Cancer centers work to address late diagnoses among Hispanic women
“They would tell me I had to wait until I’m 40. If I would’ve waited until then I wouldn’t be in this country or in this life, perhaps.”
Gloria Estrada Hernandez
In early 2020, a year after Gloria Estrada Hernandez felt a lump in her breast, she was diagnosed with stage 3 breast cancer.
She was told that her cancer would’ve been less advanced if she would’ve gotten a mammography earlier. Estrada Hernandez said she did tell her doctor about the lump in 2019 but was dismissed because she was “too young” to have cancer.
She was 34 at the time. “They would tell me I had to wait until I’m 40. If I would’ve waited until then I wouldn’t be in this country or in this life, perhaps,” she said, in Spanish.
Originally from Michoacan, Mexico, Estrada Hernandez moved to the United States 12 years ago and now lives in Bridgeport.
When she received her diagnosis, doctors were surprised by her previous doctor’s response to her concerns.
Estrada Hernandez is one of many Hispanic women who are diagnosed in later stages of cancer. According to the American Cancer Society, breast cancer is less likely to be diagnosed at a localized, or early, stage in Hispanic women than in non-Hispanic white women with 59 and 67 percent, respectively.
About 430 women were estimated to have died from breast cancer in Connecticut in 2019, with breast cancer being the most common cause of cancer-related deaths among Hispanic women that year, according to the Connecticut Breast Health Initiative.
Estrada Hernandez, who encourages people to go to the doc
tor if they feel something abnormal in their body, received her first chemotherapy session in the summer of 2020 and she is currently going through follow-up treatment.
She has been a patient of the Norma Pfriem Breast Center since her diagnosis. The center is part of Smilow Cancer Hospital in New Haven and has locations in Bridgeport, Fairfield and Trumbull.
“The need for timely access is very important because once a woman finds a mass in her breast, she wants to be seen immediately,” said Dr. Melanie Lynch, director of breast surgery at the Pfriem center.
The Norma Pfriem Center is an integrative medicine program that supports women as they go through breast cancer treatment. The program’s services include transportation, rent and child care assistance, counseling, physical therapy and acupuncture.
But for many, like Estrada Hernandez, the center also offers support in one significant barrier: language.
“It’s hard not to fully understand English. I wish I understood everything, but I unfortunately can’t,” said Hernandez, who relied on the hospital’s interpreters since she had to attend appointments by herself due to COVID-19 safety measures.
But the value of having staff that understands the Hispanic community goes beyond just understanding the language. It also involves understanding people’s backgrounds. The center has a team of “patient navigators” who work directly with patients to assess their needs outside of their diagnosis to achieve this purpose.
“They bring a different level of expertise,” said Dr. Donna Twist, foundation executive director of the Norma Pfriem Breast Center. She asserted that patient navigators are community experts that support patients with counseling and social work while also understanding the cultural context. “It makes a huge difference to be able to talk through your fears and anxiety with someone from the same culture that speaks the same language,” she said.
A similar program is available at the Bridgeport Hospital Primary Care Center, where care coordinators work with small groups of patients.
“We have really focused on the disparities and the inequities of our patients in our community,” said Mary Angelucci, manager care coordinator. A successful example of this program are breast examinations. By assessing and providing support on some of the financial barriers for patients, the team has managed to get an 85 percent rate of breast examinations and timely preventive care exams, according to Angelucci.
Among some of the examples of how the center supported her, Estrada Hernandez mentioned how she received prepared food after her first chemotherapy so she wouldn’t have to cook. They also supported her family with rent, since she had to stop working during her treatment.
“Their help feels different. They are always caring for us,” she said.
The Norma Pfriem Breast Center makes its care accessible for patients who cannot otherwise afford the treatment. This is especially impactful since the Hispanic community are the least likely to have health insurance of any major racial or ethnic group, according to the American Cancer Association.
“I haven’t paid a dime,” said Estrada Hernandez, who said that without the center’s help, she wouldn’t be able to afford the treatment.
But as with many other things, breast cancer treatment got impacted by COVID-19. Patients had their surgeries delayed while others had a diagnosis delayed, which can be dangerous.
“This year, it appears to be a more advanced stage of diagnosis in our patients because many women delayed screening or treatment during COVID and now we’re starting to see the results of that in our clinics,” said Lynch.
Each year, the center assists more than a thousand women who need financial assistance in their treatment, according to Twist.
As the end of Breast Cancer Awareness Month approaches this weekend, both Lynch and Twist have encouraged people to get mammograms throughout the year which are available in the center at a low cost.
“We want to make sure that women come in and they get screened, because it will cause a problem in the future if people aren’t screened," said Twist, who also encourages people to donate to the Norma Pfriem Breast Center to keep supporting people like Estrada Hernandez.