Of Viruses and Cancer

I came across an interesting story in New York Times yesterday. The story, “Human Papillomavirus, 1985,” describes Dr. Peyton Rous’ conjecture and eventual demonstration that viruses can cause cancer. He demonstrated this fact through his work with solid tumors in chickens back in 1914.

Seventy years later, scientists would still be trying to prove that viruses cause cancer in humans. In 1983, Dr. Harald zur Hausen, definitively connected infection with the human papillomavirus (HPV) with cervical cancer. Indeed, he discovered and made HPV16 and 18, the two strains most commonly associated with cervical cancer, available to the scientific community for vaccine development. More than two decades later (2006), a vaccine for HPV infection was approved for use in girls and young women ages 9 to 26 years of age. Given that 5% of all cancers worldwide are caused by HPV, the development and widespread use of the vaccine will eventually save tens of thousands of lives every year.

While most of us have never heard of Drs. Rous and zur Hausen, we clearly owe them a debt of gratitude. I’m happy to say that both received the Nobel Prize for their work.

Particularly among Vietnamese American women, cervical cancer rates are disproportionately high. In fact, rates of cervical cancer are several-fold higher among Vietnamese women, when compared to all other racial/ethnic groups. Efforts to educate and vaccinate the Vietnamese and other Asian American and Pacific Islander communities are warranted.

Interestingly, the article did not mention the other virus that causes cancer in humans: the hepatitis B virus (HBV). HBV infection is conclusively linked with liver cancer. Given the disproportionately high rates of HBV infection among Asian Americans, it is not surprising that liver cancer rates are much higher for Asian Americans, when compared to non-Hispanic whites. The 1982 development of a vaccine to prevent hepatitis B infection by Dr. Baruch Blumberg is another milestone in the history of cancer prevention, but perhaps that is a story for another time.

- Doug Hirano, MPH, APCA Executive Director

A Death in the APCA Family

It is with extreme sadness that I report the death of Ms. Shwuing Fu, publisher of the Asian American Times. She died this past weekend in a car accident. She was a good friend to APCA – generously finding space in her newspaper to report on our events and activities and donating fine art to our fundraiser silent auctions. She worked tirelessly to report community news throughout the various Asian American and Pacific Islander communities. She was both a good friend and good colleague. She will be sorely missed, but not forgotten.

- Doug Hirano, MPH, APCA Executive Director

World Hepatitis Day Proclamation

WORLD HEPATITIS DAY, 2011

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

Across our Nation, millions of Americans are living with viral hepatitis. As many as three-fourths of Americans living with the disease are unaware of their status and are not receiving care and treatment for their condition. Raising awareness about hepatitis is crucial to effectively fight stigmas, stem the tide of new infections, and ensure treatment reaches those who need it.

On World Hepatitis Day, we join with people across our country and around the globe in promoting strategies that will help save lives and prevent the spread of viral hepatitis.

Viral hepatitis is inflammation of the liver, and can cause a lifetime of health issues for people who contract it. Hepatitis B and C viruses are the cause of a growing number of new liver cancer cases and liver transplants. In the United States, hepatitis is a leading infectious cause of death, claiming the lives of thousands of Americans each year. While we have come far, work still needs to be done to prevent and treat this disease.

Viral hepatitis touches Americans of all backgrounds, but certain groups are at greater risk than others. Past recipients of donated blood, infants born to mothers infected with viral hepatitis, and persons with sexually transmitted diseases or behaviors such as injection-drug use have risks for viral hepatitis. Baby boomers and African Americans have higher rates than others of contracting hepatitis C. Half of all Americans living with hepatitis B today are of Asian American and Pacific Islander descent, and one-third of people living with HIV also have either hepatitis B or hepatitis C. Worldwide, one in twelve people is living with viral hepatitis.

We must make sure that this "silent epidemic" does not go unnoticed by health professionals or by communities across our country. Under the Affordable Care Act, services including hepatitis immunizations for adults and hepatitis screenings for pregnant women are fully covered by all new insurance plans. My Administration has also released a comprehensive Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The plan brings together expertise and tools across government to coordinate our fight against this deadly disease. Our goal is to reduce the number of new infections, increase status awareness among people with hepatitis, and eliminate the transmission of hepatitis B from mothers to their children.

The first step toward achieving these goals is raising public awareness of this life-threatening disease. We must work to reduce the stigma surrounding hepatitis, and to ensure that testing, information, counseling, and treatment are available to all who need it. The hard work and dedication of health-care professionals, researchers, and advocates will help bring us closer to this goal. On this day, we renew our support for those living with hepatitis, and for their families, friends, and communities who are working to create a brighter, healthier future.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim July 28, 2011, as World Hepatitis Day. I encourage citizens, Government agencies, nonprofit organizations, and communities across the Nation to join in activities that will increase awareness about hepatitis and what we can do to prevent it.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-seventh day of July, in the year of our Lord two thousand eleven, and of the Independence of the United States of America the two hundred and thirty-sixth.

BARACK OBAMA

- Doug Hirano, MPH, APCA Executive Director

What’s the big idea?

The Center for the Future of Arizona is looking for “big ideas”. In early April 2011, the Center invited communities across the state to develop proposals that describe how they could improve civic health in Arizona. The reason for this call for proposals was quite simple: Arizona ranks very low on virtually all indicators used to measure civic health. Here’s a sample of the available data:

• Arizona ranks 40th in the nation for voter registration and 43rd for voter turnout among eligible citizens.
  


• 37% of Arizonans say they do not follow the news or discuss the news regularly.
  


• Arizona ranks 48th in the nation for exchanging favors with neighbors regularly and 45th for eating dinner with family/household members almost every day.

In addition, a Gallup Poll found that only 10 percent of Arizonans believe that elected officials represent their interests, and only 10 percent rate the performance of elected officials as “very good.” Other areas of concern included quality jobs for all Arizonans, a competitive P-20 education system and a healthy environment – each of which cannot be achieved without the sense of connection that Arizonans feel to one another.


This project, known as the “Five Communities Project,” is looking for big ideas to address the state of civic health and engagement in Arizona. The Center received 96 letters of intent in response to its April call for proposals – one of which was submitted by APCA. Happily, APCA is one of 33 organizations to be named as a semi-finalist in this competition.


Ultimately, there will be just five communities selected to partner with the Center in developing a collaborative proposal that will be submitted to some of the nation’s most esteemed and influential foundations. The objective is to provide partner communities with the resources to implement their plans over a three-year funding period.

What is our “big idea”? Suffice it to say that we’re envisioning a more cohesive and engaged Asian American and Pacific Islander community in the greater Phoenix metropolitan area. I’ll provide greater detail on our “Thirdspace” initiative in a future blog entry. For now, we’re pleased to be named a semi-finalist and are hard at work on the next iteration of our proposal.

-Doug Hirano, MPH, APCA Executive Director

World Hepatitis Day

The World Health Organization has designated July 28th as World Hepatitis Day. However, we don’t have to look globally to find a crisis related to hepatitis B infection.

Data from the Arizona Department of Health Services indicate that Asian Americans have constituted 40% of all reported cases of chronic hepatitis B in Maricopa County over the past five years. Considering that Asian Americans constitute only 3% of the population, this is alarming.

Nationally, it is estimated that 1 in 12 Asian Americans is permanently infected with hepatitis B, a virus that attacks the liver. For all other Americans, the rate of chronic hepatitis B infection is just 1 in 1,000. Without medical monitoring and treatment, 25% of individuals with chronic hepatitis B infection will suffer and possibly die due to severe liver cirrhosis and/or liver cancer. The Centers for Disease Control and Prevention (CDC) estimates that 65% of all individuals infected with hepatitis B are unaware of their infection.

These data suggest that nationally there are more Asian Americans undiagnosed with hepatitis B than all Americans undiagnosed with HIV/AIDS. Compared to HIV/AIDS, very little attention is paid to the problem of chronic hepatitis B – particularly among Asian Americans. This is a shame given that a simple blood test can detect the infection and a vaccine exists to prevent infection. We need to continue to spread the word that all Asian Americans get tested and vaccinated for hepatitis B.

In recognition of World Hepatitis Day, we are hosting a free hepatitis B testing and education event at the Vietnamese Community Center, 2051 W. Warner Road, Suite 22, Chandler, from 9 am to 1 pm on Saturday, July 30th. Information will also be provided to help individuals without health insurance coverage to enroll in publicly funded health insurance programs or otherwise find affordable medical care. Further information is available from the Asian Pacific Community in Action at (602) 265-4598 or www.apcaaz.org.

Stroke Hits Home

My 82-year-old mother suffered a stroke last Monday. She passed out at a grocery store and was taken by ambulance to a local hospital (in San Jose). After the first few hours, her outlook was surprisingly good – verbally responsive and without any signs of paralysis. However, later in the day she began having trouble breathing, and her speech became slurred. Her CT scan indicated a large clot in the lower brain. Her chance of survival was now deemed to be 50%.

I had just spoken to her the day before, and all seemed fine. It was Father’s Day, and she was cheery and looking forward to dinner at my brother’s house. For an elderly woman, she was in relatively good health. She worked hard out in the yard, tending to her vegetables, shaping the shrubs, and keeping the weeds at bay.

Stroke is the 3rd leading cause of death in the United States – behind heart disease and cancer. Its warning signs tend to be slurred speech, trouble seeing in one or both eyes, confusion and/or severe headache – none of which my mother displayed before fainting at the grocery store. In fact, my dad, who was with her at the time, had to work hard to convince the EMTs to send an ambulance right away – perhaps because her symptom history did not match those of a typical stroke victim.

I also know that time is of the essence in treating a stroke victim. There is a short window by which intervention can effectively avert permanent brain damage or death. My dad’s ability to get an ambulance to the scene probably saved her life.

Asian Americans are not necessarily at increased risk for stroke; however, stroke is an equal opportunity debilitating condition. Risk factors include but are not limited to tobacco use, hypertension, overweight and obesity, and heart disease. More information is available through the Centers for Disease Control and Prevention.

I’m glad to say that my mom is making a remarkable recovery. Her speech is clear, she has a good appetite, and she’s strong enough to get out of the hospital bed on her own (against the nurses’ orders). Twenty years ago, her outcome may have been much different, but for all the complaints about high tech, low touch, overly expensive medicine, it can produce seeming miracles. The doctors used a catheter, guided by CT, to administer medication in the affected area of the brain and to clear the clot.

My mom is not out of the woods yet and has a few weeks of rehabilitation ahead of her, but she seems on the road to recovery. We’re thankful to the folks at Good Samaritan Hospital in San Jose for their rapid response and compassionate care.

- Doug Hirano, MPH, APCA Executive Director

A warm reception from our President

With approximately 200 Asian American and Pacific Islander colleagues, I had the pleasure of visiting the White House today in acknowledgment of Asian American and Pacific Islander Heritage. Here’s what my “thank you” note to the President will read:

"Thank you, Mr. President, for the opportunity to visit your stately home. Your hospitality in the form of your kind words and the hors d’oeuvres and beverages was most generous – particularly since you already had a lot on your plate, including an imminent national TV appearance about the war in Afghanistan.

While I didn’t get a chance to speak to you directly, I did have the chance to speak to one of your key health officials, Dr. Howard Koh – your Assistant Secretary for Health and Human Services (pictured). He was kind enough to say that he would look into my suggestion that the federal government support a hepatitis B testing day for Asian Americans. Considering that there is already an HIV/AIDS awareness day for Asian Americans, it would seem reasonable that attention be paid to the preponderance of chronic hepatitis B infection among this group as well.

I will be following up with Dr. Koh about this matter. I believe hepatitis B among Asian Americans needs to stay on the radar screen until something more is done. There are far more Asian Americans unknowingly infected with chronic hepatitis B than all Americans unknowingly infected with HIV/AIDS. We on the front lines in various communities throughout the nation fight the good fight to increase hepatitis B awareness among the general public, among Asian Americans and Pacific Islanders, and the medical community, but sometimes one is not a prophet in his or her own land. Hearing more from our federal officials about this preventable epidemic of liver disease due to hepatitis B is critical and essential. Action can prevent more death and disability due to hepatitis B.

Again, thank you for your cordiality, and I hope that you and your family stay well. Please feel free to come visit us in Arizona, and we would be happy to share some of our Asian American and Pacific Islander hospitality in return."

- Doug Hirano, MPH, APCA Executive Director