Thinking Prevention

Isabel of Maryland cried as she described the diagnosis of juvenile diabetes her 4-year-old daughter had just received. She wanted to know what caused this disease. And two callers, including Socorro in California, were awarded rousing "applause," a sound effect that Huerta plays on a digital sound board. Socorro said she is 39, has a 12-year-old child and is ready to have her intrauterine device removed so she can have a second child next year. "¿Doctor," she asked, "qué debo de hacer para preparar" for pregnancy? ("Doctor, what do I need to do to prepare?")

"¡Aplausos, aplausos para Socorro y su excelente pregunta!" Huerta said. ("Applause, applause for Socorro and her excellent question!") His advice: See an obstetrician as soon as possible; eat a healthful diet that includes lots of fruit and vegetables; walk or exercise at least 30 minutes a day; and take 400 micrograms of folic acid daily.

"Y ahora necesitas insistir que tu esposo se ponga a trabajar bien duro," he said with a laugh, as if he were speaking with a friend or relative. ("And now you need to insist that your husband work very hard.")

Broadcasting Prevention

Huerta, 55, doesn't diagnose over the air, but he advises, reassures and comforts. Most important, he promotes good health practices in simple language: Don't smoke. Try to get a job that offers health insurance. Get a primary care doctor. Cancer in its earliest stage is silent, so get an annual checkup. Don't be afraid to ask questions. Most folkloric remedies are fine, but don't forsake traditional medicine.

"He explains things in a way that really gets to people," said Eduardo Armenta, a College Park pediatrician, "especially those not well educated in the medical field."

Armenta, who listens to "Cita Con el Doctor" three or four times a week, calls Huerta's media campaign "one of the best things" that has happened in terms of preventive medicine in the Latino immigrant community. "He urges people to see doctors ahead of time, before disease gets to the point of no return," Armenta said.

Since 1994, the Cancer Preventorium has seen almost 15,400 women and 6,000 men, and a recent survey of patients showed that 70 percent found the clinic after hearing Huerta on either radio or television, said Washington Hospital Center spokeswoman So Young Pak.

Lawrence Lessin, former medical director of the cancer institute, said Huerta's proposal to promote cancer prevention among the area's growing Spanish-speaking community met stiff opposition in 1994 from some Washington Hospital Center administrators. Nonetheless, Lessin hired him to open the clinic.

"There was a concern about getting a lot of uninsured people to the hospital and then diagnosing a cancer and being obligated to take care of it," Lessin said. "But that's never really been the case, because Elmer developed relationships with other physicians who were willing to take care of these patients every time he detected cancer or other disease."

Huerta's two requisites for taking patients are that they have no apparent symptoms and that they pay upfront. In 1994, the fee for an initial exam was $55. Today it costs $120 for a physical, blood work, consultation and a Pap test for women or a prostate-specific antigen (PSA) test for men. If patients have health insurance (only about 30 percent do), they file their own claims.

Huerta's female patients outnumber males by three to one, and the women remain his priority. American Cancer Society data show that breast cancer is the most commonly diagnosed cancer among Latino women. The five-year survival rate of Latinas is only 83 percent , compared with 87.5 percent for white women.

"Why?" Huerta asks. "They tend to have no insurance, they're fatalistic, they're poorer, they're linguistically isolated and there are few centers that are culturally sensitive."