New cancer center improves access to care for patients in St. Cloud
Elleni Ruales’ 11-year-old daughter watched her pass out for the first time in the middle of the living room of their St. Cloud home just as the pandemic began in 2020.
Ruales suffers from a severe iron deficiency and has to get regular blood tests every three to six months. If the tests show iron counts that are too low, she must get infusions at cancer centers that last about two hours.
Ruales moved from New York to Osceola County in late 2019 to be closer to family but had a difficult time finding a doctor who was taking new patients.
“During the pandemic, which was when my blood counts got the lowest and worst they’ve ever been, I couldn’t find a doctor,” Ruales said. “It was probably the worst that I’ve felt ever.”
After finally finding a doctor in Kissimmee who agreed to see her, she began receiving regular blood testing and infusions at Orlando Health Cancer Institute. But driving back and forth between St. Cloud and Kissimmee for testing forced her to stop working in December of 2021 because she was taking too many days off for treatments.
“I had to take off from work once a week for six weeks and it was pretty much a full day, because I would leave my job around 11 o’clock and I’d drive then get my treatment and come back but I was so exhausted I would climb in bed,” Ruales said.
Now, Ruales travels only six minutes from her home to receive testing after Monday’s soft opening of the Orlando Health Cancer Institute St. Cloud, the first comprehensive cancer center in St. Cloud. The center will complete 12 infusion bays early next year but is already seeing patients for exams.
Ruales’ doctor, Simi George worked in the Kissimmee office anticipating the opening of the St. Cloud cancer center where she is now the lead oncologist.
“A lot of Kissimmee patients are actually from St. Cloud,” George said. “Many patients have a complicated cancer diagnosis and most have to travel once a week and some regiments need daily checkups, so it’s like a full-time job.”
George said she only took the job at Orlando Health Cancer Center in Kissimmee because she knew the St. Cloud office would soon open.
“I love the St. Cloud community,” George said. “I’m glad patients now have this opportunity to get comprehensive care closer to home and it makes the care so much better.”
For now, the St. Cloud facility is only seeing patients for checkups. But soon it will provide infusions, some surgeries and in-house lab testing. The center also hired mostly bilingual staff and offers translation services on tablets to cater to the large Hispanic community, said Wilfredo Castro, manager of practice operations.
Kathryn Hitchcock, assistant professor at the University of Florida college of medicine for radiation oncology, recently joined the National Clinical Trials Network to improve diversity and inclusion efforts for leaders in oncology research and understands how important access to cancer care close to home can be for communities.
Hitchcock, who grew up in rural Wyoming, said people who have to travel long distances to receive comprehensive health care often get seriously ill from things that could have been treated.
“Their families just didn’t have the money or ability to be away from their jobs long enough to get them to the care that they needed,” Hitchcock said.
Bringing a cancer center into a community that didn’t have one close, like St. Cloud, brings down the cost of cancer care, Hitchcock said. If the treatment center is too far away, patients pay for the medication and treatment but also the cost of gas or transportation and the loss of wages, Hitchcock said.
“This center will probably make it possible for at least a few people who really couldn’t have gotten treatments otherwise, which is a huge deal,” Hitchcock said.
Ruales experienced the harmful impact of lacking access to care. Before she resumed regular blood testing and iron infusions, she would pass out regularly and constantly feel tired. Working as a clerk at the Osceola County school district, she said she would ask for a chair to pass out in — and then continue working.
“I was in tears,” Ruales said. “Probably the scariest thing was driving and I was scared to be anywhere by myself because I could feel it coming.”
Hitchcock also praised the St. Cloud center for its bilingual staff. It’s not enough to have an interpreter to cross the language barriers because you also need to understand patients’ culture and values, she said.
Over 56% of Osceola County residents identify as Hispanic, according to the Census Bureau and the county has the largest percentage of Puerto Rican population outside of the island, with an estimated 33% identifying as Puerto Rican.
Mistrust among some marginalized groups is another factor doctors must take into account, and why diversity is important in the medical field, Hitchcock said.
“Ultimately, we are not telling patients how we’re going to cure their cancer,” Hitchcock said. “We are offering them options and explaining what works and letting them make a decision themselves. ... If we can’t connect with them through the way that they view the world then we’re not going to do a good job.”
