|
From Comadre to
Comadre
When Teresa* learned
that she had breast cancer, she was scared,
embarrassed and confused, overwhelmed by the feeling
of being alone. She couldn’t even bring herself to
talk about it. During a first meeting with a doctor,
she covered her face and couldn’t speak through her
sobs.
|
Fortunately,
Teresa was not alone. Not only were her fear
and uncertainty shared by many other cancer
patients, but Teresa, who is in her 50s and
speaks predominantly Spanish, had somewhere
to turn.
Her doctors referred her to the Comadre a
Comadre (CAC) Project, a bilingual,
bicultural program developed to address the
unique needs of Hispanic women newly
diagnosed with breast cancer, as well as
their families. When Teresa was ready to
talk about her cancer, she called Elba L.
Saavedra, Ph.D., director of CAC, and began
to share her concerns and emotions. “It was
a breakthrough,” Saavedra says. “After that,
we met her many times at the clinic and
advocated for her.” |
|
 |
|
Las Comadres:
Top row, from left: Elba Saavedra,
Viola, Guadalupe, Rosario, Amanda,
Dalila, Frances, Flora; bottom row,
from left: Pauline, Christina,
Corrine, Juanita, Tina. |
|
Thousands of women are diagnosed with breast cancer
every year: The American Cancer Society estimated
that 215,990 new cases of invasive breast cancer and
59,390 new cases of in situ breast cancer would
occur in 2004. Hispanic women are diagnosed with
breast cancer 40 percent less frequently than women
of non-Hispanic origin, but they are often diagnosed
at later stages, making treatment more difficult and
lowering survival rates. There may be physiological
reasons Hispanic women seem to have fewer cases of
breast cancer, but the numbers are also lower
because Hispanic women are less likely to use
screening tests.
Eight years ago, Saavedra was studying issues such
as this, focusing her dissertation work on the most
needy and under-served breast cancer patients in the
state of New Mexico, where she works at the
University of New Mexico. “I began to see cultural
similarities and needs among the women,” Saavedra
says.
The survivors she worked with expressed that they
wanted more support both when they were diagnosed
and during their treatment, and even years later as
survivors. They felt there were cultural aspects
that made breast cancer different for Hispanic
women. To address these issues in a culturally
relevant way, Saavedra began collaborating with
survivors who wanted to use their experiences to
show other women that they can survive and to guide
them through the journey. With assistance from the
University of New Mexico, the National Cancer
Institute, and the Susan G. Komen Foundation, the
Comadre a Comadre Project was born.
The idea of comadres and compadres, a network of
very close friends that lend assistance just like
family would, is a natural and comfortable part of
Hispanic culture, Saavedra explains. Applying this
concept to CAC, Latina breast cancer survivors,
called Comadres, provide support, guidance and
information in many forms, including a support
group, one-on-one support, advocacy by accompanying
women to doctor’s appointments and treatments, and
referrals to help women with any other issues that
may be involved in their healing processes. “We work
with a person not just as a cancer patient. We look
at other hardships and how can we support the whole
person,” Saavedra says. “We integrate the importance
of culture and value … and prayer or traditional
medicine.”
For Latinas, breast cancer is not just about an
illness and treatment; there are also cultural,
spiritual and family values that come into play.
“Hispanic women are so private. [They] don't share
easily, feel they need to carry the load alone, [and
that it] shows weakness if they complain. Sometimes
macho men don't help situation,” says Esther Chavez,
a Comadre with CAC.
Also, awareness is often limited. “The experience
has been that we see loved ones die very quickly
[from cancer], or there may be no experience with it
at all. But breast cancer is highly treatable when
diagnosed early.”
Accurate information and survivorship are CAC’s
chief messages, but presenting the faces of Hispanic
women who have survived breast cancer resonates much
more with newly diagnosed Latinas. Information is
bilingual, and Comadres can act as translators and
assist women to ask important questions so they
aren’t intimidated during their doctor’s visits.
Patients feel comfortable discussing things only
another cancer patient could understand, Saavedra
says. Comadre Rosario Gonzales says of Comadre
Dalila Romero, “We can sit here and say things to
each other, and she will know exactly what I am
talking about, things that someone who hasn’t
experienced it could never understand.”
During support group sessions, there are tears and
laughter, discussions of hair loss and breast
reconstruction, even giggles as Comadres share their
most intimate stories — “and food, always food,”
Saavedra jokes. Studies have proven sharing,
receiving support, and relieving stress this way
improve the overall quality of life, adding a new
dimension to the healing process.
As survivors, the Comadres feel dedicated to giving
other women the help they never had. The focus is on
aiding the patients, but Gonzales and Romero agree
that being a Comadre is also therapeutic, an
important part of their healing process. The
Comadres’ families even get involved to serve as
comadres and compadres to family members of newly
diagnosed women, helping them understand and cope
with the illness.
Although CAC is currently limited to women in
several New Mexican counties — Bernalillo, Santa Fe,
Sandoval, and Valencia — it hopes to expand as
interest and funding grow. In the meantime, CAC and
the National Hispanic Latina Advisory Council for
the Susan G. Komen Foundation are producing a
bilingual video called Adelante con Esperanza that
will be available nationally in February.
Through the project’s continued work and efforts,
the Comadres can continue to help women who, like
Teresa, are scared and confused, who worry about not
having the chance to see their children and
grandchildren grow up. Teresa has continued working
with CAC and is doing better, Saavedra says.
“We’ve seen her blossom. She has come through
treatment. She still has a lot of work to do, but
she has hope now.”
 |
Am
I at risk for breast cancer?
Though any woman or man has some
risk of developing breast cancer,
there are some factors that increase
that risk.
• Gender. Just being a woman means
you are at a higher risk. Though
breast cancer can affect men, too,
especially if there is a family
history, it is about 100 times more
common in women.
• Age. Breast cancer is more
prevalent among women over 40 and
risk continues to increase with age.
Almost 80 percent of cases are in
women over 50.
• Family history. Women with breast
cancer in their family histories
have an increased risk, which is
even higher if a first-degree
relative — mother, sister, or
daughter — has had it.
• Hormones. Several hormonal factors
and differences can affect risk,
such as starting menses before age
12, experiencing menopause after 55,
never having had children, and
having your first child after 30.
Some studies show slightly increased
risk in women who use oral
contraceptives or hormone
replacement therapy.
• Race. White women generally have
higher incidences of breast cancer,
but women of other races are more
likely to die from the cancer. This
may be partly due to lack of medical
care and diagnoses among non-white
women. |
|
What are the symptoms and warning
signs?
Warning signs can vary widely and be
different for every woman, and
early-stage cancer may have no
detectable symptoms. It is important
to do self-exams and visit your
doctor regularly. Women over 20
should have a clinical breast exam
at least every three years; women
over 40 should have a clinical
breast exam as well as a mammogram
once a year.
• Irregular mass. Though breast
tissue changes during the monthly
cycle and small lumps may appear and
disappear, a painless mass is the
most common symptom of breast
cancer.
• Breast pain. Approximately 10
percent of patients or fewer have
breast pain with no mass.
• Breast changes. These are less
common but may include thickening,
swelling, skin irritation or
distortion, dimpling, spontaneous
discharge from the nipple, and
erosion, inversion or tenderness of
the nipple.
Can I prevent breast cancer?
There are no guaranteed ways to
prevent breast cancer, but some
lifestyle changes can decrease risk.
• Healthy body weight. A recent
study by the American Cancer Society
found that overweight women are 60
percent more likely to die from
breast cancer than women of healthy
weight.
• Physical fitness and activity.
Though studies aren’t yet
conclusive, experts report a link
between physical activity and breast
cancer — the more active you are,
the lower your risk.
• Decreased alcohol consumption. The
equivalent of just two drinks a day
can increase breast cancer risk by
21 percent. Though other studies may
show that some alcohol, like red
wine, could have health benefits,
women concerned about breast cancer
should limit alcohol intake.
• Healthy diet. There are infinite
reasons that a balanced diet, full
of fruits and vegetables, is good
practice — reducing cancer risk is
just one.
• Tamoxifen and prophylactic
mastectomy. These are more extreme
measures for women at particularly
high risk. The drug tamoxifen has
long been used to treat cancer, and
the results of one recent study
showed that, as a preventive
measure, tamoxifen may decrease risk
by as much as 49 percent. Preventive
(or prophylactic) mastectomy is an
operation in which one or both
breasts are removed before cancer is
present.
Information provided by the American
Cancer Society, the National Cancer
Institute and the Susan G. Komen
Breast Cancer Foundation.
*For confidentiality, the patient’s
actual name has been changed. |
|
|
