Vixay Vue: This is SBS Radio Hmong Program, today we have a special guest which is Dr. Jennifer Kue who is from the state of Ohio, USA. She has recently received USD 1.7 million grant from the American Cancer Society to study and do research in to how to prevent cancer in refugee and immigrant communities. Welcome Dr. Jennifer Kue and audience to join this conversation. Can you tell us more why you did receive grants from this organisation to implement these tasks?
Dr. Jennifer Kue: So first, I just would like to thank the American Cancer Society. I am very honored to be awarded with this grant from this wonderful organisation, and I am working very hard to write the proposal, to do the work that I do in cancer prevention, and control with refugee and immigrant population especially the Southeast Asian communities that I work with. Because one, I am from this community and I am working with this population nearly all my professional life. So we really want to make a difference in the community in terms of cancer prevention. So in this study what we really want to do is we want to test the efficacy of culturally resilience and to a navigation intervention that delivered by bilingual and cross cultural community health advisers to help increase the of age appropriate breast and also cervical cancer screening completion with Southeast Asian mothers and daughters. And so when I am talking about Southeast Asia women I am specifically targeting, Vietnamese, Lao and Cambodian women and I really want to include Hmong women in this study, except for Ohio, where I live in Columbus Ohio there are not many Hmong women or Hmong people for that matter. So most of the Hmong community in Ohio live up Cleveland and Akron so this study will take place at Columbus Ohio where the Ohio State University is located.
Vixay Vue: Do you think that in the future you might expand this program so other state like Wisconsin, Minnesota or California where Hmong live can participate?
Dr. Jennifer Kue: Yes definitely that would be my ultimate goal to do something like that but right now we want to study smaller area and just do one site, but I would love to expand this if this navigation work of proven to work with other population, I would love to expand to other site and other community such as Minnesota, California.
Vixay Vue: You said that you wrote proposal to this organisation, do you feel surprise that you are nominated and got the grant?
Dr. Jennifer Kue: I feel elated, I feel that this is a huge accomplishment, because not a lot of study that I have seen has focused so much on this Southeast Asian group neither study has been done with Vietnamese or some Cambodian group but you know no one has looked at the Lao population. I think that there are so many issues in the community that we have not addressed. So this is really one of those things and so I am very excited that we are paying attention to the Southeast Asian community.
Vixay Vue: How many type of cancer and why do you target specific type of cancer?
Dr. Jennifer Kue: There is a lot of different type of cancers and I focus on cervical and breast cancer in particular because, I used to work in social services back in Oregon promoting breast and cervical cancer with Asian immigrant women. And that’s where I started my passion and interested of working with Asian women around cancer prevention. For these two cancers, we don’t know for sure way to prevent breast cancer but there are things that we can do that lower people risk of getting breast cancer. For cervical cancer, we know that we can prevent it through screening and vaccination. So these cancers are preventable and that’s why I am interested to look into this, but also:
"cancer is the leading cause of death for Southeast Asian immigrant women. And over the past two decades new cases of breast and cervical cancer have significant increased across age groups and Southeast Asian immigrant women compare to other Asian group and white women. And so with Lao, Cambodian women, there is two and a half time likely to be diagnosed with cervical cancer, this means that these women are 40% likely to be diagnosed with cervical cancer than white women. And breast cancer is the most commonly diagnosed cancer and the second leading cause of death in Asian immigrant women," said Dr. Jennifer Kue.
So these are two very important health priorities that we need to look at preventing these type of cancer.
Vixay Vue: Can you really tell us what cause cancer and how do we prevent it?
Dr. Jennifer Kue: Yeah, like I said, there is no sure way to prevent cancer, but we can do things that will lower our risks or risk factors or anything that affect your chance of getting this disease such as breast cancer or cervical cancer.
"But just because you have risk factors you are not going to get that disease. So some risk factor you really can’t change for example you are a women, getting older or having some certain type of genes from your family you know breast and cervical cancer happen in women, and so it is important to know that 8 out of 10 women who got breast cancer don’t have a family history, but women who have close blood relative with such as like a mom, daughter or relatives with cancer have higher risk for the disease". "And so there are other lifestyle related risk factors that might affect our risk of getting disease such as diet and exercise, being overweight or obese. There is drinking alcohol has been linking to an increase risk of getting breast cancer, and cervical cancer the most important risk factor has been the infection by the Human Papillomavirus (HPV), so that by screening and immunization against the Human Papillomavirus is so important in preventing cervical cancer."
Vixay Vue: You just mention about cancer in women, are there another type of cancers that might affect men like colon cancer within Southeast Asian community including Hmong?
Dr. Jennifer Kue: I am not an expert in those other type of cancer, but in the Hmong community especially liver cancer is very prevalence in our Hmong Southeast Asian community, is cost by the hepatitis B. So there is a lot of study here, Hmong not a lot, but there are a few studies here in the US that looks at the Hmong in liver cancer and how to prevent liver cancer. I would also say that some of the other cancer is an issue in Hmong community as well. Lung cancer has been always on the part 5 list cancer living cancer in Southeast Asian communities because of smoking and environmental factor.
Vixay Vue: Currently there are some research break through like immune therapy, gene therapy or new method of chemotherapy, are they available for the public to access of they have to pay to get the services?
Dr. Jennifer Kue: I can’t really answer those questions. I work in prevention. In terms of prevention, in terms of preventing cancer in women for breast cancer, mammogram are typically used to detect cancer early and Pap test or Pap smear and Human Papilloma virus test are used to detect or to prevent cervical cancer.
So those tasks are often paid by insurance companies. And it depends on the insurance you have and it could depend on the type of insurance you have and not every insurance will cover that. But typically I would say, insurance will cover mammogram and Pap test.
And so people who have insurance do have access to those. For those who don’t have insurance, there are breast screening programs available for women who qualify so then the mammogram are paid for. But in terms of chemotherapy and that sort of treatment for cancer, you know it just depends on your insurance.
Vixay Vue: So it means that we cannot access unless we have health insurance, but does it related to Medicaid the US universal health care packages?
Dr. Jennifer Kue: The affordable care act you know requires that private insurance plan cover some recommended prevented services like immunization ie.,HPV immunization, Pap test and Mammogram but I’m not quite sure about treatment.
Vixay Vue: Apart from what we have discussed are there any other factors like being stigmatizing, stereotyping, language and cultural barriers preventing women from access screening?
Dr. Jennifer Kue: There are many reasons why immigrant women don’t get screening. It is simply that they are not aware of the importance of getting screened, the services that are available or why we need to get screened? So prevention is not something that is practiced.
Often times in our communities, prevention in terms of what is in prevention, going to see doctors getting your annual exam, the cost associate with the exam can also be a barrier. For many women, a lot of women here are not insured or under insured, so that those factors are barriers for women in terms of getting mammogram or Pap test. I believe that prevention is so important and it is really the focus of my study.
"You know we really have to change the way we talk about prevention in our communities. Getting mammogram or Pap test is not a scary thing to do. We need to talk about and do it as if it is something easy as brushing our teeth or something you know or getting our car fixed and also get oil changed. With our own bodies we need to do those same things." "And we need to encourage our mother, our sister, our aunt to get screening, and those are the sort things that growing up we don’t talk about those things ever with my mom. It is like a taboo thing that we don’t talk about cancer we don’t talk about screening. I don’t talk about women top issues. Those are taboos topics so one of our goals is to change those conversations between mothers and daughters. Being able to talk about changes and our thinking around prevention so that future generation don’t think that it is a taboo issue is important. I was just like to encourage mothers and daughters to talk about health issues and not when it became so serious issue that is too late, because these things are not actually taboo."
And I think we need to encourage each other to seek out prevention measure. I am just so grateful to do such meaningful work and the reputation in my community and I so am very honored to be rewarded this awards.
