The first African-American woman to be appointed to the faculty of the Department of Surgery at New York-Presbyterian Hospital/Columbia University Medical Center (NYPH/Columbia), Dr. Kathie-Ann Joseph has made significant contributions to breast cancer research and treatment. Particularly interested in public health and the sociology of medicine, Dr. Joseph has studied how race affects health and has worked to improve access to health care for those in need. In particular, she is interested in serving the needs of African-American women, who face greater breast cancer mortality than do white women.
Joseph joined NYPH/Columbia's Breast Surgery Section of the Department of General Surgery in 2003. She directs research on the role that a cell surface receptor molecule, RAGE, plays in tumor growth, a subject that shows some promise in new treatments for breast cancer. In addition, she has worked to improve breast cancer screening and treatment for African-American women and low-income women. In 2005 Crain's New York Business weekly named her one of its "40 Under 40" rising stars.
Inspired by Family
Born in her parents' native land of Jamaica around 1970 but raised in Brooklyn, New York, Joseph attended public schools and graduated from Stuyvesant High School. Her father worked as a manager for Pan Am and her mother was a nurse. "My parents … sacrificed so much for my education," she told a writer for the Columbia University Medical Center Department of Surgery Web site. "They moved here from Jamaica so my siblings and I could have a better life." She never wanted to be anything else but a doctor. As a girl, she devoured books about the body and how it worked, and admired physicians in their ability to heal people who were sick. During high school, Joseph volunteered in a hospital and also participated in PREP, a weekend program at Columbia University that she described in a Fox News interview as a premed orientation for high school students.
Despite her medical ambitions, Joseph did not choose a traditional pre-med major at Harvard, instead earning a bachelor's degree in sociology in 1991. She was glad, she noted in the Fox News interview, that she took the advice of a mentor who encouraged her to use her undergraduate years to get a broad education. Though the environment at Harvard could be challenging, she enjoyed meeting people from all over the world. She loved studying sociology, she said, adding that it affects how she practices medicine today. During the summer between her junior and senior year, she worked on a breast and cervical cancer-screening project at Harlem Hospital, New York, for elderly African-American women. The experience opened her eyes to the fact that "not everyone is exposed to the same health care," she noted. In fact, she met elderly patients who had never had a pap smear or a mammogram, tests that have long been considered a routine part of women's primary care. Her work at Harlem Hospital became the basis for her undergraduate thesis, which won Harvard's Hoopes Award.
But there were dark times as well during her college years. In Joseph's freshman year, her mother died of cervical cancer. The day the aspiring physician got the devastating news, just after completing her exams, was the hardest day of her life, she commented in a Crain's New York Business profile. But it also inspired her to devote her life to treating women with cancer. "I know firsthand what it's like to have a family member with cancer," she noted on the Columbia Department of Surgery Web site. "I know the impact a cancer diagnosis has not just on the patient but also on the family."
Got the "Surgery Bug"
After completing her undergraduate degree at Harvard, Joseph earned a joint M.D. and M.P.H. at the Columbia University College of Physicians and Surgeons. She credited her surgery instructor, Dr. Ken Ford, the first African-American surgical resident at Columbia, with inspiring her to specialize in surgery rather than primary care medicine. "Up until meeting him I thought all surgeons were white, old men," she told Fox News. But studying under Dr. Ford and another black surgeon, Dr. Spencer Amory, infected Joseph with what she called the "surgery bug." She went on to complete her seven-year surgical residency at New York University Medical Center.
During her busy residency she gave birth to two children, sons Devon and Justin. Following her residency, Joseph was awarded a two-year research fellowship in surgical oncology at NYU Medical Center. She then received a fellowship in breast oncology at Columbia. She was appointed an assistant professor of surgery at Columbia in 2003, becoming the first African-American woman to hold a faculty position in this department.
According to the Columbia Department of Surgery Web site, Dr. Joseph's research into the mechanism by which blockage of RAGE affects the growth of tumors has yielded significant results. Initial findings in mice have shown that blockage of RAGE "resulted in strikingly decreased local growth, less invasion of neighboring tissue, and fewer metastases." Joseph's research has been supported by the Breast Cancer Alliance, which awarded her a two-year Young Investigator Fellowship, and by the American Cancer Society and the National Institutes of Health.
Worked to Improve Access to Health Care
Her work with patients in Harlem convinced Joseph that African-American women often received inferior medical care and experienced worse outcomes when diagnosed with cancer than white women. Black women, for example, have lower overall rates of breast cancer than white women do, but have worse mortality rates at every stage of the disease. In addition, black women tend to get the disease earlier than do women in other ethnic groups. The reasons for such disparities, she explained to Fox News, include lack of screening and education about the disease. In addition, some research indicates that in black women "the biology of [breast cancer] tumors may be slightly different and more aggressive than those suffered by women of other ethnic groups." To improve the odds for African-American women, Joseph initiated a free cancer-screening program at NYPH/Columbia. The program provides free mammograms for women who lack health insurance; breast cancer patients can also get surgery, chemotherapy, and reconstructive surgery through the program.
At a Glance …
Born in Spanish Town, Jamaica; married David Joseph; children: Devon, Justin. Education: Harvard University, BA, sociology, 1991; Columbia University College of Physicians & Surgeons, MD/MPH, 1995. Religion: Christian.
Career: New York-Presbyterian Hospital/Columbia University Medical Center, oncology surgeon and assistant professor of surgery, 2003–.
Memberships: American Association for Cancer Research; American Society of Clinical Oncology; Association for Academic Surgery; Association of Women Surgeons; American Society of Breast Surgeons; American College of Surgeons.
Awards: Hoopes Award, Harvard University, 1991; Joanne Masin Breast Cancer Alliance Young Investigator Award; AACR Minority Scholar Award in Cancer Research, 2004; Crain's New York Business "40 Under 40" rising star, 2004.
Addresses: Office—New York-Presbyterian Hospital/ Columbia, Irving Pavilion, Room 1025, 161 Fort Washington Ave., New York, NY 10032.
Joseph also continues to advocate for improved access to mammograms for all women. In "The Crisis in Mammography," which she wrote for the Columbia University Medical Center newsletter InVivo, she stated that the number of mammogram facilities in the United States and of radiologists specializing in breast imaging have both declined significantly since 2000. As a result, many women must wait up to four to six months to obtain a mammogram, a situation that Joseph described as a crisis. "The concern," she wrote, "is that the gains made in decreasing overall mortality rates over the years due to early detection may reverse as a result of delays in obtaining mammograms." Though this problem affects all women, she added, "poor and minority women who already have low screening rates may stand to suffer the most."
Though medical research can be demanding and sometimes frustrating, Joseph remains motivated by the spirit she sees in her patients. She commented on the Columbia Department of Surgery Web site that her work can be exhausting, "but when I see my patients who actually have breast cancer—they are facing a far greater struggle. It's amazing to see how courageous these women are. They inspire me to continue." She also finds strength in her Christian faith. She prayed all through school, she told Fox News, and her spirituality has always affected how she treats her patients. What is more, those of her patients with a spiritual life, she has found, seem to fare better than patients who lack faith.
Joseph has published results from her research in several medical journals, including The Breast Journal, Archives of Surgery, and American Surgeon. She has given presentations across the country and internationally; many of these have related to issues about breast cancer and ethnicity. These have included "Breast Cancer Size and Stage in Breast Clinic Patients Versus Private Office Patients," given at the Lynn Sage Breast Cancer Symposium in Chicago in 2002; "Race Is Significantly Associated with Higher Breast Cancer Stage in Young Women with Breast Cancer," presented to members of the American Society of Breast Diseases in Dallas in 2003; "Indigent Breast Cancer Patients among All Racial and Ethnic Groups Present with More Advanced Disease Compared to Nationally Reported Data," given to members of the American Society of Breast Surgeons in Atlanta in 2003; and "Epidemiologic and Pathologic Characteristics of Chinese Breast Cancer Patients," presented at the Fifth Milan Breast Cancer Conference in Milan, Italy, in 2003. More recently, she has presented several papers outlining her research on RAGE and tumor growth.
In 2004, Crain's New York Business named Joseph one of its "40 Under 40" rising stars. This distinction was especially significant because the awards usually focus on individuals in the business field. Joseph was recognized for her positive contributions to the welfare of New York City residents. She has also received the Joanne Masin Breast Cancer Alliance Young Investigator Award and the Minority Scholar Award in Cancer Research from the American Association for Cancer Research.
"Crain's New York Business Honors Dr. Kathie-Ann Joseph," Columbia University Medical Center Department of Surgery, www.columbiasurgery.org/news/awards/2005_joseph.html (February 27, 2006).
"The Crisis in Mammography," InVivo, Columbia University Medical Center (November/December 2004), www.cumc.columbia.edu (November 21, 2005).
"New York's Rising Stars," Crain's New York Business, www.newyorkbusiness.com (October 26, 2005).
"Q&A with Dr. Kathie-Ann Joseph," Fox News, www.foxnews.com (October 26, 2005).
"Staff Profile: Kathie-Ann P. Joseph, MD, MPH, FACS," Columbia University Medical Center, http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=kpr2&DepAffil=Surgery (November 15, 2005).
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