How MSK Is Reducing Inequality in Cancer Care in Harlem and Beyond

Lewis Kampel speaks to a staff member

Medical oncologist Lewis Kampel has been Medical Director of the Ralph Lauren Center for three years.

On April 1, 2019, the Ralph Lauren Center for Cancer Care (RLC) officially became part of Memorial Sloan Kettering. Opened in 2003 as a partnership between MSK, the Polo Ralph Lauren Foundation, and the former North General Hospital, the RLC has served as a model for quality and equity in healthcare for residents of Harlem and surrounding neighborhoods.

We recently spoke with Lewis Kampel, an MSK medical oncologist and Medical Director of the RLC, about the center’s mission and his goals for its future.

MSK Ralph Lauren Center
Learn how the MSK Ralph Lauren Center brings high-quality cancer prevention, diagnosis, and treatment to residents of Harlem and surrounding communities.

Why was the RLC originally established, and what was MSK’s role?

The intellectual spark for the center came from Harold Freeman, a prominent African American cancer surgeon. He had begun noticing disparities in cancer incidence and outcomes in Harlem and the surrounding community. He was one of the first to bring this important topic to the public’s attention.

Dr. Freeman connected with fashion designer Ralph Lauren. At that time, through his foundation, Mr. Lauren was developing an interest in cancer research and access to care. The two of them joined up with Harold Varmus, who was then President and CEO of MSK. Dr. Varmus also felt strongly about reducing disparities in cancer care.

So MSK has been a vital part of the Ralph Lauren Center from the very beginning.

What changed this month?

Until now, the RLC has operated as a separate corporation, even though it was owned and controlled by MSK. Now that we have received approvals from the New York State Department of Health and other state agencies, it will operate more like MSK’s other outpatient facilities.

Could you talk more about the mission of the RLC?

The mission of the Ralph Lauren Center is to reduce disparities in cancer incidence and outcomes in the communities we serve. We do this by providing high-quality prevention, screening, and treatment services to those who might otherwise face challenges in getting them. The communities we care for may be underserved for a number of reasons. These include financial barriers and a variety of others.

It is important to emphasize that the mission and culture of the Ralph Lauren Center will not change. We will continue to provide high-quality care in a community-friendly atmosphere. As part of MSK, we will be able to tap into the expertise, experience, and technology available at a world-class cancer center.

What services are offered at the RLC?

When possible, we try to prevent cancer from developing in the first place. For example, we know that obesity is a risk factor for many cancers. So we offer nutrition counseling focused on healthy eating and weight reduction.

We also offer vaccinations for the human papillomavirus (HPV). This virus is associated with several cancers, including cervical cancer, anal cancer, and head and neck cancers. HPV vaccination can lower that risk. And of course, tobacco is another huge risk factor. We will be resuming a tobacco cessation program later this year.

If we can’t prevent cancer, we try to detect it early, when it’s more likely to be cured. Currently, we offer screenings for breast, cervical, lung, and prostate cancers, as well as periodic screening for skin and head and neck cancers. Eventually, we will offer screening for colorectal cancers as well. Later this year, the Breast Examination Center of Harlem will be moving into our space, which will help streamline the screening process.

We make every possible effort to treat anyone who needs our care.
Lewis J. Kampel Medical Director of the Ralph Lauren Center

For those diagnosed with cancer or certain blood diseases, we offer chemotherapy and other systemic therapies. We also have a breast surgeon on staff who can evaluate people with breast lesions. We refer those who require surgery or radiation therapy to MSK or other hospitals, depending on the patient’s choice.

Eventually, we hope to offer clinical trials to patients getting their treatment here. These studies are designed to determine the best treatment for a given cancer. Historically, people of African American descent have been underrepresented in clinical trials. Because of that, the conclusions of those studies may not apply to them.

What’s offered at the RLC that’s different from what people might get at other MSK outpatient locations?

We have several patient navigators, and they are key members of our team. Before patients even come for their first appointment, the navigators reach out to them to make sure that we have all the information we need from the referring doctor. Navigators can arrange things like transportation and child care, and help with financial and insurance issues.

We know that for breast cancer as well as other cancers, reducing the length of time between the initial diagnosis and the beginning of treatment can make a big difference in outcomes. So our navigators make sure that patients are seen here as quickly as possible after they receive a diagnosis and start treatment in a timely manner.

Good nutritional status is important for getting through cancer treatment, so our nutritionist provides advice on healthy eating. Many of our patients may not have access to healthy food, so our food pantry can provide food packages.

Who are the patients treated at the RLC?

Our patients come from all over New York City, especially upper Manhattan, Harlem, and the Bronx, as well as Brooklyn and Queens. They also come from southern Westchester County and even parts of New Jersey. Many of them find it convenient to get their care here.

Roughly 40% of our patients are African American and 40% are Hispanic. Many of them speak Spanish. We’re also starting to see patients of West African descent who speak French. Our patients tend to be lower on the income scale and have other medical problems in addition to cancer.

Some of our patients don’t have insurance, and others are underinsured. We make every possible effort to treat anyone who needs our care.

How did you get involved in the center, and when did you become medical director?

I grew up in Newark, New Jersey, and at a very early age I became aware of how the experiences of poor people within the healthcare system were very different from the experiences of those who were not poor. I also came of age in the 1960s and was strongly influenced by the social justice movement.

When I joined MSK in 1993, I began focusing on prostate cancer. I soon became aware that men of African descent — African American men and Caribbean men — have a much higher risk of prostate cancer than men who are white. Their disease also tends to be more aggressive. About ten years ago, I began working with the consul general of Jamaica and members of the Jamaican community in New York to study these issues. Genetics play a role, but there may be other factors as well.

At about the same time, I was Chair of the Quality Assessment Committee at Memorial Hospital. Through that work, I became interested in the issues surrounding equity in care. Being able to offer high-quality care doesn’t mean much if that care isn’t available to everybody.

When the opportunity to lead the Ralph Lauren Center as medical director presented itself three years ago, I jumped at it. It is the perfect role for me. It allows the convergence of several issues I am passionate about.