Cancer Victims ‘in a Panic’ Over Health Care Cuts

Nancy Costello was an inmate in the Orange County Women’s Jail when a doctor told her she had cervical cancer.

Costello, 37, needed an operation and needed one soon. But she was released from jail without undergoing surgery. For the past month, Costello--who has no insurance and little money--has searched in vain to find a doctor who will treat her.

“The cancer’s been growing for a month now, while I’m trying to get a doctor,” she said last week. “I’m in a panic. I’m freaking out about this.”

Costello’s case is unusual but far from unique, say local doctors and health officials, who estimate that 1,100 to 1,200 county residents need cancer treatment but cannot afford it.

Their emotionally trying plight has been worsened by state and county cutbacks in services for medically indigent patients. Last year alone, county officials were forced to trim more than $11 million from indigent medical services when the state reduced the program by that amount and the county could not come up with the money to take up where Sacramento left off.

That has meant that an already overburdened system of providing health care to low- and moderate-income residents is straining even harder.

In response, a group of cancer doctors is proposing to form the Orange County Cancer Care Network, a group that proponents say could deliver badly needed cancer care to people with income levels that make it difficult to cope.

The group has applied for a $500,000 county grant, but it will compete against dozens of other groups vying for a piece of a $1.7-million fund created by revenue from the state tobacco tax.

Those groups filed their requests Thursday. A panel of experts will review them before making recommendations to the Board of Supervisors in June.

The review process is internal. The exact list of applicants and requests has not been released by the county. Last year, several networks of physicians--including groups that treat infants and provide general medical care--were awarded grants under the program, which has received state recognition for its innovative use of the limited money it receives.

Cancer doctors, however, worry that their patients have so far gotten short shrift from the grant program. That’s especially ironic, they say, because money for the program comes from state tobacco taxes.

The cancer doctors backing the network argue that because tobacco causes cancer, revenue from tobacco taxes ought to help cure it.

“We think there’s a certain justice in that,” said Jacques Souadjian, a Tustin oncologist and chairman of the cancer network.

Others agree and stress that any efforts that could ease the burden for cancer sufferers are badly needed.

“Under our current system, patients with cancer are being told that they don’t qualify for emergency services,” said Bruce Vancil, assistant director of community services for the American Cancer Society’s county unit. “They come in and they’re told, ‘I’m sorry. Your cancer is at an early stage. Come back when you have an emergency.’ ”

The network would bring together a group of doctors and hospitals, working with community clinics, who would try to diagnose cancer in its early stages and quickly treat it.

The American Cancer Society, which is not applying for the money but has assisted with the application, would provide cancer screening programs. Chapman General Hospital in Orange would manage the records and distribute money to participating doctors and clinics as reimbursement for services.

Doctors at UCI Medical Center and the Clinical Cancer Center would also participate in the program, providing care to patients referred by the network.

“We are concerned that indigent patients who have cancer are not getting their fair share of funds,” said Souadjian of Tustin. “Patients could receive drugs, X-rays, professional care, nursing care through this network.”

For cancer victims with sparse resources, the need for such a program is beyond dispute.

“This has been so devastating,” said Nancylee Krueger, 53, who discovered three weeks ago that she has breast cancer. “In the past couple of weeks, I’ve probably cried more than in the rest of my life.”

The discovery was shocking, she said. The treatment, chemotherapy, has been painful. And overshadowing it all is the fear that when the bills come due, there will simply be no way to pay.

Krueger, a widow who works as a secretary and co-office manager of a chemical company, has applied for help under the indigent medical services program. But her condition is critical, so she could not wait for a response and began immediate therapy.

Doctors tell her that the care she is receiving will cost upward of $40,000, money that she does not have. But she has plunged ahead, hoping for the best.

“I can’t tell you how frustrating, how terrible it is not knowing if somebody’s going to care for you, how you’re going to pay for it, whether you’re going to get better,” she said. “You lose control of everything, and the money--it’s just astronomical.”