Behind bars, cancer care comes too late for many
(NATIONAL) Few words carry more weight than a cancer diagnosis. But, for many people across the US, it is a reality they face every day. According to the American Cancer Society, one in three people will be diagnosed with cancer in their lifetime.
In the United States, cancer is the second leading cause of death for the general population. For the prison population, it is the leading cause of death.
The Prison Journalism Project (PJP) is amplifying the voices of incarcerated people who have been impacted by cancer through their new series “Cancer in Confinement".
“It’s not clear that being incarcerated itself increases the risk of cancer,” said Dr. Christopher Manz. “But it is clear that if someone is diagnosed with cancer while they are in prison, that their survival is a lot worse.”
PJP teamed up with Manz, an assistant professor in medical oncology at the Dana Farber Cancer Institute and Harvard Medical School, to create a guide to help incarcerated people navigate cancer.
Manz told Crosswinds News that the guide is also based on experiences of people who have had cancer while incarcerated or had incarcerated friends who experienced a cancer diagnosis.
Manz says PJPs new series is important to highlight the challenges that people in prison with cancer are facing.
“They help amplify the voices of people who have been through these experiences or have had friends or family who have been through these experiences and really capture their words,” said Manz. “The frustrations and the challenges they face that are fundamental to the fact that when people are locked up and don’t have autonomy or ability to advocate for themselves, they can’t ensure their care is done appropriately and on time.”
Those voices are incarcerated people across the country, including the story of Bethany Lott, who was diagnosed with breast cancer while behind bars in Oklahoma.
Lott said she had to advocate hard for herself to get the diagnosis and care she needed.
“I knew it was bad because the lump was so big. Even though the nurse had dismissed me, I didn’t quit writing paperwork. I was flipping out, writing medical requests nonstop- because I was not dying in prison,” said Lott.
In Oklahoma, the picture of Native American incarceration is difficult to measure and often understated. The most recent state data shows Native people make up about 9% of the prison population, based on 2023 Oklahoma Department of Corrections reporting, but that figure only tells part of the story. Since the Supreme Court’s decision in McGirt v. Oklahoma, many cases involving Native defendants have shifted to federal courts, meaning incarceration is now spread across state and federal systems. At the same time, how Native identity is counted, especially for multiracial individuals, can significantly change how representation is understood.
Another incarcerated woman in Oklahoma reflected on the experience of a friend who ended up dying of lung cancer.
“In January 2019, a woman I considered a grandmother was diagnosed with lung cancer," wrote Kelsey Dodson. “Throughout 2019, she was scheduled and rescheduled for appointments sometimes months apart. I remember her telling me she was unable to get correct information to make a decision about treatment. Eventually medical staff told her she had stomach cancer that spread to her lungs. She died in December that year.”
Manz says the time it takes for a person to see the right doctor and find out whether or not they have cancer is a barrier that people in prison face.
“Diagnoses are often delayed. It takes a long time to get a diagnosis and to get set up for treatment,” said Manz. “A lot of the care falls through the cracks because the oncologists are on the outside of the prison and they’re determining what needs to be done but they can’t set anything up.”
In an effort to aid people in prison who are diagnosed with cancer, the guide Manz created includes information about screening ages and guidelines for different cancers, what symptoms to look for, and what questions an individual should ask if they receive a diagnosis.
He also offered advice on how people can get family involved even when they can’t be at appointments with their loved ones behind bars.
“We encourage people to sign the paperwork that allows the doctors to share information with family members who are not incarcerated, because then those family members can communicate and advocate for the patients who are incarcerated,” said Manz. “But without that signature, the doctors, no matter how much they want to help you or help the failing, they are not allowed to talk to family unless the patient actually signs consent.”
Manz also says that an aging prison population is one of the biggest factors contributing to the increase in cancer among the incarcerated population.
“When people are incarcerated there’s a phenomenon called accelerated aging, where people at age 55 have health conditions similar to people who are older,” said Manz. “We look at the typical age of a cancer diagnosis in the community, it’s usually 66, 67 years old. In prison, it’s about nine or ten years younger than that.”
Manz shared recommendations on what states can do to make the process of administering cancer care better for the incarcerated population, such as bringing oncologists to the prison for appointments, even if just through telemedicine, and offering chemotherapy treatments inside the facility to avoid having to transport a patient for them.
For patients who are not a risk, the answer might be to release them.
“A lot of the patients that are diagnosed with cancer are older and if they’re not a security risk the easiest thing would actually be to release them on medical parole or compassionate release,” said Manz. “They could get their care in the community. This care is expensive. It’s very hard on prison systems to deliver and it could be a win-win for everyone.”
