Making Latinas think pink, too Oct 31, 2010
By Esther J. Cepeda, Washington Post Writers Group
CHICAGO – As we look through the rearview mirror at October's wall-to-wall pink-ribboned extravaganza of breast cancer awareness efforts, let's take a moment to consider that there are many out there who didn't engage in the national conversation.
There was almost no getting away from marketers' aggressive pinkifying – T-shirts, bagels, disposable batteries, professional sports club tie-ins, etc. – aimed, ostensibly, at making the topic socially acceptable in any setting and garnering support for the organizations dedicated to curing this disease. And if you felt warm, fuzzy and pink about how much this brand or product cares about women's health, well, then, all the better.
While I'm not endorsing the commerce-induced oversaturation of a health threat, we do need some more of it aimed at Latinos. Even with independent efforts to specifically target both Spanish – and English-speaking women in cities with large Latino populations, breast cancer awareness among Hispanic families has not yet reached a critical mass.
Part of the reason is that, according to the Centers for Disease Control and Prevention, Hispanic women are 33 percent less likely to have breast cancer than white women – I can't tell you how many times I've heard a Latina say that breast cancer is "not something we get" – but it's actually the most commonly diagnosed cancer and the leading cause of cancer death among Hispanic women.
Breast cancer in Latinas is more likely to be diagnosed at an advanced stage than in other women because the disease tends to manifest in Hispanics at far younger ages – some studies say about 10 years earlier than the national average for all women – making it more difficult to treat successfully.
On top of that, Latinas, like African-American women, are more likely than white women to be diagnosed with triple-negative breast cancer, which occurs in the youngest women, is more aggressive, has distinct growth patterns, resists most treatments and offers bleaker survival rates than the more common strain.
According to Dr. Bhuvaneswari Ramaswamy, an oncologist at Ohio State University where clinical trials are under way to find a treatment for the triple-negative strain, 40 percent of all breast cancers in African-American and Latino women are of the triple-negative variety, compared with 15 percent to 20 percent in non-Hispanic white women.
Despite these numbers, Latinas are less likely to get screening, which makes heightened awareness even more vital.
"Only 38 percent of Latinas are screened for breast cancer compared to almost 80 percent of white women," Ramaswamy said. "There are many reasons why breast cancer doesn't enjoy the same level of awareness in the Latino community as in the rest of society – there is general poverty and lack of insurance, cultural and language barriers and differing levels of trust in non-Spanish speaking doctors."
Indeed, the myriad factors that come into play are as complex as they are plentiful. A study published in October on the website of the journal Cancer found that even when economic, social class and levels of access to insurance are accounted for, African-American and Hispanic women are still less likely to get recommended breast cancer treatments than white patients.
"Many times there is a sense of fatalism, of 'well, it's going to happen, so if God wills it what's the point?' in seeking treatment – I see that in the Indian community as well," Ramaswamy said. Though some Latinos bristle at the hyper-religious stereotype, Springer's International Journal of Behavioral Medicine just published a study affirming this anecdotal evidence. The researchers found that a higher number of Latinos believe that cancer cannot be prevented and that death is inevitable after diagnosis.
Finally, Ramaswamy noted a modesty in the Latino community that keeps women from openly talking about, well ... you know. I can't speak for every Hispanic family in the U.S., but growing up in mine you did not talk about breasts. Not yours, not someone else's, not ever.
Alas, all is not lost. As awareness of breast cancer in the Latino community gets to center stage – and as young English-speaking Latinas grow up in an environment where it is completely natural to talk about breast cancer treatments and triumphant survivors – things will change. But it'll take many culturally sensitive conversations every month of the year.
Esther Cepeda writes for the Washington Post Writers Group.