Breast cancer screening saves lives.
Cancer can strike anywhere in the breast – the milk glands, the milk ducts or in the connective tissue. In cancer, cells grow out of control. Healthy lifestyle choices, knowing your body and your family history, and getting regular mammograms lessens opportunity for cancer to develop or escape early detection.
Constance Carter was 44 when her mammogram conducted on the BJC HealthCare mammography van detected an abnormality.
Because of the history of cancer in her family, Chantelle Nickson-Clark stayed on top of her self-breast exams. She was 32 when she found a lump. Her employer let her go six treatments into eight scheduled chemotherapy sessions following a double mastectomy.
Neakisha White of St. Louis was diagnosed at 26, although she knew a year earlier that an unwelcome presence had invaded her breast.
Two of the women had breast cancer long before the recommended age to begin routine mammogram screening (guidelines revised in 2009 recommend that screening begin at age 50 for women in general but age 40 for African American women and women with high risk factors). They also incurred job loss around the time of their diagnosis. When their need was greatest, Gateway to Hope in St. Louis provided no-cost breast cancer care and treatment, using the same specialists, hospitals and facilities that care for breast cancer patients who have insurance received.
“The physicians and facilities all donate something so that the patient doesn’t have to come with any out-of-pocket, said Dr. Melvin Maclin, of the Gateway to Hope board of directors. “In some instances, we actually pay for things out-of-pocket through donations … no one actually gets paid for their services.”
For Carter, a Bellefontaine Neighbors, Mo. resident, two lumpectomies did not remove all of the cancer and she had a mastectomy. Carter was in the end stages of treatment when she lost her job. She hung on to her insurance for a while under COBRA, a law that allows temporary continuation of group health coverage . She found out about Gateway to Hope through a small ad in The American.
“By the time I ended up at Gateway to Hope, I was cancer free and completely through with all of the surgeries and everything. What Gateway to Hope did is basically provided me with the follow-up treatments that I needed … and they were able to help me with medications,” Carter said. “I would have had a hard struggle to take care of covering the cost of the follow-up visits … there are tests that I have to have done, like ultrasounds and CT scans … every three to six months…Whenever I had to have these tests done, they were able to provide that follow-up treatment for me. Gateway to Hope pretty much paid for the last year-and-a-half.”
Chantelle Nickson-Clark had employer-provided health insurance that did not cover much, and when facing a catastrophic illness, added to the nightmare.
“The office visits maxed out at $1,000; the hospital bill maxed out at like $1,500; my prescriptions maxed out at like about $350,” she recounted. “I found, even though it was my employer’s insurance, it still was the worse insurance possible that anybody can ever have,” Nickson-Clark described.
She read an article about Gateway to Hope in The American.
“I reached out to them and they have been a blessing to me every since,” Nickson-Clark said. “They were able to cover everything. It was almost like, a burden lifted off of my shoulders because everything else that my insurance didn’t cover – they covered. And were also able to assist me with the current bills that I had already accrued from the time I got diagnosed.”
In addition to the tough lesson of learning to read all of the fine print in insurance policies, Nickson-Clark realized she did not have to fight breast cancer alone.
“I felt like I was the only person diagnosed with breast cancer, and I didn’t want to talk to anybody. I didn’t want counseling. I didn’t want to do anything. I just felt so alone, like my world was ending,” Nickson-Clark said. “They provided a sense of hope for me, letting me know that I am not in this by myself and if I needed someone to talk to… they are just a phone call away every time.”
As caregivers have been known to do, Neakisha White put someone else’s well-being above her own.
“I was doing private duty [nursing] 52 hours a week and I had been with this lady for six years. My mother was her first nurse, and I didn’t want to leave her and didn’t know who was going to take care of her,” White said. “She was 93 years old when she passed. So when she passed in ’08, I said, ‘okay, let me take care of me now.’ And I went and had the biopsy done and, sure enough, it was cancer.
“I really didn’t need to do an exam, because you could see it. The mass was about the size of an orange, so you couldn’t help but to notice it. I would take a shower, and I would bump into it while I was taking my shower…when I would go to bed, and you know, when you lay down and ‘the girls’ go up – and it stayed right there where it was at. You couldn’t help but to notice it.”
The lump was a sarcoma, a rarer form of breast cancer located in the connective tissue. [Sarcomas can form in any of the connective tissues of the body, such as cartilage, blood vessels, bones, fat, nerves, deep skin tissues and muscle.
White had no health insurance. She admits, she also avoided getting treatment because she felt she would be alone going through it.
“I’ve been on my own since I was 16, and I knew that, whatever the diagnosis was, that I would be alone going through this,” White explained. “Even though I had come to terms with what was going on, I wasn’t ready to actually deal with it.”
After exploring her options on the phone and via internet, White eventually found Gateway to Hope. She went to the Siteman Cancer Center at the Center for Advanced Medicine for a partial mastectomy and aggressive radiation.
Gateway to Hope only treats breast cancer patients who reside in Missouri. The organization started its work in December 2005, since that time, it has provided some sort of breast cancer care to about 150 women and one man.
“That’s anywhere from diagnosis to treatment, to reconstruction to even they lost their job and we just help pay their COBRA so they could continue to get health care,” said Maclin, who is a board-certified plastic and reconstructive surgeon. He also helped in treatment for, Carter, Nickson-Clark and White.
The organization also works with clients who are diagnosed as having a high risk for breast cancer. Maclin says staff members also have been touched in some way by breast cancer.
“A lot of the women that work their either have some personal reason for helping Gateway to Hope … some are just very dedicated professionals that understand the sensitive nature of breast cancer treatment and recovery,” Maclin said. “We provide a comprehensive service because it’s not just about the money – it’s everything. When an individual is affected with breast cancer, it doesn’t just affect that breast. It affects the entire person, plus the entire family unit to which she belongs.”
The American Cancer Society says although African American women get breast cancer less often than other races, it is diagnosed at more advanced stages and can be more aggressive and more difficult to treat.
Currently there is no guaranteed method to prevent breast cancer occurrence. In the report, “Cancer Facts & Figures for African Americans 2009-2010,” the ACS says a woman’s overall best preventative health strategy to reduce her known risks for breast cancer is “avoiding weight gain and obesity, engaging in regular physical activity, and minimizing alcohol intake.”
Cancer is the No. 2 cause of death among African Americans, second only to heart disease, according to the CDC. Breast cancer is leading site of new cancer cases for African American women and is second only to lung cancer as the main cause of cancer death.
Board certified Plastic Surgeon, Dr. David Kaplin and Dr. Marlys Schuh, a board-certified breast cancer surgeon, are the cofounders of Gateway to Hope. Filling that void until inequities in the health system catch up with individual health needs is what Gateway to Hope does.
“It just goes to show you when a community works together to keep everybody together,” Maclin. “There is no other program like this in the United States. This is a unique ‘experiment.’”
Maclin calls it an experiment because, “this is not how health care should be done. There should be a better way for every patient who needs health care to get health care.”
Gateway to Hope patients have access to a full range of options, including lumpectomy, mastectomy, breast reconstruction, chemotherapy, radiation, drug therapy and genetic testing.
The organization’s partners have provided transportation, medication, medical supplies, home health care, house cleaning, breast implants, bras, wigs and meals.
Gateway to Hope operates through donation of time, talent from health community and funds through public and private donations. For more information about Gateway to Hope, contact them at (314) 569-1113 or http://www.gthstl.org.
