinic’s inclusive approach has resonated with patients. To close the cancer care gap and address disparities that contribute to late diagnoses and poor outcomes, cancer researchers need to understand the full scope of disparities LGBTQ+ people face. "From the disparities we know exist, there's a whole underlying level of disparities that we suspect but haven't even been able to pinpoint or understand. That's a huge reason I think this work is so important," says Dr. Cathcart-Rake.

Making an Appointment

Housed on the 10th Floor of the Gonda Building on Mayo Clinic's campus in Rochester, Minnesota, the Rainbows Breast Cancer Clinic is open to anyone who wishes to be seen in an LGBTQ-focused breast clinic.

Contact: Call the Medical Oncology Appointment Office at 507-284-8815 and mention “Rainbows.”

Virtual visits will be allowed for any patient, as laws allow.

Original article published in Mayo Clinic Comprehensive Cancer Center Blog