Who Will Reduce Barriers to Cancer Care?

Jill Vondrasek, MBA, and Mary Smania, D.N.P., FNP-BC, AGN-BC - PHOTOS BY KRISTY TAYLOR

Who will make a difference in the fight against breast cancer? Who will reduce barriers to care for men and women who cannot afford life-saving services? Patient advocacy, education and taking care of women at one of the most vulnerable points in their lives drive family nurse practitioner and breast health advocate Dr. Mary Smania. She is passionate about increasing access to breast cancer screening and diagnostics. For more than 11 years, she has been a leading provider of breast care services in the Greater Lansing community.

Mary is also a certified advanced genetics nurse, specializing in assessing an individual’s risk of a genetic mutation, along with coordination of testing for genetic mutations. She provides patients with a comprehensive clinical breast exam and conducts health history assessments that save lives. She is on the inside of a complex health care system fighting for her patients,finding ways to care for them when the business side of health care says “no.” When frightened, uninsured or underinsured women are paralyzed by finding a lump or being diagnosed with breast cancer, Mary connects them to the resources they need. Mary has provided breast services to underserved individuals through five Susan G. Komen grants. She has cared for more than 135 new patients, provided an estimated 300 diagnostic tests and given more than 130 follow-up appointments to patients who would otherwise not have had access to care. She believes that no one should have to choose between caring for their family and caring for themselves when diagnosed with breast cancer.

As a child, Mary was too young to remember her Grandma Lou’s first breast cancer diagnosis, but when she was 12, her grandma was diagnosed a second time. She observed the struggle as her beloved grandma had to go through another radical mastectomy and axillary node dissection, chemotherapy and radiation. Her diagnoses and treatments were in the late ’60s and ’70s, which meant that she had radical mastectomy surgeries removing all of the breast tissue and muscles in the chest. Her grandma took all of this in stride, not letting it affect her outlook on life. However, the cancer eventually metastasized to her liver and she died. That was the moment that awoke Mary’s passion for women’s health.

In 2016, Mary received $75,000 for the Pink Impact: Breast Care at MSU grant that serves individuals in mid-Michigan. Through the grant, essential screening and diagnostic breast care services are provided for men and women who cannot afford life-saving services due to high deductibles and copays.

Efforts to improve care and reach underserved populations are being accomplished through the use of an interprofessional team led by a nurse practitioner using expertise within the health care team, in the community and through marketing and social media. Mary has spoken on this approach to care at the National Nurse-Led Care Consortium with her presentation, “Impacting Breast Cancer Health Disparities With A Nurse-Led Interprofessional Breast Program for the Underserved.” She will also be presenting at the American Association of Colleges of Nursing Faculty Practice Pre-Conference in 2017.

Data that support the impact of her nurse-led care efforts include:

Health Insurance

»» 30 percent of participants had no health insurance.

»» 70 percent of participants had health insurance with high deductibles.

»» Deductibles range from $2,600 to $10,500 per year.

Access to Care

»» Most participants (80 percent) agreed or strongly agreed that they would not have received care without our program.

Education

»» Most participants (90 percent) reported that they felt more knowledgeable about breast disease after our education.

Satisfaction

»» All participants (100 percent) strongly agreed that they would refer the program to other women. Some of their comments:

• “My nervousness about what could be going on in my body is severely lessened — without anxiety about how much money this will all cost.”

• “Provided a service I would have not otherwise followed through with due to a high deductible.”

In addition, MSU was able to host its first Breast Cancer Survivors & High Risk Symposium for breast cancer survivors, their families and those at risk. More than 100 people attended, connected and learned the latest knowledge from experts in the field, all of whom were brought together by Mary and her team. Topics included genetic testing, prevention of lymphedema, health disparities and their impact on breast cancer risks, and a demonstration on nutrient-dense ingredients and how to cook healthier meals at home.

One of her patients, Amber Meyers, recently received the Young Survivor award from Susan G. Komen Michigan. She was diagnosed when she was pregnant for the first time and concerned by the loss of her health insurance coverage. Mary gave her hope during diagnosis and treatment that she would still be able to receive care through the Susan G. Komen Michigan grant at MSU. Mary went through this cancer journey by Amber’s side, and played a significant role in her cancer journey.

Meet two more young women who got a second chance at life because of efforts led by Mary. View the Be More Than Pink video (https://tinyurl.com/jzzjcoy) that shares a glimpse of Mary’s impact in the community.

What is next for Mary Smania? Community outreach and a focus on reaching the Latino population in 2017. She recruited Lucianna Solis, a breast cancer survivor and an advocate for Komen’s Powerfully Pink hero recognition program, to her team. Together, they plan to give hope to individuals no matter what their life circumstances or economic status are. Efforts have started and will continue through their recent appointments to the Lansing Latino Health Alliance Board of Directors.

Mary identifies the area of greatest need, recruits the best talent to serve her mission and does whatever is necessary to take on the giant known as breast cancer. When abnormal becomes your normal, Mary will be there. When your insurance abandons you in your time of need, Mary will be there. She may not know you, but she will fight for you when you face a breast cancer diagnosis.