When Brittany Spedaliere was diagnosed with Hodgkin’s Lymphoma, she was in her first year of studying at Hartnell College. She was 18. She had a bump on her throat, but “I was feeling fine,” she said.

She was treated at Lucile Packard Children’s Hospital at Stanford, in Palo Alto. Spedaliere’s treatments were done on an outpatient basis and she said she was fortunate that her father has a flexible job so that he could drive her for the 160-mile round trip from Salinas to Palo Alto.

She also had a friend who was home from college who helped take her to treatment appointments.

Patients from Monterey County often have to travel to urban areas to receive the specialized care required of the many different diseases that are encompassed under the wide umbrella of cancer, as do patients who live in other rural communities around the state. In June, 152 patients from Monterey County received care at the Stanford Cancer Clinics. Nearly 400 patients also traveled from Central Valley communities in San Joaquin, Stanislaus and Merced counties, among other areas of the state.

Of the patients served at Stanford Cancer Clinics, 31 percent come from Santa Clara County, where the clinic is located, with others coming from around the state, from other states and even overseas. The clinics had 6,000-7,000 patient visits on average each month last year.
Holly Gautier, the director of the Stanford Cancer Supportive Care Program, said one of the first things her staff members do when a new patient arrives is connect them with a social worker.

“They are there to help with transportation and housing,” she said. “They can help with access to resources from other organizations…They try to give normalcy and they really are the knowledge base.”

For patients who do have to travel long distances for treatment, the American Cancer Society has a mileage reimbursement program to help cover the cost of transportation. The hospital also partners with Angel Flights, which provides free flights to patients who need services. She said three or four patients fly in each month, either for transplant services or cancer treatment.

Gautier said the clinic does have some housing available for families that need to stay for long-term treatment, unlike Spedaliere, who was able to go home each treatment day. But Gautier said the number of units is limited and there are strict guidelines that determine who has priority, starting with transplant patients. After transplant patients, those receiving daily radiation are next in line and the third is families of patients in the hospital. They also have RV parking for patients who want to stay close by.

One way that Stanford medical personnel try to lessen the impact on patients from rural areas is by working with local doctors to split the care.

“Sometimes they might be receiving standard care at a local hospital and specialized care at Stanford,” Gautier said, for head and neck cancer, which the hospital specializes in, blood and bone marrow cancers, or for clinical trials. “They might get regular chemo at the local hospital and come up for a trial.”

She said some patients who come up for a second opinion on a cancer diagnosis choose to be treated at a hospital near their home, but they have their lab work reviewed by doctors at Stanford who can then adjust the treatment plan.

“It really depends on the diagnosis,” Gautier said.

Gautier said Stanford’s services are available to all patients regardless of financial constraints and social workers work very closely with patients to connect them with the services they need.

For Nicole Zardo, her own cancer treatment takes her even farther from home.

Zardo was 24 when she started feeling under the weather. She said she didn’t have many specific ailments – she just felt tired.

“I thought I was tired because I was working too hard,” she said. “I was dragging.”

When she woke up one day with a pain in her side, she thought it was appendicitis and rushed to the emergency room near her Fresno home. The doctors found it was not her appendix, but cancer. Zardo was initially diagnosed with ovarian cancer. She had surgery, followed by chemotherapy and then an additional surgery before doctors realized she actually had peritoneal mesotheliamo, a rare type of cancer that occurs in the thin cell walls surrounding the abdominal cavity. Less than 3,000 people a year are diagnosed with it each year in the United States, according to the American Cancer Society.

“I had my first surgery in San Jose and I’ve been to see doctors at Stanford (in Palo Alto,”) she said. “I’ve been to New York (to see doctors.) What’s really cool is that on my trip to New York to see a doctor 3,000 miles away – it sounds expensive – but one of the programs Relay For Life funds is the Hope Lodge.”

The American Cancer Society’s Hope Lodge program offers free lodging for cancer patients in 31 states in the U.S. Zardo estimated that her eight trips to New York since her diagnosis would have cost her $10,000 in lodging fees.

“Every chance I get if I come across someone going through treatment or who just got diagnosed, I give out the 1-800 number,” she said, of the 1-800-227-2345 number.

After her experience, Zardo, who moved from Fresno to Salinas, got involved in the Relay For Life. The fundraiser for the American Cancer Society serves a dual goal of raising money for cancer research as well as raising awareness of prevention efforts. The Salinas event was held June 9 at the city’s sports complex, and is the second-largest Relay event in the state. The relay events are held in more than 5,000 communities in 23 countries.