Cultural Taboos Influence Minority Patients' Cancer Care
The Wall Street Journal on Saturday profiled the Maimonides Cancer Center in the Chinatown section of Brooklyn, N.Y., which is "among several hospitals nationwide attempting" to be "more sensitive to cultural nuances" associated with the diagnosis and treatment of cancer among racial and ethnic minority patients. The center's patient population comprises Chinese-Americans, Caribbean-Americans, Hasidic Jews, Pakistani Muslims, Russians and blacks.
According to the Journal, "Though starkly diverse, these groups often share strong beliefs about keeping a cancer diagnosis -- and possible treatments -- under wraps." Among Chinese, Russians and Muslims in particular, cancer is "such a cultural taboo that families have been known to shield loved ones from the seriousness of their condition," and often are "reluctant to seek or heed medical advice; others even refuse to utter the word 'cancer.'" Among Orthodox Jews, cancer is "considered to be something of a social blemish," and "[m]erely being seen entering or leaving a cancer center might spark rumors that could have profound repercussions for a family," according to the Journal.
While U.S. law states that patients must be informed about their medical conditions to consent to medical treatment, some families "want their loved ones to know as little as possible about their cancer" and do not fully explain to patients consent forms that are written in English, according to the Journal. Yiqing Xu, a Chinese oncologist at Maimonides, said cancer is such a taboo among some Chinese families that staff members in certain cases avoid using the word "cancer" and instead use "lesion" or "mass." Instead of saying "chemotherapy," doctors might say "treatment," she said.
Harold Freeman, founder of the Harlem, N.Y.-based Ralph Lauren Center for Cancer Care and Prevention, said, "There are so many myths that can influence a person's tendency to seek care or refuse care -- there are many examples from Harlem to Appalachia to Native America." Freeman adds, "We need to be careful. It is very tough to separate race from poverty from culture, yet you need to do that" (Lagnado, Wall Street Journal, 10/4).
Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.