Reaching Out for Life Hollings Cancer Center’s mobile health unit goes on the road to provide cancer screening, early detection and prevention strategies By: Molly Hulett 
Last August, Pamala Reese decided she had let too many years slip by between mammograms. At age 46, this busy machine operator and mother of two grown sons says her personal medical history, paired with a powerful prescience, nudged her to take charge of her health. Reese received a mammogram on Hollings Cancer Center’s mobile health unit, a medically equipped 40-foot recreational vehicle that stops at her health center in North Charleston. Her mammogram triggered a need for a biopsy. When the health center called to schedule an appointment to discuss the biopsy results, dread seeped in as she realized something was wrong. Reese initially submerged herself in denial when she learned she had breast cancer. The denial quickly turned into fear. “At first, it was a death-defying situation to me,” she remembers, recalling the paralyzing sensation of hearing the diagnosis and trying to comprehend a blur of words across a page. “It was like someone had just given me a death sentence.” Because Reese needed immediate follow-up care, she became part of HCC’s Avon Breast Health Patient Navigation Program, which helps uninsured, low income and underserved women receive timely, thorough and top quality care throughout the diagnosis and treatment of breast cancer. Patient navigators guide women through the complex health care system, assisting with a vast range of issues, including completing financial paperwork, arranging reliable transportation, scheduling appointments and providing emotional reassurance. The mobile health unit and the patient navigation program work in tandem to help provide the best outcomes for women. Patient navigator Silvia Martin stood by Reese in the ensuing weeks as she received expert multidisciplinary care from HCC’s Comprehensive Breast Care program. Medical oncologist Alberto Montero, MD, and breast surgeon Megan Baker, MD, along with a dedicated oncology team, helped Reese make informed choices throughout her treatment, from a minimally invasive stereotactic biopsy to successful breast-sparing surgery that removed the cancer, which was in its early stages. “Silvia and the others took care of everything,” says Reese, who exudes gratitude for the warmth and breadth of care. “They were like my family. I didn’t have to worry about anything. They made my burden much lighter.” Now on long-term medication to help prevent the recurrence of disease, Reese credits her deep faith, dedicated doctors and supportive family for her recovery. “I feel truly blessed to be here,” she says, relieved that a recent check-up revealed a clear mammogram. “It turned out not to be as bad as I though it would be. If I had not gotten that mammogram when I did, I don’t know what would have happened. Now I always urge other women to get their mammograms. It’s so important to find out what is going on in your body.” Reducing cancer disparities
Since 1998, Hollings Cancer Center’s mobile health unit has served as a medical office on wheels for thousands of adults like Reese, extending the center’s comprehensive care into twelve rural Lowcountry counties. In May 2007, HCC will launch a new mobile unit, which includes a mammography room, exam room, lab, and dedicated space for counseling and waiting. The unit is equipped with cutting edge digital mammography, one of the best imaging techniques for the early detection and diagnosis of breast cancer. Health care professionals on the new unit will offer screenings for breast, cervical, skin, prostate, colorectal and mouth cancers. Additionally, patients will receive appropriate educational materials and guidance for key health strategies such as self-screening, nutrition and exercise, and tobacco cessation. Thanks to generous support from organizations like Nissan North America, Wachovia and the Susan G. Komen Breast Cancer Foundation – as well as various departments throughout the Medical University of South Carolina – the mobile health unit offers a caring, consistent health care home for medically underserved adults who have difficulties accessing health care and who are at risk for developing cancer. 
“Hollings Cancer Center is committed to eliminating racial, economic and geographic disparities in cancer prevention and treatment throughout the state,” says Andrew Kraft, MD, HCC’s Director. “The mobile health unit helps broaden our mission to encompass communities that need it most.” The mobile health program partners with federally funded community health centers and DHEC clinics to become a part of patients’ routine medical care. From 2004 to 2006, more than 4,000 people were screened on the unit – many of whom might never have otherwise received this type of care. For example, survey results demonstrate that 40% of women receiving breast cancer screenings on the unit had never had a mammogram or had infrequent mammograms. These same women reported that they would not get a mammogram if the mobile unit did not come to their community. Brenda Nickerson, RN, MSN, HCC’s Administrator for Cancer Prevention and Control Research and Outreach, says the mobile health unit assists many women in the Best Chance Network, which helps screen South Carolina women within certain age and income parameters for breast and cervical cancers. “Because the community health centers in the network don’t have mammography, it might take a woman a couple of months to get a mammogram after her clinical screening,” she explains. “Now, we work with those providers to make it easy for a woman to get a mammogram on the mobile unit, just steps away from her doctor’s office.” The unit combines state-of-the-art technology with state-of-the-heart compassion. “Over and over, patients have said they feel more comfortable on the unit than they would feel in a hospital or clinical setting,” says Debbie Bryant, RN, MSN, HCC’s Director of Outreach Services. “The clinicians and staff on the unit understand the patients’ communities. They reach out beyond hospital walls to have a true personal touch with patients. It’s a warm, nurturing place.” Boosting healthy worksite partnerships
The mobile health program also hosts cancer awareness events, such as well-attended annual summertime skin cancer screenings at local parks, and provides worksite screenings, an area that will expand with the introduction of the new unit. Last October, Select Health of South Carolina booked the unit for a day to provide mammograms for employees in honor of Breast Cancer Awareness Month. 
“We want to be able to help our employees reach their goals to become healthier,” says Pam Culbert, the organization’s Wellness and Training Coordinator, noting that screenings are part of a plan to achieve “well workplace” certification from the Wellness Councils of America. “We felt like this was one of the ways we could help stamp out breast cancer,” continues Culbert, saying she received overwhelmingly positive feedback from employees. “The people who participated absolutely loved the convenience of it, and they said it helped them not put off getting a mammogram. We also received a lot of comments that the people on the van were very, very friendly and put everyone at ease, which helps a lot when you’re getting a mammogram. We’ve already booked our date to have them come back this October.” As it covers the broad stretch of miles between corporate partners and rural counties focused on a healthy future, the mobile health unit is driving toward a cure and reaching out for life. | 
