Meet Dr Alison Berner, Speciality Trainee and Clinical Research Fellow in Medical Oncology and the Barts Cancer Institute, and Specialist Registrar in Gender Identity at the Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust.
Please could you tell us a bit about your research and clinical work?
I am a specialty trainee in medical oncology, which means that I care for patients with cancer and prescribe systemic anticancer therapies such as chemotherapy and immunotherapy. However, at the moment, I am out of clinical training undertaking a full-time CRUK-funded PhD study the genomics of exceptional survivors of colorectal cancer, which means I spend most of my time undertaking wet lab work and bioinformatics related to whole genome sequencing, transcriptomics, and epigenetics.
I also have an interest in sex-differences in cancer, and in cancer care for the LGBTQ+, and particularly the transgender, community. For this reason I do a clinic a week in gender identity medicine, and help provide advice for trans patients with cancer or a genetic predisposition to cancer. I am working on a few pieces of research and education related to this field, including on the knowledge, attitudes and behaviours of oncologists treating LGBTQ+ patients and the experiences of trans and non-binary people having cervical screening.
What do you think are some of the biggest challenges that Covid-19 has presented for LGBTQ+ cancer care?
I think isolation is a big challenge for everyone at the moment, and this can particularly affect LGBTQ+ people, who may struggle to access the right support services that cater to their needs. General LGBTQ+ spaces have been closed and some older LGBTQ+ people may not be equipped with the technology or skills to connect remotely. LGBTQ+ people experience a greater burden of mental health problems such as depression due to minority stress associated with their gender or sexual orientation, and this can be compounded by Covid-19. This may also result in great misuse of substances such as alcohol. With clinics busier due to staff shortages, there may not be time to explore gender, sexuality and support structures as well, and assumptions may be made that can alienate LGBTQ+ patients. Finally, lock-downs and the pausing of screening services, may have lowered screening rates for some hard-to-reach populations, such as trans men and non-binary people accessing cervical screening. All of these factors may act to widen health inequalities, and as we recover from this pandemic, LGBTQ+ people with cancer should not be forgotten.
More information onLGBTQ+ cancer care and Covid-19 can be found in this report by the charity Live Through This.
Could you tell us a bit about what living through the pandemic has been for you?
I think I have incredibly lucky to be surrounded by wonderful people during this pandemic. All of my supervisors and managers have been incredibly supportive and patient during this tough time.
I was redeployed to my local hospital in Milton Keynes for 4 months, where I met some fantastic colleagues on both the covid wards and in oncology, some of whom will remain friends for life.
I have a terrific network of friends, some of whom I live with and others I have been able to see for walks, so I don’t think I have ever been lonely. I do miss latin dancing, which was my main hobby, but we managed a few classes when cases were low and I am looking forward to being able to do that again, and to travel too. I have taken up yoga meanwhile and am trying to keep my fitness up.