CANCER AND CARING
EVERY DAY BLACK WOMEN DIE FROM BREAST CANCER— SOMETIMES SIMPLY BECAUSE THEY CAN’T GET TO CHEMO. THERE ARE WAYS YOU CAN HELP BY JEANNINE AMBER PHOTOGRAPHY BY GINA LeVAY
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MAKEU P, T. COOPER USING MIR AB ELL A
enise Mack remembers the day she almost lost her fight with the dreaded “C.” Diagnosed with stage II breast cancer in 2003, Mack, a retired finance manager from the Bronx, says the first few treatments of chemotherapy were difficult but tolerable. But over time, the side effects—constant vomiting and bonecrushing fatigue— became more than she could bear.
HEALTHY &
HAPPY
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HEALTHY & HAPPY : CAREGIVERS
Mack credits her survival to sisterhood.
Mack accompanies women to chemo.
A cancer survivor, Denise Mack (right) now cares for others.
“It put me in a dark place,” she recalls. “I remember lying in bed one day and I didn’t want to get up, eat or even bathe. I felt awful, I thought to myself, If this is what it’s going to be like, I’d rather go on home with the Lord.” Mack lay in her dark room, sick, despondent and alone. Then the phone rang. One of her friends was calling to check in. “I said, ‘I don’t want to live anymore,’ ” Mack admits. “And she said, ‘Oh no you don’t. If I have to drag you myself, you’re going to complete the treatment!’ ” From then on, Mack’s friends accompanied her to every appointment. But Mack would look around the treatment center and realize with dismay that every other woman (and a few men) there seemed to be alone. Ten years later, Mack, wearing a bold pink blouse with a matching pedicure, dabs her eyes at the memory: “My girlfriends saved my life. If I’d stopped treatment, I wouldn’t be here.” She vowed to pay the kindness forward by supporting other patients facing the disease alone. Today, Mack is part of Bronx Oncology Living Daily (BOLD), a program at Montefiore Medical Center in the Bronx. She and 45 other trained volunteers, half of whom are cancer survivors, are BOLD Buddies—companions and guides to patients as they navigate through treatment. Researchers say this kind of support may be the key to saving scores of Black women who die unnecessarily from breast cancer annually.
Increasing Disparities
In March, the Avon Foundation for Women released the 2014 Racial 144 ESSENCE .COM OCTOBER 2014
This coffee can helps save lives.
Women would say, ‘I can’t afford bus fare’ or ‘I don’t have a sitter for treatment.’ It’s heartbreaking. —LESLIE MONTGOMERY, M.D. Disparity in Breast Cancer Mortality Study, which compared the breast cancer death rates of White and Black women. The results were alarming: Although the mortality rate for White women has fallen dramatically in 20 years, the death rate for Black women has remained the same—meaning the racial disparity in breast cancer survival rates is increasing. If the mortality rate were equal, 1,710 fewer Black women would die from breast cancer each year, says Marc Hurlbert, executive director of the Avon Foundation Breast Cancer Crusade and coauthor of the study. Hurlbert says our increased death rates are, in part, because we don’t get treatment soon enough. This is especially true for low-income Black women. “There can be a doctor shortage or long waits for surgery in public hospitals,” he says. But unequal access to care is only partly to blame. For some Black women doctors have noticed that personal issues—anything from not having child care to having to work— can stand in the way of treatment. At Montefiore, doctors, social workers and volunteers look for interventions.
Missing the Window
Before she took her post as director of breast service at the Montefiore Einstein Center for Cancer Care, Leslie Montgomery, M.D., spent more than a decade as a breast surgeon at Memorial Sloan Kettering, a private cancer center on Manhattan’s Upper East Side. When she arrived at Montefiore in 2010, she was struck by how many patients weren’t adhering to their treatment plans. They were missing tests, chemo appointments— even surgery. “And I’d hear explanations that never crossed my mind for why you would stop your cancer treatment,” Montgomery recalls. “Women would tell me, ‘I can’t afford the bus fare’ or ‘I can’t take any more time off work’ or ‘I don’t have money to pay a babysitter.’ ” For many patients in underserved communities, especially those caring for children or parents, “these issues take priority over their breast cancer,” says Montgomery. “It’s heartbreaking, especially because there is an optimal window of time postsurgery when chemo is most effective.” Miss that window and the chance of survival diminishes. w
HEALTHY & HAPPY : CAREGIVERS
Three years ago, moved by the plight of a patient in her eighties who she learned had to ride several buses home after treatment, Montgomery set up the Breast Cancer Relief Fund. It’s not a big nonprofit but a bright coffee can at a nurses’ station so hospital staff, visitors and even patients can help pay for patients’ incidental expenses. Montgomery’s fund illustrates the small measures that can have a meaningful impact in the lives of cancer patients.
A Friend Indeed
radiation. She was getting burn marks on her chest and she’d feel so sick,” says Mack. “She said, ‘I’m not going through this anymore.’ I was like, ‘Oh, yes, you are! You’re not going to give up now.’ And I stayed with her for every single treatment after that. That was 2011, and we’re still friends today.” £ ESSENCE contributing writer Jeannine Amber (@jamberstar) lives in Brooklyn.
THE PROGRAM
On a larger scale, BOLD’s efforts embody the care and support that has proven to be invaluable. As a volunteer, Mack has accompanied patients to doctor appointments and chemo treatments and connected them with social service agencies to help secure insurance. Often, Mack’s “buddies” need her to help manage their fear. “Some say, ‘I’m afraid of what the doctor will say at my appointment. Can you come?’ ” she says. “Of course—I’ll do whatever it takes.” The BOLD Buddies program was designed to provide such emotional support for cancer patients, explains Alyson Moadel-Robblee, Ph.D., director of psychosocial oncology at the Montefiore Einstein Center for Cancer Care. “Based on the Avon Research, our new slant is to help empower women to continue their treatments,” she says. “Some patients are mistrustful of the medical profession. Others say they want to leave things in God’s hands. Our BOLD Buddies help build trust between the patient and her doctor so women get the help they need.” Remembering how her family and friends pulled her from despair, Mack says her greatest purpose is reminding women that someone cares. “My first patient was going through 146 ESSENCE .COM OCTOBER 2014
GET INVOLVED
FOR MANY BLACK WOMEN WITH CANCER, THE BIG HURDLE IS ASKING FOR HELP. OFFER YOURS
Volunteer
Even if you aren’t a cancer survivor, you can still give your support, says BOLD director Alyson Moadel-Robblee, Ph.D. “If you have a few hours, go to your local cancer center or hospital and volunteer,” she says. Offer to go to treatments, run errands or prepare a meal.
Listen Up
BOLD Buddies get crafty.
The women bond while crocheting.
One of the best gifts to a woman struggling is a sympathetic ear. “Sometimes Black women don’t want to talk to family and friends because they feel like a burden,” Mack says. Call or visit a patient and ensure she’s going to appointments.
Be Specific
All hands are on deck for health.
If you ask a patient if she needs assistance, she’ll probably say she’s fine, shares Avon’s Marc Hurlbert. Be specific with your offer to help. “Say ‘I’m going to make lasagna and bring it over for you and the kids’ or ‘Can I take your laundry with mine?’ ”
Connect Her With Help
My girlfriends saved my life. —DENISE MACK
Not sure how to answer a patient’s question? Visit cancer.org, avonfoundation.org or cancercare.org, all of which have resources for patients, caregivers and friends. —J.A.