Mike Leonard 2015-12-08 18:22:24
Begun in 1947, Indiana Lions’ cancer project saves lives through cutting-edge equipment and soothes the worries of patients thanks to a kindly patient advocate. In the months after William Schoolar of Indiana was diagnosed with benign colorectal polyps, he accepted the opinion of his local doctors. But his mom, dad and brother had died of cancer, and he became alarmed about continuing irregularities he experienced. Schoolar recalled a talk at his club by Dottie Flack about the Lions’ Indiana Cancer Control program. “She told us how good it was and how she always recommends a second opinion,” says Schoolar, a Lion and a retired school administrator who lives in Delphi, a small city about 80 miles northwest of downtown Indianapolis. “So I didn’t think I should be taking any chances. I called Dottie and told her what was going on with me, and she said, ‘Would you mind coming down to Indianapolis for some further testing?’” “She lined up the exact right doctors and literally met us at the door when we went to the Indiana Cancer Pavilion,” says Schoolar’s wife, Jean. “She took care of my wife like she was a kindergarten student—anticipating her questions, her needs,” Bill explains. “Turned out, those polyps were malignant and I was a 2.76 on the four-point scale. If it weren’t for Dottie and the treatment I got, I seriously doubt that I’d be here today.” Flack is the Lions liaison and patient advocate for the Lions Cancer Care Control Fund of Indiana, Inc. She is the public face of the initiative, traveling the state to publicize and explain it to clubs. Flack also provides the initiative’s personal touch, navigating anxious patients through the healthcare maze. A soothing presence, she meets with them and their families to walk with them through their strange, frightening journey. Yet the Cancer Control Fund encompasses much more than counseling. Beginning with the first equipment purchase of a megavolt cobalt unit from U.S. Army surplus in 1947, the Cancer Care Control Fund has donated more than $6 million to fund the purchase of the latest cancer treatment equipment. In 1973, for example, Lions contributed $750,000 toward the acquisition of a million electron volt Linear Accelerator Sagittaire machine—at the time, the most powerful such machine in the world. The Cancer Care Control Fund assists the Indiana University School of Medicine, which is the second largest medical school in the country, the school’s Department of Radiation Oncology and the Indiana University Mel & Bren Simon Cancer Center in downtown Indianapolis. Through the fund the Lions of Indiana are able to make possible cutting-edge treatment, saving many lives. In 1997, the fund helped purchase Indiana’s first Gamma Knife, the most precise and powerful high dose radiation treatment delivery system to treat brain and base-of-the-skull tumors. The original Gamma Knife was located in the Indiana Cancer Pavilion within the Simon Center, where a bronze plaque on the pavilion wall recognizes the ongoing contributions that Indiana Lions have made to cancer care. “We’re literally part of the brick and mortar here,” says Flack. The Gamma Knife showed great promise for its power and accuracy, but the key to its further success, clinicians learned, was negotiating with the manufacturer, Elekta, to acquire some of the various molds and devices used to stabilize or decrease movement in patients being treated. “It turned out that was a critical component,” Flack says. With the stereotactic body frame provided by Elekta and other immobilizing components, doctors could make the best use of the power and accuracy of the linear accelerators that have become “the workhorse” of the department, capable of treating lung, liver and other cancers. The accelerators produce “120 individual fingers that come out and mark the exact tumor very precisely,” Flack says, “and reproducing the exact image every treatment is one of the basic rules of radiation oncology. Before, with lung cancer, a patient went through 35 to 41 treatments, one every day. Now we can treat some patients with just three treatments total, one every other day. Each [radiation] dose is not only much higher, but more effective and with fewer side effects. It’s been very effective with lung and liver cancers.” Flack, 60, is the fund’s only paid employee. A 21-person board, three Lions from each of the state’s seven districts, allocates funds that support not only equipment but also education and training for oncology residents, researchers, technicians and radiation therapy students. Lions clubs statewide donate to the fund. The Indiana Cancer Pavilion and Simon Cancer Center are located on the campus of Indiana University-Purdue University Indianapolis. Combined with the nearby Indiana University Health Methodist Hospital and IU Health North Hospital, the hospitals and clinics comprise a cancer care hub that treats about 120 patients a day. Those who find their way to Indianapolis through the Lions and patient liaison Flack get the benefit of guidance and advice they wouldn’t get otherwise. “I try to make sure that within this vast facility with hundreds of acres and thousands of physicians, I can steer them to exactly where they need to go,” Flack says. “You can cut to two days what might take five to six months in the outside world.” Flack requires that patients—not friends or relatives—call her first, to ensure they are sincerely interested in the program. She then asks for their medical records so she can study them and get the patients to the appropriate specialists. If she isn’t sure, she says, she knows how to find someone who is. “If they want me to sit in on their consultation, I’ll do that,” Flack says. “There have been so many times when I’ve sat there and heard the doctor say, ‘They were going to do what?’ I’ve seen a few times when physicians have literally come up out of their chairs when someone has been prescribed some archaic treatment. They’ve been outraged.” Flack says she and the staff at the IU School of Medicine are in complete agreement that patients deserve an honest and forthright assessment of their situation. “So many times when patients come here they haven’t been told the truth. Or at least, not all of the truth. We tell them the whole truth,” she says. The truth is leavened with compassion, however. One signature component of the Lions Cancer Care program that Flack is proud of is an agreement she negotiated with a nearby hotel to provide overnight lodging, when appropriate, at a very reduced rate that the Lions will cover in hardship cases. “For people from rural areas, coming to Indianapolis, coming to a place like the medical center, is like going to Mars. I encourage them to get here, to get settled, so they have a chance to get their feet under them for the next day. “You have to support the caregiver as much as the cancer patient,” she says. “Patients always have a certain resolve. ‘I’ll do what I need to do.’ But the caregivers are always wondering what else they can do.” Flack knows this from experience. Her mother, Barbara Legan, waged a 9-year battle with breast cancer—treatments, remission and more treatments—beginning in 1979 and ending with her death. Flack would spend as much time as possible visiting and keeping her mother company during hospitalizations, and admits that she’d often be so tired of working a full day and then making the trip from her home 30 miles south of Indianapolis to the hospital and back that she’d drive past her Interstate exit—dazed—on her trip home. “I vowed—it was midnight one night and I’d gone away from mom’s bedside—I sort of made a pledge to myself then and there to always remember that the little things matter, and I put that away,” she says. Still, it didn’t quite kick in when the first Lions patient liaison, Ira Barker, started mentioning that he would have to retire at some point and he thought Flack would be an excellent candidate to take his place. Flack, a sales manager for an air compressor manufacturer, didn’t think she had the emotional makeup to do the job. “He said anybody in this position needs to be a Lion, and I agreed with that,” she says. “But it took a while to convince me. It was going to be a complete upheaval in my life. He started it in ’86 and I didn’t come on until ’99.” Patients don’t have to be Lions to get help from Flack and the Cancer Care program. They don’t even have to be cancer patients. “I referred people to Dottie for cancer several times,” says Tom Slattery of Indianapolis. “But when my wife’s pulmonary problems got out of hand, I called Dottie and we got right to the right doctors. Turned out we never got the proper diagnosis to start with. Then we got the best care a person could get but it was too late. My wife died two years later, but at least the mystery was gone. We knew what we were facing, thanks to Dottie.” Slattery has other, happier stories to tell as well—referrals to the Lions Cancer Control program and then treatment and recovery. “Dottie Flack is the hero of anything that goes on,” he says enthusiastically. “She’s worked her magic for so many people.” Flack protests that it’s the efforts of Indiana Lions that makes the whole program possible, and she’s just doing her job. But she acknowledges that dealing with the realities of cancer and the fear and anguish of patients takes a toll, as does the practical challenge of outreach to an entire state. She is often on the road, traveling the highways and back roads of the Hoosier State to give talks to clubs. “It really is a positive place and good things do happen here,” she says. “But success is measured differently here as well. Maybe small rays of hope can create as much excitement as a curative ray of hope. Sometimes people are so desperate to know there is a tomorrow.” Flack has her coping mechanisms. “I need to seek out joy to keep myself balanced,” she says with a smile. “I recently started taking banjo lessons. People say nobody who plays a banjo can play a sad song. It’s such a happy-sounding instrument.” Being the Lions liaison and patient advocate has rewards the native Hoosier can’t measure. “It makes me so proud to be a Lion and do the work we do,” she says. “I had no idea how fulfilling this could be. There is a certain solace knowing that at the end of the day, you gave people information to have a better life, to live a better life. It’s just me bringing people to science that does it.” Digital LION The Hoosier state makes great strides against cancer thanks to Lions. Read the story from the January 1972 LION at lionmagazine.org.
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