Removing Barriers to Better Cancer Care
Famous South Dakotan Tom Brokaw’s experience with cancer at his remote Montana retreat raised perplexing questions about cancer care delivery in a rural setting. While an incredible depth of treatment resources is readily available at urban locations, what do people do when this care is hours away across the sprawling Northern Plains?
Brokaw was diagnosed with multiple myeloma in 2013. Resolving to go on with his life, he went to his Montana home to enjoy time fishing with friends. Only a little while into his fishing trip, he had to crawl out of the water, curling up in excruciating pain at a nearby cabin. After spending a couple days bedfast, his wife, Meredith, arranged for air transfer to Mayo Clinic. Brokaw related the painful ambulance trip over 60 miles of winding, bouncy roads to the airport. He then received specialized treatment at both Mayo and Memorial Sloan Kettering Cancer Center in New York. He tells the story of his cancer journey in his book, A Lucky Life Interrupted: A Memoir of Hope.
Avera recently launched its new Avera Rural Cancer Advisory Board, a group of patients, families and other stakeholders who discuss these very issues, through a project funded by a Community Innovation Grant from the Bush Foundation.
Twenty-three Advisory Board members from varied locations across the region meet to identify barriers to receiving the best possible cancer care, and ways to overcome these barriers.
“This input will guide research activities and ultimately help direct the way we deliver our care,” said Kris Gaster, Assistant Vice President for Outpatient Cancer Clinics at Avera Cancer Institute Sioux Falls.
Among members of the Advisory Board is Susan Wiebesiek, whose family operates a farm near Davis. Her husband, Darwin, passed away six years ago of leukemia.
Distance is a barrier
What’s more, farmers hate to ask for help. “We are all so geared to be independent and take care of ourselves,” Wiebesiek said. While Davis is only about 30 miles from Sioux Falls, Wiebesiek understands that pure distance is a barrier. Yet there are other roadblocks that have nothing to do with lengthy car trips. “Everything in an agricultural operation needs to keep going, regardless of illness or treatment.” Neighbors are often a mile or more apart, and they’re busy, too.
She is thankful that their grown children were there to keep the farm going during Darwin’s illness. Today, two sons operate the farm, while Wiebesiek manages the paperwork.
Yet Wiebesiek knows that help would have been available if they would have needed it. “That’s the reason we live in South Dakota. We know that people around us will step up to help their neighbors. Yet accepting that help is very hard.”
Farming is a 24/7 job
Ward Youngblom, an Advisory Board member from Veblen, S.D., works on a dairy farm in northeastern South Dakota. He believes the first barrier to optimal cancer care involves getting regular physical exams and cancer screenings. “Farmers and ranchers tend to have a mindset that if nothing is wrong, don’t worry about it. They put off going to the doctor.” He’s known people whose cancer went on undetected, until it was diagnosed in late stages.
A dairy farm, for example, is a 24/7 job. “Chores have to be done seven days a week. People never like to go too far from home,” Youngblom said.
Jim Woster, a South Dakotan who is well known in the state’s agriculture industry, co-chairs the Advisory Board. “Avera is always looking for new ways to reach out to the rural areas it serves. They believe that all residents of our state deserve equal access to the same high level of care, and so they use technology and innovation to make that happen. Just one example is Avera eCARE™, which reaches across eight states and 545,000 square miles,” Woster said. “I’m excited to see what the future will bring as a result of this project.”