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New Hampshire women diagnosed with breast cancer quickly find they’re not alone



Last modified: Saturday, October 04, 2014
When someone is diagnosed with breast cancer in New Hampshire, the state’s medical and advocacy community hope one thing is clear: You don’t have to go at it alone.

There’s a solid network of support groups, not to mention special lodging and transportation services available for those going through treatment. There are programs to connect low-income or uninsured residents with care, and still more programs to educate the public about risk factors. And there’s no shortage of volunteers who rally around the cause, during October – breast cancer awareness month – and year-round.

That kind of support is important when such a diagnosis happens often in the Granite State.

It’s the most commonly diagnosed cancer among women in New Hampshire, according to the Department of Health and Human Services. Between 2006 and 2010, breast cancer accounted for 29 percent of new cancer cases among women, and there were an average of 1,050 new cases each year.

Newly released figures from the Centers for Disease Control and Prevention also suggested that New Hampshire had one of the highest breast cancer incidence rates in the nation in 2011.

That standing might seem alarming at first – and, indeed, the disease is nothing to take lightly – but it requires context. Just ask the Dartmouth epidemiologist who helped to compile the statistics.

Judith Rees, also the director of the New Hampshire State Cancer Registry, said the state “collects very high quality cancer data” compared with others. And in 2011 in particular, she said, New Hampshire received extra funding for a special project to make sure its figures were as complete as possible. States that miss out on even 5 or 10 percent of their diagnoses are likely going to have lower rates than New Hampshire, she said.

The state’s relatively small population also means that its rates can fluctuate widely between years, Rees added. And then there are other factors at play: nutrition, exercise, smoking, alcohol use and access to health care, to name a few.

“It’s very difficult to untangle what’s going on in a whole population to understand why one place has a higher rate of cancer than another,” Rees wrote in an email, “but most experts agree that a healthy lifestyle plays a big part in cancer prevention.”

Screening, prevention 
strong in state

There’s also another caveat to the recently released CDC data: In the same year New Hampshire had one of the highest breast cancer incidence rates, it also had one of the lowest mortality rates.

The state’s lower mortality rates could be explained in part by access to health care and screening patterns, Rees and others said.

Sharon Gunsher, medical director of the Breast Care Center at Concord Hospital, said she often stresses to newly diagnosed patients that breast cancer is not inherently “a death sentence.”

“Modern therapies are extremely effective,” Gunsher said. “It’s almost like talking women off the ledge. Sometimes they are ready to come in and go out and buy a cemetery plot.”

Gunsher said treatments have evolved dramatically in recent years, and new work being done to identify genetic risks, for example, has the potential to further improve the effectiveness of medical options for breast cancer.

José Montero, director of the New Hampshire Division of Public Health Services, said a majority of breast cancer diagnoses in the state are caught when they are “in situ” or local, often before they have spread or become more severe. Between 2005 and 2009, the most recently available data, 75 percent of diagnoses detected breast cancers in that local stage.

Additionally, Montero said that in an effort to address a range of cancer – including breast cancer – the state has made a concerted effort to bring together people from the medical community, the advocacy community, the state offices that connect eligible residents with financial assistance and other areas. The partnership emphasizes educating people about risk factors, informing medical providers about the resources available for patients who are diagnosed and leveraging support networks to help get the message out, Montero said.

Such a collaboration has made it possible to provide free breast cancer screenings to about 4,000 low-income uninsured residents over the last fiscal year, Montero said. Within that group, he said 34 people were diagnosed with breast cancer.

Upon diagnosis, Montero said, patients are given the option to connect with the state’s Medicaid office to see whether they can enroll to receive help paying for necessary treatment. The state doesn’t want to leave someone to shoulder the financial burden of treatment on their own if they are unable to afford it, he said.

“That’s the way that we help create a system that makes us a healthier state,” Montero said of the screening and assistance program.

Getting the word out

Advocacy groups, like the American Cancer Society, also play a critical role in the state’s effort to address breast cancer, Montero said.

The cause has a major presence in the Concord area: The local affiliate of the American Cancer Society’s Making Strides Against Breast Cancer Walk has produced the highest fundraising per capita out of the network of similar walks held annually across the nation. This year’s event will take place Oct. 19 at Memorial Field, and the Concord Monitor is a corporate sponsor.

Its volunteer director of teams, Kathi Russ, said the event is yet another testament to the support network surrounding breast cancer in New Hampshire.

Russ got involved 18 years ago after a friend was diagnosed, and the event soon became her “passion” – but this year, it carries even more personal significance.

Just this February, Russ said she was diagnosed with breast cancer during a routine mammogram. She’s fortunate, she said: After surgery and initial treatment, she’s doing well and “the prognosis is very good.”

She’s also fortunate, she said, because her years volunteering gave her some comfort in knowing that she could turn to Cancer.Org – the American Cancer Society’s website – for initial questions on different treatment options. She also knew she could trust the care she received locally through Concord Imaging Center and Concord Hospital, she said.

The funds raised through the Making Strides event go toward helping others ease the burden of their diagnoses, Russ said – in many cases, available to people with all types of cancer. Those programs include a support hotline available around the clock, a network of volunteer drivers to shuttle people around New Hampshire back and forth to treatment, a “Hope Lodge” where families can stay free of charge if their treatment requires an overnight trip, and more.

These might seem like small things, Russ said, but they can make a world of difference.

“A lot of people really benefit from the programs,” she said.



(Casey McDermott can be reached at 369-3306 or cmcdermott@cmonitor.com or on Twitter @caseymcdermott.)