Affordable care alone may not be enough to help Latinos overcome cancer care barriers

March 5, 2013

A combination of financial, cultural and communication barriers plays a role in preventing underserved Latino men with prostate cancer from accessing the care and treatment they need, according to a new study by researchers at the UCLA School of Nursing.

The study, "Barriers to Care: Is Not Enough," is published in the March issue of the peer-reviewed journal Qualitative Health Research.

According to the , prostate cancer is the most commonly diagnosed cancer among Latino men. Additionally, Latino men are more likely to be diagnosed with later-stage disease than non-Hispanic white men.

"We found that an array of obstacles compromise access and frequently result in negative outcomes," said Sally L. Maliski, associate dean of academic affairs at the UCLA School of Nursing and senior author of the study. "Sadly, these obstacles disproportionately affect underserved individuals and require a new focus on not only adequate but also on the array of hurdles that limit patient access."

The UCLA study looked at Latino men who were enrolled in Improving Access, Counseling and Treatment for Californians With Prostate Cancer (IMPACT), a state-funded public assistance program. The analysis revealed barriers throughout the entire prostate cancer–care process, including screening, treatment and follow-up care.

Among the key findings:

Financial hardship

Low socioeconomic status was commonly cited by the Latino men in the study as the primary impediment to care. The inability to afford medical insurance not only made it difficult to access care but also intensified the gravity of the prostate cancer diagnosis, leaving many participants feeling hopeless.

Participants often had difficulty understanding state- or county-based insurance policies, and this resulted in denied claims, loss of coverage or difficulty in accessing prescriptions. It ultimately led to increased out-of-pocket expenses and a fragmented system of care, leaving patients frustrated.

Lack of doctor continuity and care coordination

Participants frequently experienced poor care coordination, increased distrust for their doctors and decreased levels of comfort when care was administered disjointedly, by a frequently changing group of medical personnel.

Their frustration was exacerbated when they perceived faulty equipment and multiple doctor referrals as a cause for delayed diagnosis. Surgical procedures for prostate cancer and treatments for side effects were also frequently complicated by poor care coordination.

Inadequate access to primary care left many participants ill-equipped to navigate a complex medical system that often requires self-advocacy to demand the right care.

Communication and education

A lack of health literacy among the men, compounded by insufficient provider awareness of this issue, frequently resulted in the men misunderstanding doctors' treatment recommendations and procedures.

Patients' limited proficiency in English also often hampered their ability to describe their symptoms and express their needs to providers.

"Our study highlighted that we have an intricate web of barriers—societal, system and individual—that when combined leave many individuals without the care they should be receiving," Maliski said. "These overlapping obstacles make it clear we need a system where not only is care affordable but where we use a multi-faceted approach to improve access, increase health literacy and greatly improve care coordination."

Explore further: Study reveals racial disparities in prostate cancer care

Related Stories

Study reveals racial disparities in prostate cancer care

August 23, 2012
A study led by investigators from Vanderbilt-Ingram Cancer Center (VICC), Nashville, Tenn., finds that black men with prostate cancer receive lower quality surgical care than white men. The racial differences persist even ...

New approach to prostate cancer care draws patients with riskiest disease

January 5, 2012
(Medical Xpress) -- In choosing where they get treatment, prostate cancer patients tend to opt for a major cancer center if they have severe disease, but stick closer to home for less complicated cases, even when offered ...

Recommended for you

Cancer-death button gets jammed by gut bacterium

July 27, 2017
Researchers at Michigan Medicine and in China showed that a type of bacterium is associated with the recurrence of colorectal cancer and poor outcomes. They found that Fusobacterium nucleatum in the gut can stop chemotherapy ...

Researchers release first draft of a genome-wide cancer 'dependency map'

July 27, 2017
In one of the largest efforts to build a comprehensive catalog of genetic vulnerabilities in cancer, researchers from the Broad Institute of MIT and Harvard and Dana-Farber Cancer Institute have identified more than 760 genes ...

Long-sought mechanism of metastasis is discovered in pancreatic cancer

July 27, 2017
Cells, just like people, have memories. They retain molecular markers that at the beginning of their existence helped guide their development. Cells that become cancerous may be making use of these early memories to power ...

Blocking the back-door that cancer cells use to escape death by radiotherapy

July 27, 2017
A natural healing mechanism of the body may be reducing the efficiency of radiotherapy in breast cancer patients, according to a new study.

Manmade peptides reduce breast cancer's spread

July 27, 2017
Manmade peptides that directly disrupt the inner workings of a gene known to support cancer's spread significantly reduce metastasis in a mouse model of breast cancer, scientists say.

Glowing tumor technology helps surgeons remove hidden cancer cells

July 27, 2017
Surgeons were able to identify and remove a greater number of cancerous nodules from lung cancer patients when combining intraoperative molecular imaging (IMI) - through the use of a contrast agent that makes tumor cells ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.