Juana Espino is a standout as project coordinator for the Houston PAP Project, which provides cervical cancer screenings at no cost to a nearly 100% Spanish-speaking population, most of whom struggle with access to health care. But it wasn’t that long ago that she learned that she had cervical cancer.
Cervical cancer diagnosis and treatment
In 2016, Espino was diagnosed with stage 1B2 cervical cancer by her obstetrician after giving birth to her third child. He referred her to Joseph A. Lucci III, MD, a gynecologic oncologist with UT Physicians, who saw her the same day and confirmed her cancer.
“Dr. Lucci explained my options and told me that a radical hysterectomy would be best for me, but also said that it was my decision. He asked me to go home, talk with my husband and family, and then call him,” Espino says. “I was worried about everything, especially my insurance, but the message he gave me was always, ‘Don’t worry. We’re here to help.’ He explained everything, drew pictures for me, and took time to make sure I understood. It gave me the peace I needed in my heart to make the right decision. I still thank God for putting him in my path.”
After her hysterectomy, Espino underwent six cycles of simultaneous chemotherapy and radiation. She completed her postsurgical treatment in September 2016.
Community involvement
At one posttreatment checkup, Lucci and a research assistant talked about an organization they were involved with, the Houston PAP Project, and asked if she was interested in volunteering. “I said ‘yes’ right away. I loved the idea of giving back to the community after my amazing experience,” Espino says. “It offered me an opportunity to share my story with other patients and give them hope. When you find something precious, you want everyone to know.”
The Houston PAP Project, a UTHealth Houston-sponsored program, provides free cervical cancer screenings one Saturday nearly every month at two clinics: UT Physicians Multispecialty Clinic–Jensen and UT Physicians Multispecialty Clinic–Rosenberg. Both clinics are recognized as a Patient-Centered Medical Home by the National Committee for Quality Assurance (NCQA) for using systematic, patient-centered, coordinated care that supports access, communication, and patient involvement. The acronym in the Houston PAP Project name has a double meaning. It refers to the cervical cancer screening Pap test and the project’s mission statement in Spanish: Prevenir, Ayudar, Poder (to prevent, help, and be able).
In addition to cervical cancer screening, the clinics provide follow-up testing and steer patients to treatment when cancer is found or suspected.
Finding purpose
After a year as a Houston PAP Project volunteer, Lucci asked Espino to join the team as a paid employee. Once again, her answer was a resounding “yes.”
“I never used to know my purpose in life. Then I went through my diagnosis and treatment, and I felt like it was for something,” Espino says. “Now I can help people, tell them there’s hope, and show them there are people who can help. That’s why I’m grateful to be part of the Houston PAP Project.”
In many ways, Espino is the heart of the project. “Having Juana working with our patients and sharing her own story gives them the courage to be screened and follow up on abnormal results,” said Lucci, a professor and director of the Division of Gynecologic Oncology with McGovern Medical School at UTHealth Houston. “Her work counseling our patients in their own language makes them feel at home and has translated to an almost 100% follow-up rate.”
In 2023, 250 women received no-cost cervical cancer screenings through the Houston PAP Project. Of those, 10 women learned they had high-grade precancer and were treated to prevent progression to cancer. The project is sponsored by the UTHealth Houston Department of Obstetrics, Gynecology and Reproductive Sciences, the medical school’s Healthcare Transformation Initiatives Team, private philanthropy, and Susan’s Rally.
