At night, Elsa Garcia laid in bed, touching the three, strange lumps in her left breast.
An immigrant from Guatemala without health insurance, Garcia, 59, had never heard of breast cancer.
And even if she knew what the lumps meant, she couldn't pay for treatment.
Like many Hispanic women in Oklahoma City, Garcia turned to an Oklahoma City-based outreach center for help.
Through the Latino Community Development Agency, she was able to get her first mammogram. After being referred to a doctor at their free women's health clinic, she was diagnosed with breast cancer in 2005.
If not for the agency, Garcia said the cancer would have gone undetected and she might not be alive eight years later.
“Latino women always think about their families and about others who need help. If I can help someone, I do,” Garcia said. “I tell to all the ladies, ‘Come to the Latino agency, they will help you.'”
And many do.
Breast cancer survivor rates among Hispanic women in the Oklahoma City area have steadily increased since 1995, according to a study conducted by the OU Breast Institute.
Researchers and medical professionals attribute the consistent improvement to free prevention programs and health clinics like the ones offered by the Latino Community Development Agency. It has provided free screenings to women for 16 years.
Survival rates have not increased as significantly among other minority groups over the same time period.
“Other ethnic groups are not able to cover as many bases, and that's what makes this population unique,” said Dr. William Dooley, surgical oncologist at OU Medical Center. “Places like the Latino Agency offer so many avenues of support and make Hispanics more engaged throughout the process so that they start treatment and complete treatment.”
The Oklahoma City study reflects a greater national trend among Hispanic women.
Fewer Hispanic women have died from breast cancer over the last 20 years, with a nationwide decrease of about 2 percent, according to the National Cancer Institute.
Though the percent may seem small, statistically, it is a significant decrease, said Kathy Cronin of the National Cancer Institute.
Dooley believes the increasing survival rate in Oklahoma represents the measurable impact of Hispanics reaching out to other Hispanics in the community.
“We think this is related to the education and outreach effort to increase breast cancer awareness and screening and take some of the negative stigma out of treatment and demystify it for the Hispanic community,” he said.
Making treatment easier
Fear of doctors and the medical world often hinders many Hispanics from seeking help.
“Historically in minority populations most people know women who have died of the disease, but they don't know many women who have survived the disease,” Dooley said.
The language barrier poses another hurdle.
“It's very scary to communicate with the doctors for some women,” said Celia Hollis, coordinator of the Latino Agency's women's health programs.
Conversations between Hollis and women at the agency after doctor visits often go like this:
What did the doctor say?
What do you have?
I don't know. I didn't understand.
For this reason, the agency often sends translators to accompany women to their appointments.
“They don't know about the prescriptions, the treatment, the follow-ups, and in the system they often don't have anybody to help them, especially women who are not documented,” Hollis said.
For Garcia, finances and finding a suitable doctor stood between her and treatment.
Mammograms can cost about $200 for uninsured patients, Hollis said.
So Hollis helps women like Garcia schedule appointments and get coupons to pay for breast cancer screenings through Oklahoma CARES, a program sponsored by the Centers for Disease Control and Prevention for low-income, uninsured women under the age of 65.
“When I see other Latina ladies that have cancer, I say to them, ‘Don't worry about it. You are in good hands,'” Garcia said.
Garcia tells them she is a survivor, which doctors believe is exactly what they need to hear.
Grateful for mornings
After having surgery in 2005, Garcia lived in remission until the cancer came back in 2009, this time in her right breast.
The doctors told her it was Stage 3. Breast cancer has four stages, with the higher numbers being more advanced, according to the National Institutes of Health.
But surgery once again proved successful.
“Each morning, I say, “Thank you, God,' because I see the sun again,” Garcia said.
She relishes mornings spent in her garden, checking her fruit trees and watering her tomato plants.
When the unripe tomatoes become blushed and swollen in July, Garcia will make pico de gallo for her children and grandchildren.
She recently found three new lumps in her left breast, but she tries not to worry too much.
Hollis and the agency have already booked her an appointment for June 28.
Garcia said the help of the agency has been lifesaving.
“If I do not come here, where could I go? This is the place they support me,” Garcia said.