Sharon Yen (pseudonym for privacy purposes) remembers that nagging pain inside her abdomen. That nagging pain later became unbearable. She remembers clearly that night while working as a waitress—carrying loads of dishes back to the kitchen like any normal night—when suddenly, the load became too heavy. Her balance was shifting and the pain internally led her to tears.
“I was so scared,” said Yen. I never had that pain before. I knew something was wrong.”
Something was indeed wrong. Yen was later diagnosed with ovarian cancer. But this diagnosis took weeks after misleading treatments from her doctor.
“I was bloating and my doctor kept thinking I was pregnant,” said Yen.
She recalls the moment she heard the word ‘cancer’ coming from the doctor’s mouth. The word was too foreign for her to comprehend. Growing up with heart disease, Yen is all too familiar with doctor visits and hospitalization. And this time, she was prepared to endure any medical procedure and treatment. But cancer was a different story.
“I didn’t know who to turn to. I had to trust my doctor for everything,” said Yen. “I remember coming out of Swedish Hospital with my husband feeling lost.”
For Yen, being diagnosed with cancer left her feeling isolated. An immigrant from China, Yen is a U.S citizen and has lived in Seattle for 23 years. But, the thought of having cancer as an Asian Pacific Islander American felt new.
“I never see bald Asian women. Maybe we just don’t talk about it,” said Yen. “And also for me, I was afraid people would ask.“
Certain types of cancer and diseases such as osteoporosis and diabetes are actually the leading health issues of API women. Cancer alone is the leading cause of death for API women in the U.S (U.S Department of Health & Human Services).
The model minority myth not only affects the API community in education and careers, but in health as well. The National Asian Women’s Health organization was founded in 1993 for the very reasons to debunk the “healthy model-minority” stereotype. Serving as a powerful voice for the health of Asian American women and families, NAWHO is conducting research and educating the health of Asian Americans to the public health field.
Yen’s diagnosis of ovarian cancer meant a hysterectomy—an operation to remove a women’s uterus. Later, she was given the CA125 blood test for ovarian cancer patients and then the routine of chemotherapy. Suddenly, Yen was bombarded with new medical terms and an overwhelming amount of doctor visits and forms to sign.
“I don’t speak English well,” said Yen. “I’m very lucky to have my son translate for me during all my hospital visits. I know he learned a lot about the cancer just by listening.”
NAWHO recognizes the need to implement cultural competency within healthcare systems. Yen also believes the benefit of having doctors and nurses be culturally sensitive towards her background and language barrier.
“I had my family and my son to help me,” said Yen. “But others don’t have that support. How doctors responded to my questions and needs affected my health.”
During Yen’s cancer battle, she has become aware of other cancer types because of her experience. But she advises all Asian Pacific Islander women to be cautious and take preventative measures. For Yen, cancer was never mentioned at home because no family member was ever diagnosed with cancer.
“I never thought I would have cancer,” said Yen. “Women, especially Asians, need to pay attention to their health because I know we don’t talk about it as much. I’m fortunate to be a survivor.”
According to NAWHO prevention programs, cervical cancer and breast cancer are among their main awareness projects because of its prevalence among Asian Pacific Islander women. For example, cervical cancer incidences in Laotian, Samoan, Vietnamese and Cambodian women are among the highest in the nation. In 2003, 67.8 percent of API women reported having a pap test within the past three years compared to 80.1 percent of non-Hispanic White women. Southeast Asian and Indian women are least likely to ever receive a pap test. Research by the U.S Department of Health & Human Services (DHHS), shows Asian Pacific Islander women tend to have much lower rates of cervical cancer screening than any other groups due to cultural beliefs that only married women should receive pelvic exams.
Breast cancer is less common than cervical cancer among Asian American/Pacific Islander women according to DHHS. But, more API women have breast cancer compared to Hispanic or American Indian women, and Pacific Islanders have the highest death rate of breast cancer among other ethnic groups.
So why should people like Yen feel isolated and alone when statistics show the increase of cancer incidence among API women?
“It’s not that we don’t want to talk about our health, but it’s difficult,” said Yen. “I think it’s how we are raised. We don’t want people to worry especially because our community is so small.”
Aside from cancer, women need to be aware of other high risk health issues including osteoporosis, diabetes, cardiovascular disease and mental health, where early detection and proper preventative treatment is critical. But too often, the lack of health insurance is an obstacle.
Based on a report produced by the Kaiser Family Foundation and the Asian & Pacific Islander American Health Forum, API subgroups face substantial disparities in health care access and insurance coverage. API’s have the highest uninsured rates in the nation. Yen was one of the lucky few.
“I was covered by my husband because his company has good health benefits and insurance,” said Yen.
Now at age 55 and living healthy, Yen is required to do annual check-ups including mammograms and pap-smears. Even though Yen’s insurance plan covers annual preventative care to patients, she no longer qualifies to be under “preventative care” because she was already diagnosed with cancer.
“I’m lucky to have insurance,” said Yen “But now my insurance doesn’t cover certain exams and it’s been hurting me financially.”
For Asian Pacific Islander women, the need to break the silence is necessary. Organizations like Seattle’s International Community Health Services are providing API women with needs as reproductive health care and screening services for early detection. ICHS also offers their Women’s Preventative Health Services program free or low-cost pap smears and mammograms to women aged 40-64. Those who qualify as ICHS patients have complete coverage if they are diagnosed with breast, cervical or colon cancer.
Many Americans still view the API population as a healthy “model minority” unaffected by the crisis of racial health disparities. But for those who share similar stories like Yen, statistical evidence proves that Asian Pacific Islander women are not fighting their health issue alone.