Live and learn: Cancer in the Hmong Community forum


Nearly 50 community members and health care professionals gathered to learn and discuss cancer and the Hmong community.

The Hmong American Partnership event sponsors and partners included Orange County Asian and Pacific Islander Community Alliance, American Cancer Society and Minnesota Department of Public Health, SAGE Screening Program. This engaging event is but a beginning in HAP’s quest to provide the Hmong community information on prevention, early detection, screening and treatment of cancer.

Next steps in HAP’s efforts include hosting a second community forum in August and creating a task force on cancer in the Hmong community.

Hmong American Partnership is working with American Cancer Society and the SAGE Screening Program to provide education and encourage women to get breast exams. According to Lee Yang, HAP Learn & Live Program Supervisor, two key messages they are sharing with the community are that breast screenings will find cancer, and that early detection can save lives.

Learn and Live’s efforts to educate the community with accurate information around the causes of cancer, risk factors as well as diagnosis and treatment options is accomplished through community education sessions. They are held at elder centers, adult learning centers, schools, universities, and community agencies, and also by hosting community forums, health events and media.

Learn & Live will also have two train-the-trainer cohorts. They will consist of 10 multi-generational families.

Each family will have four family members with one of the family member being a male. The 10 families will be learn about breast cancer, communicating the key messages about breast cancer screening, and encouraging women to complete breast screenings. The cohorts will then train other community members.

Information on breast cancer includes educating the community about the different types of breast screening and promoting its importance. Some of the key messages their project shares with community include:

  • Early detection can save lives
  • Breast cancer is not just genetic, if you are a woman, you cannot run from this disease, understanding what breast cancer is will help you be more aware of your own health
  • Learning to perform breast health exams can help improve early detection should there be a cancer diagnosis
  • Odds of detecting breast cancer early increases with annual screenings and mammography

According to Yang, one barrier Community Health Workers face when conducting community education sessions is working through the negative attitudes some elders have toward breast cancer and screening. Some of elders do not believe in western medicine and preventive messages and do not believe breast screenings should occur unless they are sick or it is visible they may have cancer.

Many shared they do not trust American doctors and some feel doctors create cancer. Some stated if they have cancer they will die anyways, therefore there is no point to having preventive care.

“Our CHWs addressed all concerns that were raised by the elders and focused on the message that preventive care can save lives,” Yang said. “For example, the CHWs shared the survival rates of the different stages of cancer to address the elders’ concern regarding cancer leading to death. Also, the CHWs addressed the mistrust of doctors by discussing client rights and the professional oaths that doctors take in order to practice medicine.”

Yang acknowledged many negative messages and myths around breast cancer exist in the Hmong community. Undeterred by these negative opinions and myths, workers use this as a way to measure community beliefs around cancer and provide them with accurate information.

She said the information CHWs have been provided by SAGE and American Cancer Society has aided their ability to address difficult questions and negative attitudes toward breast cancer education.

Another barrier CHWs face is getting women to complete intake for navigation services. After conducting community outreach sessions, CHWs conducted follow-up phone calls to women who originally expressed interest in completing breast screenings.

Many stated they were no longer interested in scheduling a breast screening appointment sharing they had discussed it with family members and decided an appointment was no longer needed. Some shared they are not sick and there was no breast cancer in their family history and therefore an appointment was not necessary.

One way they are addressing these challenges to ensure culturally sensitive messages are readily available to help women understand the importance of breast cancer screenings. They also acknowledged they need to educate the whole family and not just the women.

Three St. Paul residents and Learn & Live program participants agreed to respond to some questions around cancer.

Khou Vang, 50, works full-time and has health insurance, but qualified for a free mammogram through the SAGE program. The mammogram screening completed with the Learn & Live Program was her first mammogram.

Hope Thao, 61, has no health insurance and cares for her husband, who is a stroke survivor. She completed a free mammography through the SAGE program, it was her first mammogram.

Char Thao, 63, works full time and has health insurance, but qualified for a free mammogram through the SAGE program. Char had previously completed mammogram screenings, but wanted to be part of Learn & Live.

Learn & Live Community Health Worker connected Char to the SAGE program and attended her mammogram appointment with her.

Khou Vang expressed that back home in Laos and Thailand there had to be cancer as many villagers would get sick and they did not know what was wrong with them. There were no doctors to determine the illness, they relied on Shamanism. When someone was ill they would call for the Shaman to do a ritual called “hu plig” or spirit calling. The ritual was performed because they believed the person who was ill had their spirit was taken away by a bad spirit. The ceremony was performed in trying to retrieve the spirit back.

According to Khou there were no beliefs back home around cancer as they did not know what it was. If someone was ill with something that could not be identified they simply believed it was caused by such a thing as a dragon spirit. They relied on the Shaman to help them cure the illness and disease.

Some key messages she feels must be shared with older Hmong women in the community such as herself is that the community ought not be afraid of their doctors. She recommends getting the necessary screenings and check-ups, because you must trust your doctor to do their job. She happily noted that the main purpose for being a part of Learn and Live is so she can live long and continue to enjoy her children and family.

Hope Thao and Char Thao noted that back home there was no cancer. Cancer was known as tumors and people did not die from it. Herbal medicine, spiritual healing and shamans were used to cure the tumors. Many Hmong people still practice spiritual healing to treat cancer in the United States.

They stated some common beliefs that some community members have around cancer are that they might have been caught by the evil spirits (Raug dab), spirit of the sky (dab ntuj), dragon catch (dab zaj), Lost spirit (Poob Nplig), maybe the guarding spirit had wondered away and have been reborn to new human being, or the ancestors are looking for help or food support from family member (puj yawm yuav noj yuav haus).

Learn & Live provides community education and client navigation services. Through community education sessions, program staff provides breast health education and breast cancer awareness. Community Health Workers (CHWs) provide services to assist with breast screenings appointment. CHWs will schedule appointment, attend appointments, provide transportation, help with language and provide support during and after the appointment.

For more information on Learn and Live contact Lee Yang: 651-495-1552