‘Yo no senti ningun bulto’: New Delaware report highlights declining cancer rates and the need for early detection

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“Ámense [ustedes] mismos, ponganse primero, valoren la vida. Yo creo que no es tanto la enfermedad, sino cómo estamos viviendo el día a día…”

“Love yourself, put yourself first, value life. I believe that it is not so much the disease, but how we are living [the] day to day…”

That’s Katherina Sotelo, a breast cancer survivor from Newark, Delaware, who faced a life-threatening diagnosis that completely changed her life. Her journey, though deeply personal, reflects a shared reality for countless individuals who experience cancer’s profound impact. It illustrates both the hardships and resilience that shape so many lives touched by this disease.

Delaware’s Division of Public Health recently released its latest report on Cancer Incidence and Mortality, covering the years 2017 to 2021, which shows a decline in overall cancer rates. Despite that improvement, the report also highlights persistent disparities and identifies the cancers that continue to have the most significant impact on Delawareans.

“We’re glad to see that the numbers are slowly coming down. Back in the 90s, Delaware was ranked No. 2 in the nation. And now, as of this report, for periods of 2017 to 2021, we’re now ranked 16th,” said Dawn Hollinger, chief of the Bureau of Cancer Prevention and Control at DPH. “Others will prefer it moved a little faster in that lower direction, but, you know, we are making progress.”

According to the report, the top four cancers in Delaware for both incidence and mortality are female breast, prostate, lung and bronchus, and colorectal, mirroring national trends with slight rate variations. Female breast cancer made up 17% of all new cases, prostate cancer 16%, and lung and bronchus cancer 14%.

The report highlights that, despite overall progress, significant disparities still impact communities of color.

“When we look by racial groups, we do see non-Hispanic Black women are more affected by breast cancer than compared to other races. We also see non-Hispanic Black men are more affected by prostate cancer than compared to other racial groups,” said Sumitha Nagarajan, cancer epidemiologist with DPH.

In 2018, Katherina Sotelo was diagnosed with stage two breast cancer. For four years, she felt fine and genuinely believed she was in good health after routinely self-checking and finding no signs or lumps. However, after four years without a formal screening, she decided to undergo a test and soon received a call confirming she was in stage two of breast cancer.

“Yo no sentí ningún bulto. En realidad fue un chequeo que uno se hace en los senos y ahí detectaron, encontraron algo, vieron algo, hicieron la biopsia y era cáncer de seno en etapa 2,” ella dijo. “Las mujeres nos tenemos que hacer un chequeo cada año y yo dejé de hacerme el chequeo por cuatro años. Las mujeres siempre se tienen que estar tocándose [los senos] para saber si se siente algo. Yo no tenía nada, yo no me sentía nada y después de cuatro años me volví a hacer mi chequeo y ahí es donde encontraron que había que había algo.”

“I didn’t feel any lump. In reality, it was a checkup that one does on the breasts and there they detected, found something, they saw something, they did the biopsy and it was stage two breast cancer,” she said. “Women have to get a checkup every year and I stopped getting a checkup for four years. Women always have to touch [their breasts] to know if they feel something. I had nothing, I didn’t feel anything and after four years I had my checkup again and that’s where they found that there was something.”

Even though rates of breast cancer have remained steady, Soweto says many avoid screenings due to fear of bad news or the assumption that feeling well means they’re healthy. Being Latina, she pointed out that the lack of language support can also be a barrier and emphasized the importance of accessing available resources and support.

“Yo pienso que es más falta de información que otra cosa porque la ayuda está siempre, la ayuda está,” ella dijo. 

“I think it’s more of a lack of information than anything else because help is always there, help is there,” she said.

After receiving support from Christiana Hospital in Newark, including taking part in various programs and resources for cancer patients, and undergoing chemotherapy and radiation, Sotelo has now been cancer-free for six years. She encourages everyone to love their bodies and prioritize regular checkups.

Health officials point to programs like Screening for Life as having helped reduce cancer rates.  Since 1997, the program has provided eligible Delawareans with free access to essential cancer screenings. Through this program, qualifying individuals can receive mammograms, Pap and HPV tests, as well as screenings for prostate, colorectal and lung cancers when recommended by a doctor.

Just last year, the program saw a 13% increase in enrollment, marking its highest enrollment in six years.

“The Screening for Life program has been highly effective at connecting individuals who otherwise would not have access to routine cancer screening. Through its sister program, the Healthcare Connection, we’re also able to take those same individuals and connect them to a health home, where they receive access to Specialty medical services at a reduced rate based on income levels,” Hollinger said.

“[Do] not be intimidated by the test,” she added. “Some of these cancer screenings just take a few minutes to complete, but it could give you a lifetime of answers.”

Another comprehensive report is scheduled for publication in January 2025, detailing the clusters of various types of cancers, including breast, lung and colorectal cancers, across each county to provide a deeper understanding of their prevalence.