By Steve Flairty
NKyTribune columnist
Cancer. The case could be made that Kentucky is home to some of the worst concentrations of the disease (more accurately, “group” of diseases) in the United States. According to a 2019 American Cancer Society report, the state has over 26,000 new cases and more than 10,000 cancer-related deaths per year. It is especially serious in the fifty-four Appalachian counties of eastern Kentucky regarding those two measures. Sadly, those “cases” are real people; in truth, so much more than numbers.
Dr. Nathan Vanderford (Photo from UK Healthcare)
Dr. Nathan Vanderford had been personally touched by the scourge when his father, a heavy smoker, died in 2010 on Father’s Day from lung cancer. His mother soon after was diagnosed with breast cancer, though fortunately received treatment and is well today. With those things on his mind and seeing the data from eastern Kentucky, he decided to initiate a project to help improve outcomes in the region. In 2016, Vanderford, an assistant professor of toxicology and cancer biology at the University of Kentucky College of Medicine, helped establish a program known today as the UK Markey Cancer Center’s Appalachian Career Training in Oncology (ACTION).
The plan was relatively simple. Identify young students living in the 54-county Appalachian area of Kentucky — ones having felt the sting of cancer intruding in the lives of their own family members and friends, and who were interested in pursuing careers in the medical field. Give them instruction that would include these components: mentorship from both a UK research and clinical faculty member, cancer education and outreach activities (including in their own communities), and active peer relationship with UK medical graduate students. In short, ACTION would help this cross-section of individuals to learn more about cancer, get career education in the field, learn how to inform others, and in doing so, provide an evaluative record of the effectiveness of the initiative. Today, the ACTION web site spells out the following eligibility requirements for students: (1) enrolled in a high school within Appalachian Kentucky as a freshman or sophomore in August 2022, or (2) a current 12th-grade high schooler within the region accepted as an incoming freshman for the fall 2021 semester at UK, or (3) a current UK freshman, sophomore, or junior.
The basic schedule for participating high school students works like this. They will participate in ACTION on UK’s campus one Saturday per month during the academic year. The summer consists of a month-long residential experience at UK. The bulk of UK undergraduates fulfill ACTION activities through the regular academic year.
I first learned of ACTION after happening to read the program’s recently published book, The Cancer Crisis in Appalachia: Kentucky Students Take Action. The information interested me immediately because, like Dr. Vanderford, I had a personal connection to the disease, having lost my younger brother to pancreatic cancer in 2018 and my mother with complications from ovarian cancer in 2013. The book gives plenty of background on the program and includes 25 essays participants have written about their personal connection to cancer cases within their families and friends’ lives. Many share multiple experiences. Their essays are informative and often emotional; each person authentically shares their dreams—via the direction of the ACTION program–for career engagement that will help fight the disease. Vanderford, Lauren Hudson and Chris Prichard edited the book.
According to Vanderford, the ACTION endeavor is working well. “We are finding that they are being highly successful in the program and in the pursuit of their educational/career goals,” he said. “For example, seven students have co-authored peer-reviewed scientific publications… twelve of our alumni are now in medical school, two alumni are in pharmacy school, one is pursuing a Ph.D., and one is in a physician assistant program. Related to our outreach, we have reached over 2,000 community members, including conducting work in middle and high schools across Appalachian Kentucky. Through this work, our evaluation has shown us that we are increasing individuals’ cancer knowledge which could help people avoid cancer risk factors and lower cancer incidence and mortality rates in the long-term.”
At this point, the popularity of ACTION has necessitated a waiting list, with Vanderford saying that there are “significantly more applications than we have positions available.” That said, the program seeks to give generous opportunities to individuals facing barriers. “Our selection criteria focus on students who are underserved or underrepresented in the sciences, including those that belong to a traditional minority population, those that belong to low-income families, or that are or will be a first-generation college student. Of note, per federal guidelines by nature of living in Appalachia, all of our students are underserved and underrepresented in the sciences. In addition to that, we work to select students that have an interest in the cancer field. We intentionally deemphasize grades in our selection criteria,” explained Vanderford.
Like Vanderford, Program Coordinator Chris Prichard talked about the “incredible opportunity” ACTION affords for underserved students in Appalachia. “The opportunity to experience lab research and to shadow doctors who are at the top of their field is a life-changing experience for many of our students.” He also lauded the value of gaining college life exposure. “The experience of spending five weeks on UK’s campus proves to them that they can exist outside of their home counties,” he said.
Cancer, certainly, is one of the state’s biggest obstacles to having a bright future for the Commonwealth, and on so many levels dealing with quality of life. But with programs like ACTION, there may be more than glimmers of optimism, especially as our young and passionate people are equipped to fight cancer, both by their actions and how they communicate information. Alyviah Newby, a Russell County high school in the program, put it this way: “One day, hopefully, there will be a cure for this killer so that it cannot take more precious lives of people around us, and Kentucky’s cancer incidence can decrease. When that day comes, we won’t have to worry about treatments or the chance of survival anymore.”
For more information about ACTION, email Dr. Vanderford at nathan.vanderford@uky.edu or Chris Prichard at chris.prichard@uky.edu.
