Breast Cancer, Breast Cancer Awareness Ribbon, Pink.

When a steady, relied-upon source of funding was ending, a public-private coalition of concerned stakeholders was created in Arizona to ensure that certain critical health care services could be continued.

In June, Susan G. Komen?s Arizona affiliate announced via a letter posted online that ?based on financial challenges and current downward trends in overall fundraising and event participation which limited our ability to continue to fulfill our mission locally?we will cease operations in Arizona effective July 31, 2017, which coincides with the end of our current affiliation agreement with the Susan G. Komen organization.?

Over the years the state affiliate has contributed more than $26 million for Arizona breast cancer programs, including gap funding to treat uninsured women diagnosed with breast cancer who did not meet other treatment requirements.

…As a pubic health issue, regardless of politics, no non-profit hospital in our state wants women showing up with a mass that is going to get diagnosed late, consume more dollars for treatment, and have a poor outcome…

And without that treatment mechanism in place, continued contingent federal CDC funding for breast and cervical cancer screening programs could also be placed in jeopardy.

Komen?s funding of this gap has ranged annually between $700,000-$800,000, and has covered the treatment costs for more than 70 Arizona women who were diagnosed with breast cancer and were uninsured.

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Compounding the problem was the reality that many of these women were either undocumented or not eligible for Medicaid because their length of residency had not reached the necessary 5-year minimum requirement.

So, noting the need for proactive measures, Virginia Warren, MPA, chief of Arizona?s cancer control and prevention program called a meeting of cancer-related stakeholders throughout the state this summer, and about 50 individuals met for a ?brainstorming session? that explored multiple scenarios, according to Warren.

I first became aware of the situation through Jorge Gomez, MD, PhD, a faculty member and administrator at University of Arizona?s Cancer Center and College of Public Health who is involved in cancer outreach and health disparities.

Gomez and I have known each other for years, going back to when he was a senior research administrator at the National Cancer Institute overseeing the Specialized Programs in Research Excellence (SPOREs) initiative and later NCI?s Latin American program.

Recently, together with Nancy G. Brinker, founder of Susan G. Komen and a former U.S. ambassador to Hungary and State Department chief of protocol, we three had co-chaired an international conference on reducing cancer in Latin America.

Through Brinker, Gomez contacted Bonnie Gordon, executive director of Komen?s Chicago affiliate, who spends winters in the Phoenix area, and expressed interest in helping to raise funds for medically disenfranchised women in Arizona.

Gordon, a two-time cancer survivor, said during a telephone interview that there?s a crisis in this country to get care for the underserved, and it?s not limited to Arizona.

?The Komen funding to fill this gap will run out by the end of January, and we knew we had to come up with a short-term strategy as well as a sustainable long-term strategy to supplement those treatment costs.?

Brinker told me that Gordon?s interest in fundraising outside of Chicago was illustrative of the culture of many Komen affiliates.

?They have the common sense and passion to know the importance of community health efforts, and although it?s too early to know how things will turn out in Arizona, we?re all hoping for success,? she said.

During a telephone interview with Warren, the cancer control chief explained that upon learning of the pending funding shortfall she convened a meeting of stakeholders interested in reducing the burden of cancer in Arizona.

Representatives from various Arizona-based academic and research institutions, hospitals, and cancer-related non-profit organizations including Gomez met in August, and decided that a short-term goal would be to raise funds to cover treatment costs for those women who screened positive for breast cancer and required treatment but were ineligible under current rules.

Warren said that this more-immediate pathway became possible because her office learned it could receive donations targeted to securing treatment services for this particular population, and donors would be able to receive tax deductions. Various fundraising events are currently being discussed.

However, the greater challenge is finding innovative ways to sustain funding for the future and she noted that both goals had to be undertaken in parallel.

?As a pubic health issue, regardless of politics, no non-profit hospital in our state wants women showing up with a mass that is going to get diagnosed late, consume more dollars for treatment, and have a poor outcome,? she said.

She added that women should be screened and diagnosed in a timely fashion as early as possible and then supported in the full continuum of care someway.

?And the question is, how do we do that now that Komen is gone??

Warren acknowledged that the long-term plan will require considerable time, but she foresees more collaboration with federally qualified health centers (FQHC)?in Arizona to complement the state?s efforts to improve the quality of health services and increase screening rates.

She would like to develop a ?predetermined pathway to care? process where the FQHCs–which only provide primary care –can help find patients who need cancer treatment support and can help guide them to low or no cost treatment.

This will also require the cooperation of non-profit hospitals, which will involve meeting with those institutions? foundation managers and convincing their hospitals to be part of the effort.

For the time being, a core team of dedicated cancer-community stakeholders has been formed and will be meeting periodically with the cancer control and prevention team to discuss developing and implementing both strategies concurrently.

This editorial is part of the Eric Rosenthal Reports and offers the first article in a periodic series of reports on meeting the needs of cancer care in the community.

Last editorial review: September 25, 2017

Featured Image: Breast Cancer, Breast Cancer Awareness Ribbon, Pink. Courtesy: ? 2017 Fotolia . Used with permission.

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Eric T. Rosenthal is an independent medical journalist specializing in providing insight, perspective, and transparency into various issues, trends, and controversies in oncology, and other areas concerning the politics of health care. He is currently editor-at-large with ADC Review | Journal of Antibody-drug Conjugates and Onco?Zine, special correspondent for MedPage Today, and a contributor to The Hill. Rosenthal was formerly special correspondent for Oncology Times, and senior correspondent and news director for Vital Option International?s nationally syndicated The Group Room cancer talk-radio show. Rosenthal?s reporting is known for its balance providing perspective and context, and taking readers behind the scenes by exploring the ?how? and ?why.?? This is evidenced in his series ?Eric Rosenthal Reports,? which, in June 2017, returned to Onco?Zine. He also co-authors Op-Eds and develops forums for health care-related issues with Nancy G. Brinker, founder of Susan G. Komen, former U.S. State Department Chief of Protocol, Ambassador to Hungary and former U.N. World Health Organization?s Goodwill Ambassador for Cancer Control. Rosenthal?s work has also appeared in the Journal of the National Cancer Institute, Courage magazine, and elsewhere, and he wrote a series of guest posts for PBS/WETA-TV?s ?Producers? Blog? in 2015. He founded EvocaTalk? Research & Reports in 2002 as a service that identifies, explores, and helps resolve issues, and enhances insights through interactive interviews and analysis in both individual and group settings. After beginning his journalism career at the Trenton Times in 1972, where he received a state journalism award for a magazine cover story on schizophrenia research, Rosenthal served in a number of academic public affairs positions before returning to full-time journalism in 1998. These included: editor of publications and public affairs at the Franklin Institute; public relations director at Drexel University; news bureau manager for the American College of Physicians and its Annals of Internal Medicine; and public affairs director at Fox Chase Cancer Center, during which time he founded the National Cancer Institute (NCI)-Designated Cancer Centers Public Affairs Network in 1990. He was named press officer for the American Society of Clinical Oncology?s annual meeting in 1990, and has served on numerous national committees, including the NCI Director?s Consumer Liaison Group, the NCI External Work Group for the Cancer Progress Report, the Oncology Nursing Society?s Consumer Advocacy Panel, and as journalist member of Ken Burns? Cancer: Emperor of All Maladies PBS Documentary Educational Subcommittee. He helped organize two national conferences focusing on the medical-news dissemination process at Cold Spring Harbor Laboratory and the Mayo Clinic; is an global health adviser for Concordia and served as co-chair its Concordia Summit global cancer research collaboration session in 2016 and its cancer burden in Latin America conference in 2017; and practices ?3-D journalism? by organizing and moderating panels and conferences to further develop issues he has covered as a journalist.