Reaching the underserved through the media.(importance of media in disease prevention and health promotion)

NEW YORK -- When Elmer E. Huerta, M.D., left his oncology practice in Peru to come to the Washington, D.C., area in 1987, "I thought I was going to the heavens," he recalls.

In Peru, 85% of breast and cervical cancers are found at stage III or IV, he told physicians at a cancer symposium.

But when he arrived in the United States, Dr. Huerta found pockets of poverty and lack of access, where people were horribly underserved and where diagnosis of disease came much too late, just as it did in Peru. He treated women with breasts horribly swollen and disfigured by tumors, who hadn't sought care until their symptoms were overwhelming, and their cancers so far advanced that they were almost untreatable.

"I saw women who could not bring themselves to do breast self-exams, because their mothers and grandmothers told them never to touch their breasts," Dr. Huerta said at the symposium, which was sponsored by New York University and the Lynne Cohen Foundation for Ovarian Cancer Research.

Dr. Huerta realized that cultural barriers--as well as unfamiliarity with the health care system, a lack of insurance coverage, and linguistic isolation--were keeping many Hispanic men and women in the United States from seeking preventive health care.

Many would go to the doctor only when they were sick, which meant that diseases that could have been caught and treated early were being diagnosed in late, deadly stages.

"The challenge I faced was how to convince people to seek care when they had no symptoms," he said.