Editor's Note: Cervical cancer is the second-most common form of cancer among women worldwide. In Los Angeles, according to the LA County Health Department, Latinas have the highest rates of cervical cancer. Maria Luisa Arredondo, editor of Latino California and a 2011 CMAF/Cervical Cancer Reporting Fellow, reports that the disease not only takes lives, but also devastates victims' extended family economically and psychologically.
For more than six years, Lilia Fuentes did not get a Pap test. Lilia, whose name has been changed, didn't think it was necessary since she always felt healthy.
Then, at the beginning of 2010, she went to see a doctor after she started to bleed profusely. The test results were devastating: she had advanced cervical cancer. From that moment on, her life took a 180-degree turn.
The independent and hard-working woman who cleaned houses in San Jose, Calif., had to undergo intensive treatment that left her bedridden. To prevent the cancer from spreading, her uterus and ovaries were removed and she started chemotherapy and radiation. She spent entire days in the hospital, completely isolated.
"Neither her sister, nor her two kids -- a 22-year-old daughter and a 19-year-old son -- could see her," recalls Claudia Colindres, who works for the non-profit organization Latinas Contra el Cáncer (Latinas Against Cancer), which offers support for those who suffer from the disease, as well as their families.
Colindres says that despite doctors' best efforts, the cancer not only did not diminish it became more aggressive.
"She lost a lot of weight and they decided to refer her to a home care program for terminal patients,” she says. “I visited her and the last time I went, I knew I would never see her again. Her skin was yellow and she looked very skinny, very tired.
Lilia died two weeks later, on July 4, 2011.
The family, according to Colindres, is still so upset they refuse to even talk about Lilia, who was 58 years old at the time of her death, originally from Mexico and a single mother.
"At her funeral, the one who looked the most depressed was her sister, who had never lived apart from her. After Lilia died, the family broke up. Her daughter went to live with a friend and her son stayed with his aunt because he was going to school.”
Colindres says that the family is finding it hard to cope with Lilia’s death. They feel guilty for not pressuring her to get tested on time and take better care of her health.
To make matters worse, Colindres adds, they lost the house that Lilia had bought making many sacrifices because they could no longer make the payments.
"Lilia's mom, who lives in Mexico, cries a lot because she can’t see her again and can't even visit her grave because they cremated her here and her ashes remain here," she says.
Lilia's story illustrates the tremendous emotional, social and economic impact the death of a middle-aged woman has on a family from a preventable disease.
"In general, (these women) are the cornerstones of their homes, the ones who give unity and strength to the nuclear family," says Alejandra Casillas, an internist at the Robert Wood Johnson Clinical Scholars Program at the University of California in Los Angeles (UCLA).
Although this type of cancer affects all ethnic groups, Latinas are diagnosed with this disease twice as often as Caucasians. They also have the highest mortality rate in California, according to Casillas.
This is because, among other reasons, many Latinas lack health insurance. It is also due to cultural reasons.
"Latinas don't take charge of their health; they don't value the importance of staying healthy to support their families,” Casillas observes.
Cervical cancer is the second-most common cancer worldwide and is responsible for 250,000 deaths a year, of which 4,000 are recorded in the United States.
In California, nearly 1,400 women are diagnosed with this cancer and 400 of them die each year. The deaths are needless because cervical cancer is a preventable disease. It can be easily detected through a relatively simple, low-cost test and can be prevented by a vaccine.
The majority of cervical cancer cases is caused by the human papilloma virus or HPV. Each year, millions of women are infected with the virus, but because they do not have any symptoms, they don't realize that they are at risk of developing cervical cancer.
The California Medical Association (CMA) Foundation has undertaken an intensive educational campaign to reduce the number of victims. Carol Lee, president and CEO of CMA Foundation, notes that "with proven prevention methods, including HPV vaccine, regular Pap tests and greater public awareness, we have a tremendous opportunity to reduce the devastating effects of cervical cancer and completely eliminate this disease."
According to the Centers for Disease Control and Prevention, the highest rate of advanced cervical cancer occurs among Hispanic women between 50 and 79 years of age.
Casillas says that several studies show that in California, Latinas are the least likely to get a Pap test. Ten percent have never had the test in their lives.
Pap tests are available for free for low-income women through the "Every Woman Counts" program, and HPV vaccines are covered by insurance and through the "Vaccines for Children" program.
To see if you qualify for a free cervical cancer test through this program, call 1-800-511-2300, Monday through Friday, 8:30 am to 5 pm. Spanish-speaking operators are available. To see if your children can be vaccinated free of charge, ask your doctor about the Vaccines for Children program. All children eligible for California's Child Health and Disability Prevention (CHDP) program may also qualify for free or low-cost vaccines.
The 2011 CMAF/Cervical Cancer Reporting Fellowship is sponsored by the California Medical Association Foundation (CMAF), a charitable arm of the California Medical Association, to bridge physicians to their communities to address community health. The journalism fellowship program, administered by New America Media, is designed to raise awareness and provide public health information on cervical cancer to the at-risk Latina population in Los Angeles.
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