Brian DeCraene was diagnosed with testicular cancer in October 2010. Although testicular cancer usually occurs in young men in their late teens or early 20s, Brian is in his mid-40s. The cancer has moved into his lymphatic system, which means it is moving around his body.  As the cancer settles and grows in different lymph nodes, it causes quite a bit of pain.  Brian has worked in construction in Elkhart County all his life but, due to the economic downturn, has not worked for several months. That means Brian does not have health insurance, and as a waitress, his wife’s employer does not provide health insurance.  Brian has applied for Medicaid and disability income from the Social Security system.  United Cancer helped Brian pay for his medication, treatment costs, and transportation to-and-from the doctor.

In this picture taken in September 2010, Julie Pieper has received 9 of the scheduled 12 rounds of chemotherapy for colon cancer.  Julie had surgery to remove the cancer in March 2010.  She was working full time when she was diagnosed, but now is only able to work part time.  Fortunately, her company's disability package allows her to work part time and still receive disability payments.  Julie has a 10 year old daughter and 3 year old son, and she said she is struggling to keep up because the medication keeps her awake at night. Although most people never expect to have cancer, Julie was not completely surprised that she was diagnosed with colon cancer, as her father has also had colon cancer twice.

Davonda Wiley is a soft-spoken 21-year-old young lady who has already had half her stomach removed due to her stomach cancer.  In this picture, Davonda is undergoing chemotherapy and will soon receive radiation treatments.

Davonda is a graduate of Northridge and now works at The Maples nursing home, where she is a CNA.  Davonda is studying Medical Billing and Coding through an online curriculum at Antonelli College in Jackson, Mississippi. 

Davonda loves to hang out with her friends at local restaurants like McDonald's, Applebee's & the Olive Garden.  She also attends many local events such as The Elkhart Jazz Festival, Rhapsody in Green, and she is active in the 4-H Fair.  Davonda is doing a great job in not  letting her cancer keep her down. At the time this picture was taken, Davonda was looking forward to a trip to Miami with her cousins and a family reunion this summer in Tennessee. 

Fortunately, Davonda has a very involved and caring family, but her parents insurance will require them to cover 20% of what could easily be a $350,000 treatment plan.  Davonda is a great example of your donations at work for your neighbors with cancer.

Little did Deb Hall realize when she was diagnosed with colon cancer, that she would have surgery to remove 8 inches of her colon and be fitted with a chemotherapy pump.  However, the results of her treatment have been very good and she expects to be finished with treatment by the summer of 2010.  Deb is fortunate to have received strong support from her family, especially from her husband Troy, who is also a colon cancer survivor.

However, colon cancer came at a bad time for Deb, because she had just begun a new sales job and, still recovering from The Great Recession, her husband's home building business was very slow.  Compounding their financial worries, Deb and her husband purchase their own health insurance because they are self-employed.   Deb Hall is a great example of how your donations can help ease some of your neighbor’s financial worries while they are in cancer treatment.

Dwight & Regina Gunter have shared a life together, raised five children, and now share the experience of both having cancer.  Last fall, Dwight was diagnosed with kidney cancer and underwent an eight hour surgery.  Fortunately the surgeon was able to remove the tumor while keeping most of Dwight’s kidney.  And since kidney cancer is rarely treated with chemotherapy or radiation, Dwight’s treatment is complete.  Regina was diagnosed with breast cancer, also had surgery, and is receiving four rounds of chemotherapy.  In early March 2010, both are cancer free, and Regina is receiving her last chemotherapy treatment .  Even with the excellent family coverage that Regina has through the Elkhart schools, Dwight estimates the out-of-pocket costs for their cancer treatments to be $4000.

 Dwight is semiretired, but still works part-time in sales for a printing company, and Regina is a special education teacher in the Elkhart system.  Having raised five children of his own, Dwight enjoys working with children and spends much of his free time as a soccer & volleyball referee for many of the local middle school and high school student athletes.  After such a rigorous surgery, one might fear that the physical demands of a soccer referee might be too much, but for Dwight there is no question…he will return.

 The Gunter’s are a great example of your donations helping your Elkhart County area neighbors who are in cancer treatment.  As always, your steadfast support is greatly, greatly appreciated!

Mark Watkins was born in Nappanee and now lives in Goshen and in February 2010 is in treatment for colon cancer.  Mark is a great example of getting checkups, because his exam found a suspicious polyp in his colon that was diagnosed as cancer.

Mark has an interesting and unusual career.  Although he lives in Elkhart County, he spends the time from Memorial Day to Labor Day working in Oregon as a fisherman in a program designed to help improve the chances of survival for the salmon population.  Mark works in his own small boat fishing for pike minnow in the Snake River Valley and says that it is one of the most beautiful places in the world.  Mark also sells antiques in Arizona, and the rest of his time he spends searching for antiques, doing woodworking projects, collecting Indian artifacts, hunting mushrooms and occasionally fishing in Indiana for pleasure.  Mark is also an accomplished cook and says that his time in treatment has allowed him to experiment with new recipes.  Mark wishes that he could write a cookbook during this down time while he is in treatment, but he says that the chemotherapy affects his concentration too severely.

Mark hopes to go back to fishing in Oregon when he's done with his treatment in May 2010, but says that it is extraordinarily physical work.  He says that the water on the Snake River is extremely fast and cold, and said it's like riding a roller coaster, extreme fishing.

Mark has not been able to work since his diagnosis, and appreciates United Cancer's help as he has had surgery and will spend six months receiving chemotherapy.

United Cancer calculates our Total Benefit to the Community based on the results of our Journey Through Treatment program, which helps the cancer patient 1) form a comprehensive plan for their time in treatment, 2) catches insurance coverage gaps, 3) offers referrals, 4) provides emotional support and 5) direct financial support.

The graph above shows United Cancer’s Total Community Impact for 2010, which is estimated to be $207,550.00.  The largest portion of United Cancer's benefit (33%) was in Direct Financial Aid going to 1) people in cancer treatment ($58, 241), and 2) women needing help paying for mammograms ($10,275) totaling $68,515.00.  This Total Financial Aid figure represents an increase of $9,919 or 17% over 2009.  In 2009, United Cancer registered 153 cancer patients and helped approximately 82 underserved women pay for mammograms at Goshen Health System, totaling 235 people.

Dollars directed toward direct staff time with cancer patients were $56,850, which accounted for 27% of our total benefit and represents a decrease of $2,396 from 2009.  United Cancer was able to leverage staff dollars by hiring a part-time caseworker in 2010.  So even though staff dollars are lower, staff hours dedicated toward cancer patients actually increased in 2010.

The Journey Through Treatment program is designed to provide emotional support and help cancer patients form a plan for their time in treatment.  The plan focuses on seven areas including:  1) understanding the patient's diagnosis and treatment, 2) family issues related to cancer treatment, 3) information about the healthcare industry, 4) researches specifics about the patient’s insurance coverage, 5) budgeting and estimating treatment costs, 6) income replacement while in treatment, and 7) helping patients emotionally, such as providing tools that help patients regain some of the control over their lives that they feel they have lost. 

One key result of the Journey Through Treatment planning process refers clients to a myriad of governmental and other nonprofit programs for which they may qualify.  Referrals that make the largest financial impact would be to governmental insurances such as Medicare or Medicaid.  This kind of coverage could represent tens of thousands to hundreds of thousands of dollars in benefit for the client. However, healthcare organizations have most likely already connected patients with primary governmental insurance before they come to United Cancer.  The group of people United Cancer is most likely to refer to government insurance is senior citizens with Medicare who do not realize that they may also qualify for Medicaid.  This secondary referral to Medicaid may cover a portion or all of the 20% that Medicare leaves to seniors.  In the context of cancer treatment, this referral could represent tens of thousands of dollars in benefit for the client.  United Cancer estimates that these benefits totaled approximately $43,280 and account for 21% of the agency’s total benefit in 2010.

Another key result of the planning process addresses the issue of insurance coverage.  On average United Cancer helps 150 to 170 cancer patients per year, and occasionally finds people who are seeking cancer treatment out of their insurance network, or not optimizing the best coverage in a tiered insurance system.  Depending on the kind of treatment and the number of times the patient received treatment, moving from out-of-network or lower tiered coverage to in-network or higher tiered coverage could benefit the patient by thousands or tens of thousands of dollars. United Cancer estimates that we saved cancer patients approximately $38,904 in unnecessary out-of-pocket costs in 2010 and accounts for an additional 19 % of our total benefit. 

The final portion from the graph above, $10,275, goes to a fund at Goshen Health System to help underserved women pay for mammograms. This represents half of the proceeds from United Cancer's signature breast cancer awareness month event, the Middlebury Breast Cancer Walk.

The chart above breaks down the Direct Financial Aid portion of UC’s programming

for 2010, totaling $68,516. 2010 was an unusual year for United Cancer's direct financial aid program, because the category of General Patient Aid constituted the largest portion of our direct payments. 

Due to the economic turmoil and the passage of the Federal Government's Stimulus Package, Elkhart County's FEMA program received significant additional funding in 2010.  Traditionally, United Cancer receives a small grant from the Elkhart County FEMA Emergency Food Fund each year to purchase nutritional supplements for cancer patients.  Because United Cancer has been online with FEMA grants for many years, our agency was eligible for the additional funding.  United Cancer received $23,100 in additional funding which could be used for rent and mortgage aid.  As a result United Cancer’s General Aid category, which usually covers mortgage, rent, utilities and other such normal costs of life, was our largest financial aid category at $25,588.  Providing aid to cancer patients in this category is important, because traditionally the most common reason that patients seek help from United Cancer is loss of income due to their inability to work during treatment.

The next largest portion of United Cancer’s financial aid was mentioned above, and is our fund helping underserved women receive mammograms at Goshen Health System.  With the improved economy and hard work of our committee, the Middlebury Breast Cancer Walk had a dramatic increase in revenue and in-kind gifts, beating last year by some $10,000. The result is that United Cancer effectively doubled the financial aid in this category over 2009, providing $10,275 in aid.

The categories of Treatment Costs & Medication traditionally constitute our largest financial aid.  In 2010, United Cancer provided $14,817 or 22% of our direct financial aid toward Treatment Costs and $8,892 toward Medication Costs or 13%.  Supplies ($5,119 or 7%) are generally nutritional supplements and post surgical needs, and Transportation ($3,825 or 6%) generally provides help with the costs of out-of-town travel.

Our experience clearly shows that a cancer patient’s greatest need comes in the first year of their treatment.  The first year creates this great need because cancer patients face high initial test & treatment expenses combined with the loss and/or reduction of their income.  Expense issues include a battery of initial tests; expensive treatments (surgery, chemo & radiation), and high out-of-pocket insurance deductibles.  Most patients are not able to work during treatment and many employers no longer offer disability income benefits.  Those employees that do have disability income often face delays of weeks or months before income begins, plus the cancer patient must continue to pay their portion of health insurance costs. 

United Cancer does not limit the types of cancer required for help from our agency, as many other cancer organizations do.  As the graph below shows, into 2010 United Cancer helped people with 25 different kinds of cancer.  Interestingly, year after year breast cancer has been the most common diagnosis and consistently represents over 20% of the number of people asking for help.  Lung cancer has consistently been the second most common diagnosis leading people to ask for help.  But as you can see from the graph below, this year those two diagnoses have changed position.  Skin cancer, which is the most common cancer, is rarely represented in United Cancer clients, because it tends to be very treatable at low cost.  Prostate cancer was usually underrepresented in our diagnoses, however we have connected with a group of urologists and are now receiving more prostate cancer patients.

2010 has seen changes in United Cancer's revenue, the financial aid distribution, diagnoses, and the changes continue with insurance disposition.  The common perception that United Cancer is funding low income people afflicted with cancer has traditionally not been the case.  However, the graph above shows a significant change in the situation of clients seeking United Cancer's help.  2010 marks the first year that more clients came to United Cancer with Medicaid than with private insurance.  We can only assume that this change is based on the rapid economic changes from The Great Recession.

In 2009, 44% of United Cancer's clients had private insurance, compared to 34% in 2010.  Patients registering with Medicaid represented 40% of United Cancer's clients, compared with 2009’s figure of 29%.  As the number of clients served 2009 and 2010 are almost identical, this represents a significant change in the economic situation of the client at registration.

Cancer patients of all types and ages ask United Cancer for help.  2010 saw a return to our standard age trend of the largest group being between the ages of 50 and 69, representing 55% of United Cancer's clients.  However, cancer knows no age boundaries.  UC has helped babies as young as two weeks old and seniors in their nineties.  In 2010, our youngest client was one year old and our oldest was 89 years old.

United Cancer clients are eligible for funding if they live, work, or have worked in Elkhart

County, and a doctor verifies that they are in cancer treatment.  Clients living outside Elkhart

County made up 10% of our clients.  The geographic range of client cities increased from 11 in 2009 to 18 in 2010, a 63% increase.  The chart above is typical United Cancer's geographic service area and shows a good cross section of Elkhart County hometowns for 2010.

United Cancer’s goal is to help cancer patients reduce the financial and emotional stress during treatment, so they can concentrate on healing.  UC works to keep in regular contact with our clients and, according to their reports, we were very successful in our goal.  We achieved our goal through the combination of helping our clients devise a plan for their time in treatment, educating them about key issues related to the medical and insurance industries, connecting them to the network of government and non-profit resources available, and, of course, distributing $68,515 in financial aid.  Clients report that our information and referrals are extremely helpful.  Not to be minimized in the United Cancer experience is the emotional support and caring that our staff provides to our clients.  United Cancer works to stay in touch with our clients as they progress through treatment and move into remission.  Clients often report that the information they gain from the Journey Through Treatment program is just as valuable as the Direct Financial Aid that we provide.

Maintaining Financial Viability

The question of economic viability is obviously an important one going into 2011. Fortunately for United Cancer, economic viability has not been an issue even considering the economic downturn. 2009 saw only a 2.8% reduction in overall revenue, and that was due completely to outside organizations reducing their support, because fundraising initiated and organized by United Cancer actually increased in 2009. For 2010, we are so thankful to report a dramatic increase in revenue over 2009.  In fact, thanks to the tremendous work of the Elkhart County community, 2010 is the highest grossing revenue year in United Cancer's 52 year history!

These comparisons speak volumes to the strength of United Cancer's financial viability, especially when we realize that 2008 was a record revenue year as well. At a time when local businesses and nonprofit agencies in Elkhart County were retrenching and laying off staff, United Cancer’s donor base grew and our supporters showed tremendous loyalty and generosity.

Going into 2011 United Cancer still faces challenges in fundraising, as does any nonprofit in Elkhart County.  However, United Cancer’s Executive Director and Board believes that 2011 will still be a strong year and that the agency will provide resources for Elkhart County area cancer patients at a level equal to or greater than 2010. In June of 2010, the Executive Director and Board of United Cancer decided that it was time to change from a strategy of survival in a severe economic downturn, to planning for growth and becoming the most recognized and best supported nonprofit agency in Elkhart County.

To that end, United Cancer has been awarded a grant from the United Way of Elkhart County to expand our comprehensive planning process for cancer patients from a format of one-on-one with patients seeking financial aid, to a classroom setting which we will offer to every person diagnosed with cancer in Elkhart County. This is an aggressive increase in our program and will surely lead to an increase in the number of people seeking financial aid. So support from the community will be vital for 2011. United Cancer believes that with the expanded exposure of the classroom program, UC will receive double the number of people seeking financial aid.

Our Board and Executive Director recognize that the Elkhart County community’s steadfast support over the last several years has been a vital part of our success, and we greatly appreciate the faith that you have shown in our agency and our mission.  This year more than ever, your support is vitally needed and tremendously appreciated.

As an independent, grass roots organization, United Cancer’s success is based on the support of the people of the Elkhart County area.  If you are a supporter, I hope that you will continue to help.  If you have not given in the past, I hope that you will consider a gift now.  Each year, the number of cancer patients coming to ask for help continues to rise, and our ability to help relies on you. 

Thank you for your interest and support!

Peter T. Norton

Executive Director