Beatriz Galvan treasures spending time with her granddaughter, Mia Camila, after being successfully treated for breast cancer at MSK.
The phone call was startling. Beatriz Galvan was not expecting to hear from her doctor on a Sunday. The 62-year-old grandmother from Bayville, Long Island, had just had a long-overdue checkup and her first-ever mammogram to screen for breast cancer. Her doctor asked to see her first thing Monday morning.
Beatriz had not been feeling well for some time. She felt a mass in her breast the year before, but was focused on supporting her family in her native country of Colombia through the devastating loss of her brother to stomach cancer and her father to prostate cancer.
That Monday morning, as they sat in her doctor’s office, Beatriz and her husband, Octavio, received even more devastating news. She had breast cancer. Beatriz, who speaks Spanish and little English, felt lost and terrified. “I had no job, no insurance, and I didn’t know anything about breast cancer,” she says. “What was I going to do?”
Facing Barriers to Expert Cancer Care
Sadly, Beatriz’s circumstances are not unique. According to the Centers for Disease Control and Prevention, cancer is the leading cause of death for Hispanic or Latino people in the U.S.
They face challenges that make it harder for them to get medical care than for non-Hispanic white people, explains Lisa Diamond, MD, MPH, a researcher in the Immigrant Health and Cancer Disparities (IHCD) Service at Memorial Sloan Kettering Cancer Center (MSK). For example:
- Language barriers that make it difficult for patients to communicate with their doctors and other care providers, fully understand their diagnosis and treatment options, and make informed decisions about their care.
- Misinformation about their risk factors and chances of surviving a cancer diagnosis.
- Lack of awareness about cancer prevention and early detection.
- Not having timely access to screening services or treatment.
- Resistance to seeing a doctor when symptoms arise due to fear or mistrust in the healthcare system.
- Lack of health insurance, transportation, or childcare.
- Inability to afford the cost of treatment.
- Housing and food insecurity.
- Having a job that doesn’t allow you to attend frequent appointments.
“Identifying these challenges when a person first comes to MSK is a crucial part of care,” says Dr. Diamond.
MSK Outreach Programs Support the Hispanic Community
To help more patients like Beatriz, MSK’s IHCD Service has been working for more than a decade to break down barriers to cancer care among people in the Hispanic and Latino community and other ethnic groups. Programs include:
- The Integrated Cancer Care Access Network (ICCAN), which connects medically underserved patients with services such as health insurance, transportation, childcare, financial assistance, and healthy groceries from hospital-based food pantries throughout the city.
- Access to Telehealth (AcT), which provides phones and tablets to people with cancer and teaches them how to access their patient portal and use telemedicine services.
- MSK’s traveling Mobile Health Unit (MHU), whose bilingual staff offers health screenings, help getting health insurance, and other resources.
The MSK Mobile Health Unit and its bilingual staff bring services directly to communities.
“We take the time to listen and engage with people to understand their specific challenges, follow up with them, build trust, and offer culturally sensitive materials and interventions that support their needs,” says Josana Tonda, IHCD Community Outreach Manager. “Our work is important because when we break down healthcare barriers in underserved communities, we can save lives.”
Accessible Cancer Care in NYC and Surrounding Areas
After one of Beatriz’s friends recommended MSK, Beatriz was happy to learn there was an MSK location in Commack, near her home. Her daughter, Diana, called MSK and easily was able to make an appointment for her mother to see breast oncologist Iris Zhi, MD, PhD, and breast surgeon Tracy-Ann Moo, MD, right away. Beatriz was also referred to MSK’s Financial Assistance Program to apply for additional support beyond Medicaid to help cover her care.
Dr. Zhi explained that Beatriz had locally advanced cancer in the right breast. She would need four months of chemotherapy to first shrink the tumor, then surgery to remove it, followed by five weeks of radiation. She would then have to take medicine (endocrine therapy) for 10 years to reduce the risk of the cancer coming back.
Beatriz wondered if she could handle all that treatment, but she says she trusted Dr. Zhi’s expertise and was impressed with the warm, friendly environment at the MSK Commack Nonna’s Garden Foundation Center.
“From the person who greeted us in reception to the staff who work in the doctors’ offices, everyone was so kind and attentive, and it made me feel good,” she says. “The doctors and nurses calmed my nerves, and I felt a lot of peace there.” It also helped that Beatriz’s daughter, Diana, was welcome to participate in every discussion.
“I’m grateful for my daughter’s support,” adds Beatriz. “She never left my side and encouraged me every step of the way.”
Language Interpreters Are a Must for People Who Don’t Speak English
Dr. Lisa Diamond is a member of the research faculty of the Immigrant Health and Cancer Disparities Service.
Beatriz’s MSK care team made sure there was an interpreter present in person or over the phone or video during all her appointments. “They kept us informed and ensured that we understood everything we needed to know about my treatment,” says Beatriz.
Dr. Diamond says providing qualified, competent interpreters must be a priority at a cancer hospital. “Conversations about cancer are emotional and complicated, and patients see numerous clinicians throughout their experience,” explains Dr. Diamond.
Her research focuses on how the quality of care and outcomes improve when a provider is truly fluent in the language a patient speaks — called “language concordance.” This work has led MSK to launch a new program for bilingual employees to test the strength of their language skills before they speak with patients in that language in the clinical setting.
“Patients completely open up and change their demeanor when you speak to them in their own language,” Dr. Diamond says. “That plays a huge role in making them feel welcome, and it’s the right thing to do.”
Improving Access to Clinical Trials for Hispanic Patients
After Beatriz finished her course of chemotherapy, Dr. Moo confirmed that the tumor was small enough to be removed with surgery. Beatriz had the operation and then underwent radiation therapy.
Beatriz then agreed to participate in a clinical trial. She underwent MSK’s state-of-the-art genetic testing called MSK-IMPACT® to look for changes that fueled her cancer. The study is evaluating whether a new drug that targets those changes taken together with the endocrine therapy would further reduce the risk of her cancer returning.
“One of MSK’s strengths is our effort to enroll patients from underrepresented populations into clinical trials,” says Dr. Zhi.
A recent study found that 13% of people with cancer are Hispanic, but only 3% to 6% of those who participate in clinical trials are Hispanic. Inclusivity in clinical trials is important so researchers can get a better picture of how a new treatment affects different ethnic groups.
“I was able to sit with Beatriz, listen to her concerns, answer all her questions about the study, and help her walk away feeling like I had her best interest at heart,” says Dr. Zhi. “I think that human touch made a big difference for her.”
“I was happy to sign up so MSK could learn more and help more people like me,” says Beatriz.
‘Impossible Not to Get Well’: Support Continues After Treatment Ends
Beatriz Galvin is grateful her daughter, Diana, could be by her side during her treatment for breast cancer at MSK.
“The care at MSK is wonderful, and the staff is well prepared and very professional. I never met anyone who made me feel bad or that I didn’t belong because I was Latina,” says Beatriz. “I believe that when a person as sick as I was finds so much compassion and support in one place, it’s impossible not to get well.”
Today, Beatriz feels well and continues to be monitored for cancer recurrence. She will soon transition to MSK’s Survivorship Program to support her overall health and well-being.
“I wake up every morning thankful for my family and my MSK doctors who got me through this dark storm,” says Beatriz. “They saved my life.”