Dr. Nathan Vanderford, director of ACTION, is also the assistant director for research and education at the University of Kentucky's Markey Cancer Center. (Photo by Pete Comparoni | UKphoto.)

Editor’s Note: This interview first appeared in Path Finders, an email newsletter from the Daily Yonder. Each week, Path Finders features a Q&A with a rural thinker, creator, or doer. Like what you see here? You can join the mailing list at the bottom of this article and receive more conversations like this in your inbox each week.


College and high school students from a rural region with some of the highest cancer rates in the nation have a chance to participate directly in cancer-fighting research and treatment through ACTION, Appalachian Career Training in Oncology. 

The program, which is based at the University of Kentucky’s Markey Cancer Center, offers Appalachian Kentucky students research, clinical, and education experiences to help them learn more about pursuing careers in fighting cancer.

Two years ago the Markey Cancer Center published the Cancer Crisis in Appalachia: Kentucky Students Take ACTION (University Press of Kentucky, 2020). It’s a collection of essays written by high school and undergraduate students who have participated in the ACTION program. The program is publishing a second edition of the book, which features firsthand accounts of growing up in a place with the nation’s highest rates of cancer. 

Nathan L. Vanderford, PhD, MBA, is director of ACTION and an editor of the new volume of student essays. He spoke with Tom Martin about the new book and the work of ACTION in bringing Appalachian young people into the field of cancer treatment and research.

Listen to Tom Martin interview Nathan Vanderford on Eastern Standard, here.


Tom Martin, WEKU: Why is it important to the fight against cancer in Eastern Kentucky to encourage young people from the region to consider careers in oncology?

Nathan L. Vanderford: We truly do have a cancer crisis in Appalachian Kentucky. The state continues to rate number one in overall cancer incidence and mortality rates. And so it’s critically important that we bring awareness to this fact across the state, and particularly in Eastern Kentucky. And then we are on a mission, and we think it’s really important to train the next generation of oncology professionals who are going to tackle the cancer problem in Appalachian Kentucky, and to have those be individuals who were born and raised and have a personal understanding of the issues that the area faces. And who best to do that than the youth of the region?

WEKU: There are distance issues in coming from some parts of Southeastern Kentucky all the way up to Lexington [for treatment]. So it’s better to have an oncologist there. And also there is kind of a communications and trust issue, isn’t there?

NV: Absolutely. I think about Pike County, Letcher County, these are three hours away [from Lexington], three hours plus. It takes me three and a half hours to get to these beautiful areas of our beautiful state, and there’s a barrier in terms of getting patients here. So we definitely need more practitioners in that immediate area to take care of our patients. But also in terms of the trust issue, I think all of us want to be able to connect with the people that take care of us, and I think rural Americans … and just people groups from all over would like to connect with people that understand who they are, where they come from, why they do the things they do. So I think that’s one of the reasons why this program and having the goal of getting these students back to their home areas is so important.

WEKU: How does this exercise of sitting down and writing an essay help these students? What have you noticed?

NV: That’s a great question. So in this program, we do activities where we get students engaged in cancer research and cancer education activities, where we sit them down in a classroom and teach them about cancer in general, from the basic biology of the disease, all the way to behavioral specs and epidemiology. They learn a lot about cancer. They start working on the problem through their research. And I didn’t even really envision this happening as much as it has. When they write these essays, they start to connect the dots between what they’re learning, which is a lot about cancer, and what they see in their homes and among their broader family and in their community.

And they start to see the things that we tell them that are driving the high cancer rates in Eastern Kentucky. They see that. They experience it firsthand. And many times we have students, they encounter these things and they think it’s normal. And to them, it is normal. But the high smoking rates and things of that nature that really drive [cancer rates], and the transportation, the distance issue to places like Lexington to get the care that’s so greatly needed. It’s just normal to them. So their eyes start to become wide open in terms of what the causes of the crisis really are.

Markey’s ACTION Program Hosts Successful Inaugural Summer Residential Program – YouTube

WEKU: Do you hope to reach an audience beyond Eastern Kentucky? And if you do, why is that important to any success in reducing cancer in the region?

NV: Absolutely. And I think we’ve done that with the first edition [of student essays], certainly in Kentucky. We’ve had people throughout the state that have become more aware, and actually we partnered with a group in Chicago and they have a similar group as ours, and they had their students read our first edition of the book. And so their students are urban students from Chicago and they read the book, and then we got on a Zoom call during the pandemic with those students. We had some of our essay authors discuss their personal experiences with the students in Chicago. And it was eye-opening to the students in Chicago to learn about the ruralness of Eastern Kentucky and why cancer is so incredibly bad there. So I think it’s important for spreading the word and helping others understand why we have such a problem. And I think that as we shine more light on the issues, that can help us have more attention within Kentucky on the things that we need to do to help solve the problems.

WEKU: You and the editor of the second edition, Chris Pritchard, are going to work to get this book into the hands of people in the region. Tell us more about that.

NV: We’ve already given our essay authors multiple copies of the book, and what I’ve told them is spread these far and wide. And freely. We’re giving them away for free. We’re having the students place copies wherever think could be impactful, in local libraries, school libraries, wherever else. We’re giving away literally hundreds of copies all across Eastern Kentucky. We’ll do what we can to spread it far and wide beyond that also. It’s also available for purchase. So others can buy the book and all the proceeds go back to the ACTION program so that we can continue doing programs, projects like this to help the students learn more and connect with the community.

WEKU: Tell us what you have found to be rewarding about this work.

NV: I became really passionate about cancer and cancer disparities when I lost my dad to cancer. He died of lung cancer in 2010. And then just shortly thereafter, my mom was diagnosed with breast cancer, and luckily she was diagnosed early and went through some successful treatment and she’s OK today. So from a personal perspective, and again, I’m from rural Appalachia, so many of the issues I have seen in my own family. So I’m deeply passionate about this work because of that. But in general, I just absolutely love working with students. It’s just so exciting to work with students, particularly students from Eastern Kentucky. We have amazing students in this state and they just need opportunities. In many of these rural areas, there’s fewer opportunities, outstanding students, and they can just excel when given opportunities like this to take the ball and run with it, so to speak.

Appalachian Kentucky students who are interested in applying to participate in ACTION may find information on the Markey Cancer Center website. The deadline for high school students apply is May 13. The deadline for undergraduate applications has passed for this year.


This interview first appeared in Path Finders, a weekly email newsletter from the Daily Yonder. Each Monday, Path Finders features a Q&A with a rural thinker, creator, or doer. Join the mailing list today, to have these illuminating conversations delivered straight to your inbox.


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