San Antonio Express-News: Latino cancer researchers set course for more study

This story was published in the San Antonio Express-News March 4.

By Elaine Ayala

Ask Latinos what disease is most likely to claim their lives, and their answers are likely to be cardiovascular disease or death by diabetes.

Wrong.

While heart disease remains the leading cause of death for non-Hispanic whites, in 2009 cancer replaced heart disease as the No. 1 killer of U.S. Latinos. And the numbers are climbing. From 2000 to 2014, the group’s cancer rates went up by 72 percent.

Research now shows that by 2030, rates are expected to climb by 142 percent, in part because the Latino population is aging and cancer is a disease of the aged.

But for reasons researchers don’t yet know, specific and different cancers such as liver, kidney, gall bladder and gastric cancers, for example, strike Latinos more than other U.S. demographic groups.

And that’s just the beginning of the differences and disparities.

In February, Dr. Amelie Ramirez, director of the Institute for Health Promotion Research at UT Health San Antonio, convened the nation’s Latino cancer researchers.

Though the field remains small, Ramirez says the Advancing the Science of Cancer in Latinos conference drew 225 researchers from 23 states and Puerto Rico. They shared lab studies, new research, best practices, drug therapies, interventions, mortality and survival rates.

Data has come a long way. While researchers once collected it for whites, blacks and “others,” Ramirez says studies now include Latinos and subgroups of Latinos.

A decade ago, it would have been hard to amass so many researchers. “It’s still small,” she says. “But San Antonio wants to become the leader.”

Ramirez’s work on the National Hispanic Leadership Initiative on Cancer: En Acción was the first comprehensive look at Latino cancer risk factors.

Researchers are in early stages of investigating why Latinos are being diagnosed with liver, stomach, gall bladder and other cancers at higher rates, seen in San Antonio and South Texas.

“The needle has moved slowly,” said Ramirez, who also serves as associate director of Cancer Prevention and Health Disparities at the Mays Cancer Center.

The data is dire, and more Latino participation is need in clinical trials and studies, researchers say.

Research has found fewer Latinos get routine screenings because of fear and denial, or what Ramirez called decidía, or indecision.

Latinos are also diagnosed in the later stages of disease and are less likely to survive. Early detection and treatment are key.

Latinas are less likely to be diagnosed with breast cancer — but more likely to die of it.

Ramirez says doctors report seeing Latinas “come in when tumors are already protruding from their skin.” She has counseled some who’ve compared mammogram screenings to “a tortilla press. I tell them several moments of discomfort can save you.”

While awareness is crucial, Ramirez says longer-term research goals include finding “precision medicine” for Latino patients.

The conference served as a catalyst for more research, she said. The next one in 2020 will open up to Latin American researchers.

“It was the first time Latino cancer researchers came together to share what we know about cancers in Latinos,” and the energy was palpable, she said.

It included Dr. Edith Perez, vice president and head of U.S. medical affairs for Genentech/Roche BioOncology, a major cancer drug developer; Dr. Paulo Pinheiro of the University of Miami Sylvester Comprehensive Cancer Center, who spoke about 21st-century cancer patterns among Latinos; and Dr. Marcia Cruz-Correa of the University of Puerto Rico Comprehensive Cancer Center on underrepresented cancers with unequal burden among Latinos.

Dr. Francisco Cigarroa of UT Health San Antonio spoke about liver cancer among Latinos in South Texas; and Dr. Ronald Rodriguez, also of UT, on the high rate of late-stage kidney cancer among South Texas Latinos.

Every cancer researcher left the San Antonio conference more hopeful than they arrived, Ramirez said.

Yet they took with them another disturbing reality.

Cancer-wise, U.S.-born Latinos will fare worse than their immigrant counterparts. It’s the “Western lifestyle,” Ramirez said, including higher rates of smoking, drinking, obesity and sedentary behavior.



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