The cancer survivorship experience among rural Hispanics in Washington state

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Purpose. The purpose of this project was to explore the experience of cancer survivorship among Hispanic men and women in a rural Washington community.
 Methods. Cancer survivors and family members of current or former cancer patients were recruited from a rural community in the Yakima Valley of Washington. Three focus groups were conducted by trained bilingual facilitators from February-March 2006 with 21 Hispanic individuals (16 women; 5 men). Topics addressed in focus group sessions included reaction to and method of cancer diagnosis for self or family member, perceived causes of and cures for cancer, type of treatment received, patient interaction with physician, impact of cancer diagnosis on family and challenges faced, sources and availability of cancer information and suggestions for the types of cancer information that should be made available to Hispanics in the community.
 Results. Reactions to cancer diagnosis ranged from denial and disbelief, fear of death, sadness, helplessness, confusion, vulnerability, concerns about family and treatment cost, to feelings of strength, courage, faith in God and hope. The majority of cases discussed were detected by a physician at late stages when treatment was difficult. Barriers to seeking diagnosis and treatment included shame in showing the female body to a male physician, norms against touching oneself through breast self examination, and inaccurate risk perception. Participants identified smoking, environmental exposures, sun exposure, and pesticide or other chemical exposures as causes of cancer. Operating on cancerous tumors was believed to cause the spread of cancer to other body organs. Participants reported the use of conventional medical procedures to treat cancer including surgery, chemotherapy, radiation and adjuvant therapies in pill form, but identified traditional herbal or natural remedies as cures for cancer. Satisfaction with physician was mixed; both positive and negative experiences were reported. Dealing with concerns about children and finances, fear of losing medical coupons, finding a regular source of care, and experiencing depression were identified as challenges faced after cancer diagnosis. A lack of sufficient support in the community to connect cancer patients with one another was commonly identified. Suggestions for information to be made available to others in the community included: language- appropriate information on prevention, smoking cessation, education about cancer and treatment options, where to go for diagnosis, how to find a specialist and where to be seen without insurance. Participants emphasized the need for the community to support those diagnosed with cancer and suggested the formation of support groups to link cancer survivors with one another.
 Conclusions. Cultural and knowledge barriers to obtaining cancer diagnosis exist within this population of rural Hispanics, as do misconceptions about causes of and cures for cancer. The presence of cancer survivor support groups in the community can serve as a means to provide accurate and practical information for survivors, family members and other individuals in the community. Information elicited from focus groups is presently being used to organize support groups in this community and will create a forum for cancer survivors to share experiences that may help those newly diagnosed.