Poverty can lead to cancer deaths

August 27, 1991|By Robyn Washington

For a long time, it was assumed that race was the primary factor predisposing certain groups of people to developing cancer. Health experts are now finding that race alone does not predispose one to cancer, but that socioeconomic status contributes to high rates of cancer and cancer-related deaths.

The inability to access health care systems, certain lifestyles and dietary habits, and attitudes toward cancer are believed to be the primary reasons why blacks and other minorities more often become victims of the disease.

Dr. Miles G. Harrison, Jr., an assistant clinical professor of surgery on the faculty at the University of Maryland School of Medicine echoes this sentiment, saying that the socioeconomic status of patients does affect their ability to seek health care. According to Dr. Harrison, "Moving toward having insurance for disadvantaged patients will possibly increase survival rates."

Born and raised in Baltimore, Dr. Harrison is a third-generation surgeon. He has a private general surgery practice in Baltimore with a special interest in the diagnosis and treatment of breast diseases.

Dr. Harrison's special interest in breast cancer extends to a support group which he started two years ago for women with breast cancer. The members of this group, who are all patients from his practice, volunteer their time to counsel breast cancer patients.

They are also being trained to provide community outreach and education services.

Falling victim to cancer, according to Dr. Harrison, is avoidable. Early detection is one of the keys. "Technology like the mammogram," says Dr. Harrison, "can pick up problems at earlier stages." Cancers are being detected in earlier stages within all populations, but as blacks and other minorities are disadvantaged in higher numbers, they have inadequate access to health care, and seek care at later stages of the disease.

Bernie Carey, former acting supervisor of the Bureau of Health Education and Promotion for the Baltimore City Health Department, says that the best weapon against cancer is early detection, which allows for treating the disease before it has an opportunity to spread. But, she also says that attitudes are often at the crux of many people's failure to be diagnosed and treated for cancer early.

"Sometimes people who have health insurance don't go for check-ups," she says. She says that they are afraid or believe that if they are diagnosed as having cancer, they are doomed to die. "Having cancer," she says, "does not automatically equal death."

Questions abound regarding why cancer is so prevalent among blacks, particularly in the Baltimore area. "If we could answer all of the questions as to why," says Dr. Harrison, "we could more effectively treat and possibly prevent some of the adverse outcomes of cancer."

Dr. Harrison and Ms. Carey encourage getting regular physicals, finding out what tests are required and at what age they should be taken, and following a diet that is low in fat content. According to both experts, avoiding a high fat diet may also decrease the possibility of getting colon cancer and heart disease.

For women, Dr. Harrison advises starting breast self-examination as early as the late teen years, particularly for women who are high risk candidates for breast cancer (someone with a mother, grandmother or sibling with the disease).

If a young woman begins breast self-examination in her late teens, she will be proficient at it by her mid-20s.

Additionally, he recommends that women get a baseline mammogram between the ages of 30 and 35, and to ask their gynecologist for yearly examinations as well.

Dr. Ralph Howard, a urologist with the Madison Medical Center on North Avenue in Baltimore, also recommends early detection as the best defense against prostate cancer. He says that unlike a breast self-examination, a prostate self-examination is not physically possible for men. Men over the age of 40 are advised to receive yearly rectal examinations from their physicians. Dr. Howard said that there is a blood test being used that can screen for prostate cancer in the early stages.

When levels are elevated in the prostate specific antigen test, there is a possibility of cancer. From there a biopsy is done to confirm the diagnosis.

While early detection seems simple enough to achieve on an individual basis, as human behavior would have it, many people do not take the necessary steps toward early detection.

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