Sandra Morales: Helping Latina Women with Cancer by Overcoming the Language Barriers

In 2008, Sandra Morales felt a very uncomfortable sensation in her left breast. But as a 38-year-old woman with no known breast cancer risk factors, she was told that there were no mammograms recommended for women under 40. Two years later, Sandra felt something again in her left breast, and this time, she was able to schedule an appointment for a mammogram.

“I literally did have my first mammogram the day of my birthday,” Sandra remembered. The test found a suspicious mass in her left breast, which led to a biopsy and ultimately to the diagnosis of stage III breast cancer in May 2010. Sandra’s doctor told her that she had an aggressive form of cancer and recommended that she should have a mastectomy as soon as possible. The news took Sandra through an emotional roller coaster.

“It was the worst experience of my life. When you hear the word ‘cancer,’ you associate it with death, right away,” she said. “I just wanted to cry. I thought I wasn’t smart enough to listen to my body. I thought maybe I did not have the right doctor or the right attitude. But I remembered my daughter and thought, if I break down, she’s going to break, too. And a mother’s instinct came over me. I felt OK and I asked my doctor, ‘So, what is the next step?’”

Sandra went to see an oncologist for a second opinion. After additional screening and genetic tests that confirmed her cancer, she started her chemotherapy. Even though her oncologist spoke some Spanish, it was Sandra’s husband who helped translate complex medical terminology for her. Sandra’s experience and interaction with the health care and insurance systems got her thinking about other women who do not have someone helping them understand their disease, the treatment options and side effects, and how to navigate the financial aspects of cancer care.

“It’s very complicated to understand how insurance works, or if you have the right insurance, or why you have so many copayments, or the financial stress you feel over having to choose between going to your treatment or going to work,” Sandra said. “I know a lot of Latina women who have been diagnosed but they are the breadwinners of their families. If they go for their treatment, they don’t work enough hours to have their insurance. And if they don’t keep on paying the rent, how can they continue living? It’s very hard.”

Cancer treatments and the financial burden of her disease were not the only stresses Sandra faced. She was also grappling with cultural barriers and perceptions about a cancer diagnosis that are all too common in her community. She only told her sister and an aunt to whom she was particularly close.

“She said to me, ‘I don’t understand why this is happening to you. You are such a good person. What did you do that was so wrong that you got cancer?’” Sandra recalled of her aunt’s reaction. “And I know that she didn’t mean anything bad, I know she loves me, but it was a real concern she had.”

It took her some time to realize that illness is a part of life. Through her experience, Sandra has become an impassioned voice for those diagnosed with cancer, especially those who face language, financial, cultural, and other structural barriers in accessing the health care they need.

She has become a certified clinical interpreter, explaining to patients—step by step —the type of cancer they have, their treatment options, and their health insurance. In the six years that she has been helping patients, she has now developed contacts within the clinical system, as well as within the community, to get patients the care they need, whether it’s changing an appointment so their treatment plan can start sooner or connecting patients with support groups who can provide transportation services or other assistance.

“I say this position is important for everybody, something that should be available in the hospital. Patients are very thrilled when they see that there is a patient navigator who is going to be involved in their care,” Sandra said. “I also visit policy makers and legislators and advocate for more funding for cancer research and cancer treatments, especially for the vulnerable individuals.”

Sandra is currently doing well. She sees her oncologist twice a year and is receiving hormone blocking therapy to prevent a recurrence. And she gets great satisfaction from her work and advocacy.

“I am very lucky to have the life I have now. And I never imagined that I would be helping other women going through the same illness I had,” she said. “I feel very fortunate. I am very happy that with my experience and my knowledge, now I can help other women overcome all the barriers they have to getting treatment.”

Her advice for people is to be proactive regarding their health; to go for annual checkups so if something is going on, it’s caught sooner; to get all the information they can; and “Don’t be a witness to your experience with cancer; play an active role.”