Promise Fund of Florida creates equal opportunity for low-income women to defeat breast cancer
South Florida Sun Sentinel | November 2, 2022
By Scott Luxor, Correspondent
While breast cancer is an equal opportunity scourge for people regardless of income, screening and treatment of cancer is not available to all women everywhere. But there is hope for women on the economic margins of society.
Nancy Brinker, the founder of the globally recognized Susan G. Komen Foundation, recognized that the numbers of women at risk were at “unacceptable” levels in Palm Beach County, where she now lives. Brinker started the organization in 1982 in memory of her sister who died from cancer at 36.
But after raising and investing over a billion dollars toward a cure and assisting over 220,000 women with care and treatment, Brinker realized that many women still were not getting helped because they simply didn’t have the means.
To address the hard reality that so many women with cancer continue to face, Brinker co-founded the Promise Fund of Florida in 2018 in Palm Beach County. The fund is a nonprofit committed to helping women overcome financial as well as cultural barriers to help prevent cancers from getting to the point where it’s too late to get them effectively treated.
According to the fund, marginalized women are dying at a much higher rate from breast (and cervical) cancers. In the U.S., Black women are twice as likely to die from cervical cancer and 40% more likely to die from breast cancer than white women. A similar disparity exists for Hispanic women where 40% more likely to be diagnosed with cervical cancer, and 30% more likely to die from the disease.
The goal for the Promise Fund has been to improve health equity and reduce deaths from late-stage breast and cervical cancers. They employ patient “navigators” or guides who help patients through screening and treatment of the disease. The difference with this fund is that none of the women who are served have to forgo treatment because of their limited incomes.
The fund accomplishes that by partnering up with community-based healthcare service providers like the Boynton Beach-based Caridad Center, the largest free healthcare clinic in Florida, in an effort to make the service both efficient and to reach as many at-risk women as possible.
Promise Fund co-founder
Brinker could be considered the mother of the breast cancer awareness campaigns.
“After 40 years of building the Susan G. Komen Foundation, I had a wake-up call that came when I saw these startling cancer numbers coming out of Florida and Palm Beach County. All these women were at risk, even though over the years the foundation raised billions of dollars, mostly for research and education. Through affiliates all over the country, we gave almost $2 billion toward community care and health.”
Brinker said that she realized something was wrong. She realized that the model that was set up with the foundation to help women wasn’t reaching everyone who needed to be reached.
“According to the Women’s Philanthropic Trust assessment, Palm Beach County came in 49th out of 50 states in terms of the health benefits given to non-elderly women,” she said. “That was shameful to me. There are between 80,000 to 100,000 women at high risk in the county.”
Brinker said that before she died from her struggle with the disease, her sister asked her to do things.
“The first thing she asked me to do was to fund cancer research so we would understand what this disease is all about,” Brinker recalled. “And then she wanted me to make sure every woman had access to the screening and care and treatment. So the Promise Fund is really fulfilling the second part of the promise I made to her.”
Brinker said that the biggest challenge has been creating a system that allows people who are under-resourced and have no insurance or other safety net, to have equal access to health benefits.
“We’ve already educated, screened and treated almost 20,000 women just this year,” she said. “Next year, we want to double it to 40,000. We really want to reach as many of the at-risk population of women in Palm Beach County as possible.”
In addition to breast cancer treatment, Brinker said that they’ve added cervical cancer screening and treatment to their services.
“I spend most days thinking about how we can make our healthcare system better,” Brinker said. “I’m very excited and working hard to connect with the right people in Washington to get attention to this healthcare model.”
Brinker said that they are creating a model that can be used in any community in the United States. She said that part of the success of the Promise Fund is that they involve existing health centers in communities to serve their local populations.
“Communities have a big role in diagnosing cancer early, making sure women are prepared and then educating and treating them,” Brinker said. “You can’t just do this by sending a patient off to a cancer center five hours away from where people live, because the women we treat have limited income.”
The compilation of putting together various services for women is one of the distinguishing features of the fund. A major barrier to treatment is transportation. For the last four and a half years, the Promise Fund has worked with Uber Health to get patients to the clinic for screening and treatment.
“The other thing we do is aggregate services,” Brinker explained. “We have a special problem in Palm Beach County that we don’t have in most other counties. We have no county hospital or non-profit hospitals. We have mostly private care that operates for a profit. So we’ve had to go to each one of them to ask them to donate services to us rather than money.”
Caridad patient navigator
Aydeivis Jean Pierre is a patient navigator at Caridad Center. She has a specific role through the Promise Fund to help guide breast cancer patients through education, screening and treatment. She is also a translator for patients whose primary language isn’t English.
“I am responsible for doing the mammogram screening, doing the scanning and making the appointment for the women,” she said. “I help the patients with appointments because sometimes they have transportation issues. We also help schedule them with an oncologist and the surgery if needed.”
Jean Pierre believes in the mission of the Promise Fund because she sees patients at Caridad who desperately need the assistance.
“The fund is needed here because it helps low income people in Palm Beach County to qualify for screening and treatment for cancer,” she said. “Otherwise, many of these patients would never be able to afford or even be aware of their cancer.”
Jean Pierre said that before the Promise Fund cancer diagnosis was often late. Because patients knew they didn’t have the money to take care of any serious problems, they would wait until late in the development of cancer when it might be too late for any real chance to cure it.
“Now, with the Promise Fund, a lot of patients can benefit,” she said. “Before, when a patient needed information and education, we would provide it. But we couldn’t do the treatments for mammograms or other treatments. Now, with the fund, they can actually get the procedures done that they need and it can be done right away.”
Martha Lerma, of West Palm Beach, learned of her breast cancer in late 2021.
“I felt a lump in my breast, but I never went to a doctor, because I always had to work and I didn’t have enough money,” she recalled. “One day, I went to my church and told them about it. I was afraid it was going to be too expensive for me. They told me to go to the Caridad Center and that they could help me, because of the Promise Fund.”
Lerma decided to go to the clinic in December 2021.
“When I came to Caridad, the patient navigator ordered a mammogram for me,” she said. “She also handled all the process when it came to going to the oncologist. They told me that, in the past, they weren’t always able to pay for chemotherapy treatment because it’s very expensive. But they told me that now the Promise Fund would pay for it all.”
Lerma received six months of chemotherapy. Then in July, she got three weeks of radiation therapy. After that, the cancer went into remission.
“They did what they promised and now I’m cancer-free,” she said smiling. “If the Promise Fund wasn’t there, I might be dead by now.”
Cancer survival rates
When cancer is more advanced, it is more expensive to treat. The following numbers illustrate the issue:
Costs: For a patient with Stage 1 breast cancer, the average treatment costs $43,530; for a patient at Stage 4, that amount jumps to $223,568. The need for chemotherapy also impacts the expense of care. For breast cancer patients not receiving chemotherapy, the overall healthcare cost within two years of diagnosis averages $80,870; for those who receive chemotherapy, that figure rises to $200,045.
Survival rates: For a patient diagnosed at Stage 1, the 5-year survival rate is 99 percent. When the diagnosis shows cancer at Stage 4, the survival rate is 22 percent.
To learn more about the Promise Fund, go to: promisefundofflorida.org