Video Transcription

Aboriginal & Torres Strait Islander Patients, Family & Community

The Head & Neck Cancer Innovations 2020 Video Series is brought to you by St Vincent’s Hospital Sydney & The Kinghorn Cancer Centre. In this episode we talk to head & neck ENT surgeon and proud Worimi man, A/Prof Kelvin Kong about the particular needs of Aboriginal and Torres Strait Islander patients and their families and how to close the gap in survival and quality of life. Kelvin qualified as the First Aboriginal Fellow of the Australasian College of Surgeons. For more information please visit our website or our You Tube channel. The podcast versions can be found on our SoundCloud channel.

Julie McCrossin, Head & Neck Cancer Survivor
A/Prof Kelvin Kong, Head & Neck ENT Surgeon, John Hunter Hospital

Julie McCrossin
Hi, my name is Julie McCrossin and welcome to this video looking at head and neck cancer and the Aboriginal and Torres Strait Islander community.

This is part of a series of videos on head and neck cancer innovations to improve survival and quality of life. And they’re hosted by St. Vincent’s Hospital Sydney and the Kinghorn Cancer Centre. And we’re broadcasting to you today on the land of the Gadigal people of the Eora nation. We’re in Darlinghurst.

And I’m thrilled to be connecting to Associate Professor Kelvin Kong in Newcastle. Welcome to this program Kelvin.

Kelvin Kong
Thank you so much for having me. And I acknowledge that I’m on Awabakal Land in Newcastle, and our beautiful new centre here, which is located in a building that we’ve called Konara, which is related to community gatherings and being together. So it’s wonderful to be here today.

Julie McCrossin
Fantastic. Can you introduce yourself to the audience and give them a sort of a snapshot overview of the sort of work you do as a surgeon, a paediatric and adult, otolaryngologist, is that how you pronounce it?

Kelvin Kong
Fancy words for that.

I should also just quickly say thank you to St Vincent’s for having me on their video being all the way in Newcastle. But my training route started in St Vincent’s Hospital. So to Professor Gallagher and the team, thank you so much for having me on board and it’s a pleasure to be here.

I am an ear, nose and throat surgeon, which is probably the easy way to talk about it rather than anything fancy. And I’m really privileged and humbled to be able to work in a very diverse practice which looks at hearing, implantation, babies and breathing troubles, and obviously for this conversation, importantly, head and neck cancer operations.

It’s a big part of our head neck cancer journey. I think it’s something that we underestimate the impact of. I grew up on Worimi land. I’m a Worimi man. A proud Worimi man.

And being on a Awabakal country allows me the privilege to look after a greater set of our population. Not just in this area, but the greater western New South Wales and greater northern New South Wales. All the beautiful lands that it incorporates. To be part of their lives and sharing that and helping their world is very lucky

Julie McCrossin
And Kelvin may I ask, what proportion of your work would be head and neck cancer patients?

Kelvin Kong
It varies so much and I must confess I’ve tapered off a little bit more recently because I’ve been doing a lot more hearing stuff.

But probably about 25% of the work that we do here presents with head and neck cancer. And that starts at the very early stage and early diagnosis stage right through the operative intervention.

We have quite a big head neck unit in Newcastle. And headed up by the ENT surgeons, Dr. Robert Eisenberg and Dr. Darren Cope, which is a fabulous unit, and Dr. Johnson Huang of course, which is a reconstructive unit as well.

So we’re seeing quite a lot. It’s a very diverse population. And the kind of mix we get is one of those unusual parts in Australia because we’re considered an urban population Newcastle, but we also look after regional New South Wales and also remote New South Wales. So we’re covering all parts of Australia and I think one of the conversations in cancer, particularly with our Aboriginal population, is that diversity landscape that we look after. And how we need to change our management paradigms to make sure we cater for the relative community that we’re dealing with.

Julie McCrossin
Well, it’s those changes in management paradigms I think I want to ask you about. But can I just say quickly, at the beginning of each of these videos we’ve made for this video series for World Head and Neck Cancer Day, on the 27th of July,

I’ve said that Aboriginal and Torres Strait Islander people are disproportionately represented with head and neck cancer patients. And I went on to the Australian Institute of Health and Welfare website, and I just thought I’d quote a couple of figures to help our audience with that.

So for the total Australian population, in 2019, there were just over 5200, head and neck cancer diagnoses, so 5200. And the survival rate for five years for Non-Aboriginal people was 71%. And the survival rate for five years for Indigenous Australians was 42%. So a very significant lower rate of survival.

The other thing I thought I’d just say, if I give people the numbers, is there’s a big difference between the rate of head and neck cancer for men and women. So for the whole of the population, there were just over 3800 men had head and neck cancer in 2019. Just over 1400 women had head and neck cancer. And of both the men and the women, nearly 1300 were indigenous people.

So it’s a very significant extra number of people who are Aboriginal and Torres Strait Islanders who get this cancer and they survive less. Why is that so?

Kelvin Kong
I think it’s a really interesting and very sobering for me to hear the realities of some of those statistics. Obviously, you know, those kind of statistics happen.

But the reality of that is that represents family members. That represents fathers. It represents mothers, cousins, uncles, aunties. And what’s really hard in taking all that in is, I still think in the medical world, we are fixated on a medical fix, or a treatment paradigm, which focuses on disease.

And I really think we need to move away from that to look after how we actually treat the patient. And there are so many different components that which I’m very happy to break down.

The first part of that is how do we actually get access to the care that we need? When you look at those statistics that you speak of and we break them down. It’s not only that there’s a higher rate it’s that the diagnosis is often at a later stage.

And if you have the same diagnosis stage and you’re non- Indigenous versus Aboriginal, then your treatment options are varied. And that’s an implicit bias that we have in terms of how we’re treating and managing those things, which can be geographical, or it can be racial in nature, that we’re not really aware of.

And so I think there needs to be a lot more work around what that data set looks like, and how we actually tease out those stats

But importantly, I think, and it’s probably timely at this stage to reflect on, how do we as a health profession, as a head and neck health profession, that we’re trying to improve this, actually change the structure and the systems that we have to cater for the needs of Aboriginal patients. Of Torres Strait Islanders patients. Of vulnerable patients.

And a big shout out to our rural and regional patients because I think they’re the kind of people who don’t get the same treatment as you would in parity. If you look at those statistics were 42% compared to 70%. That’s a huge difference.

And the other part of that which you didn’t include in there is that under the age of 55, that rate actually increases significantly more. There’s another young population we have.

The wonderful thing about Closing The Gap campaign is we’re actually living longer. And as we live longer, you’re gonna see this explode. And it wasn’t long ago where cardiovascular disease was our number one killer. It wouldn’t surprise me now, if cancer is actually taken over as a number one problem for death. The number one problem for burden of disease. And number one problem in general health in our population. I think that’s really important to know.

Julie McCrossin
It is my understanding Kelvin that there was a recent announcement that cancer had overtaken heart disease as the major killer of Indigenous people in Australia. Could I say to you, what I’ve tried to do in this series is to focus on examples of good work, to try to inspire those who are keen to improve those early diagnosis, survival and then rehabilitation, so that indigenous people, not just live to five years, but live beyond, with the best quality of life.

I want to share examples of good work. Are there examples of Aboriginal-controlled services, or services using Aboriginal staff, or in partnership with mainstream services, where you think they are working well with Aboriginal cancer patients or particularly head and neck, if possible.

Kelvin Kong
I think we’re not recognizing enough the Aboriginal-controlled health organizations and the work they do.

Our work in the local area is purely determined by how well the community functions. And the Aboriginal Medical Services, or AMS, as we call them, are they the backbone and the life and blood of the access to understanding.

One of the biggest issues, where we’re getting really good innovations and understanding, is that translational research that’s out coming about the stats that you talk about and therefore pass them into the community.

And where the really good examples are is that the community understands it, and the community embraces it. Then we’re going to see more action in these areas.

The days of this is a problem, and we’re going to treat you, are long gone. It’s a management system that we need to make sure that the community are actually leading the way in the research. They’re leading the way in the treatment pathways. And they’re leading the way in the innovations that we need to do.

So locally, we really try and engage our community as much as possible. Where groups like this are really important in that area, to make sure that there’s a strong voice to say this is what happened to me.

Julie McCrossin
Just following up in relation to that whole-of-community approach with Aboriginal communities. I was thinking we would call this particular video, this interview with you Kelvin, “Patient, family and community” in the title. Because it strikes me that with the non-Aboriginal population, one of the recommendations for future work to improve earlier referral to an ear, nose and throat doctor, so earlier stage identification and diagnosis.

We tend to think of it as education for General Practitioners. For then the individual head and neck cancer patient to get referred by the individual GP. And I’m wondering if in the Aboriginal and Torres Strait Islander context, we need to think rather in terms of community and family, rather than individual patient.

And so the way forward may be more work with the Aboriginal Medical Services on awareness around head and neck cancer, not simply with drug and alcohol, and tobacco, which have often in the past, as we know been the main causes for all of the whole population, but with this new rising Human Papillomavirus -related throat cancers.

So my question is do we need a community approach with Aboriginal and Torres Strait Islander people that is specific to the community, If we’re going to improve that data?

Kelvin Kong
Oh Absolutely, I think you sum it up quite nicely because the real issue here is how do we actually get the community on board to acknowledge this. There are a couple of things that there’s a bit of noise in the background. And that noise in the background is there are so many other issues that are occurring on our Aboriginal patients.

They’ve young, so children, particularly take up a huge proportion of concern and care, and therefore there’s a lot of focus on the kids.

Employment opportunities. Housing. All those kind of things play a big role. So if you’ve got something niggling your throat, and you’ve got an unwell kid who needs antibiotics. You got no money for work. You need to get to work, otherwise you don’t get paid, or you’re gonna get kicked out of house because you’re not going to get rent paid. Then a niggly throat becomes the most minor thing that we are worried about in that kind of aspect. And therefore it may represent a later stage of diagnosis and presentation.

One of the beautiful things on a positive note is the resilience in Aboriginal communities is amazing. And with the knowledge in the right hands, that you have some elders talking to you, that you have someone that they have a strong link with, that can actually understand that.

And that’s where you need that identity to be able to say, you know what, that’s something easy, get sorted out. Go see the ENT clinic. They’ll get a biopsy and sort it out and you won’t have to worry about a thing and you get back to your job.

That’s the kind of attitude we need to have around this. And that’s where we need to play a lot more focus, rather than waiting for a long period of time. Where they put it behind barriers. They’re shamed with it. Worried about losing work. Worried about all these other things.

And you know what, these are problems that we all have, whether you’re Aboriginal or not Aboriginal, in general society. And that’s the problem that we have.

So we need to break those down. And a big part of that, then is that, how do we ensure that when we can get that information to the community, that then we provide the pathways and the access about the correct information, seeing the right people and getting it sorted out appropriately.

And I think you said it beautifully there, is that, again, we’re moving away from the days of the General Practitioner being that primary leadership holder. And it’s rather the community with that knowledge base and the Aboriginal Medical Services that actually say, you know what, get and get that done. Get in here now.I’ll get it all nice for you. And then you’d have to worry about a thing. It’s really changing that and pushing that along.

Julie McCrossin
You know, if I could just share some of the ideas that have been put forward in the other interviews we’ve been doing about, you know, what can we do to improve early identification, treatments, survival, quality of life, for all head and neck cancer patients,

Things like turning up to every session of radiotherapy, radiation therapy, if you’re getting it. Not missing a single session. Now travel, transport, is a huge thing, as we know, in health in rural and remote, but it also is in outer suburban, which is where a lot of Aboriginal people live in mainstream cities.

Secondly, there’s been a lot of emphasis on the need for a national network of specialist head and neck cancer nurses, just as we have with breast cancer and prostate cancer.

Because when I see that lower survival rate, you know, 71% of non-Aboriginal people make it to five years, only 42% of Aboriginal and Torres Strait Islander people.

I’m wondering if they’re turning up, your people are turning up for all those checks.

When I was a patient, I had to turn up every three months for a couple of years. Well, if you’re in rural and remote or outer suburban, and there’s a lot of travel to get yourself there. And I’m wondering if, in a in a network of specialist nurses, we also need a network of Aboriginal health workers who are briefed and knowledgeable on the head and neck matter to get those numbers to change

Kelvin Kong
I think two points to talk that is that

The network of nurses. We need to encourage Aboriginal nurses into this field. We need Aboriginal nurses in here to represent and actually take the lead in all of this because that’ll make a big difference.

We need to obviously engage the health workers because they provide such a huge role. But there is so much on their plate, that again, when they’ve got multiple priorities, head neck cancer becomes a smaller priority.

So why not let’s chase with the CATSINaM network, which is the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives to actually engage more nurses. Say this is an area we need you to work in.

The other part of that, which if I can flip it on its head, so to speak., Is if you have the people who can’t attend the appointments and one of the biggest frustrations I have with data sets in the hospital is what we call the DNA rates or the “do not attend rates”.

And the “do not attend rates” are a bad reflection on the hospital. And so we sit in these meetings say you know, your DNA rate for this Aboriginal clinic was 50%. Why didn’t you actually fix it?

They’re not coming. They’re not coming for treatment. So therefore it’s a waste of time.

The rebuttal for all that all the time is, what are we doing so wrong that makes so many people not show up? That makes people not attend the appointments?

And I think some of them articulate there with the travel and the cost with that.

But there’s a whole lot more behind that, than just than travel and costs.

It’s about how appropriate is a service? Is it somewhere where they feel comfortable? Is it culturally safe? Is there something that we can do in surveillance clinics? Where we run a head neck surveillance clinic and we run it in AMS. We don’t do it in the hospital? We do it at the Aboriginal Medical Service with our ENT head neck cancer surgeons, so that the patients go a place that they’re comfortable with.

We have 120% of attendance there.

In fact, more people come because they feel more comfortable.

So it’s not actually just looking at the old. The data sets can be actually quite tricky because you need to actually understand what they mean. And by understanding what they mean, you can change the whole way in which people present and how they attend.

Julie McCrossin
That’s very interesting because I’ve been to Albury-Wodonga on the border of New South Wales and Victoria with a local Aboriginal woman who’s had a head and neck cancer.

She did an art exhibition, decorating the radiation mask and I was an MC of a fundraiser there with her.

And we went that day to the Albury-Wodonga Cancer Centre where people could not have been more friendly. But it was a very um. My fellow patient who was an Aboriginal woman was manifestly less comfortable in a more flashy, if I could put it that way, clinical environment.

We then traveled across town to the Aboriginal Health Service, and she immediately went into a kitchen and made me a cup of tea.

There were dental appointments that you could have there and that was all advertised at the desk.

She just related to it as if I had gone into her house.

Now I’m not actually meaning to criticize Albury-Wodonga Cancer Centre. It was just a really noticeable difference of level of ease. So what can mainstream services do to help bring that ease?

Do you know? Have you got any examples there?

Kelvin Kong
It’s all about self-reflection and it’s a really hard thing to do, because it’s actually admitting that your service is not providing for the community that its looking after.

And as a clinician, you can be quite offended. I’ve got the guys here today in our new flash rooms and it looks wonderful,

But sometimes it’s about how you make that environment, a lot more comfortable for the patients to appreciate. And we all know that feeling and people find it hard to struggle, but if you’re in, say, overseas in a non-English speaking country, and you’re unwell in the emergency department of the hospital. If you hear that Aussie twang, or an Aussie accent, your eyes light up. You look straight for that corner. You go try and find them.

And you may not know them. They might be from Perth, or somewhere as ghastly as Melbourne, and you actually relate to them straight away. And you want to have that conversation and link with them.

And that’s pretty much with Aboriginal people. We’re such a diverse culture. Yet we’ll always looki out for each other because we know we’re comfortable in those roles.

And I think if I can explain. I’m trying to give a nice way to explain implicit bias in what we have.

And I was talking to a friend in America. And so this is a story we reflected together, where I think I’m very non-sexist. Yet, in my bias, I think, in my unconscious bias it is, you know,

I was on the plane going to America and there was a female pilot on a long haul. And I thought, this is fantastic. Power to women. All great. How great is this?

Hit a bit of turbulence. I’m going. Oh, I hope she doesn’t drive like a woman.

And in my immediate mind, it was just a reflection. Whereas if I’m on a plane with a pilot who’s a male I would have never have thought that.

But it was important for me to be able to reflect on myself and think, hang on a sec. Why do I have that bias?

Why is that bias there? And it’s ok to have a bias, but as long as you actually understand that your bias is out of character, and not based on any truth in it.

And I think for us in that clinic setting, it is saying, you know what? Our clinics aren’t really prepared for patients who are vulnerable. Who are non-English speaking. Or Aboriginal. Who are all these other different things that are vulnerable and need that help. And we need to make sure we create that environment where they do that.

So for us here, we make sure there’s lots of artwork, which is so, I guess, a bit outdated now in that sense. But

The fact that that we have staff who can relate. That people understand rural, regional. We have Aboriginal. We have all different diverse backgrounds. And it’s really important for us to make sure that we can relate somewhere. That someone can see something. And also that we, as a group, are continually reflecting on how we can improve ourselves.

Julie McCrossin
Okay, so non defensive, self-reflection of the team and engagement with local Aboriginal people and organizations?

Kelvin Kong
Non-defensive, critical reflection. And it’s really important to be harsh on yourself. And be able to absorb some of that . To say, you know what, maybe that is like that.

And sometimes you might disagree, that’s okay. But you still need to be able to reflect on those things. So the DNA (Do Not Attend) is one of the really good ones. When you talk to the managers in the hospitals about how they have the DNAs and the way they treat that.

It’s really eye opening to watch the faces in the room and say, well, why are we doing such a poor job?

If you opened up a shoe shop. And it was the most amazing shoe shop in the world. And no one came into it. You’re not going to sit at the front and blame everyone for not coming into your shoe shop,

You’re actually going to work out, what have I done so badly where people don’t want to come in the shop and buy stuff?

And this is what we’re trying to do, in that kind of, I guess, it’s a client thing.

It is a patient ratio. But it’s making sure people are welcome. Making sure people know where to go to. Making sure people are familiar.

And you know, as a head neck cancer patient, when you’re going to hospital so much, you should not feel like a visitor there. You should be part of the family there.

And how do we create that environment there?

Julie McCrossin
One example, because I love practical examples. I’ll share one with you. And if you have another one I I’d be grateful. But when I was a patient in 2013, with stage four cancer of the tonsils, tongue and throat.

I had 30 consecutive days of radiation and weekly chemo. And I don’t know if this is still happening at St Vincent’s. But where I was sitting in St Vincent a number of what you might call… there were homeless patients. There were some Aboriginal patients. And there was some patients with mental health issues.

So very obviously vulnerable patients. And there was a social justice program. And there was a series of volunteers who went and picked up the patient and brought them to the radiation and sat with them and then took them home.

Now, I don’t know if that’s still working. But it struck me as an incredibly practical way of ensuring vulnerable people got that consistent 30 day radiation treatment that was utterly critical.

Have you ever seen any other suggestions like that where to help with that consistent follow-up, both in treatment, but the checking after that so crucial to catch recurrence early.

Kelvin Kong
It’s funny you say that because I think most of my experience in people that have good outcomes, and had a good relationship, are always based on personal relationships within the facility or within the treatment area.

So whether it’s that they see and see that special nurse is looking after them. Whether it’s the same face you see at the front desk when you go in there,

Whether it’s the wards man that comes in and always says g’day with a smile. Whether it’s the community person that drops you in. There are plenty of community services that do that kind of travels stuff.

But it’s that familiarity, of being able to be feel part of the team in tracking your treatment journey,

The journey that you’re going on through, a cancer treatment is your own journey and everyone else’s on that.

I think sometimes we feel like it’s a hospital machinery, and you’re just coming in as part of that number.

And I think the more we can try and personalize that the better.

Which comes back to why it’s so important to have these head and neck clinic nurses. Whose value you could not pay for. And their kind of follow up. Their care. Their empathy. Which makes a huge difference, not only for the journey as an individual going through, but as cancer survival and also cancer tolerance if I can use it that word

And that is all the other things that go with it. The emotional rollercoaster you go on. The family dynamics that go on. The employment prospects. The income prospects. Alll those kinds of things that play such a huge role.

Yet we focus on radiation, chemotherapy, surgery, and we forget about all the other things.

So I’ll come back to, it’s really important for us to book end.

And one of the lovely things that we’re happy to share all the time is, in Aboriginal culture, we talk about that spiritual, cultural, emotional, and physical wellbeing.

And that is truly the pathway for cancer patients.

How do we book in all those services. Bring the family on the journey with emotion. That’s good.

And the other part of that is demystifying it for the larger family at home.

If you’re going through treatment, it’s not contagious.

You can give a cuddle. You can understand what you’re going through. This is why I’m going to be a bit sad. This is why I’m a bit tired and lethargic.

And I think none of that is actually explained. And when you’ve gone through that treatment, as I’m sure you’re aware, when you’re asked one or two times you don’t mind. But when you are asked for the fiftieth time. By somebody, maybe two, three people removed from you. You kind of roll your eyes. I mean, I and I’ve had enough of this.

Yet people go through this every day. So how do we as a profession then have the websites with the information that we can find that information.

How do we put it in a medium that people understand.

So other meetings where there’s cartoons. YouTube. Digestible formats. These kinds of conversations where people are able to go, you know what? This conversation is good.

Even hearing the stuff we’re talking about today makes people realize there is such a great community group of people behind this, that are looking for ideas. That are happy to engage in those ideas,

But also that we’re always looking to how we can improve this journey. And it’s not just about treating a disease. It’s about looking after a person.

Julie McCrossin
You’ve touched on something I wanted to raise with you there. And that is that question of literacy and health literacy. And to me, because traditionally head and neck cancer patients have been heavy drinkers or smokers. And I’ll come to HPV with my last question in a moment but

It’s increasingly has been,

It’s been traditionally more men than women, and a more working class, lower socio-conomic group of people who get head and neck cancer.

And many Australians can’t read or write reliably. And while there is a brilliant website that we’re promoting on this series of videos run by BeyondFive. So And we’ve got links on the YouTube site where a lot of people will be watching this.

And it’s a brilliant website. It has diagrams and it has videos. But the level of literacy required is pretty high.

And I’d like to see a lot more materials made, not just for Aboriginal and Torres Strait Islander people, but that very big proportion of people for whom English isn’t their first language. Or they are Anglo Australians but they just haven’t learned to read and write.

We need a lot more visual material for the head and neck cancer patients. Would you agree Kelvin

Kelvin Kong
Absolutely, I think that’s so important.

I think the other part of that is that it’s really important for the people going through treatment to understand.

But it’s really important for the wider community to understand this that they’re going through.

And I also think

I get so frustrated with the blame game and the negative connotations with the alcohol and smoking. This is a life style that wasn’t accepted by them, rather pushed on from circumstance or whatever it is. We don’t know that background, and

99.9% of my patients with head and neck cancer are the most beautiful people.

And the lovely thing is they all love yarn, because they’re use to having a good yarn,

They’re always smiling and so positive.

And we’re treating a patient. I’ll come back to that.

And so you know, the notion of, you know, they’re smokers. They’re drinkers. They deserve it,

We’ve got to get rid of that out of our vocabulary altogether and not even talk about it.

And when we do that and take away from the blame game, then we’ll get better outcomes. And you see that with many other disease processes.

When HIV was first diagnosed in Sydney, the connotations, the stereotypes were just absolutely appalling.

And as soon as we got rid of that, look at the treatment and the kind of survival rates we’re getting now. It’s fabulous.

And that’s the way we should be treating health. Health is a human right. No matter what your background is. No matter what circumstance you found yourself in. How to get back to being back in that positive strain to get people through this.

Julie McCrossin
You’ve raised an issue there that segues great into my final point and that is looking at the Human Papillomavirus, the HPV. Because it’s my understanding that the rate of head and neck cancers caused by the Human Papillomavirus, HPV, is increasing rapidly and there are now more HPV-related head and neck cancers in the United States than cervical cancers.

And it’s because predominantly because of oral sex. Now, why I raised this is that, are there particular sensitivities in the Aboriginal and Torres Strait Islander community around talking about oral sex? It’s hard enough in the mainstream community.

Kelvin Kong
I think in saying that there’s sensitivity in any culture raising those kind of taboo topics.

But the important part of it is that we need to talk about these taboo topics. But we need to find a medium to talk about that.

So in women’s business, in men’s business, we need to bring them up in a very sensitive manner to talk about that.

There’s been some wonderful work in the Central Australia, around STDs with some of our major Aboriginal researchers. And to get big randomized control studies looking at that was incredible.

And that journey, in getting that research, was a really powerful journey. And I think I reflect on some of those kind of conversations, because there must have been so hard to get that data. That we need to replicate that and bring it into the community and actually benefits all of us in understanding this process.

Absolutely we need to break down those taboos. And as health professionals, we should be able to bring it up without having those kind of connotations or the stigma that goes on with it, because again, going back to what I was saying before,

It is so important to be non- judgmental in this area. And more so than ever, with particularly the HPV, the outcomes are absolutely superb.

So you can get a cancer and present with something that looks absolutely horrific. But the treatment paradigm, we have for it shows survival rates to be amazing. Which is wonderful. So this should be celebrated.

Julie McCrossin
Well, look, is there anything else you’d like to add Kelvin? Thank you so much. We just very much wanted to raise awareness of the higher rate of incidence and the poorer outcomes for indigenous people. Is there any other issue you’d like to raise?

Kelvin Kong
Yeah, I think I’ve touched on it before. The only thing I’d really like to leave as a message to people listening to this is to be strong and be supportive of each other.

But the most important thing is, as a healthcare professional, more than the patient’s, how do I change my environment? And how do I use my spheres of influence to make sure all my patients, most particularly our Aboriginal and Torres Strait Islanders patients and vulnerable patients, get looked after equally and that’s challenging because equally doesn’t mean the same treatment

Julie McCrossin
Look, thank you so much. And I’d like on behalf of everyone watching to thank Associate Professor Kelvin Kong. An Ear Nose and Throat surgeon working in Newcastle. And this has been part of a series of videos hosted by St Vincent’s Hospital Sydney and The Kinghorn Cancer Centre, looking at innovations to improve survival and quality of life.

And if you’ve got any questions, you can go to the Information and Support Line that’s run by Cancer Council 13 11 20.

And they can refer you on to other services including indigenous services.

And another great source of information is the BeyondFive website

Thank you so much for taking an interest in head and neck cancer and the particular challenges for Aboriginal and Torres Strait Islander people.

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