Joey Wahler (Host): It's a partnership providing valuable information to patients and their families. So, we're discussing cancer resources. Our guests, Andrea Shallcross, she's treasurer of the Eastern Sierra Cancer Alliance, also known as ESCA, since 2010, and Rosie Graves. Both serve on the Board of Directors of the ESCA.

This is Mountain Medicine, a podcast from Northern Inyo Healthcare District. Thanks for joining us. I'm Joey Wahler. Hi there, Andrea and Rosie. Welcome. Great to have you.

Andrea Shallcross: Thanks. Nice to be here, Joey. Thanks.

Rosie Graves: Thanks for having us.

Host: Absolutely. So, the Eastern Sierra Cancer Alliance is a valued partner of Northern Inyo Healthcare District, providing financial, educational, and emotional support for residents of Inyo and Mono counties facing a cancer diagnosis. So first, for you, Andrea, how did the ESCA begin in the first place and how was its relationship with Northern Inyo Healthcare District first established?

Andrea Shallcross: Well, back in the year 2000, a person who was a nurse at the Northern Inyo Healthcare District, formerly Northern Inyo Hospital. Her name was Patricia Ramirez, and she attended a cancer event, a three-day event elsewhere, and had that aha moment that, "Wow, we could be doing this in the Eastern Sierra." So, she came home and started putting together an organization called the Eastern Sierra Breast Cancer Awareness, that was our first name. And she was a hospital employee at the time and the hospital from day one was very supportive of our efforts, all the employees and management. They provided even a resource center location for us and still do to this day, almost 25 years later. So, we have a space where patients can visit with our volunteers and receive the emotional support and other resources.

Host: And how did you establish this relationship with Northern Inyo Healthcare District?

Andrea Shallcross: Well, because Pat was already an employee, she had relationships with management and administration and just asked, and if you don't ask, you don't get. So, like I said, they've been very supportive in providing a space as well as allowing their employees, I believe, work time, but correct me if I'm wrong, Rosie. And we have many fundraising events at the hospital where recently they sold pink t shirts in support of us and gave us a donation of $1,010 basically raised amongst the employees.

Host: And indeed, Andrea, mom always said, "If you don't ask, you won't find out," right?

Andrea Shallcross: That's right.

Host: So Rosie, for you, what support services does ESCA offer to rural cancer patients and how do you staff the organization?

Rosie Graves: Well, first and foremost, our organization is staffed 100% by volunteers, from our board members to our angel mentors to the volunteers that work the resource centers and the event support that we get continuously throughout the year. So again, I'm 100% volunteers, but the type of support, it varies, honestly. We have what I mentioned earlier was a mentor program where if someone is diagnosed with a cancer diagnosis, we pair them up with someone who's gone through that journey, and they've gone through extensive training and ongoing monthly training to be able to be there for them and give them the education that they need. We also have support groups that's held once a month at our Resource Center to bring people in, bring families in that just need someone to talk to and such.

Our volunteers are actually there twice a week at the Resource Center. And so, as an Oncology Navigator myself, I actually encourage patients and families to go there when they're open so that they can reach out to people when they just don't have someone to talk to or just feel the need to talk to someone and such. And many of our volunteers actually come from healthcare. We've got retired nurses. We've got retired mammography techs. We've got just a variety of people that just feel that they want to help. We have a psychologist from town and such. So, again, they're there and we just direct them to them from people hearing about it through town, from hearing about it from our events, from hearing about it from navigation, which we do have Oncology Navigation at Northern Inyo Healthcare District and such.

So, again, it's that funnel in. And in the resource center itself, there is also educational materials that they can get. There's prosthetics they can get. There's scarves and beanies and just a variety of things. And again, you won't know what you need until you go in there and see it probably. So, we just always recommend people just reaching out and seeing what we do have for them.

Host: And Rosie, naturally there are unique challenges faced by patients living in the Eastern Sierra. So, how does the organization in terms of its services address those challenges?

Rosie Graves: Well, one, first and foremost in a rural area, we are 250 plus miles north and south, east and west of any other larger medical organizations that have Oncology services. So, what we can do is direct people to support them with financial support to offset travel expenses and going out of town and that's the big part of our fundraising efforts that we do with our events that we have throughout the year, is helping patients not go under the financial struggles that they're faced with gas, food, lodging, unnecessary medical expenses that they have to pay for out-of-pocket and such. So, we encourage our patients to save receipts and that's our policies, and they save these receipts, turn them in, and our board approves those or approves as much as we can per month, and we send financial support to them. So, that's a big way.

Again, we talk about the proximity and not having the medical support and such, so we try to, again, just do as much as we can. The navigation piece is big at Northern Inyo where we will direct people to Angel Flight to flying people out of town other transportation partnerships with like insurances and such. We partner in with the churches in town to help patients to get to where they need to go. So, you got to just think about there's no one fit all for any cancer patient and we just have to talk to that patient, talk to their families, and figure out what their needs are, and then we start asking questions or finding the resources, and we just branch out and do it, and that's part of navigation, and that's part of what our volunteers do also, and knowing where to turn and to get the answers or possibly get the resources.

Host: Gotcha. So Andrea, how has the Eastern Sierra Cancer Alliance evolved over the past 25 years? What changes have you seen? What programs are you most proud of?

Andrea Shallcross: Well, I'd say budget wise is the most amazing change. The first year of 2001, when they were getting going the budget, they raised about 8, 000 that first year. And this last year in 2023, we raised almost $140,000. So, that's a huge change. The first, actually the very first part of a year, they gave $400 out in assistance and the next year, $5,000. But this last year, we gave a high of $73,447 to cancer patients in the area. Our monthly budget currently is about $6,000 of what we give, and we spread that amount amongst our patients. And I'd say that's probably the program that has the biggest impact on the people that we support. Because for many of them, I don't know about many, but some of them, they would not seek treatment if they didn't get assistance with travel, because they just do not have the resources. So, I can safely say that we have saved some lives.

The other program we're very proud of is one that we started back in 2010 where we got involved in a partnership with the hospital called the We Care Program, which offered low-cost mammograms. Screening mammograms to anybody who asked for it. And at that time, I believe they made a $10 copay, and then we made a substantial donation to the hospital, and then it got spent down to cover the actual costs of those mammograms. And they recently were going to do away with that program, and we said no, no, no. We really, really want that program in place. So, we have a renewed contract with Northern Inyo Healthcare District to provide those. I believe we're charging now $20 for the copay. But otherwise, we are covering the cost, the hospital is billing us directly for that. So, I'm really excited about that program.

Host: That sounds great. So, Rosie, what preventative strategies does ESCA promote to help reduce the risk of cancer among the rural communities that you serve?

Rosie Graves: Well, with the Eastern Sierra Cancer Alliance and partnering with Northern Inyo Healthcare Districts and even the other medical organizations in our area, we support any type of preventive outreach efforts and outreach is huge because anything we can do to raise an awareness to prevent cancer. So, October is Breast Cancer Awareness Month. Everyone always hears about that. March is Colorectal Awareness Month. So, what we do is have our big events, the two big events that we have is in March and October for those areas and such, so what we do is bring that awareness to get people to get their preventive services, to get their screenings. If they're not educated about what age to get proper screenings and such, we can direct them and help educate them on that, and that's part of the educational resources they do have at the centers. But again, we do this at the events that we host and, again, having the medical partners there and promoting and encouraging people to take care of themselves is key.

Host: And for all of this great work that you and yours are doing, back to you, Andrea. How is it all funded at ESCA? What can people do to lend their support? And are you finding strong support for this in the communities that you serve?

Andrea Shallcross: Yes, we are. I think that our community, especially the Bishop community, because this is where most of our donations come from, because our activity is here. We have amazing community support. We have business sponsors. I have to say, up until the year of 2020, which was the COVID year, we had never received any government type grant money. Everything was self-funded through fundraisers and donations coming in often if somebody passes away in a family, then the family, instead of sending flowers, they ask for donations to go to our organization. And that's been a wonderful thing.

There are many, many angels out there that we don't even know their names because we get donations without knowing where they came from. And when we have a fundraiser, like I said, the business sponsors are huge because they pony up a bigger amount of money per pop. And then, for the privilege, we put their names on our advertising, like our fundraiser T-shirts. Actually, the fundraiser, we didn't say what they are. They're fun runs that are 5k and every participant gets a t shirt or some other thing. Last March, we did a beanie with our logo on it, which was really a great thing.

So yeah, since 2020 though, we've got a few local grants because of COVID, which was super helpful because our donations really tanked that year. And we've also gotten onto some-- it's not a government sponsor, but we've received some grants from the Albertsons and Vons Foundation, so we are really excited about that new partnership. They also fund us with breakfast bar items for our events. So, we're really grateful to Albertsons and Vons Foundation, the Department of Water and Power Employees' Association. We annually reapply to be one of their recipients. Their employees have amounts of money taken out of each paycheck, which, you know, really mounts up, and they're the biggest employer in our area. So, I really want to do a great shout out to the Los Angeles Department of Water and Power for that reason.

Also, always, Northern Inyo Healthcare District has been a huge sponsor in years when they can. They have allotted us funding, but always support in terms of the space at the Resource Center and every other kind of support.

Host: A great job there with the shout outs, Andrea. Just a couple of other things for you too. Rosie, what best advice can you give to cancer patients and their families that are joining us about navigating the emotional and physical challenges they often encounter? And where does ESCA fit into all that?

Rosie Graves: Yeah. The most important thing is to ask and whether you're asking your primary care doctor or you're asking for a social worker or an oncology navigator, there are resources at every medical organization and oncology navigation is growing immensely right now and such. So, Northern Inyo Healthcare Districts jumped on that bandwagon eight years ago. And, you know, we actually just hired another navigator, which is great and such. And so, those type of resources funneling into resources like the Eastern Sierra Cancer Alliance that gives that emotional support, that gives the financial support that can direct them to women needing prosthetics and needing bras and needing scarves and hats and such for all genders.

You know, again, ask. I would just say please ask. There's always help out there. There's national organizations as well, and our volunteers will direct to the national support depending on what their cancer diagnosis is, but it doesn't start unless someone asks. So whether you're the family member of a loved one that's going through the diagnosis or you're that patient yourself going through it, please find out about what local resources that you have closest to you and such and where you can find the most support.

Host: Absolutely. Great advice indeed there. And in summary for you, Andrea, what are one or two key takeaways you want those joining us, if they are cancer patients, to understand about the resources you offer?

Andrea Shallcross: I want them to know that there are people who care and are willing to help. One thing we didn't mention is we have something like a Make-A-Wish Program kind of in the back of our arsenal, which is if you have something that you always wanted to do in your life, but never had the opportunity. And if it's something we can help with, we're going to try to set it up, whether it's fly fishing or whatever it is. We try to find somebody who can help with that, making your dream come true.

 But the key takeaway is we're here, you're not alone. I think that alone is probably very, very big for somebody who's facing a cancer diagnosis, that feeling of, "Oh, my God, I'm the only one." And just to know that there are others out there who've been there, who've survived, who can take your hand and lead you through the journey, I just think it's priceless.

Host: No question about that. So again, keep in mind, folks, just ask for help if you need it. And there are indeed people that care. We trust you're now more familiar with cancer resources. Andrea, Rosie, keep up your great work and thanks so much again.

Andrea Shallcross: Thanks so much for having us. We appreciate the opportunity to outreach.

Host: Absolutely. And keep in mind, Northern Inyo Healthcare District is proud to partner with the Eastern Sierra Cancer Alliance, encouraging all cancer patients across the Eastern Sierra to connect with ESCA for vital support resources. ESCA relies on the generous support of the communities it serves. To learn more about available services or to make a donation, please visit escanceralliance.org. And for more information about Northern Inyo Healthcare District, please visit nih.org. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. Thanks again for being part of Mountain Medicine, a podcast from Northern Inyo Healthcare District.