Navigating Breast Cancer Care Barriers in Rural Settings

In rural health care, the path to a timely breast cancer diagnosis and treatment is rarely blocked by a single obstacle. Instead, as MinhTri Nguyen, MD, discussed, it is often an "accumulation of multiple things" that creates significant delays for patients.

Nguyen broke down the complex web of challenges facing rural populations, categorizing them into:

• Systemic Factors: High-level hurdles such as transportation logistics, financial constraints, and caregiver burden.
• Individualized Factors: Unique personal stories and specific circumstances that vary from patient to patient.

Nguyen, a breast medical oncologist and editorial advisory board member for ONCOLOGY, emphasized that these hurdles add up quickly, especially when they appear early in the care journey. He advocated for a proactive approach, where the entire care team—including physicians, nurses, and coordinators—prioritizes asking the right questions early on to identify and mitigate these struggles before they compromise patient outcomes.

Transcript:

It’s not just one thing. It’s an accumulation of multiple things. Then, even within that, there are systemic factors and individualized factors. The larger systemic factors are usually transportation, finances, [or] caregiver burden. There’s much more, but these are things that can affect a patient’s ability to get care quickly. I would say, for the patients whom I’ve seen, it’s not just one or the other. Usually, it’s a combination of that, and these small burdens or hurdles that they have to go through add up, especially if it starts early in their care. When we talk to our patients, there’s limited time to do this, but there’s a whole care team that at every point, especially earlier on, one of the members—be it the physician, the nurse, the nurse coordinator, or APP—has to start thinking about how we ask these questions or how we get this information from our patients early so we then know what’s facing their particular struggle. I talked about the systemic issues that we have to solve, maybe from a policy level [or] maybe from an institution level. Then, there’s the individual issues as well that may be very particular to a patient.