Taking Care of Your Health

Listen in: Dr. Brandon Blue - Blood is Thicker Than Water Podcast

June 18, 2021


Moffitt Cancer Center has launched a new podcast focused on the impact of cancer in the Black and African American communities from the Office of Community Outreach, Engagement and Equity. Cancer in our Community is a series of conversations hosted by Dr. Brandon Blue.

In this first episode, Dr. Blue introduces himself, his work, and what to expect for future episodes.

Tune in to hear from the experts working to create health equity. 

Show Summary

Dr. Brandon Blue is an oncologist in Malignant Hematology, meaning he is a doctor who treats blood cancers. But he is also a researcher interested in how education and behaviors can change health outcomes. Listen as Brandon talks about why he’s so engaged in community outreach. Learn more about the common features of blood cancers, and how you can learn to identify them and advocate for better treatment for you and your loved ones.

Show Transcript

Parmvir: Hello, and welcome to Cancer in our Community, a podcast where we're having conversations for Black health equity. Why? Because while cancer is a disease that could affect any of us or our loved ones, the Black community is at greater risk. Whether that's through poor diagnosis or treatment, they're more likely to develop and die from many cancers. But there are those studying how to close these gaps in health care and ensure that Black patients and those close to them receive the care that they deserve.

According to the Centers for Disease Control and Prevention, health equity is achieved when every person has the opportunity to attain their full health potential. And no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. Join us to hear more from the experts, studying the effects of biology, society, and education to meet these goals of health equity a reality.

This series of recordings comes from the Office of Community Outreach, Engagement and Equity at Moffitt Cancer Center. This podcast is brought to you by a generous gift from Dr. Michael VogelBaum and Ms. Judith Rosman by the TOP Jewish foundation.

This episode was recorded for National Black Family Cancer Awareness Week. You can find out more about this initiative using the hashtag #BlackFamCan on social media.

Parmvir: Hello, and welcome to the first episode of a brand new podcast series brought to you by the Office of Community Outreach, Engagement and Equity at Moffitt Cancer Center. In the coming months, we'll be introducing you to a series of experts in the healthcare field, working to close the gaps in care, diagnosis, and treatment for members of the Black community.

My name is Dr. Parmvir Bahia, I'm a neuroscientist at the University of South Florida and the head of an outreach nonprofit called Scientists, Inc. I'm also your host for today's podcast, but you're not here to listen to me. So please let me introduce you to Dr. Brandon Blue. How are you Brandon?

Brandon: Doing well, thanks for inviting me.

Parmvir: Of course. So Brandon earned his MD at Meharry medical college in Nashville, Tennessee then completed an internal medicine residency in the Department of Medicine at Washington University School of Medicine in St. Louis, Missouri. He's completed several fellowships related to blood cancers most recently at Moffitt where he's currently based.

Finally, Brandon is a proud two time coach of his kid's baseball team, and part-time swim instructor and gymnastics cheerleader for his daughter for whom he cheers very loudly. Quite the introduction and must keep you busy.

Brandon: It does, for sure. My, my weekends are just as much work as my weekdays.

Parmvir: I'm sure they are! So I'd like to begin by asking about your work as a physician and a medical doctor. So can you tell us more about blood cancers, for example, who gets them? What are the symptoms and what are the treatments?

Brandon: Yeah, so specifically I work in the department for hematologic malignancies and what that incorporates are blood cancers, specifically what they call multiple myeloma, leukemia, and lymphoma.

Those are the big ones that are in that department. And within those departments, those are diseases that people have really never heard of. Unfortunately cancer exists outside of breast cancer, outside of lung cancer, outside of prostate cancer, but not all cancers, unfortunately get the same limelight.

So I do appreciate this podcast. Being able to kind of shed light on something that many people may have never heard of before. So specifically leukemia, lymphoma and multiple myeloma are what they call blood and bone marrow disorders. Without getting too much in the science of it. Just to know that your bone marrow makes all your blood.

So the blood that you've had in your body for your lifetime had to start somewhere. And the bone marrow is that beginning piece. Unfortunately, as we age, one little mistake turns to two, two turns to four, four turns to 10. And unfortunately some of those mistakes that the body has in just making new blood turns cancerous. And when that turns cancerous, that's where we become involved and we get to find ways to actually cure it. And if not cure it, at least make sure that it goes away for quite some time until it maybe shows its head again. And so because those mistakes are cumulative, or something that just takes a while just to build up, it's typically a disease of the elderly or the aging, right?

So typically we do see these diseases in people who are 65 and older, however cancer, doesn't always follow the textbooks and doesn't always read the rules. So we do see people as young, as twenties, thirties, sometimes what we call AYA patients. So these young adult and adolescent patients can have these blood cancers. And it is an unfortunate thing, but typically as a general statement it is something that is seen as we age.

Parmvir: So what are the kind of symptoms that people have. And what are the treatments that you use?

Brandon: Unfortunately, again it's more of a silent diagnosis, or I hate even to call it a silent killer because really the problem is most of the people don't know they have it until they have very advanced stages of this disease.

I'll give you an example. If someone has breast cancer, they feel a lump in their breast and they say, oh, it makes sense. That shouldn't be there. Let me go seek medical attention. People who have colon cancer. They unfortunately have blood in their stools. So they might say, oh, it makes sense. Blood shouldn't be back there. Let me go get that checked. But unfortunately, with a lot of these blood cancers, a lot of the symptoms are: fatigue, feeling sleepy, back pain. And, these people are older, so they look around, they ask their other 70-year-old friends, "Hey, are you tired?" And they say, "Yeah."

And then they ask their kids, "Hey, I'm taking a nap." And they're like, "You're 70 dad. It's okay." Right? And then that just kind of cumulatively unfortunately adds up until they finally go into the doctor to get checked typically for something else. And then the doctor's like, "Something's off" and then they end up coming to us and then we take good care of them.

Parmvir: Yeah. So is there something in particular that would stand out within the Black and African-American community you think?

Brandon: Yeah. So the main thing that I always tell people is that: You know your body, okay. You know, your body better than anybody, better than the doctor that's standing in front of you for the 10, 15 minutes that the doctor's in the room.

If you know something is off, you really have to communicate that. And unfortunately, as people of color, sometimes we get a little bit, I don't want to use the word star struck, but sometimes when a doctor comes in the room, the only word that we know is "yes" and "okay." When really it's not yes. And it's not okay. And that's just something that as a culture that we need to really get out of.  

If you know, hey, I'm taking a nap, but I'm waking up and still tired. I'm still having this fatigue or, I'm having this pain in my back and it's not from, you know, exercising at the gym or I can be laying down watching television and still having pain, typically that's not normal.

And so, you know, that something's off. And so you just have to tell your doctor, "Let's take that next step to kind of dive a little bit deeper" because unfortunately there is no screening for a lot of these blood cancers, meaning there is no mammogram that you can just kind of go and take. There is no colonoscopy. Some of these things that some of these other cancers have, we don't have this [for blood cancers]. So it really takes the person to kind of be an advocate and say, "My body's telling me something's not right." We need to answer that call.

Parmvir: Yeah. So this seems like an excellent segue into kind of the other aspect of your work, which is your scientific research. And what you're trying to do there is look at where these disparities lie. Right? Can you tell us more about that work?

Brandon: Yeah, so unfortunately in a lot of different cancers, African-Americans and Black patients have worse outcomes than people of other races. And the same holds true for people with blood cancers.

So for example, in people who have this leukemia that I was telling you about, one of the more aggressive types is called acute leukemia, and what they saw was that in people who are younger, meaning that this was already a disease of the elderly or the aging, as I talked about in those unfortunate few who get it at a younger age, they see Black patients just don't do as well.

You say, well, maybe it's, you know, their income or maybe it's their education level. We have done studies, even controlling for some of those things. And unfortunately, just self-identifying as an African-American or as a Black patient leads to worse survival. And that same holds true in lymphoma, which one of the more common types, is what they call diffuse, large B-cell lymphoma. We unfortunately see that African-American patients also do worse.

The same holds true for multiple myeloma, where unfortunately, a lot of [Black] patients with multiple myeloma, get it at a much higher rate and at a younger age than some of those people who wait until 65 or 70 years old. African-Americans may be getting it at 50, 55 years old and that just creates a big problem.

Parmvir: So do you know anything about the kind of the history underlying these disparities?

Brandon: Yeah. So that's actually where a lot of the research is going. We're trying to figure out, is it nature or nurture? And that's really the big question. Is there something biologically happening in these blood cancers that is making it more likely to affect one group versus another?

We don't really know, but we're studying that to try to figure out that question. Or is it a matter of circumstances? Is it just because a certain community of folks tend to have certain unfortunate inequities, whether that be in lack of access to transportation, whether that be lack of education, whether that be what they call food deserts, you know, or lack of fresh fruits and vegetables. All of these things, a lifetime of those circumstances, is leading to these cancers later in life.

And unfortunately we don't know the answer to that, but there is research out there. We do plan to figure that out. But right now we know that it's a problem, but how it started, we don't know if it's the chicken or the egg.

Parmvir: Can you give us an example of your research, identifying a particular need and possibly even something that's led to a change in care or outcomes?

Brandon: One of the things that I'm really excited about right now is some of the work that we're doing in what we call CAR T-cells or cellular immunotherapy [whistles]. It's a mouthful, but really what it's doing is it's using the body's own immune system to be able to kill cancer cells, which is very exciting.

Typically your body is used to fighting off the common cold, fighting off any bacteria that you may have, or really fighting any virus that's out there in the world. But [not] fighting cancer cells sometimes. Traditionally really we've relied on things like chemotherapy, but now we figured out a way to use the body's own killing mechanism to say, Hey, take a break from maybe killing, you know, the next bacteria, focus your efforts on killing these cancer cells. And we've seen tremendous results.

The problem is that with any new innovation, we have the opportunity to have some new disparity. And so I noticed when I was seeing a lot of patients who were having this new groundbreaking treatment, that they looked really all the same. And I said, this is a problem.

Parmvir: Yeah.

Brandon: If we know that a certain group of people aren't doing as well. Why aren't those people the ones who are getting this treatment? It just didn't make sense to me. And so actually right now, we're studying that and looking at Moffitt's whole, what we call catchment area, looking at the whole state of Florida and to say, Hey, how can we get people from all walks of life, regardless of income, regardless of education level, regardless of the color of their skin, into Moffitt to get some of the latest and greatest? Because while it does help us move the needle forward, by coming up with these groundbreaking and new technologies, if the people who need them the most can't get them, then that's doing people a disservice.

Parmvir: Yeah, absolutely. And I know as someone who was born and raised in Florida, it was important for you to bring your skills and your training back here. Can you tell us why and about your work doing local community outreach?

Brandon: This is my community. The people who I treat are people I grew up with, people I went to school with, former teachers, former principals even, people that I had gone to school with, people I've gone to church with. These are my extended family. And so I knew that if I was going to make an impact anywhere, I might as well start at home.

And so that's really where I've put most of my focus. And so it's allowed me to have a little bit of an edge up to say, Hey, these you guys know me, I'm from this community, and this is something I believe in. I've had to go away to study and really learn about all these things, but now I'm back and I'm ready to help.

And so it allowed me to kind of give talks and be able to really get into the community, to be able to help people and educate those who unfortunately wouldn't really have access to this type of information.

Parmvir: Yeah, and I think it's really easy to kind of underestimate the cultural connection that you have with people.

For example, I could tell you all about Punjabi people who are immigrants to the UK, what their needs are, what the language disparities are, all of these things. So it really helps to have someone who understands. And basically looks and sounds like you, right?

Brandon: Yeah. You know, it's unfortunate too, because even something as simple as clinical trials, there are some communities that look at clinical trials as a positive thing, and they say, "Oh my gosh, I can't wait. Sign me up." While other people look at the same word clinical trials and say, "No way, I'm not a Guinea pig, no testing, don't do that to me." Right? And I think it takes astute doctors from different backgrounds to really look and say, Hey, not everybody's the same. And really, how do I focus on those people again, who need it the most, who the research is showing are dying at a higher rate? How do I help them? Because that's really what we need.

Parmvir: So I'm sure that folks really appreciate the time and the care that you give them when you give them this information and what they receive in return. For our listening audience who are likely busy people, can you give them a couple of thoughts about what they can do to advocate for themselves, or, you know, if they have a specific health concern, how can they move forward? How can they improve their own health outcomes?

Brandon: Now, I appreciate you asking me that. For everyone listening, there's three easy steps that if I had to tell anyone, I would tell my own mother of, these are things that you can do to really help yourself.

  1. Number one, as I said before, know your body and communicate when there's something wrong. Please, don't be afraid to say, "Hey, I don't feel right. Something is wrong." And let your doctors know that you have a problem. And don't be so quick to just agree with the doctors. They get it wrong sometimes. You know your body, know yourself better than anyone else and be vocal about it.
  2. Number two. Get a second opinion. Again, there's a disparity there that a lot of communities look at, well, my doctor has known me for so long. I don't want to go behind their back. No, that's not the way to do it. We need to hear someone else's take. It only takes someone's interpretation of your symptoms to say, "Hey. This actually isn't correct. This actually sounds just like someone else who I had with this very similar presentation" and they might be able to come with not only with the diagnosis, but with a better treatment plan because doing what you already have been doing sometimes may be outdated. Sometimes it may just be blatantly wrong and it's not the doctor's fault. It's just that, not all doctors stay up to date on the latest and greatest at equal rates. And so, getting a second opinion is a must.
  3. And then, number three is talk to your family members. Being sick, having a cancer is not something to be ashamed of because you need to tell your family what's going on with you. Because if we, as doctors, know that someone has a family history of a certain cancer, that may help them in the future, or even prevent someone else from having a cancer. And I know we all would like our family members to benefit from our circumstances.

And so, those are the three things. Number one, know your body and be vocal about it. Number two, get a second opinion, make sure that the different doctors know your story and what's going on. Make sure that those doctors agree. And then, number three, talk to your family. Don't keep your cancer a secret and make sure that those family members also tell their doctors and say, "Hey, I have a loved one who has this cancer. Am I at risk?" Ask the doctors those tough questions, because most of the times they'll give you an answer. And sometimes those answers can save your life.

Parmvir: So I wanted to ask from the other point of view as well. So if you have a family member that you suspect of showing symptoms or something, like, what would they be looking out for, particularly in the case of blood cancers?

Brandon: Yeah. Sometimes, it can be very subtle, right? It can be, I'm looking at my grandma and I noticed that she's just not herself. She loves cooking pies and she hasn't cooked a pie in six months. Not like her, something's off. Let me go get her checked. Or, I noticed that my uncle is sleeping all day when typically he likes to tinker around outside and, do things in the yard or, you know, tinker with the cars, but he's not doing that anymore. He is just kind of laying around, something's off, might want to get them checked, you know?

And so again, these are people that you guys know much more than us as the doctors. And so we have to rely on you guys to really look and say, "This is what I know this person to be like. They're not that." Unfortunately, the reason behind that might be something more serious than what you think. And don't just downplay and say, "Oh, they're getting old." We have a lot of things that our brain will tell us or trick us into saying, oh, don't worry about it, but really it could be something big and it just takes something subtle. You would want to go to the doctor and a doctor to tell you, everything's okay. As opposed to the opposite. Not going and thinking it is something that you shouldn't worry about and actually making things worse.

Parmvir: So we very much appreciate you speaking about your work today. It's so important to make sure that everybody has a fair shot at having a good and healthy life. And clearly the work you're doing is invaluable to achieving that aim.

Brandon: I think that one thing that we always try to do is to focus on equity and really making sure that those groups of people who unfortunately have these worse outcomes and really aren't doing as great. Let's give them a leg up. Let's really help and focus our efforts to lifting some of those people up. Nobody wants to have cancer, but if you're going to have it, you at least want to make sure you have the resources, the education, and the knowledge to do the best that you can. If you want to be equipped with all the armor that you can to battle such a terrible disease.

Parmvir: Absolutely. Because obviously equitable health care means the outcomes are better for everybody.

Brandon: Yeah. That's exactly right.

Parmvir: Perfect. Thank you so much for your time today. Dr. Brandon Blue is an oncologist here at Moffitt. And how can people contact you if they need to?

Brandon: I think something important to do is to always contact us here at Moffitt. I'd be happy to see any new patients.

I'm also on Twitter @DrBlueBMT. I can also be found on Instagram @DrBlueMD and follow Moffitt's social media. We'll be happy to accept new patients. And like I say, you don't want to have cancer, but if you do, you want to come to the right place and Moffitt's that place.

Parmvir: Wonderful. Thank you so much.

Brandon: Thank you.

The Office of Community Outreach, Engagement, and Equity (COEE) works to uphold Moffitt’s commitment to maximize the impact of its research through engagement in the cancer center’s catchment area and beyond. For questions about the COEE Office or additional information about community based research, or outreach and engagement, please email us at coee-office@moffitt.org.

Podcast produced by Scientists Inc.