[00:00:00] Adam Walker: From Susan G Komen, this is Real Pink, A podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Welcome to the Komen Health Equity Revolution podcast series. Each month we invite patients, community organizations, healthcare providers, researchers, and policy advocates to discuss strategies and solutions that drive the health equity revolution forward for multiple populations experiencing breast health inequities.
[00:00:36] Breast cancer is the most commonly diagnosed cancer among Asian American, native Hawaiian, and Pacific Islander women. But far too often, cultural stigma, language barriers, and a lack of tailored education prevent early detection and timely care. To celebrate AANHPI month, we’re joined by Dr. Judy Wang, a national leader in cancer prevention and behavioral science at the Georgetown Lombardi Comprehensive Cancer Center.
[00:01:05] Dr. Wang unpacks how breast cancer uniquely affects AANHPI communities and why culturally responsive communication is critical in closing gaps in education, screening and survivorship. She also shares how providers, advocates, and researchers can better meet AANHPI women, where they are with humility, trust, and cultural understanding.
[00:01:29] Dr. Wang, welcome to the show.
[00:01:32] Dr Judy Huei-yu Wang: Oh, thank you so much for your kind introduction, and thank you for inviting me. I’m very honored and excited to join you.
[00:01:39] Adam Walker: I’m, I’m happy to talk to you, uh, and I really appreciate you, you bringing your expertise to the table to talk about for this month. Um, so start by telling us a little bit about your background.
[00:01:49] What drew you to focus your research on cancer cancer prevention in the AANHPI community?
[00:01:56] Dr Judy Huei-yu Wang: Okay, uh, first introduce myself. I grew up in Taiwan and came to the US for graduate studies to explore like a cultural impact on human development. So having been educated and immersed in both Asian and American cultures, I have observed that, uh, Asian people are guided by a different cultural philosophy, like
[00:02:20] distinct like beliefs and attitude for healthcare compared to the mainstream population here. So it is worth noting that over 70% of Asian Americans are immigrants. So who often like strongly maintain their cultural practices. Cancer is the field that delineates various factors to human development. So therefore, I decided to focus on cancer prevention and control research in my career.
[00:02:48] Yeah, I, uh, uh, greatly appreciate Susan G Komen for the cure to promote, like breast cancer prevention. My first grant was sponsored by the Komen Foundation, national Risk for the Cure Funds, when they have like running the 5K, like walking in the national capital area.
[00:03:08] Adam Walker: Oh, love that. Oh, that’s so great. Uh, I did, I did not realize that.
[00:03:13] It’s so great. I’m so happy to hear that. Okay.
[00:03:16] Dr Judy Huei-yu Wang: Uh, one of the motivation for me.
[00:03:18] Adam Walker: Mm-hmm. Yeah. That’s great. Um, so we know breast cancer is most commonly diagnosed cancer among AANHPI women. Um, what do people often miss when we talk about how it affects this group?
[00:03:34] Dr Judy Huei-yu Wang: Yeah, this is a very good question.
[00:03:36] So national reports like, uh, show that Asian Americans or AANHPI have the lowest like breast cancer mortality race than other racial and ethnic groups, and which has a that to their breast cancer risk overlooked. Yeah. For example, like a participant in my previous research shared that when they first told their physicians that they ha, uh, felt their breasts were abnormal and their physicians saw all that will not be likely they were too young to have breast cancer just because they, they are Asian Americans.
[00:04:13] Yeah. And also, like AANHPI are often not seeing as like experiencing like a disparate breast cancer outcomes. However, large studies show that they have the poorest health status, including like low quality communication with providers, and there’s access to quality care compared to other racial and ethnic groups.
[00:04:37] Yeah. And furthermore, there like a breast cancer incidence rates have been steadily, like a rising over time. And according to the American Cancer Society, 2024 to 2025 to reports AANHPI shows like a steeper like increase in breast cancer than other racial and ethnic groups. Yeah, and AANHPI actually have a higher breast cancer incidence rate than Hispanic women.
[00:05:08] Adam Walker: I did not realize a lot of those stats. Wow. Okay.
[00:05:11] Dr Judy Huei-yu Wang: Yeah. And also I would like to mention the majority of the Asian Americans are immigrants, so who have a fewer, like a culturally and in particularly like, uh, uh, appropriate educational and healthcare resources.
[00:05:25] Adam Walker: Mm-hmm.
[00:05:25] Dr Judy Huei-yu Wang: To understand like a breast cancer risk screening, treatment options, and the clinical recommendation for follow because Asian Americans are a small population.
[00:05:37] Accounting for like 6% of like US population and consists of like a diverse, like a cultural heritage and languages. So research and community resources are located to them, are very limited. For example, like in articles published in JAMA and reported that funding for, uh, in the AANHPI research has been less than 1%.
[00:06:07] So unlike like other racial and ethnic groups, cancer is a leading cause of deaths among Asian Americans, and breast cancer is the second leading cause of deaths among Asian American women. So Asian Americans are also like projected to, um, to be the fastest, like a growing minority in immigrant population in the US.
[00:06:31] So therefore, they should be included in research, health promotion, and agenda. They should also be promoted with more evidence-based educational program to enable, uh, active access to recommended healthcare services.
[00:06:46] Adam Walker: Yeah, yeah, that’s a great point. And, and you mentioned also kind of the, the cultural and the culture and systemic barriers, uh, that they deal with.
[00:06:55] Can you talk a little bit more about that when it comes to, you know, breast cancer screening and early detection?
[00:07:00] Dr Judy Huei-yu Wang: Hmm, yeah, that’s a also very good question. AANHPI have a strong beliefs in nature, so, and it’s, uh, the nature’s connection to the mind and body. So nature approaches are always preferred, such as like a self-care through like a healthy diet and regular exercise.
[00:07:22] So many of them believe that if they practice like a healthy lifestyles, their risk for cancer will be lower. Especially. Yeah. If they do not have a family history of, uh, breast cancer, they, they perceive they wouldn’t have a chance, uh, count, uh, contracting with cancer. And if they hear that Asian are less likely to be diagnosed with cancer or breast cancer, they will Less likely.
[00:07:49] Yeah. To obtain screenings regularly.
[00:07:52] Adam Walker: Right. Right. They don’t feel the need to go get screened. Right. Yeah. Yeah.
[00:07:56] Dr Judy Huei-yu Wang: So, however, like many may not know, like over 75% of breast cancer is hormone like related and is not inherited. Right? Yeah. This may explain why the, AANHPI, still have the lowest, like a mammography utilization rate compared to other racial and ethnic groups.
[00:08:16] Yeah. And so mammography is not a natural measure. Yeah. For them, they source that, uh, that exposure to radiation, uh, too much can increase their breast cancer risk.
[00:08:28] Adam Walker: Right.
[00:08:29] Dr Judy Huei-yu Wang: And, and, and the firm, like pressures apply through the mammography may cause like, unnecessary pain or even invisible harm. Yeah. So for them, they prefer other measures.
[00:08:41] Uh, instead of like a western radiation type of screening.
[00:08:46] Yeah.
[00:08:46] Adam Walker: Right, right. So you men, you mentioned kind of the, the, you know, nature taking care of themselves, sort of thinking it’s not an issue. Can you also talk about how language and family dynamics and generational values influence women’s willingness to seek or to talk about a diagnosis?
[00:09:01] Dr Judy Huei-yu Wang: Yeah, so for like, because language, like many of them are immigrant, right?
[00:09:06] So English is the second language, and if you want they to navigate the complicated healthcare system, that’s a challenge.
[00:09:16] and also like when they need to make the, the appointment for mammography. I think my previous participants say they call the free lines and the free lines need to take their some questions in English, they don’t have someone who can speak their language. Right. And they even, they answer their question, have their family support.
[00:09:35] They still need to be referred to another office, to another service and they need to make effort to call. And sometimes even waiting for the scheduling is taking already much longer time. And they have a family duties, they have their job and they sometimes they need to like have a different shift.
[00:09:54] Right.
[00:09:54] Adam Walker: Yeah.
[00:09:55] Dr Judy Huei-yu Wang: So that like create all like barriers for them, uh, to obtain even the low cost and free the mammography screening available in the county Yeah. Or in their local areas.
[00:10:08] Adam Walker: Yeah, I mean those are, that’s a lot of barriers and it, I think it’s barriers that a lot of us just don’t think about on, on a daily basis.
[00:10:13] I appreciate you, you bringing those up. Um, and, and speaking of that, I mean, I know you’ve worked around improving cancer communication tools. Like what does culturally responsive care look like in real terms?
[00:10:26] Dr Judy Huei-yu Wang: In the real terms? Uh, I would like to say like in clinical visits, if providers are aware of AANHPI’s cultural values.
[00:10:36] Such as that they are highly respect medical authorities, consider provider’s time and, uh, greatly value, uh, the provider’s recommendations. If their providers are willing to listen to their equation and concerns, understand their barriers, regardless of their English proficiencies, and taking all these like cultural factors into account to make their recommendations as well as explain why their recom, uh, recommend like those, like a treatment options or in screening modalities.
[00:11:11] I think the AANHPI will be motivated into comfort, uh, comfortably like, uh, communicate with their providers and such culturally competent care is responsive.
[00:11:23] Adam Walker: Yeah. Yeah. I mean, I, I, I, I think we’ve all seen, you know, the, or had the experience where the doctor’s rushed. Right? And that’s when we speak the same language as the doctor.
[00:11:32] And, and for people that don’t, it is gotta be even more difficult and make them not want to go see a doctor, which is kind of a major issue here. Right?
[00:11:42] Dr Judy Huei-yu Wang: Uh, yeah, because I think they, they consider provider time. Like in my research I found like a Chinese, uh, uh, American, uh, breast cancer survivor always say, oh, physician are very busy.
[00:11:54] I don’t want to ask too many questions. I think they kind of running in and out. Yeah. I haven’t heard my, uh, why, like a breast cancer survivor say so. No. They just say, I need to ask my question. Yeah, yeah, yeah. I have the right to get my care.
[00:12:09] Adam Walker: Yeah. They’ll, they’ll demand the time of the physician versus the Asian American that might, that might not wanna take up the time of the physician.
[00:12:16] And that’s something I think that physicians certainly need to be aware of. Right?
[00:12:19] Dr Judy Huei-yu Wang: And they wouldn’t like to challenge physicians when they ask physician about their symptoms and physicians say, I haven’t seen this symptoms and Asian women will just stop there. But I think the, uh, the con compared to non-Hispanic white women, they are more auto autonomous communication.
[00:12:39] They’ll ask more question and follow up with the physicians.
[00:12:43] Adam Walker: Mm-hmm. I got it. Yeah. That’s, that’s, yeah, that’s very helpful. And, and I think, again, something we don’t often think about if we’re not experiencing those things. Um, can talk a little bit about, you’ve kind of alluded this. Talk a little bit about how healthcare providers, researchers, or even large organizations like Komen can do better
[00:13:01] when it comes to engaging AANHPI communities? May maybe, maybe the better way to question is like, what’s the best way healthcare providers, researchers, or large organizations can engage AANHPI patients?
[00:13:14] Dr Judy Huei-yu Wang: Uh, I think like Komen has, uh, has been very supportive. Like they sponsored my research and also to develop the first, like a culturally appropriate Chinese mammography screening, uh, video.
[00:13:26] And then my community partner in California received Komen founding in the previous, uh, several years ago to use the video to educate immigrant Chinese women in the community about the importance of early
[00:13:41] detection of breast cancer. So if we can have more resources like to develop and test the evidence-based, culturally appropriate programs that can extend the, uh, community, this community work, like in co collaboration with clinical practice, like integrate in, uh, connecting the community like, uh, education with the, uh, primary care network such as
[00:14:06] that using to understand how to implement the evidence-based program to broadly reach out to like AANHPI and engage them in breast cancer patients. I think that will be very helpful.
[00:14:18] Adam Walker: Yeah, absolutely. What, uh, what, what gives you hope in this work? I mean, do, do you see any promising programs or any findings or any trends that are showing that there’s progress being made?
[00:14:30] Dr Judy Huei-yu Wang: Oh, I would, I would need to say like breast cancer patients and lay women who participated in my research projects have substantially like encouraged my work. So they share their symptom experiences and emotional distress, um, which make me like realize that they face like many social, cultural, physical, cognitive, psychological, and financial challenges.
[00:14:54] So they desperately like, look for macers to help them like, cope with these challenges. And therefore, my research, uh, our research findings are essential to guide them to apply for evidence based practice to overcome challenges and have a better quality of life. So for breast cancer screening, I found a culturally appropriate video is superior to generic material to immigrants like Chinese women.
[00:15:22] In my previous like intervention trials, we have like over 450 Chinese immigrant women out like 950 participants to obtain a mammogram. And those like Chinese women haven’t had the mammography screening for over two years. We found seven out of them were diagnosed with breast cancer. So early detection education is very important.
[00:15:46] And moreover, there are even fewer like intervention program developed for AANHPI women with breast cancer. So I’m examining like integrative care approaches, such as like a self acupuncture and dietary measure, uh, for symptom management among breast cancer survivors. So pilot testing of, uh, self acupuncture, like shows like a, like a promising effects.
[00:16:12] So currently my colleagues and I, uh, my colleagues and I, uh, trying to like obtain resources to test the program in the larger trial, we hope like we will identify effective, like a program to alleviate their cancer related symptoms such as fatigue, sleep disturbance and cognitive problems, and eventually we can promote the quality of life outcomes.
[00:16:37] Yeah.
[00:16:37] Adam Walker: Yeah. That’s great. That’s great. Good. Uh, good work. Good work there.
[00:16:42] Dr Judy Huei-yu Wang: Hopefully.
[00:16:42] Adam Walker: What is, what is one thing you wish more people understood about breast cancer in the AANHPI community?
[00:16:51] Dr Judy Huei-yu Wang: So these groups suffer, like AANHPI’s suffers from breast cancer similarly to women in the other racial and ethnic groups.
[00:17:01] Adam Walker: Hmm.
[00:17:01] Dr Judy Huei-yu Wang: They experience like a similar symptoms, uh, or even more symptoms like my study show that Chinese like, uh, breast cancer patients experience like a fatigue and join the promise more often than white survivors. So, although they are not like a many intervention program developed for this group, uh, they attempt to help themselves through like a dietary mixers,
[00:17:25] or other integrative approaches, uh, such as, uh, meditation for stress reduction in the use of Chinese, uh, traditional Chinese medicine. These approaches are deeply, like alluded in their culture. So it’s unknown whether these measures, uh, reduce their risk, uh, for mortality. So we, we will need more research to better understand their coping strategies and whether this distress is well managed or under-reported.
[00:17:55] And what factors contribute to their lower risk of breast cancer mortality than other groups to inform like a breast cancer survivorship.
[00:18:04] Adam Walker: Hmm. Gotcha. Okay. Uh, and last question. Um, for listeners who want to be better advocates, which I hope is all listeners for this episode, uh, whether they’re survivors, caregivers, clinicians, or allies, what’s one step they can take today?
[00:18:22] Dr Judy Huei-yu Wang: So I sincerely appreciate this opportunity to talk about breast cancer in AANHPI population. Uh, I think many like a breast cancer survivor, caregiver providers, organizations like home and health been dedicated to support breast cancer research. Currently, they are, uh, far fewer research resources compared to previous years.
[00:18:44] So I keep advocating the crucial role of research in combating
[00:18:50] like breast cancer and by continuously understanding like breast cancer through different like racial ethnic population..
[00:18:57] Adam Walker: Mm-hmm.
[00:18:58] Dr Judy Huei-yu Wang: And identifying effective, like screening modalities, treat options in survivorship care. Like, and altogether we can mix and progress and ultimately yeah. Win the war with breast cancer.
[00:19:11] So thank you so much.
[00:19:12] Adam Walker: Yeah. That’s why we’re, that’s why we’re here. That’s why we do what we do. I love the work that you’re doing. Thank you for doing that work. It’s important work, and thank you for sharing it with us on the show today.
[00:19:24] Dr Judy Huei-yu Wang: Yeah, it’s my great pleasure, thank you so much. Yeah.
[00:19:27] Adam Walker: And thank you for joining us for another episode of the Komen Health Equity Revolution podcast series.
[00:19:33] We will continue to galvanize the breast cancer community to support multiple populations experiencing breast health, inequities, and advance and achieve breast health equity for all. To learn more about breast health equity at Komen, please visit komen.org/health equity. And to learn more about resources and support, please call our Komen Patient Care Center at 1 8 7 7 4 6 5 6 6 3 6, or email helpline@komen.org to get started today.
[00:20:10] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit real pink.komen.org. And for more on breast cancer, visit komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam. You can find me on Twitter at AJ Walker or on my blog adam j walker.com.