For UC Irvine alumnus, Tin Tran, MPH ’22, receiving a cancer diagnosis at 28 years old has understandably altered his entire life plan. Prior to being diagnosed with a rare type of blood and bone cancer, acute promyelocytic leukemia (APL), ironically, he was planning to go to medical school to become an oncologist. He had spent the larger part of his adult years preparing for a career in medicine. He completed a bachelor’s degree from UCLA in biochemistry followed by a Master of Public Health degree (emphasis in epidemiology) from UC Irvine to gain a perspective on whole-person care for his future patients.
“A key theme that stood out to me during my MPH candidacy was how powerful a health equity lens can be for public health solutions,” says Tran. “Health equity is woven into UCI Public Health’s mission and vision, and that made an impression on me.”
For the time being, Tran has halted plans to pursue a medical degree and is instead concentrating on living in the moment instead of for the future. “I realized how limited our time on earth is, and that I didn’t need that accomplishment to be happy,” he said. “There’s a lot more I can do at the community level. There’s the saying that people won’t remember what I did, but how I made them feel.”
Tran’s cancer journey began in December of 2022 when he noticed abnormal bruising and bleeding. Given his background in public health and cancer research, he knew something was off. At that time, he was in a transition phase of employment. He had been working in a cancer-prevention research lab and was in the process of being hired, so he was temporarily covered by Medi-Cal, California’s no-cost or low-cost health insurance, at the time of diagnosis.
“At the most stressful point in my life, I was struggling to get an appointment and then finally being seen by a practitioner that probably had dozens of patients to see that day,” said Tran. “I had to push for a thorough exam and a full blood panel because if I didn’t demand those tests, I wouldn’t have been evaluated to the point I needed to be.”
It turns out Tran’s intuition was spot on. Three days after that initial appointment and before he was even able to have the community clinic run their pathology tests, he was in the Emergency Department at a larger hospital near his residence having his blood panel taken. Within a few hours, he was told that he had leukemia.
A key theme that stood out to me during my MPH candidacy was how powerful a health equity lens can be for public health solutions. Health equity is woven into UCI Public Health’s mission and vision, and that made an impression on me.”
– Tin Tran, MPH ’22
Cancer prevention and screening inequities
Routine cancer screenings are a critical component of preventative care as they can help find cancer at an early stage before symptoms appear, which will make cancer easier to treat or cure. But electronic health records data from the past few years are showing troubling signs.
At the start of the pandemic, there was a 94% decrease in both breast cancer screenings and cervical cancer screenings and an 86% decrease in colon cancer screenings. While cancer screening rates rebounded in 2021 from early pandemic lows, experts suggest that it will take years to fully understand the impact of missed screenings, especially for cancers with longer recommended intervals between screenings.
“I think about the individuals who didn’t know what to look for, ignored their symptoms due to work obligations, and didn’t seek treatment because they didn’t have insurance,” said Tran. “You have immigrants who are working two jobs to feed themselves and their families while dealing with a pandemic– where is the time to go to the doctors?”
For those who do act and seek out screening tests, they may still face additional barriers. Several studies have indicated that physicians may sort patients by their insurance status, serving patients with public insurance differently than other patients. Additional evidence lies in the fact that some physicians are not willing to accept Medicaid patients because of the low reimbursement rates.
“The healthcare system is fundamentally flawed where I found myself not just battling my cancer, but I was also concerned about how my insurance status would affect my care,” said Tran. “There is a sense of urgency in private insurance that is missing from public insurance, and it sadly costs lives. People shouldn’t be condemned to a worse outcome due to their insurance, but the quality of care is completely out of their control.”
Road to treatment and remission
Tran is one of the fortunate ones who was able to identify APL before it progressed. The cure rate for APL is more than 90% if treatment is initiated right away. He was able to secure a gold PPO plan and started chemotherapy immediately after his diagnosis. The treatment consists of him traveling to several City of Hope sites in Irvine and Newport Beach, Monday through Friday for several hours of chemotherapy. He does this for four consecutive weeks followed by a 4-week break; Tran is hoping that he only has to complete four rounds of this regimen.
For the moment, Tran’s outlook is good but his journey to get to this point has been hard.
“I do worry that even the slightest delay in my care could possibly lead to a poor outcome. I don’t feel out of the woods just yet,” he said. “I’ve concluded that if you want the best outcome for yourself, early detection and prevention are lifesaving.”
The fact that early detection can save lives rings true, especially in Orange County where the risk factor for cancer is exceptionally higher in Hispanics, Asians, and African Americans who experience delays in timely mammograms, pap tests, and colorectal exams.
Tran believes a lot of our healthcare problems stem from a lack of awareness around routine cancer screenings by the public and barriers to accessing care. “My education and experiences in healthcare equipped me with the tools to advocate for myself, but for many in my community that is not the case,” he observed. “I hope my cancer journey can serve as a reminder to our community to get their annual check-ups, talk with their providers about available screenings, and empower them to be their own advocate.”
For now, Tran is taking a break to focus on his recovery. He is in remission, but cancer survivorship will be a new journey to embark on. He hopes for a long-lasting remission and that in the future he will be deemed “cured.” Future plans entail working for his family business, and he looks forward to being able to work for himself and be around family.
“I’m very fortunate to now have time to be with family and support our family business,” said Tran. “Life doesn’t stop here, and I’m going to keep on living my life.”
