Opinion: What does it take to fight cancer in rural America?
About 40% of Americans will have a cancer diagnosis in their lifetime. For Americans living far from cities and cancer institutes, cancer treatment looks very different
President Joe Biden reignited his cancer moonshot on Monday, efforts to end a malady that’s likely to impact you, your family or your extended family sometime in your life. About 40% of Americans will be diagnosed with cancer, according to the National Cancer Institute. If you live in rural America and you get cancer, you’re more likely to die from the disease than a cancer patient who lives close to a major medical center.
John Reichert, a 63-year-old father and grandfather knows that struggle. The river that runs below his acreage in Whitehall, Montana, seemed much farther than the 61⁄2-hour drive from Salt Lake City. He was well into radiation treatment in Salt Lake City for his prostate cancer, and it took every bit of energy just to get out of bed. Reichert stayed in patient and family housing through Huntsman Cancer Institute hotel lodging at a reduced rate with easy access to treatment.
Still, he missed home.
Too often, people who live in rural parts of the country miss out on medical advances that give many others a fair chance to beat cancer. With record inflation and sky-high gas prices, traveling isn’t an option for many. They face barriers to accessing screenings like mammograms and colonoscopies that can prevent or detect cancer at its earliest, most treatable stages; genetic counseling to identify cancers that run in families; precision treatment plans; and the opportunity to participate in cutting-edge clinical trials.
Thanks to five decades of federally supported cancer research and treatment and a network of national cancer centers, our nation has had a major impact in reducing this scourge. The cancer death rate has dropped 32% between 1991 and 2019, according to the American Cancer Society.
Yet, the benefits of this medical revolution are not accessible across all communities. As a cancer scientist and leader of the only National Cancer Institute-designated Comprehensive Cancer Center in the five-state Mountain West, a region equal to 17% of the land mass of the continental U.S., I know that simple distance can compromise access to basic cancer prevention, screening and treatment for many members of our communities.
Cancer affects all populations, but certain groups bear a disproportionate burden. If you live in a rural setting, you’re more likely to be in the eye of a perfect storm of impediments.
In the Mountain West, one of the most sparsely populated regions of the country, the farther a person lives from one of these cancer centers, the less access they have to state-of-the-art cancer prevention strategies and treatment options. This distance translates to a grim statistic. People who live in rural areas are 10% more likely to die from cancer, even when accounting for age and other factors.
The next phase in our national cancer strategy must involve eliminating rural cancer health disparities in places like Whitehall, a town of 1,000 people in southwest Montana. This requires the collaboration of health care providers, cancer researchers and community hospitals, combined with government support. It also requires a willingness by the insurance industry to provide broader coverage to enable all residents to benefit from receiving optimal cancer prevention, detection and treatment.
First, our nation’s cancer centers must offer more services to patients where they live: in their communities and, in some cases, their homes. Huntsman Cancer Institute has shown promising strides from our Huntsman at Home program, an innovative service that brings acute care and symptom management to the patient. Results show a significant decrease in unplanned hospitalizations and medical costs for patients.
The COVID-19 pandemic demonstrated the value of telemedicine, distant screening and remote diagnosis. Unfortunately, too many rural communities and medical offices lack adequate internet and modern digital capabilities.
State and local governments and health departments can benefit their communities by working with telecom providers and IT suppliers to ensure everyone has access to adequate technologies. Achieving this goal would facilitate the ability of all communities to access advances in cancer prevention and treatment.
Commercial insurance carriers and Medicare and Medicaid programs need to expand coverage when travel and lodging is necessary for people who live hundreds of miles from the nearest cancer center. This would ensure our rural neighbors can receive expert care at a major medical center for specialty procedures, as well as outstanding community providers who provide critical care for patients back at home.
Reichert is in good health now. But not all rural cancer patients are so lucky. As a nation, we must ensure all people can share in the marvels of modern medicine — no matter where they live.
Mary Beckerle is CEO of the Huntsman Cancer Institute, a federally designated Comprehensive Cancer Center and Hospital in Salt Lake City. She was recently elected as a member of the National Academy of Sciences.