​How Berkeley’s Women’s Cancer Resource Center adapted to COVID

By Lou Fancher

​For clients of the Women’s Cancer Resource Center, a Berkeley-based nonprofit offering free health care navigation and wellness programs for people with cancer and their caretakers, the onset of the COVID-19 pandemic and the announced shelter-in-place orders in March 2020 awakened an all-too-familiar memory.

There’s been nothing quite equal — until the pandemic — to that jarring, life-altering moment when a doctor says to a patient, “It’s cancer.” Ever since the pandemic began, people have tended to use the word “pivot” when describing lifestyle adjustments made in response to lockdowns. A cancer diagnosis requires choreography that spins on an equally grand scale. Similarly, the complexities of living with and treating cancer multiply exponentially for people of color, immigrants, low-income workers, women and individuals identifying as LGBTQ or nonbinary.

“It boils down to health equity for me,” says WCRC Executive Director Amy Alanes when asked to highlight one point she wants people to know about cancer in America. “Because everyone’s economic status is so different in this country, cancer impacts them differently.”

The WCRC operates with a $1.2 million annual budget and offers guidance though the health care system with a network of widespread services including cancer navigation, support groups, psychotherapy from licensed providers, transportation, coordinated information and referrals, a help line, emergency financial support and community wellness programs. The center is designed to address or prevent problems often encountered by people with limited access to essential, life-giving care. An art gallery and resource library at the center have been closed during the pandemic.

For clients of the Berkeley’s Women’s Cancer Resource Center on Ellsworth Street, above, a nonprofit offering free health care navigation and wellness programs for people with cancer and their caretakers, the pandemic and shelter-in-place orders awakened familiar memories of major adjustments made in response to life-changing moments. (photo courtesy of Amy Alanes) Alanes says what was strikingly different about WCRC clients even before the pandemic was that before addressing their cancer there were many other obstacles to overcome. She says clients faced homelessness, a lack of food, systemic racism or language barriers in the health care system, among other problems.

“Cancer is hard, but if you’re dealing with food or housing insecurities or racism that showed up before and glaringly during COVID, we see clients dealing with many issues preventing them from having the best care possible,” says Alanes.

Eliminating two barriers immediately, the WCRC’s services are all free and presented online in English and Spanish. Increasingly, more of the center’s therapists are people of color who are able to provide services in four languages: English, Mandarin, Spanish and Tagalog (Filipino).

“We have 30 licensed therapists donating their time to see low-income women at no cost for 12 sessions,” she says. “We had our largest increase of referrals into that program now that it’s remote therapy. What’s been wonderful is that prior, there was a transportation challenge to match a client with a therapist who lived in close proximity. Now, we have therapists all over the Bay Area who can see our clients.”

Another benefit to shifting services from in-person to virtual? Minus transportation logistics, the center reaches more people and plays host to medical professionals nationwide who offer workshops in advanced treatments.

“We want to be as accessible as possible,” Alanes says. “One example: We’ve held the ‘Swim a Mile for Women with Cancer’ fundraising event for 26 years at Mills College. Last year we were forced to reimagine that event and turned it into ‘Swim a Mile, Move a Mile.’ We created new ways for people to participate anywhere; they biked, hiked, walked. We increased social media and used a platform that was almost like a blog. People posted videos and chatted on an active interface. It kept people more engaged.”

The in-person swim event in recent years garnered roughly $400,000, about a third of WCRC’s annual budget. During last year’s reconfiguration, $325,000 was raised despite the event being virtual. Alanes says that although institutional funding shifted to COVID emergency services and has dropped, individual donors maintained or gave at higher levels. Telehealth (online remote care) has reduced transportation and translation expenses, but funding challenges persist for treatment services, technology training and other needs.

Cassandra Falby, a licensed marriage and family therapist with a private practice in Oakland is the former WCRC program director. In a 35th anniversary virtual event this week, “UNITE for Women with Cancer,” Falby was among three women to be honored for their contributions to the WCRC: Falby received the Compassion Award; former WCRC Executive Director Peggy McGuire the Change Award; and Dr. Kim Rhoads, who directs the Office of Community Engagement at the UCSF Helen Diller Family Comprehensive Cancer Center, the Community Award. Falby recently shared a dream she holds for WCRC and other nonprofits supporting people with cancer.

“One of the things that can be a barrier to WCRC and others serving the community is consistent funding,” Falby says. “What is the next level of support for our community? That is a question you can hire for, plan programs around and make larger answers possible and have real impact on systemic inequities.”

Falby’s private practice has grown and is the reason she stepped away last November after six years as program director. She continues to be involved and insists that while government health agencies have functional roles aimed at specific problems, nonprofits provide more empathy and flexibility.

“Government programs can have rigidity. There are caring and warm people who are part of state services, but the nonprofit organization with a mission puts everyone working in that place within that mission.”

As an example, Falby points to WCRC’s annual gathering at which people talk in ways that are real about cancer: about cancer’s biology, treatment, nutritional response and other topics hard to discuss when information is coming quickly in an office visit or in a one-time encounter with a government employee.

Falby says converting in-person support to online services due to the pandemic was “like drinking from a fire hose.” A $5,000 grant funded the race to Zoom. “We wanted the community to know we didn’t disappear. We didn’t want people to feel lost,” she says. “Some folks were without Wi-Fi or not comfortable with technology; it was a hard shift for them. There were questions about treatment, about engaging with their care team. The isolation was huge. We needed to be as present as possible as quickly as possible.”

Falby says there are reasons to hope the inequities said to have been revealed by COVID will at last improve.

“This time I think is different. The issues around police brutality and the push of that forward in conversations makes this different,” she says. “There’s also more corporate accountability because people are more discerning. They won’t participate with companies that aren’t holding themselves accountable for achieving more equity. Some homes had no computer or no access to wireless, so those people who charged ahead and said ‘let’s all go online,’ it showed the gaps. Especially in communities with people of color, it was not possible. Now, there’s more conversation with clarity, and I try to maintain hope for increased equity.”