- Cervical cancer's lack of awareness, cash flow (Photo: Associated Press)
In 2001, 25-year-old Tamika Felder was diagnosed with cervical cancer after three years of lapsed pap spears. Now 35, Felder is celebrating her tenth cancer-free year—and working to fight the disease in other women. Through Tamika and Friends, the Upper Marlboro resident stages walks, retreats, and risque party games to raise awareness about the importance of a pap.
"Cervical cancer is completely preventable," says Felder. "We have a test to detect it. We have a pap to screen for it. We have HPV vaccines to prevent it. You can’t say that about any other cancer."
But Felder didn't miss her annual pap smears because she wasn't aware she needed them—she received regular check-ups throughout college. Then, she lost her health insurance. By the time she regained coverage three years later, it was already too late.
The District of Columbia has one of the highest rates of cervical cancer [PDF] in the nation. It's also got one of the highest poverty rates for women and girls. Twenty-six percent of black women live below the poverty line in D.C.; women across the region are 35 percent more likely to live in poverty than are men.
And cancer prevention doesn't come cheap. According to Planned Parenthood of Metropolitan Washington, a basic gynecological visit for a woman without health insurance ranges from $80 to $120. If her pap comes back abnormal, she'll need to fork over $200 to $400 for a colposcopy, which allows the doctor to look at problem cells under a microscope. If those cells show moderate to severe dysplasia, she'll need to get them frozen or burned off, at a cost of $200 to $800. For many women, just getting into the exam room presents a cost barrier. "It's a huge stress on women," says Felder. "You have to take time off work. You risk losing your leave. You could not get paid at all."
Even if D.C. women are fully aware of the importance of cancer prevention, what happens when they can't afford all those necessary tests, screens, and vaccines?
"Our hope is that cost is not prohibitive," says PPMW's Adrienne Schreiber. For women who can't finance an $800 cryotherapy treatment, "we're not going to turn anybody away simply because they can’t pay," she says. Schreiber says the clinic is committed to helping connect women with federal Title X funding, grants, and nonprofits like Felder's to help defray the costs.
Part of the battle is making local women aware that the cost of medical treatment isn't necessarily out of reach. But it's also making sure that money is available when women ask for it. "We’re not an American Cancer Society. We're not a Komen. We don’t have $5 million. We barely have $5,000," says Felder. "We say we're small but mighty."
Despite its modest scale, Felder says her organization receives applications "from around the country"—sometimes around the world—from women with cervical cancer who can't afford their medical costs, child care, rent, and bills. Often, larger cancer organizations send cervical cancer sufferers Felder's way. And meeting those demands is getting harder. Tomorrow, Tamika and Friends will hold its fifth annual cervical cancer awareness walk at RFK Stadium. It was nearly derailed for lack of a corporate sponsor.
For a "small but mighty" organization like Felder's, consciousness-raising and community-building efforts are a lot more feasible than personally financing the costs of cervical cancer prevention and treatment for the world's women. District women shouldn't have to choose between securing preventative healthcare and feeding their kids. But until the money's there, they may just have to rely on sheer determination. "I have what I call my 11th commandment," says Felder. "Busy, broke, or scared, never miss your pap."