How I Found (and Trusted) My Doctor for Skin Cancer as a Person of Color

When Glen Issac, a Black man from Washington, D.C., learned he had stage 2 skin cancer, he thought his life was over.

Issac was diagnosed with squamous cell carcinoma, an aggressive type of skin cancer that can spread to other organs, at 56. He first noticed a raised brown scaly lesion on his foot when he was 49 but did not have medical insurance after being laid off from his job.

“When I first noticed the lesion, I thought nothing of it. I definitely did not think it was cancer,” Issac says.

After a series of misdiagnoses and being uninsured for several years, he wasn’t sure where else to turn, but fortunately, he was able to find the right doctor to treat his cancer. If found and treated early on, most skin cancers can be cured. But even with a delayed diagnosis, like Issac, proper advocacy and finding the right medical team can be life-changing.

Disparities in Healthcare

Although white Americans have a higher risk of developing skin cancer, Black Americans are more likely to die from it, largely due to a handful of factors. These include delayed diagnosis, disparities within the healthcare system between how white patients and people of color are treated, and stigma among healthcare providers.

According to Manish D. Patel, MD, a hematology oncologist at Piedmont Cancer Institute in Newnan, Georgia, healthcare disparities that Black patients face in diagnosing and treating skin cancer can significantly impact how effective their treatment is and the chances they’ll survive.

A study conducted by the U.S. Centers for Disease Control and Prevention (CDC) examined the overall incidence of melanoma among Black people from 2011 through 2015 and found that, despite the small incidence of melanoma among members of the Black community, they have a lower chance of surviving compared to white people with melanoma. Similarly, a study published in the Journal of the American Academy of Dermatology found that Black people with melanoma are typically diagnosed at later stages of the disease than white people.

Although scared and reluctant to see a doctor, once Issac became insured, he made an appointment to see his primary care provider, leading to several misdiagnoses.

Dr. Patel says these misdiagnoses are not uncommon among Black patients, as Issac was first diagnosed with eczema, followed by rosacea. His daughter encouraged him to seek a second opinion, which led him to finally be diagnosed with stage 2 squamous cell cancer.

“Oncologists, primary care doctors, dermatologists, and the profession as a whole [have] to do a better job of being able to properly diagnose these types of skin diseases on all skin types and tones,” says Syed M. Jilani, MD, a board-certified expert in the treatment of hematologic malignancies at Torrance Memorial Medical Center in Torrance, California. “It’s well known that skin cancer presents differently on darker skin. Medical providers should be aware of these differing presentations.”

Black Americans and Trusting the Healthcare System

Lack of trust in the healthcare system also makes Black Americans more hesitant when it comes to seeing a doctor. Issac admits that once he did get medical insurance, he also waited several weeks to make an appointment to see a doctor.

“I know it sounds ridiculous, but it was tough for me to go to the doctor,” says Issac. Growing up, he never heard any older men talk about going to the doctor. “My grandfather actually wore not going to the doctor as a badge of honor. So I think I unknowingly adopted some of those ideas about seeing a doctor. My grandfather used to say he knew more about his body than any white doctor could tell him.”

Current research has consistently found that Black Americans are regularly undertreated for pain and receive differential treatment relative to white people. “Black Americans have never had full access to consistent, quality, unbiased healthcare across the board,” says Patel. “This, coupled with masculinity and gender expectations that suggest that men who admit when they are in pain or seek help are weak, only compound the issue.”

Creating Your Dream Medical Team

Being diagnosed with skin cancer is not easy to process and can devastate most people, like it did Issac. However, he created his “dream team,” which he feels was instrumental in saving his life.

“When I first was diagnosed with cancer, I didn’t know where to start,” says Issac. “I told myself right then that I was going to die. But it was my daughter and wife who pushed me to have hope and build my dream team.”

His wife and daughter encouraged Issac to seek a second opinion. He took their advice, and that doctor is still his oncologist. Ideally, Issac wanted to be treated by a Black doctor, but none in his area were taking new patients.

Issac also decided to join a cancer support group at his church and began to regularly meet with his pastor for counseling, which he says were crucial decisions in helping him deal with some of the emotions and fears he experienced. Now that he has been treated and is cancer-free, Issac still fears his cancer will return. But when his fears and anxiety overwhelm him, he makes an appointment with his pastor.

If you need help finding the right doctor, Issac recommends these tips:

1. Get a second opinion. Issac admits that he did not feel a direct connection with the doctor who first diagnosed him with skin cancer. This was one reason he decided to seek a second opinion, which led to him finding a doctor who made him feel heard and better supported. His second doctor also recommended a slightly different treatment plan based on Issac’s specific needs.
2. Don’t hesitate to ask questions. Ask as many questions as possible when meeting with various doctors. Begin thinking about your questions in the days leading up to your appointment and writing them down as they come to mind. If possible, bring someone with you to your appointments to take notes and to ask follow-up questions that you may not think about.
3. Do your research. Turn to credible sources that specialize in health content, such as the American Cancer Association, the National Cancer Institute, the CDC, and academic journal articles. Use the information you find to help inform your questions. It’s also a good idea to research your doctor to make sure they have expertise and experience with your type of skin cancer and to find out how many patients of color they have worked with.

Issac acknowledges that being diagnosed with cancer can feel extremely disempowering and discouraging. However, “we have some control over all of this,” he says. “We can have some control over our choice of doctor, and if we are forced to go to a specific doctor, we have control over the kind of questions we ask and making sure that our concerns are heard."