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For this Allagash woman, driving to treatment was a ‘brand new form of cancer’ — Maine Focus — Bangor Daily News — BDN Maine

For this Allagash woman, driving to treatment was a ‘brand new form of cancer’ — Maine Focus — Bangor Daily News — BDN Maine

Jessica Potila | SJVT

Jessica Potila | SJVT

Margaret McBreairty is preventing a second spherical of breast most cancers. Touring from her Allagash house to southern Maine and Massachusetts for medical remedies has not been straightforward, however she credit her close-knit household for serving to her to survive.

By Jackie Farwell, •
October 1, 2018 6:00 am

Margaret McBreairty of Allagash traveled from one army base to one other throughout her decade of service within the U.S. Air Drive and later journeyed to Iraq and Afghanistan to work as a personal contractor. However in any case that, driving to Boston for medical care was almost her undoing.

McBreairty, 58, had survived breast most cancers, however the illness returned and unfold to her bones, sending her into emergency spinal surgical procedure this spring. A number of return journeys to Boston quickly adopted to deal with problems, and McBreairty made the roughly eight-hour journey south each three weeks for 5 months.

“I absolutely will not lie about it,” she stated by telephone from her residence overlooking the St. John River. “It caused me to lose my damn mind.”

As her docs tried to restore leaking on the incision website, McBreairty, who’s now unemployed, was pressured to cowl the prices of fuel, tolls and resorts. She estimated it value her $1,000, on prime of her $2,000 co-pay, for all her journeys.

“It is stressful,” she stated. “I told them it was creating a whole brand new form of cancer in my body.”

As well as to being an added stressor throughout an already making an attempt time, problem touring lengthy distances for treatment has been proven to have an effect on the treatment that sufferers pursue. Chemotherapy, for instance, sometimes requires repeated visits, and transportation difficulties have been proven to have an effect on the probability that most cancers sufferers obtain it.

The transportation problem is a symptom of a broader actuality: Maine’s rural areas usually have each the very best charges of most cancers and the fewest assets to deal with the illness.

[Kids in Maine are more likely to get cancer, and no one really knows why]

Washington County presents a stark instance of the geographical limitations sufferers face. It has the very best demise price from most cancers within the state, however not a single oncologist practices inside its three,000-plus sq. miles, in accordance to a September 2017 research carried out for the Maine Most cancers Basis by Market Selections Analysis.

Maine Well being Knowledge Group | Maine Most cancers Basis

Maine Well being Knowledge Group | Maine Most cancers Basis

The typical round-trip distance most cancers sufferers traveled for treatment in every county in 2015.

It’s not alone. Lincoln and Sagadahoc counties and southern Aroostook County additionally haven’t any oncology suppliers, in accordance to the research.

In a state the place most cancers is the main trigger of dying amongst adults and an estimated eight,600 new instances shall be recognized in 2018, serving to sufferers make it to and from their medical appointments has taken on larger urgency. A quantity of organizations all through the state have convened to pursue potential options, starting from enhancing outreach to sufferers about present transportation choices to the extra daunting problem of attracting extra most cancers docs and treatment amenities to rural areas.

Miles to go

Nadine Lewis of Ellsworth survived most cancers in 2006 and nonetheless struggles to discover transportation for care associated to that analysis.

“Having medical problems is hard enough,” she stated. “When you have to travel, you might not have the amount of energy or the stamina that an average person would have, so it’s really, really important to keep your energy to make those trips.”

Lewis works on the Beth C. Wright Most cancers Useful resource Middle in Ellsworth, a nonprofit group that helps individuals affected by most cancers in Hancock and Washington counties, together with linking them with transportation suppliers.

Michael Reisman, the middle’s government director, broke down the challenges that sufferers needing care face.

“If you live in Calais, you’re traveling 100 miles one way to get to Brewer for radiation treatment,” he stated, referring to EMMC Most cancers Care’s oncology middle.

Relying on the sort of most cancers a affected person has, radiation treatment sometimes includes 5 remedies per week for 4 to eight weeks, he stated. If a affected person travels 1,000 miles per week for six weeks, in a automotive that will get 30 miles per gallon with fuel ringing up at $2.80 per gallon, that totals a hefty $560 for the course of treatment. With many sufferers additionally hit with co-pays, excessive insurance coverage deductibles and time misplaced at work, it’s no small added expense.

Then there are sufferers with no entry to a automotive. Many depend on transportation organizations together with group journey teams and contractors that serve MaineCare beneficiaries. Most of these suppliers are small, serving fewer than 50 sufferers per yr and providing free and discounted fares, in accordance the Maine Most cancers Basis research. Almost half of the 22 transportation suppliers the research surveyed reported turning away sufferers over the earlier yr as a result of they lacked the assets to meet demand.

In 2015, greater than 6,000 sufferers wanted transportation to chemotherapy, radiation and immunotherapy remedies, in accordance to the research. That determine virtually definitely consists of overlap amongst sufferers who required multiple form of treatment.

Most cancers sufferers who obtain such transportation providers journey a mean of 70 miles per spherical journey, the research discovered. That doesn’t embrace journey outdoors the state, which is widespread for sufferers, reminiscent of McBreairty, who should journey to Boston or elsewhere to meet with specialists.

Maine Well being Knowledge Group | Maine Most cancers Basis

Maine Well being Knowledge Group | Maine Most cancers Basis

The typical round-trip distance for all cancer-related care by municipality, with pink circles indicating areas with the very best distances.

Anecdotally, sufferers say that the time, power and cash required to journey for appointments weighs closely on them, stated Aysha Sheikh, director of packages on the Maine Most cancers Basis.

With some sufferers, “They just say, ‘Forget it, I’m not going to do this,’” she stated.

Sheikh stated she’s even heard of breast most cancers sufferers choosing a double mastectomy relatively than deal with the burdensome journey related to much less drastic programs of treatment.

Easing the hardship

Of the roughly 200 oncologists within the state, almost half are situated in Cumberland County, the research discovered. However even sufferers dwelling in Maine’s most populous county wrestle with transportation, similar to those that use wheelchairs and wish help getting out of the door and into a taxi or van.

“While the distances that need to be traveled by people in Aroostook County and Down East in general are so far, there are fewer patients there than … in areas of southern Maine, where there is still a need,” Sheikh stated.

To assist meet that want, the Maine Most cancers Basis is getting ready to award a spherical of grants to organizations that present transportation to most cancers sufferers all through the state. The inspiration additionally convened a process pressure devoted to the difficulty.

As well as to increasing funding for transportation suppliers, the research beneficial partnering with hospitals to present transportation for his or her sufferers, enhancing public transportation, and boosting the capability of volunteer and community-based transportation networks.

“So many of these organizations are volunteer organizations who don’t have enough funding,” Sheikh stated.

The transportation concern prompted a 2015 research revealed within the journal Oncology, which famous a “projected increase in demand for cancer care due to the aging population” in rural areas. It highlighted “a number of promising strategies and interventions,” together with having specialists go to rural areas for normal clinics.

In Iowa, such preparations between rural clinics and bigger city practices lowered the median driving time to the closest oncology clinic from 52 to 19 minutes and boosted the speed of chemotherapy administration amongst rural sufferers with invasive cancers from 10 to 24 %, the research discovered.

The authors additionally highlighted efforts to join sufferers with oncologists remotely by means of telemedicine know-how, and utilizing grant funding to assist oncologists who follow in underserved areas to repay their medical faculty loans.

Maine Well being Knowledge Group | Maine Most cancers Basis

Maine Well being Knowledge Group | Maine Most cancers Basis

Estimated complete miles most cancers sufferers drove for treatment in 2015, by municipality

McBreairty has reduce on her journeys to Boston after connecting with a wound care specialist on the Maine VA Medical Middle in Augusta, whom she hopes will efficiently deal with her surgical complication, a persistent leaking on the incision website. However she nonetheless sees an oncologist in Portland and stated she feels fortunate to have household in southern Maine to stick with after her appointments. Some most cancers sufferers in her space journey 2½ hours a method to Presque Isle for radiation treatment, she stated.

“I think that’s horrendous,” McBreairty stated. “I don’t know that I could do that.”

And regardless of the hardships of her journey to Boston, these docs saved her life, she stated.

“The alternative to this treatment is to lay down dead,” she stated. “So I guess I’ll get treatment.”

That is the second piece in an ongoing take a look at the prevalence of most cancers in Maine, which is the No. 1 trigger of dying amongst adults within the state. The primary piece explored excessive charges of most cancers amongst Maine youngsters. When you have an concept for a story, contact Jackie Farwell at jfarwell@bangordailynews.com.

Maine Focus is a journalism and group engagement initiative on the Bangor Daily News. Questions? Write to mainefocus@bangordailynews.com.


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