D.C. number one in cancer death rate


Wednesday, December 05, 2007


Black women often their own enemy with breast cancer, study finds



By Zenitha Prince
Washington Bureau Chief Afro American Newspaper
Nadine Winter has survived cancer four times. She said she knows exactly what the issue is when it comes to Black women and the deadly disease.

"We're in complete denial," a frustrated Winter said. "I don't care how educated they are, nobody talks about cancer.

"Politicians don't preach about it. Preachers don't preach about it. When it comes to health, we believe God's going to take care of it and we don't have to do anything to help ourselves."

And that is the reason that the recent finding of an agency that advocates for more advancements in breast cancer research comes as little surprise to Winter, 84, who has formed her own agency to deal with breast cancer and Black women.

The study by the Susan G. Komen for the Cure had good news for women overall. It found that the number of women dying from breast cancer has declined overall by 2 percent over the past 17 years.

But that wasn't true for Black women. While African-American women are less likely to develop cancer than White women, they are 35 times more likely to die from the disease.

"More than 19,000 African-American women [out of an estimated 40,000 who contract the disease] will die of cancer this year and that translates into incalculable loss to many families across the country," said Dwight Randle, a senior scientific advisor at Susan G. Komen.

And the news was especially dire for the women of Washington. They are more likely to die from breast cancer than women any where else in the country.

"If you cross the street from D.C. to Maryland, your chance of dying from cancer plummets," Randle said. "Why is that?"

According to the study, the answer lies in a confluence of factors.

Lack of access is one of those key factors, said several cancer advocates, including Susan Butler, executive director of the D.C. Cancer Consortium, a group of 67 organizations that came together to create a plan to address Washington's cancer epidemic.

"Access to care, that tells the story," said Butler, a breast and cervical cancer survivor. "The reason why African-American women are dying in disproportionate numbers is that they're not being treated."

Geography often inhibits access, especially for women living in rural areas, who are forced to travel long distances for health care, Butler said. But even in a relatively small city like Washington, geography plays a role, she said.

While the nation's capital boasts 11 hospital and medical centers that offer superb cancer care services, most are located in higher income areas and the services are unaffordable for the city's poor and uninsured.

According to the U.S. Department of Health & Human Services' Bureau of Primary Care, 30 percent of the city's residents live in federally-designated Medically Underserved Areas.

"The system is dysfunctional," Butler said. "When you look at the hospital system in the District, look at Wards 7 and 8, how many hospitals are there? One, Greater Southeast Hospital and it's in trouble."

Other medically based contributors are harder to identify and to treat, however, especially since ethnic and racial minorities make up less than 10 percent of cancer clinical trials.

"Black women are getting more aggressive types of cancer at a younger age," said Dr. Robert DeWitty, a surgical oncologist at the Howard University Cancer Center. "We think this may be a different disease in Black women. And if it is a genetic disease, we may need different treatments for African-American women."

Current theory teaches that women should start getting regular mammograms at 40.

Nikia Hammonds-Blakely, 29, found the lump in her left breast when she was 16. She was taking a shower before school when she discovered the mass, but she paid it little attention.

Two weeks later, doctors found the mass at a regular checkup, but were unconcerned since she was so young. A biopsy, however, revealed an aggressive tumor that had already spread through much of her breast tissue. Declining total mastectomy, Hammonds-Blakely, of Gary, Ind., said she opted for lumpectomy and radiation. In the end, a large portion of her breast was removed.

"I felt like an alien, Hammonds Blakely said of the surgery. "There was no one in my family or my church who could come to me and say, 'I know what you are feeling,'"

"And at that age you're already battling insecurity. I was always a bit heavier. People could sometimes be insensitive and it was all very traumatic."

Lack of knowledge about the disease and the resources available poses a major challenge among the poor and uninsured.

"It's not about fear and stupidity, it's about money," Butler said. "People think if they go for screening they have to pay."

Even with resources, Winter and others said ingrained beliefs, determined ignorance and a sense of fatalism have thrown up roadblocks to treatment and prevention.

"I think it's an overall belief that Black people have that 'I'm going to fight it out' mentality," said Sonya Lewis, 47, of Chicago, who has seen family and friends fall victim to the disease and who recently found out that she may have it as well. "Some people find the lump and then don't go back [to the doctor]. Maybe they think it's undefeatable."

The 2 million breast cancer survivors in the United States belie that belief, but getting the poor, uninsured and others to buy into the hope of survival and to get them connected to the services they need will demand an extensive education campaign, advocates said.

"We have to get the word out that people can get free screenings and other services-that's the heart of it," Butler said.

It's also about people taking control of their own destiny, Hammonds-Blakely added. "We're so busy taking care of everyone else that we tend to put ourselves last. But we have to take control of our own health so that we can take care of the ones we love."