States are failing to promote and improve access to the Breast & Cervical Cancer Treatment Program, costing thousands of women their lives...

From the Wall Street Journal

September 13, 2007, 8:13 am
A Breast Cancer Death, Tangled in Bureaucracy
Posted by Jacob Goldstein

Shirley Loewe died of breast cancer in June. In the four years after she was diagnosed, she was “denied assistance or care at least six times, for reasons that ranged from not being poor enough to not being sick enough,” the WSJ reports.

Loewe (pictured with her daughter) was a hairdresser in Longview, Texas. She didn’t have health insurance and her $15,000-a-year income was too high to qualify for Medicaid in the state. A little known federal law, the Breast and Cervical Cancer Prevention and Treatment Act, allows women to be covered by Medicaid even if they don’t otherwise meet all of its eligibility criteria.

But in 2003, when Loewe was diagnosed, Texas was one of more than 20 states where the law only applied to women initially diagnosed at clinics that get funding from a federal cancer-detection program. Because she was diagnosed at a medical center that didn’t qualify, rather than a different clinic less than a half mile away that did, Loewe was ineligible. She wound up cutting back her work hours, which allowed her to qualify for charity care but forced her to move out of her apartment. Texas has since changed its rules so that it doesn’t matter where a woman is diagnosed. But similar rules still apply in 21 states.

Her odds of surviving wouldn’t have been good even if she had qualified for coverage under the law. She had inflammatory breast cancer, a rare and often fatal form of the disease, and her tumor had grown to four inches in diameter by the time she was diagnosed. But, the story suggests, if she had been covered by Medicaid from the time she was diagnosed, she might have received care more promptly, and her life might have been less fraught with worries over money and bureaucracy.

“People die every day waiting for the system to catch up,” a social worker told Loewe’s daughter. “Why should your mother be any different?”

Link

An interesting editorial in the recent issue of the Journal of the National Cancer Institute (JNCI) which discusses the recently published results of a randomized trial on use of hypnosis in reducing stress and pain in patients undergoing excisional breast biopsy or lumpectomy for breast cancer.

 

 "Cancer is a disease that hijacks patients' attention. Those coming for diagnostic surgery are understandably anxious about the outcome. They are thus hyperattentive to every pain and its possible implications. The operating room is a novel environment, and humans have evolved to pay special attention to new and potentially threatening situations. Thus, a means of redirecting attention while using the brain to induce physical relaxation rather than promote muscle tension can be especially helpful to cancer patients during their initial surgery. It is now abundantly clear that we can retrain the brain to reduce pain: "float rather than fight." Esdaile would have been proud to read this issue of the Journal. He might even have said, "Ladies and Gentlemen, this is no humbug."

 

Read the editorial here