Language Barriers in Cancer Treatments
by Melody McBride
October 31, 2023
In our increasingly interconnected world, language barriers present significant challenges across various fields, particularly healthcare. The ability to communicate effectively is crucial for patients with limited English proficiency (LEP) in order for them to receive the best possible care. When it comes to cancer, a life-threatening disease with a wide range of symptoms, clear communication becomes even more critical.
This issue is of particular importance within Chinese populations for two main reasons. The Chinese language comprises over 300 different dialects, which can be completely incomprehensible if one does not speak that specific dialect. For example, while Mandarin and Cantonese share the same written language, they have distinct phonetics. Chinese people also constitute the largest Asian subgroup in the United States, with approximately 3.3 million Chinese Americans residing there. Additionally, one-third of Chinese households in the US face linguistic isolation.
As the child of a Chinese immigrant, I have witnessed my mother struggle to articulate her concerns to doctors. Although she learned English as a second language and became fluent after living in the US for many years, medical terminology presented a whole new realm of the English language. Familiarizing oneself with the names of medications or effectively describing symptoms proved challenging. Unfortunately, her frantic concerns were often dismissed by doctors as anxiety or depression, when in reality, there was something far more serious occurring.
My mother is not alone. LEP patients encounter greater difficulties when navigating the healthcare system. They are less likely to comply with necessary laboratory orders, such as blood tests, which are crucial for accurate diagnoses. Many of them spend additional time during doctor's appointments trying to express their concerns. Furthermore, Asian Americans consistently undergo cancer screenings at lower rates compared to other racial groups. All of these issues contribute to misdiagnoses, erosion of trust, and ultimately, inferior healthcare outcomes.
So, what are potential solutions? Bilingual doctors and trained translators can certainly help alleviate this issue to some extent. However, their effectiveness is limited. As mentioned earlier, Chinese has many unique dialects, so a doctor fluent in Mandarin may not be able to effectively communicate with someone who speaks Cantonese, for instance. Additionally, certain nuances can be lost in translation when relying solely on interpreters. Research has shown that between 23% and 52% of translated materials by interpreters contained misinterpretations or omitted important questions posed by doctors.
While these steps can mitigate the issue, resolving it at the political level is necessary to ensure the right to quality healthcare for everyone. The Diversifying Investigations Via Equitable Research Studies for Everyone (DIVERSE) Trials Act aims to include all demographics in cancer research trials. Medical costs, transportation, and other barriers already make it difficult for many patients to participate in these trials, and if information about trials is only available in English, patients with limited English proficiency (LEP) may not even be aware of their existence. When reintroduced, the DIVERSE Trials Act should place higher emphasis on distributing clinical trial information in multiple languages.
AAPI (Asian American and Pacific Islander) month plays a significant role in addressing these language barriers within the healthcare system. By sharing our diverse cultural experiences, engaging in advocacy efforts, and raising awareness, we can collectively strive towards achieving equitable healthcare for all individuals, regardless of the language they speak.
