Beyond the City Limits: Comprehensive Cancer Care for Every Corner of Rural America

A cancer diagnosis is never easy to process. For the patient, their family, and their friends, even if given an optimistic prognosis, life turns upside down as soon as they hear the words. For residents of rural communities, getting complex care close to home isn't always possible.

"Everyone has been impacted by cancer, whether it be a family member, friend, or co-worker," said Nancy Demarais, Sanford Fargo executive director, cancer. "It is crucial for us to invest in the latest advancements in technology so we can provide our patients and the communities we serve with world-class health care close to home."

Local solutions for lifelong health

The Sanford Health Roger Maris Cancer Center in Fargo, North Dakota, was recently named on the Becker's Healthcare Hospital Review's top 100 hospitals and health systems with great oncology programs list. The list features oncology programs that are accelerating innovation, discovery and greater access to care while simultaneously providing novel treatments, conducting cutting-edge research, holding clinical trials, and upholding safety designations to improve patient outcomes.

The Roger Maris Cancer Center serves about 600 patients daily and provides chemotherapy services in locations across North Dakota and Minnesota. One of its latest advancements in cancer care is partnering with Perham Health to open a chemotherapy infusion center.

Wade Sjolie from Perham, Minnesota, has multiple myeloma, an incurable cancer of the blood that requires constant treatment, including a blood draw every Thursday, and a chemotherapy infusion every Friday. For years, his wife Jodi drove him three hours round trip from Perham to Fargo for treatment. But now, thanks to the partnership with Perham Health, that trip is just two minutes each way.

"I tried to explain to people that coming to Perham Clinic was the biggest relief since his chemo started," said Jodi. "And it probably sounds like 'Oh, it's not that big of a deal,' but it really is. I have to work it out with work and it's a whole day to Fargo, and if we have anything else going on, you just have to go."

Shelby Goodman, a nurse practitioner in oncology at Perham Clinic, explained: "The RNs and the other staff working here in the infusion center went up to Roger Maris Cancer Center in Fargo to be trained. So, they have the same amount of training as the nurses in Fargo. So, it's really an exact replica of the skillsets that they have up there."

The short commute also means a great deal to the Sjolie family because of the constant treatment Wade will need for the rest of his life. Now, no matter what the weather is like, or what they have going on at work or in their personal lives, the Sjolies can go right down the road from their home for treatment.

From early detection to treatment and recovery

Patients in several rural Sanford Health communities now have increased access to 3D mammograms, the gold standard in breast cancer detection. The technology, which provides a clearer picture and helps detect breast cancer at its earliest and most treatable stage, was recently installed in-house at Sanford Health in Brookings, Chamberlain, Canby, Luverne, and Vermillion.

In many cases, those living in rural areas in central and southeastern South Dakota and western Minnesota who wanted 3D mammograms had to travel an hour or more to get screened. With 3D mammography available in more Sanford locations, patients can now get screened closer to home.

"Anytime you improve access to care, you make it easier for someone to come and get a service. It allows them to potentially improve their health outcome," said Erica Peterson, senior director of Sanford Chamberlain. "Anytime we can make things simpler and more accessible for people, the more likely they are to utilize the service and take those preventive measures seriously."

To alleviate a bit of the cancer care gap in rural communities within Sanford Health's footprint, Sanford clinicians have expanded the traditional care team. Following diagnosis, patient cases are presented to specialists throughout the Sanford organization at cancer-specific tumor boards. Made up of surgeons, oncologists, radiologists, pathologists, geneticists, researchers, nurses navigators and other experts, the board reviews diagnoses and collaborates with patients and their clinicians on the best plan forward.

investing in radiation technology is also providing cancer patients with state-of-the-art treatment by specialized cancer teams close to home. Varian linear accelerators are devices programmed to deliver high-energy X-rays that conform to the specific size, shape, and location of a tumor.

Varian linear accelerators give providers the ability to target and destroy cancerous cells in a precise area of the body, with minimal exposure to surrounding healthy tissue. It enables the care of tumors that can be hard to reach or are located near critical organs. The accuracy of these treatments also permits higher radiation doses because of the reduced risk of affecting healthy tissue. They are available at the Sanford Cancer Center in Sioux Falls, the Sanford Roger Maris Cancer Center in Fargo, the Sanford Worthington Center in Minnesota, and the Sanford Joe Lueken Cancer Center in Bemidji.

"Located between several Native American communities and trial nations, nearly a quarter of the community members we serve face additional barriers to timely cancer care," said Karla Eischens, president and CEO of Sanford Health Bemidji Medical Center. "We have taken further steps at Sanford Bemidji to specifically assist patients navigating their cancer diagnosis, treatment, and survivorship."

Tabitha Chilton, Native American Community Advocate in Bemidji, not only advocates for their care but also assists patients with socioeconomic issues, family support and accessing additional resources, including travel and lodging during treatment. In 2022, Tabitha Chilton and the Sanford Joe Lueken Cancer Center team connected 34 patients in need with financial assistance through a grant from the American Indian Cancer Foundation and Angel Fund.

The future of cancer care at Sanford

Sanford Research 's core of cancer research is uncovering the basic mechanisms underlying the development of cancer, understanding the importance of the immune system and in turn, developing novel approaches to treat cancer.

Recently award a $6.2 million grant from the National Institutes of Health for continued cancer research in upper Midwest, Sanford Research's focus on cancer research includes expertise in pediatric brain tumors, osteosarcoma, leukemia, head and neck cancers, and breast cancer.

"Through the trust that's been instilled in us by the NIH, we've been able to create clinical oncology programs to help better understand how different therapies can help our immune systems destroy cancer tumors in humans," said David A. Pearce, president of Sanford Research. "We also continue to mentor young researchers and equip them with the skills and experience that will set them up for success as they launch their research careers and become successful independent investigators."