Posts tagged breast cancer
Latinas who have an abnormal mammogram result take 33 days longer to reach definitive diagnosis of breast cancer than non-Hispanic white women, according to a new study by the Institute for Health Promotion Research (IHPR) at the University of Texas Health Science Center at San Antonio.
Such a time delay can have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer.
For this study, published online in SpringerPlus in March 2013, IHPR researchers worked with partners in the federally funded Redes En Acción: The National Latino Cancer Network to evaluate the differences in time to diagnosis of breast cancer among 186 Latinas and 74 non-Hispanic whites who received an abnormal mammogram result in six U.S. cities.
Analysis showed that Latinas’ median time to definitive diagnosis of breast cancer was 60 days, compared to just 27 days for non-Hispanic white women.
“This long delay puts Latinas at greater risk of being diagnosed with larger tumors and more advanced-stage breast cancer, which can affect prognosis,” said Amelie G. Ramirez, Dr.P.H., the study’s corresponding author, director of the IHPR, and Professor of Epidemiology and Biostatistics in the School of Medicine at the UT Health Science Center at San Antonio.
Given this delay and that cancer now is the leading cause of Latino death, this study also signals a greater need for ethnically and culturally appropriate interventions to facilitate Latinas’ successful entry into, and progression through, the cancer care system, Dr. Ramirez said.
Dr. Ramirez’ team recently found that extra support for patients, called “patient navigation,” can lead to faster diagnosis for Latinas after an abnormal mammogram result.
In that study, published in Cancer, women who received help from trained patient navigators had significantly shorter time delays between an abnormal mammogram and definitive diagnosis—whether positive or negative for breast cancer—than those who did not receive navigation. Services provided by navigators included culturally-sensitive support and help overcoming barriers related to transportation, child care, insurance, language and more.
The Prevent Cancer Foundation has designed, developed and pilot-tested “Campeonas contra el cáncer de seno” (Champions Against Breast Cancer), a culturally appropriate, peer-to-peer outreach effort to improve breast cancer screening among Latinas.
By sharing their own experiences with being screened for breast cancer, “Campeonas” encourage their female friends and family members over the age of 40 to get mammograms.
“Campeonas” training and free-standing community educational materials are now available for free on the Prevent Cancer Foundation’s website (in both Spanish and English) for community health organizations.
One of these materials is an illustrated novela, “Un Encuentro Oportuno: Conversando Sobre el Cancer de Seno” (A Timely Encounter: Talking About Breast Cancer), which uses pictures and a story to share information about breast cancer screening.
“It is especially unique in that all elements of the project were created with input from women in the Washington D.C. Latina community to ensure cultural appropriateness, interest and usability,” said Karen Peterson, Vice President of Programs for the Prevent Cancer Foundation. “The grassroots nature of the project also allows for a highly personal and comfortable discussion on breast cancer screening.”
Funding for this project was provided by the Prevent Cancer Foundation and the National Capital Area Affiliate of Susan G. Komen for the Cure.
Extra support for patients, called “patient navigation,” can lead to faster diagnosis for Latinas after an abnormal mammogram result, according to a new study by the Institute for Health Promotion Research (IHPR), part of the School of Medicine at The University of Texas Health Science Center at San Antonio.
The study, published this week by the journal Cancer, also suggests that patient navigation should be carefully targeted to have the greatest impact on eventual health outcomes.
IHPR researchers worked with partners in the federally funded Redes En Acción: The National Latino Cancer Network to examine the experiences of 425 Latinas in six cities nationwide. Each woman had received an abnormal result in initial breast cancer screening and was referred for further evaluation.
About half of the women received help from trained patient navigators, who provided culturally sensitive support and help overcoming barriers related to transportation, child care, insurance coverage, language and more. The rest of the patients did not receive patient navigation.
The study’s patient navigators, all Latinas themselves, were high school graduates between the ages of 25 and 47, and were trained to coordinate care according to the same patient navigation model.
For patients who received navigation services, the time between an abnormality being found and eventual diagnosis – whether positive or negative for cancer – was significantly shortened.
Those who worked with patient navigators were diagnosed in an average of 32.5 days, compared with 44.6 days for those who did not receive patient navigation.
“This study demonstrates that patient navigation can influence the time to cancer diagnosis for Latinas,” said IHPR Director Dr. Amelie G. Ramirez and study author.
More specifically, researchers found the greatest benefit for women whose abnormalities were categorized upon discovery as “probably benign” – or BI-RADS-3 on the American College of Radiology’s Breast Imaging-Reporting and Data System.
The likelihood of cancer in a woman with a BI-RADS-3 screening result is about 2-4%.
Health care providers typically instruct these women to return for another screening within six months; however, delays and anxiety occur, appointments are missed and Latinas may skip subsequent screenings altogether, potentially setting the stage for confirmatory diagnoses at more advanced stages of cancer with lower survival probability.
In this study, on average, women with “probably benign” abnormalities received a diagnosis more than 40 days sooner if they worked with a patient navigator.
“For women with more ambiguous screening results, a faster diagnosis through patient navigation relieves them of the burden of worrying about their health,” Dr. Ramirez said. “We can target Latinas who are falling through cracks and prevent situations where cancer advances to worse stages because Latinas aren’t following up an ambiguous screening result.”
Latinas tend to have positive attitudes and strong interest in genetic testing for breast cancer risk, yet lacked general knowledge about testing, its risks and benefits, according to a new study led by researchers at the Institute for Health Promotion Research (IHPR) at the UT Health Science Center at San Antonio, the team behind SaludToday.
The study, published recently in the journal Community Medicine & Health Education, conducted focus groups with 58 Latinas in Hidalgo County, a largely Latino part of South Texas.
Researchers used analyzed focus group responses and themes and uncovered several cultural factors, such as religious beliefs, that impacted Latinas’ decisions to get genetic testing.
“Key Latino values—religiosity, importance of family and the influential role of health care providers in health decisions—should be considered when designing strategies to deliver culturally adapted risk information to increase and ensure Latinas’ understanding of breast cancer genetic testing during their decision-making processes,” said Dr. Amelie G. Ramirez, the study’s corresponding author and director of the IHPR at the Health Science Center.
Genetic testing for breast cancer risk may facilitate better-informed decisions regarding cancer prevention, risk reduction, early detection, and better determination of risk for family members.
However, among women who are tested, less than 4% are Latina.
Finding reasons for Latinas’ low participation was the goal of Dr. Ramirez and her team, which included IHPR researchers Dr. Patricia Chalela and Edgar Muñoz and investigators from the University of North Texas Health Science Center and the University of Texas-Pan American.
The researchers found that none of the focus group participants had ever had a genetic test, and most didn’t know what the test was or how it is done.
Most women, after learning what a genetic test was, indicated they would get a genetic test in the next six months if it were available—at no or low cost—to be able to prevent cancer through healthy lifestyle changes or act as soon as possible to treat disease.
But among some of lesser-educated focus group participants, lack of accurate information about testing and cultural beliefs may hinder their use of genetic testing for breast cancer.
For example, some Latina participants viewed God as the only one who can cure cancer, which might impact their preventive health behaviors. And given Latinos’ tendency to trust the advice of health care providers, some Latinas who lacked health insurance or access to a regular doctor may have fewer opportunities to learn about genetic testing.
“Further research is needed to identify effective ways to communicate genetic risk susceptibility information to Latinas to help them make informed testing decisions,” Ramirez said.
Read more about the study here.
Two University of Texas Health Science Center at San Antonio researchers today were awarded a total of $4.7 million by the Cancer Prevention and Research Institute of Texas (CPRIT).
These awards for cancer prevention, along with $2.9 million to University Health System, make San Antonio the largest recipient of funds in this CPRIT funding cycle—28% the $26.3 million awarded.
Dr. Cynthia Mojica, assistant professor of epidemiology and biostatistics in the Institute for Health Promotion Research at the UT Health Science Center, will use a $2 million award to partner with federally qualified health center CentroMed and community organizations to offer breast, cervical and colorectal cancer screening to San Antonio residents otherwise unable to afford them.
“This grant allows us to greatly expand what we’ve been doing in terms of giving people in underserved populations the opportunity to be screened,” Dr. Mojica said.
A $2.7 million grant to Dr. Gail Tomlinson, interim director of the Greehey Children’s Cancer Research Institute (GCCRI), allows her team to help health-care providers map out their patients’ cancer risks and to share information with the community about the importance of understanding family history. They will work with CHRISTUS Santa Rosa Health System and other groups. The grant will also support screening services for people at high risk who might not otherwise have access.
“A family history can yield strong clues to understanding a person’s risk for cancer,” Dr. Tomlinson said.
The awards reflect the kind of work that goes on at the Health Science Center, said Dr. William L. Henrich, president of the Health Science Center.
“Extending better cancer screening opportunities and the latest expertise in genetic counseling to the people at greatest risk here in South Texas is the perfect expression of our mission at The University of Texas Health Science Center at San Antonio,” Dr. Henrich said.
CTRC director Dr. Ian M. Thompson Jr. noted that this is not the first time CPRIT has supported both researchers.
“Prevention is one of the most important ways to fight cancer,” said Dr. Thompson, professor of urology in the School of Medicine at the Health Science Center. “Dr. Tomlinson’s genetic research will give us the capability to bring a person’s potential cancer risk into sharper focus, helping them make decisions in advance to prevent the disease. Dr. Mojica’s community outreach will give our friends and neighbors the opportunity to be screened for cancers for which early diagnosis can mean a cancer cure. I am delighted that CPRIT continues to help them both help San Antonio and Texas.”
Redes En Acción: The National Latino Cancer Research Network has released three videos on cancer issues and research methods that were used to train Redes En Acción researchers and patient navigators in Miami and San Antonio and Austin, Texas, who are involved in a study examining how patient navigators who use the LIVESTRONG Cancer Navigation Services Program can improve the quality of life of Latino breast, colorectal and prostate cancer survivors.
The videos are designed specifically for the study, funded by the National Cancer Institute; but the videos may be useful in any patient navigator studies involving Latinos.
Video 1 teaches researchers and patient navigators the proper steps on how to manage a potential mental health emergency or psychological related emergency that may arise during a survivor’s participation in the research study, as well as specific trainings on two cancer types, prostate and colorectal.
Video 2 covers various lectures related to the research project including: a project overview; a LIVESTRONG Cancer Navigation Center overview; a training on an online database; and research implementation overview.
Video 3 features a presentation on breast cancer.
For more info about Redes En Acción, go here.
Redes En Acción is led by the the Institute for Health Promotion Research at The University of Texas Health Science Center at San Antonio, the team behind SaludToday.
Find the latest in Latino health—from fighting Latina breast cancer to helping Latinos pursue doctoral degrees—in the new E-newsletter from the Institute for Health Promotion Research (IHPR) at The UT Health Science Center at San Antonio, the team behind SaludToday.
The E-newsletter has these stories:
- Story and Video: Giving Latinas a Chance vs. Breast Cancer (Pg 1)
- Story: How a Typewriter Helped a Latina Launch a Career in Health Promotion (Pg 2)
- Story and Video: Depression after Cancer Keeps Latinas from Follow-Up Care (Pg 3)
- Story: Apply by 3/1/12 for Éxito Program to Get Help Pursuing a Doctoral Degree (Pg 5)
- Story: San Antonio Schools Get Salad Bars (Pg 6)
- Story and Video: Latino Man Works to Interrupt Street Violence (Pg 8 )
The E-newsletter is jam-packed with even more info on the latest local and national health disparities-related news, resources and events.
Visit the IHPR here.
Latinas and older, poorer women all are more likely to have lymph nodes under the armpit removed unnecessarily during breast cancer surgery, according to a new study, Reuters reports.
That’s despite 2005 guidelines recommending a gentler surgery that spares most of the lymph nodes, avoiding side effects like pain, swelling and numbness down the line.
Based on a California cancer registry, researchers found that more than a third of about 18,000 women who had undergone mastectomy for early-stage breast cancer had had their lymph nodes removed as well.
Yet all of these women had node-negative tumors, meaning the cancer had not spread beyond the breast.
Margaret Moran, president of the League of United Latin American Citizens (LULAC), explored the often-frightening term “breast cancer” among Hispanics in a recent Huffington Post article.
She notes that, even though Latinas have lower breast cancer rates, they are screened less and are diagnosed at later disease stages. Breast cancer is alos the most-diagnosed cancer among Latinas.
When I was a young girl, we didn’t talk about breast cancer. Now, we must not only talk about it, but be sure that all women have access to proper screenings and treatments. We need to ensure that Hispanic women have the knowledge and medical care to put an end to this disease. Breast cancer affects everyone, not just the person diagnosed. Likewise, everyone needs to do their part to minimize the risks within our community.