NEWS | February 18, 2003


New education effort targets one of California's most vulnerable populations


As a Hmong medical interpreter for UC Davis Medical Center for the past 15 years, Norepaul Mouaryang, 47, has translated his share of bad news to his countrymen: "You have cancer." "It is inoperable." "It is terminal."

"The saddest is when we hear the doctor say, 'Surgery is not possible because the cancer has spread. Chemo is not possible because you are already too skinny. Radiation is not possible because you are too weak,'" Mouaryang says. "It is sad because many of these cancers could have been cured if they had been caught early enough. Too many first-generation Hmong people are still afraid of doctors, afraid of surgery, ashamed of illness."

Mouaryang hopes a new health education program, Cancer Awareness 101 for the Hmong, will help lessen the toll. The first Hmong cancer awareness course will take place Saturday, March 1 from 9 a.m. to 4 p.m., in the Grand Ballroom of the Courtyard by Marriott Sacramento Midtown on the UC Davis Medical Center campus, 4422 Y St. Mouaryang will be there as an interpreter, helping to translate cancer prevention and early detection messages into Hmong for elders and other leaders of the Hmong community.

The pilot course is a new program of the Asian American Network for Cancer Awareness, Research and Training (AANCART), an $8-million, five-year project headquartered at UC Davis. The course is co-sponsored by the Hmong Women's Heritage Association, a non-profit community service organization based in Sacramento.

"We are proud to be a co-sponsor of this course," says Lou Moua, a medical interpreter at the Hmong Women's Heritage Association. "There is very little information available in Hmong about cancer. This will give people in the Hmong community information they need to preserve their health."

Thanks to decades of public health efforts, cancer early warning signs have become household wisdom throughout mainstream America. Few people born in the United States have escaped public-health admonitions to avoid sunburn, do breast self-exams or get Pap tests.

But these life-saving messages haven't achieved the same penetration among immigrants from non English-speaking communities. The Hmong, whose language has no word for cancer, may be among the least informed.

Moon S. Chen, Jr., associate director for cancer prevention and control at the UC Davis Cancer Center and principal investigator of AANCART nationally, hopes to develop three levels of cancer awareness training tailored for the Hmong. The most basic level, to be offered March 1, is intended to provide the basic self-help information all adults should have about cancer prevention and early detection, from early cancer warning signs to lifestyle risk factors to cancer screening recommendations. A more advanced course, still in development, will provide medical interpreters with the specialized vocabulary and knowledge they need to effectively translate discussions about cancer diagnosis and treatment in doctor's offices and hospitals. The third course will train instructors who can teach the first two courses. Ultimately, Chen hopes to develop a standardized curriculum that can be offered in Hmong communities throughout the United States.

Reginald Ho, the first Asian American to serve as president of the American Cancer Society, will teach the March 1 course. Ho is a medical oncologist at the Straub Clinic and Hospital in Honolulu, Hawaii, and clinical director and regional principal investigator for AANCART in Hawaii.

Funded by the National Cancer Institute, AANCART's mission is to reduce cancer in Asian Americans, ethnic group by ethnic group. Chen, who is also a professor in the Department of Epidemiology and Preventive Medicine at UC Davis, oversees AANCART activities at eight other cancer centers (MD Anderson Cancer Center in Houston, Dana-Farber Cancer Institute in Boston, Herbert Irving Comprehensive Cancer Center in New York City, Fred Hutchinson Cancer Research Center in Seattle, Solove Cancer Research Institute in Columbus, Ohio, the Cancer Research Center of Hawaii in Honolulu, Jonsson Comprehensive Cancer Center at UCLA and the UCSF Comprehensive Cancer Center).

In Sacramento, one of AANCART's populations of emphasis is the Hmong, a people from the mountains of Laos who fought alongside the United States during the Vietnam War. Thousands fled their homeland after the fall of Saigon in 1975, many settling in California. Today California has the nation's second-largest Hmong population, estimated at about 65,000. (Minnesota has the largest.) Sacramento is home to about 17,000 Hmong.

UC Davis Cancer Center, the only National Cancer Institute-designated cancer center between San Francisco and Portland, Ore., serves about 3,000 new patients a year from throughout Northern California, southern Oregon and western Nevada.

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