The Dallas Examiner
At the age of 9, Emelda Thein left Burma with her family and ended up in a Thai refugee camp for 15 years before moving to the U.S. She shared her experience during the Think About the Link Campaign summit and screening event held May 20, where she described the substantial difference between the primitive conditions of such an environment versus the elements that make up health care in America.
“The doctor in the refugee camp, who we call ‘doctor,’ is the person who went through six months of medical training, so it is very different from here,” she explained.
The summit, held at the Crowne Plaza Dallas Market Center, brought together health care professionals of different backgrounds to raise awareness about the connection between human papillomavirus, hepatitis B and hepatitis C, and liver cancer, since too few people understand the link between certain viruses and cancers, especially in the Black, Hispanic and Asian communities. The event also underscored the importance of the HPV vaccine in combating such preventable conditions.
Thein further explained that education in the camp was minimal; insurance was not needed; medicine could be purchased based on the unscientific decision of how someone else’s medication best relieved past symptoms rather than via prescription after consultation with a physician.
Thein, who is now a Lay Health Educator with the UNT Health Science Center, believes her mother died in the camp of hepatitis or a similar liver disorder, based upon the camp’s conditions and her mother’s symptoms. She mentioned that refugee healthcare was “at zero level and here it’s tenth level.” Still, the educator exposed an ironic conclusion about both systems: They potentially lack basic preventable disease care in certain populations.
“Here, you have to have health insurance. Not enough; you have to pick a plan. Not enough; you have to pick a doctor. Not enough; you have to know which doctors will accept insurance,” she said, noting that such a system could be very challenging to anyone, let alone a foreigner.
Her lesson as it related to the summit was that, even though an effective treatment is available in the form of the HPV vaccine to combat multiple types of cancer, sexually-transmitted diseases and even birth defects, many choose not to take advantage of the treatment because they are unaware of its benefits or are even in the dark about its existence.
Just as Thein helps the local Burmese community navigate the U.S. health care system and educates them on immunization, supporters of the summit would like to provide the same opportunity to others who are underserved, including African Americans.
“We have methods to prevent cancer by screening for HPV, screening for hepatitis C, vaccinating against HPV and hepatitis B, and we can treat hepatitis C, and in every case then you stop the march towards cancer,” said Carolyn Aldige, president and founder of Prevent Cancer Foundation.
“And yet, this vaccine is so underutilized and it really is all about the way it’s communicated,” she added.
Overall, less than 46 percent of adults are aware that with immunization, HPV-related cancers can be avoided, according to a survey conducted by the Prevent Cancer Foundation in partnership with Russell Research Firm. Per the Centers for Disease Control and Prevention, every year in the U.S., about 20,000 men and 8,000 women get liver cancer, and about 16,000 men and 7,000 women die from the disease.
The Foundation survey also indicated that 76 percent of adults are not aware that the hepatitis B vaccine can lower the risk of liver cancer; 73 percent of adults are not aware that hepatitis C treatment can reduce the risk of liver cancer. Only 9 percent of adults said their physician has discussed prevention strategies for hepatitis C.
When it comes to minority communities nationwide and locally the statistics are worse. In an article by Glenn Ellis published July 2016 by The Dallas Examiner, the author revealed that African Americans born between 1945 and1965 have twice the rates of hepatitis C virus as other baby boomers.
“While African Americans represent only 12 percent of the U.S. population, they make up roughly 22 percent of the estimated 3.2 million persons with chronic HCV infection. Moreover, chronic liver disease, often hepatitis C-related, is a leading cause of death among African Americans ages 45 through 64,” Ellis wrote.
Part of the issue is representation during a drug’s experimental phase, he also emphasized. “African Americans are usually underrepresented in clinical trials of treatment for acute and chronic HCV infection, even though their prevalence of chronic HCV infection is higher than among Whites. African American subjects currently represent only 5 percent to 10 percent of participants in clinical trials involving HCV infection.”
When Campaign summit speaker Dr. Parvez Mantry, medical director of The Liver Institute Research Methodist Dallas, was interviewed by The Dallas Examiner in December 2013 about then-investigational hepatitis C medication sofosbuvir he, too, noticed a divide in treatment.
“Specifically, certain communities that we see in Dallas, and other communities that we see in Dallas which have a disproportionately high rate of hepatitis C, [are] African Americans,” the doctor said at the time. Past hepatitis C treatments had been less successful with African Americans as opposed to Caucasian Americans “… and therefore the burden of untreated disease in this community is much higher,” according to Mantry.
As there is a clear link between HPV, hepatitis, and a variety of cancers, public education can be a matter of life and death.
“We’ve already heard that 80 percent of our children will come in contact with HPV, the type of HPV that can cause cancer,” said Dr. Jason Terk, distinguished consultant with Cooks Children’s Health Care System during the summit. “We need to move away from this idea that this is a risk that our children can somehow potentially avoid.”
He admitted that children and adolescents were at the highest risk of getting the infection. Yet, many parents are not aware that their children, male and female, can go through a short series of injections before the age of 15 to insure future immunity.
“This is a cancer-preventing vaccine,” the doctor pointed out. “Fifteen years ago, 20 years ago, we dreamed of having a vaccination that protects against cancer. Well, this is it.
“I think it’s a health equity issue; it’s a disparity issue, the same way there are so many disparities between racial and ethnic groups.”
Aldige reflected on the treatment gap the summit attempted to bridge.
“HPV is one of the most safe and effective vaccines that has ever been approved,” she said. “We know pediatricians should be offering it to all their patients at the age of 11. It’s not being done, so we’ve got to do a better job of communicating to the healthcare providers, and also to parents, to the general public.
“Hepatitis B and C are the same thing; they’re just not being vaccinated against or screened and treated the way they should be, and if people understood that this is all about cancer prevention – it’s not about risky behaviors. That’s not the message. The message is cancer prevention.”