Agency bridges gap between treatment and cost
21 Jan 2016 by Ted Escobedo
‘Shock.’ Estela Barientos sat on the couch holding a handkerchief and describing when she was first told she had cervical cancer. She softly repeated, ‘shock.’
Fear and shock are universal emotions when first learning of cancer detection. The initial diagnosis can set off a chain reaction of concerns in the patient’s mind. ‘What will be the next step? How do I tell my family? What treatment will I need? How will I afford the medical costs?’
For women with no health insurance, limited income and who are
unfamiliar with the healthcare system, these questions can become
overwhelming. Guiding these women is the work of the Cancer and Chronic
For 25 years the CCDC have helped
thousands of women who are diagnosed with breast or cervical cancer
obtain specialized Medicaid assistance. Easing the financial concern of
cancer treatment is often just the beginning. The CCDC also offers
their clients patient navigation, social services and support throughout
their cancer care journey.
For Barientos, the CCDC helped her after she was first diagnosed with cervical cancer in Ciudad Juarez, Mexico, and didn’t know where to go next. Barientos, like many women in El Paso, often seek medical care in Mexico. But crossing cultural and economic borders can prove to be more difficult once cancer is diagnosed.
Barientos tells her story in Spanish.
“When I first went to the gynecologist,” she said, “ The doctor told me that I had already been sick for about three years. I thought it was something else. I would feel a pain here.” She touches her abdomen on the left side of her body. “But I would take a pill and the pain would go away. After a while I felt like my legs were not responding, they were sore as if I had been walking a lot. I was very tired.”
Her family became concerned at her lack of energy and loss of weight. “I would say that I was too embarrassed to go to the doctor. ” As her pain increased she lost color in her face and continued to lose weight. “I got very thin.”
It was at that point that Barientos agreed to seek medical care in Juarez. “I went to go see a friend (amigito) of my daughter who is a gynecologist.”
She realizes now the importance of that first step.
“You know, most women say that they are embarrassed to go to the doctor, that they don’t have time. We come up with a million excuses. And when you want to do something about it, it’s too late.”
Barientos learned of her cancer and began treatment in Juarez. “They took me for a week of radiation in Juarez but it was too expensive. My daughter began to look for treatment here in El Paso.”
Barientos story is one that Adriana Valdez, co-executive director of the CCDC finds all too familiar. Barientos daughter brought her case to the attention of the CCDC and soon after a plan for care was enacted. She began seeing an oncologist in El Paso that was provided by a special Medicaid program procured by the CCDC. Unfortunately that is when Barientos learned that her cancer was stage three and inoperable. Her doctor’s recommended course of action was radiation and chemotherapy. She received treatment in December of 2015 and is now resting and awaiting follow-up care.
Like Barientos and her daughter, patients trying to navigate the confusing maze of cancer care find the CCDC to be of invaluable help.
“After a patient is diagnosed with cancer we guide them to the next step of care,” said Valdez. “We will make appointments for the patient to see a specialist. We will even pay for a biopsy.” The guiding hand of the CCDC continues from there. “We keep in touch with the physician and schedule the next appointment. Many times we don’t wait more than two weeks. We start care right away.”
But care comes at a high cost. Finding a financial solution to the patient’s daunting journey is of primary importance at the CCDC. “There is a specialized Medicaid program that is available to patients who are diagnosed with cervical or breast cancer,” said Valdez. “We help them to get on the program.”
Not all women qualify however, in order to receive the Medicaid benefit the patient must be a U.S. citizen or have been a legal resident of the U.S. since 1996. Valdez says that even though some women may not qualify for the Medicaid Program, there are other alternatives such as seeking disability or utilizing County resources.
“If a patient does not qualify, we will send them to University Medical Center and follow up with doctors there,” Valdez said. “We find a way to help them.”
Aside from the financial guidance, compassion plays heavily into the culture of the CCDC and their employees. “Compassion is a requirement for everybody that works here.” Valdez says. “We know the type of situation or experience that people who come here are going through. We hire people that are comfortable working with people one-on -one in emotional situations. We are here to help them walk that path. We do not want to be seen as a stone or an obstacle to impede them from letting their emotions go.”
Equally important to assisting patients who are diagnosed with breast or cervical cancer is the prevention and educational efforts of the CCDC outreach programs.
Valdez believes that reaching uninsured and underserved Hispanic women in our area is best done by hitting the streets and reaching out to them in the communities where they live-and by speaking their language. Staff members called promotoras, are specially trained to go into these neighborhoods to educate women in both Spanish and English of cancer risks and encourage them to get screened on a regular basis.
The work is challenging because of cultural barriers Valdez says.
“I mention during the presentations that I do that when it comes to cancer, we (Hispanics) do not even want to hear the word. We do not want to talk about the disease. But knowledge is your best defense. You have to change their mind set about the disease.”
Barientos understands first hand how vitally important it is to bring a message of education and prevention. (In Spanish)“When I was a young girl we didn’t ever talk about these things. When I got my first period, I didn’t know what was happening to me. We just didn’t discuss it. Now, we can talk more openly about women’s health issues. Fortunately because of television and the internet it is easier for women today.”
Encouraging screening and early detection of cancers can often save lives. Barientos believes that women must overcome any obstacles that may get in their way from getting healthcare. “Women need to get over their fear and embarrassment and get checked on a regular basis. I didn’t, and I knew that as a woman, I should but I simply didn’t.I needed to.”
Screening should begin at an early age Valdez says. “Now with the HPV Virus, we see women in the twenties diagnosed with cervical cancer. We also see breast cancer earlier in women. That is a trend that I see in the community.”
Here again, Valdez believes education is paramount in addressing this trend. “ We tell patients to talk to their physician. We encourage our patients to communicate and ask questions to their doctors. We tell our patients to eliminate barriers of communication with your doctor. Because it’s your life.”
Valdez believes that it is important for women to understand their risks and get screened even though they may be fearful or unsure. “There are a lot of services out there that you can have access to. There are screenings and medical services for the uninsured and underserved. There are many programs for people with low incomes. We need to empower patients to get screened and take advantage of these programs. Patients need to get over their fear. Cancer doesn’t mean death.”
Mrs. Barientos agrees. As she continues on her journey she maintains resolve. “I have to keep trying (echarle ganas) for my family; my daughters, my grandson. Whatever happens, it’s in my hands and I am going to fight until I can’t anymore, ” she said in Spanish. ‘Ganas.’