As told to Page Leggett.
As a bilingual community patient service coordinator for the prevention, education and early detection program at the Novant Health Cancer Institute, I do more than interpret for my patients who don’t have health insurance. I advocate.
When I first started working for cancer prevention and early detection at Novant Health 13 years ago, our program worked mostly in the Black community. Culturally, Latinos are not accustomed to going to the doctor for prevention. I grew up in Peru, and, there, we go to the doctor only when we’re sick.
So, besides a language barrier for the Hispanic community, there’s an idea that going to the doctor when you’re well doesn’t make sense.
Now, there is more demand from the Latino community, and I do a lot of work in both Black and Hispanic communities. When I first started working with our mobile mammography screening unit – at churches, schools, community centers – we completed about 50 or 60 screening mammograms in one year. Now, we provide 600 annually on the mobile lab alone, and almost 50% of those are for Spanish-speaking patients.
When a woman comes to the mobile unit, it is not just for a screening mammogram. It is also for breast cancer health awareness prevention and screening education. In addition, every woman is taught the importance of knowing what her breasts look and feel like so that she is aware if there are changes. We also discuss the importance of following-up on abnormal mammography findings.
If you don’t have health insurance, you’re not going to the doctor every year. Our patients are always worried about how they’ll pay. I explain that grant money allows us to provide mammography services for free. So, no insurance is no problem. We also tell them this is a test they need to have annually starting at age 40. Also, having a mammogram helps find cancer before women even know it’s there. And when we catch cancer early, it means the treatment is less invasive and the survival rate is higher.
For women who are having their first mammogram ever – their baseline mammogram – we tell them that it is not unusual for a doctor to call them back for a second mammogram. You learn to anticipate certain reactions. We assure them it doesn’t mean they have cancer. I say, “Don’t be afraid. The doctor is just trying to be thorough and get the best image possible.”
But there are times when a woman is called back because the doctor thinks cancer might be present, and she needs a biopsy. In a biopsy, we get a few breast tissue cells so we can examine them for cancer.
If one of my patients is going to get that news, I want to be there with her. A lot of these women are in this country alone. Their parents and siblings are still in their home country. I don’t want anyone to have to hear this news by herself.
Here is a time when I can do much more than interpret. When a patient hears “cancer,” in that moment, she doesn’t know what to think or ask. Some women cry; others ask if they’ll lose their hair. Some say, “I cannot tell this to my family. My children must not know.”
I ask the questions they don’t think to ask. I tell the doctors, “I’m going to ask you questions this patient won’t ask because she doesn’t know what to say.”
These women are usually worried about their jobs. They are hard workers and don’t want to miss work. I try to convince them their health comes first.
If my patient needs to go to the infusion center for chemo, I will make time to visit her. I go to the hospital to be with patients before they have surgery.
For patients with little to no support system, I try to be their support system. One patient of mine – she was young and didn’t have children – she and her husband were alone in this country. The husband left her when she told him she had cancer. He couldn’t deal with her cancer! She was more depressed over him leaving than she was about her cancer. I was so happy when she called to tell me she was cancer-free.
I don’t do this work alone. I have a support system at the office to help me deliver the best care to my patients. While I might be the most familiar face to patients, they all get the benefit of the knowledge and compassion of our whole team.
I try to be positive always. I don’t cry with patients; that’s not helpful. I support them. If a patient worries about losing her hair, I say, “That’s not important right now. It will grow back.”
I tell them, “This is going to pass.” If a patient is upset because she’s lost her hair, I say: “That is good news. That means the medicine is working!”
I follow up with my patients at the end of their treatment. The nurse navigator and I talk to them about life after cancer – how to get back to a routine, how to make healthy lifestyle choices, yoga and exercise, what to do if you start feeling sick again. Cancer support services information is provided to all patients to meet their needs during and after treatment.
I am very passionate about what I do and find it so rewarding. I always tell patients from the beginning: “If you need something, call me. If I don’t know the answer, I will try to find it.”
