By Dan Sorenson
Sometimes winning the battle against cancer isn’t really the end of the struggle.
“Sometimes it is as hard surviving cancer” as it is to fight through surgery, chemotherapy and radiation, according to Dr. Marilyn K. Croghan. Patients worry “Will it come back? What should I do to keep it from coming back?”
Beyond that, Croghan said, a common burden experienced by cancer patients has nothing at all to do with recovery, remission and recurrence. “There are patients whose insurance falls short – or they don’t have insurance at all.”
Some patients survive the battle only to face staggering medical costs – or smaller ones that nibble away at their quality of life because they forgo treatment that would help them.
Now there’s a new source for services and assistance – the Arizona Oncology Foundation.
Patient assistance ranges from cost-free programs such as support groups and providing wigs for patients who’ve lost their hair during chemotherapy, to reduced-cost acupuncture, massage and nutrition consultation. The nonprofit organization, founded in 2010, sometimes even provides counseling services to patients’ families.
Croghan is a radiation oncologist with Arizona Oncology Associates and president of this new nonprofit patient-support organization. The foundation was set up by Croghan and partners in the oncology practice to provide integrative services that promote health and healing for patients and their families throughout their cancer journey.
The foundation is a bare-bones operation, Croghan said. The idea was to minimize the infrastructure, with only two full-time employees, and office and therapy space donated by physicians. The therapists and other service providers are contractors and typically work for half what their hourly fees would be in private practice.
Rather than “reinvent the wheel,” Croghan said the foundation partnered with established Tucson organizations – both businesses and nonprofits – to provide services for patients. They range from American Sewing Guild’s Tucson chapter and Unique Fashions to the Laura B. Carrillo Breast Cancer Foundation, Hope Has a Name Fund and University of Arizona Medical Center North Campus to the Loft Cinema, UA Music and Medicine Club, Cakes for Causes and Lineweaver Elementary School fourth graders.
Rosemary Poppe, Patient & Volunteer
Rosemary Poppe, Patient & Volunteer knows cancer treatment from both sides – the Arizona Oncology medical practice and the nonprofit foundation for patient assistance. She’s a 66-year-old breast cancer survivor, five years removed from a bilateral mastectomy. She’s also an Arizona Oncology Foundation volunteer, connecting patients with services.
“I lost a sister to breast cancer. And both of us were treated by Arizona Oncology physicians,” Poppe said. “I thought when I felt better I would give to the organization that treated us.”
Although Poppe had insurance that covered much of the medical costs of her treatment, including surgery, she said some of the post-op services were not adequately covered.
“I definitely see the need,” Poppe said of the foundation. In particular, she needed treatments for lymphodema following her bilateral mastectomy and removal of lymph nodes. “Lymphodema, an accumulation of subcutaneous fluids is painful and uncomfortable, and many times disfiguring,” she said.
What’s needed is a labor-intensive manual massage to remove the fluid. “I need a manual drainage every couple of weeks” – yet her insurance coverage limits treatments to 12 a year. The Arizona Oncology Foundation provides hour-long sessions for $35, which is less than her insurance plan’s co-pay, Poppe said.
Cathy Adelman, Acupuncturist
Acupuncturist Cathy Adelman is a registered nurse and former hospice nurse who now works with Arizona Oncology Foundation to provide acupuncture therapy to cancer patients. She also has a private practice.
“We treat cancer patients throughout their health care continuum,” Adelman said. “We manage the side effects of chemo and radiation – insomnia, nausea, diarrhea, anxiety, post-op pain. And after treatment, we say it’s a good time to treat the lingering impact” of these and other side effects “like hot flashes – a lot of breast cancer patients experience that,” she said, “also numbness and tingling in the hands and feet as a result of chemo therapy.”
Adelman’s use of acupuncture is broad, sometimes even beyond the specific cancer patient.
“I had a patient who had breast cancer. I asked her if I could help her quit smoking.” Adelman also is a certified smoking cessation therapist. “We know that with breast cancer patients who continue to smoke after treatment, their risk of cancer coming back is two to three times greater” than those who quit.
Then Adelman learned that the woman lived with her son and husband, both smokers. “The only way she could do it was if they all quit smoking. They were skeptical. I treated all three of them.” Sixteen months later all three were still non-smokers.
Mary Marian, Clinical Dietician
There’s more to cancer patient nutrition than advising patients to eat lots of green, leafy vegetables and lay off the bacon. They can face a variety of nutritional challenges, often varying greatly between patients stricken with otherwise identical types of cancer, said clinical dietician Mary Marian. She has a private practice and teaches at the University of Arizona.
“You can’t hand them a sheet of paper and say ‘do this,’” she said. One patient may “be having a terrible time trying to eat, to keep anything down. There are studies that show if a person is not eating and malnourished, they don’t do as well in treatment. And women undergoing treatment for breast cancer may gain weight, and that’s not good either.”
She said good nutrition advice isn’t just for patients who have been successfully treated and are expecting long-term survival. “There is mounting evidence that if you have a healthy body weight and maintain nutrition, you have a better quality of life” – whether you’re in early stage, recovery or end stage.
“If you have a positive attitude and have the energy and stamina to do that – even if you don’t feel great – you’ll have a better quality of life than the person who does nothing. What I’ve found out from people is you can’t tell how long they’re going to live.”
As a 501(c)(3) nonprofit organization, Croghan said the foundation is seeking more support from the community to help continue the foundation’s mission.
Safeway of Arizona is one of the latest donors, giving $35,000 from the grocer’s statewide charitable fund. Nancy Keane, Safeway’s director of public affairs and government relations for Arizona, said the foundation was a good fit for Safeway, which raises money specifically for cancer every October. She said Safeway distributes roughly $6 million in charitable contributions statewide annually.
“It looks like they are going to use this money to ease their patients’ suffering. You can’t argue with that,” Keane said.