When a woman wins the battle with cervical cancer, that does not necessarily mean her struggle with the disease is over. Survivors can face lingering challenges to their health and well-being that corrode quality of life long after they are cancer-free.
According to City of Hope research, the challenges are considerably tougher on poorer, Spanish-speaking Latinas. And study leader Kimlin Tam Ashing-Giwa, Ph.D., professor of population sciences, plans to help close this gap.
Ashing-Giwa and her colleagues found that among cervical cancer survivors, Latinas who only spoke Spanish reported poorer quality of life than English-speaking Latinas and non-Latina whites. She sees cause for alarm — especially considering cervical cancer strikes Latinas at twice the rate it does Caucasians. The study was released online Dec. 5, 2008, in Gynecologic Oncology.
|Kimlin Tam Ashing-Giwa (Photo by Judy Tejero)|
“I’m really concerned about survivors, especially Latinas and others who are underserved,” said Ashing-Giwa, director of City of Hope’s Center for Community Alliance for Research and Education (CCARE). “This is a particularly huge problem in L.A. And since January is Cervical Cancer Awareness Month, it’s a perfect time to promote prevention and screening, as well as the development of services to address the physical and psychosocial burden of cervical cancer.”
Through regular screenings using a Pap test, cervical changes can be caught early before they can turn into cancer, Ashing-Giwa noted. These screenings save lives.
Medical advances have helped reduce the risk of cervical cancer. Most notably, a vaccine is now available against human papillomavirus, or HPV, which causes most cervical cancers.
But the medical community cannot claim total triumph over the disease. The American Cancer Society (ACS) estimates that more than 11,000 women were diagnosed with cervical cancer in 2008. It strikes more often, and is deadlier, for Latinas and African-Americans compared to Caucasians. And, Ashing-Giwa noted, while the disease’s overall incidence is down nationwide, it is on the rise in California.
Even those who beat cervical cancer can face long-lasting effects like bladder and bowel malfunction, infertility and sexual dysfunction.
Ashing-Giwa’s report is the first multiethnic, multilingual examination of these and other aspects of health-related quality of life among cervical cancer survivors.
Funded by the California Cancer Research Program, scientists surveyed 560 cervical cancer survivors in Southern California. Researchers asked women about their physical, social, emotional and functional well-being, as well as other factors that could influence how they feel.
|City of Hope's Mayra Serrano counsels women in a pilot program run through the Department of Population Sciences. (Photo by Jasmine Leah Klintong)|
Spanish-speaking Latinas received less social support, had poorer relationships with their doctors and experienced greater sexual dysfunction than their English-speaking Latina and white peers — factors associated with diminished well-being. They also were less educated, reported lower incomes and had less health insurance coverage.
Providing health care sensitive to social, linguistic, familial and cultural factors is the key to quality treatment, according to Ashing-Giwa.
“A navigation program that facilitates patient access to appropriate services from diagnosis through survivorship would benefit all cancer patients and their families, in particular our most vulnerable and under-resourced,” she said.
Ashing-Giwa explores how culture, ethnicity and other contextual factors influence health outcomes. She has led CCARE’s community-engagement efforts to translate research into practical public interventions since starting the center in 2006.
She and her colleagues developed a unique psycho-educational counseling program for cervical cancer survivors based on their findings. The research team is recruiting participants for an ACS-funded study evaluating the program. If the intervention proves effective, she will promote its implementation by community practitioners and support groups. According to Ashing-Giwa, it is a natural progression.
“If we document a burden on cancer survivors, what’s the next step?” she said. “The next step is to do something about it.”
In California, cervical cancer screening and treatment are covered by the Every Woman Counts program. For more information, call 800-511-2300.