02.06.18

Rural Cancer Care: We’re Not in (the Twin Cities) Anymore!

A majority of Firefly Sisterhood participants live inside the 21 county metro area. As the Twin Cities continues to expand, suburbs that used to be considered “rural” are no longer so (e.g., Hudson, WI, and Maple Grove, MN).

Being within this radius, Twin Cities folk have access to multiple health care systems, each having their own dedicated cancer center. So when you or someone you love hears “You have cancer,” there may be multiple options for doctors, treatment, surgeries, and rehabilitation.

Venture into greater Minnesota and Wisconsin and someone with that same diagnosis may have several additional challenges when it comes to meeting their cancer care needs. As Firefly continues to expand and serve rural women facing a breast cancer diagnosis, we simultaneously expand our network of healthcare professionals who share our one-to-one matching program with their patients.

Firefly interviewed several of these professionals in rural healthcare facilities about their work with, and challenges experienced by, rural cancer patients. One of the biggest challenges for rural patients is transportation. “My patients sometimes have long drives to get to (our facility), and even longer drives to get into the Twin Cities if they need specialty care,” describes Caro.

Such long commutes are often a barrier to getting complete or adequate cancer treatment. Caro points out that “sometimes patients are afraid to travel long distances for care or leave the comfort zone of their community, often times choosing not to complete all of the prescribed chemo and/or radiation because of this.”

In addition, Lonnie feels that her rural patients may be already financially stressed prior to a cancer diagnosis. “With the additional costs of travel, gas, insurance co-pays, and limited local financial assistance, some patients are only able to receive part of their treatments or fill partial prescriptions, sometimes choosing not to fill them at all or to forgo treatment due to financial problems. It is alarming, especially towards the end of the year, when foundations have run out of cash to assist even our neediest patients.”

Typically, rural facilities only have a single oncologist who cares for all patients, regardless of cancer type. “While the oncologist is coming from (a facility) in the Twin Cities,” describes Jacinta, “the oncologist is only there certain days, and may not be available to patients immediately. For some patients, it is hard to wait, even if the wait is only for a week.”

This challenge can then require “reassuring patients that the care they receive (in rural facilities) is the same care they would receive in a big facility,” explains Rhoda. “Patients think they need to ‘go big’, but their care and treatment can be done just as well locally, with less physical and emotional trauma.” Pat agrees, “Just because we are rural doesn’t mean we don’t have what our patients are looking for or can’t help them navigate where to find it, if it’s not offered here.”

“Rural patients can sometimes fear the ‘small town’ factor—that their privacy and confidentiality may be compromised because they may know the staff at (the healthcare facility). We work to educate patients that they do not have to worry—we maintain strict confidentiality,” points out Jacinta. “But the ‘small town’ factor can isolate rural patients even more as they choose not to attend support groups or get the social support they need.”

Some rural facilities are finding solutions for the challenges that rural patients experience: sending staff members for specialized training (e.g., in palliative care), designating content experts at large Twin Cities clinics for questions, revamping and updating methods of patient education, acquiring (a facility) vehicle for patient transport to and from cancer-related appointments, and experimenting with telehealth in which a specialist doctor video-conferences an appointment with a rural patient.

While the challenges are great, working with rural patients is equally rewarding for these rural healthcare professionals. “I love working in rural cancer care because I have more one-on-one time with my patients,” explains Lucretia. “I care for my patients throughout their treatment and establish great relationships with them. Of course, this makes losing a patient incredibly difficult.” Caro agrees, explaining that “Oncology patients are different and refreshing. They seem to be living their lives to the fullest and appreciate any little thing you do for them, even if it is as small as opening the door for them.”

Firefly Sisterhood is not affiliated with any local or national health system, and we strive to ensure that our one-to-one matching program is available to any woman facing a breast cancer diagnosis. We are thankful for all rural cancer care healthcare professionals who choose to work in challenging areas and who share the Firefly Sisterhood program with their patients.

A huge thank you to Pat, Caro, Lonnie, Jacinta, Rhoda, and Lucretia for shedding a light on the challenges faced by rural cancer patients.

*All names have been changed to protect privacy.

Written by Amy Tix, Firefly Staffer and breast cancer survivor.

One thought on “Rural Cancer Care: We’re Not in (the Twin Cities) Anymore!

  1. Robin Rotchadl on said:

    I live in North Mankato, MN. Yes, it is hard for rural patients to find support. I attended a firefly event last year because my sister, Naomi, was diagnosed as well with breast cancer and she lives in the metro area and heard about your organization while going through treatment. Our mother, was diagnosed a week after me, 7 years ago. My mom, stage I and myself, stage III, are doing well. My sister, Stage II, is done with treatment, recovering from the whole sha-bang.
    I would be happy to be a support mentor for someone around this area, but don’t know how to go about getting the word out. Perhaps, you may come across a gal, in your organization, from around the Mankato area. Letting you know that I would like to volunteer for this opportunity, if there is a need. Thank you, Robin

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