For those who are uninsured, underinsured, low-income or living within limited means, coping with breast cancer is especially challenging, but those people stand a better chance of catching cancer before it becomes insurmountable through the services provided by the Sea Mar Community Health Center of Marysville, Community Health Centers of Snohomish County and Planned Parenthood of the Great Northwest.

Sea Mar Community Health Center of Marysville

Jasmine Potter, the nursing supervisor at Sea Mar in Marysville, explained that Sea Mar’s main role lies in screening for cancer. She touted this role as especially important since Sea Mar serves a number of clients for whom English is a second language or insurance coverage is not an option.

“A mobile mammography unit comes here every month to every other month,” Potter said. “If our screenings yield suspicious findings, we refer them on to other providers. We partner with so many other agencies that we’re often able to get those services greatly reduced or at no cost to our clients.”

Sea Mar takes into account factors such as age, low income levels and family histories of cancers to try and provide access to as many clients as possible. The Breast, Cervical & Colon Health Program of Washington state is one of their partners in this endeavor.

“If our clients are eligible, we can even get their mammographies paid for,” said Potter, who also touted Sea Mar’s work with Familias Unidas to provide counseling, advocacy and information services to clients regardless of culture or ethnicity. “We can do a certain amount of lab work in house, but a lot of our work is on the phone, scheduling appointments and followups with folks who might not be comfortable speaking in English.”

Sea Mar’s customer service likewise includes assistance in applying for insurance and filling out forms for the state Department of Social and Health Services.

The Sea Mar Community Health Center of Marysville is located at 9710 State Ave. and can be called at 360-653-1742. For more information, log onto www.seamarchc.org.

Community Health Centers of Snohomish County

Dr. Katie Dunbar noted that the Community Health Centers of Snohomish County in Arlington and Everett, like Sea Mar, also refer their patients to other clinics for mammograms and biopsies, while screening services are provided in-house. However, she sees the CHC as serving another essential role for patients.

“We’re a primary care provider that’s sort of the captain of the ship, coordinating a number of different aspects of health care for them,” Dunbar said. “Navigating the health care system can be scary, and a lot of folks don’t know where to go for the services and resources that they need.”

While Dunbar would welcome any expansion of health care coverage and access that the Affordable Care Act might bring, she acknowledged that it also comes with no small amount of confusion, which she wants to help clear up for her patients.

“A lot of our patients are uninsured or have limited means, but I hate to see them play the odds by putting their symptoms on the back burner,” Dunbar said. “What was once a very scary diagnosis can now be countered with a lot of very effective treatment, which is less invasive than ever before. Your best chance of beating breast cancer is catching it at an early stage through regular screenings.”

The Community Health Center of Snohomish County in Arlington is located at 326 S. Stillaguamish Ave. and can be called at 360-572-5400.

Planned Parenthood of the Great Northwest

Planned Parenthood of the Great Northwest, which has offices in Marysville and Everett, emphasized that it’s not just women who are 40 years and older who need to be attentive toward their breast health.

“There’s a lot that women under 40 can do to reduce their risk of breast cancer,” said Dr. Kara Cadwallader, senior medical director of Planned Parenthood of the Great Northwest. “Our big push is for women to take charge of their own health through early detection.”

Of Planned Parenthood’s patients in Snohomish County, 94 percent are under the age of 40. Although Cadwallader acknowledged that women under 40 make up a small portion of the total number of women diagnosed with breast cancer every year, she warned that when breast cancer does occur in younger women it is often aggressive. As such, she strongly urged women to see their health care professionals if they notice any changes in their breasts.

Planned Parenthood of the Great Northwest’s doctors and nurses provide as many as tens of thousands of breast exams on young women each year. If a Planned Parenthood provider finds an abnormality during an exam, the patient is referred to a breast specialist for further examination which may include diagnostic tests such as an ultrasound or biopsy. Planned Parenthood health care professionals also inform young women of factors that can reduce their breast cancer risk, among them getting regular exercise and limiting their alcohol intake.

Planned Parenthood of the Great Northwest’s diagnostic grant program helps to cover the costs of these tests for patients when possible, since the tests can be costly, especially for uninsured and low-income women. Cadwallader cited studies showing that Hispanic Americans tend not to get screened for common cancers, such as breast cancer, as regularly as non-Hispanic whites, and added that Hispanic women are 20 percent more likely to die from breast cancer when compared to non-Hispanic white women diagnosed at similar ages and stages.

“African-American women actually have the highest incidence of breast cancer under the age of 40, and it’s much more aggressive than the breast cancers that are found at similar ages and stages among white women and Latinas,” Cadwallader said. “With Latinas, by the time the diagnosis is made, it’s more likely to have a poor outcome.”

Cadwallader identified a number of intersecting factors as contributing to higher incidences of more aggressive breast cancer among African-American women, as well as the higher mortality rate of Hispanic women, including the increased difficulty of leading a healthier lifestyle when you have more limited means, as well as a lack of access to basic health care services. While she still recommends that women exercise and reduce their intake of both alcohol and tobacco products, she shares Dunbar’s hopes that the implementation of the Affordable Care Act will open more health care options to millions more women.

“We’re doing a big push in October to help people understand the Affordable Care Act and get enrolled in new health plans,” said Cadwallader, who referred people to Planned Parenthood’s microsite at http://ppvoteshealthcareinfo.org for further details.

In the meantime, since breast cancer remains the leading cause of cancer death among Latinas, who are sometimes reluctant to seek care due to a language barrier, Planned Parenthood educators are continuing to speak with Latinas in their communities about the importance of screening and connecting women to health care services, helping them take control of their health.

To schedule an appointment at the Marysville or Everett Planned Parenthood health centers, call 1-800-230-7526 or log onto www.ppgnw.org.