Pamela Trombero, 68, said it was a like a “slap in the face” when she received the news in 2006 that she was diagnosed with Stage 1 lung cancer.

After her diagnosis, Trombero stopped smoking and went through six months of chemotherapy and surgery. Now, 18 years in remission, she leads a virtual cessation program to help others quit smoking and encourages her friends and family members to regularly get screened for lung cancer.

“People need to do that,” she said “People should not be afraid of it, because it’s better to prevent anything from happening.”

The American Lung Association agrees with her. According to the “State of Lung Cancer” report released Tuesday, screenings are one of the best tools to catch lung cancer early.

“We know that not enough people are getting screened, and I think Maryland falls right in line with that,” said Aleks Casper, the association’s director of advocacy for Maryland, Delaware, Virginia and Washington, D.C. “If we can get somebody screened, we can get them an early diagnosis and you can get them access to treatment.”

Screening and early diagnosis were the two areas where Maryland was weakest compared to other states, according to the report, which looked at data from 2021, the most recent year for which numbers were available. The report said Maryland was 23rd of 50 states and the District for screening, and 26th of 47 states for early diagnosis.

In other areas, Maryland did relatively well. It was 16th for the rate of new cancer cases, at 50.2 per 100,000 residents, compared to a national rate of 53.6 per 100,000. It was 13th of 47 states for the lung cancer survival rate, at 30.1% compared 28.4% nationally.

Maryland did best when it comes to the number of smokers: The 9.6% of adults in the state who smoke was second only Utah. Nationally, 12.8% of adults smoked in 2022, the most recent year for which that data is available.

Overall, trends improved over the five-year period from 2017 to 2021 that the report looked at. Nationally, survival rates went up and the number of new cases went down, the report said. But close to 235,000 people will be diagnosed with lung cancer this year nationwide, according to the report, and 361 on average will die from lung cancer per day.

Dr. Panagis Galiatsatos, a spokesperson for the American Lung Association National and an assistant professor for Johns Hopkins School of Medicine, says that “more needs to be done.”

“I think we are doing fine, but there’s still plenty of room for improvement,” he said.

The people most at risk for lung cancer are those aged 50 to 80 years old who have a history of smoking or are current smokers. People who fit this category are urged to get annual lung cancer screenings.

“Screening with annual low-dose CT scans can reduce the lung cancer death rate by up to 20% by detecting tumors at early stages when the cancer is more likely to be curable,” the 2024 report says.

Another way to improve the state of lung cancer is to reduce smoking. While Maryland does well as a state in that area, the rate of smoking varies by location within the state, Galiatsatos said.

“In your rural areas and in your urban areas, you still see high rates of smoking occurring, so the state as a whole hasn’t seen a uniform drop,” he said. “It’s rather disproportionate and really falls along the lines of rural status and socio-disadvantaged neighborhoods in cities like Baltimore.”

The 2024 report also looked at which states currently insurance to cover what’s called biomarker tracking, a wide range of tests where blood, tissue or other samples are collected throughout cancer treatment to see if the selected treatment has been effective.

Maryland passed a law in 2023 requiring that insurers cover biomarker testing, one of 15 states that does so. The law went into effect for private insurers in January, and will go into effect for Medicaid enrollees starting July 2025, so long as there is money in the state budget.

Casper hopes that the biomarker law in Maryland will help improve treatment and survival rates for lung cancer patients.

“Biomarker testing is a huge opportunity … that helps determine what treatment will be the best for individuals.” Casper said. “That’s something that we’re really highlighting, that Maryland has really made steps to ensure that people who are living with a lung cancer diagnosis have access to the best treatment available and individualized treatment available through biomarker testing.”

But there is not one solution, she said. Reducing the toll of lung cancer in the state will require a multifaceted approach and that advocates, doctors and policymakers need to “continue focusing on what we can do to make people healthy.”

“We can prevent people from starting to smoke anything … and then ensuring that people have the resources to make them successful when they want to make that quit attempt,” she said. “And then the follow-up piece ensuring that we are talking about messaging, both as a consumer … but also to a provider to be talking to their patients about eligibility and talking about how to receive lung cancer screening.”

by Danielle J. Brown, Maryland Matters
November 19, 2024

Maryland Matters is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Maryland Matters maintains editorial independence. Contact Editor Steve Crane for questions: [email protected]. Follow Maryland Matters on Facebook and X.

Kent County Shore Community Outreach Team members Michelle Matthews, Emily Welsh and Amanda Webster are shown with their patient, William Miller, whom they helped to overcome homelessness while supporting his recovery from various health problems.

Modern day health care is complicated. Most diagnoses and treatments come with a long to-do list for each patient—appointments, prescriptions, co-pays, physicals, bloodwork, follow-ups, paperwork.

Now imagine attempting all of that as an elderly person without access to a computer, or as someone who lives in a rural area with little or no family support, and without a car or a phone. Health issues are much more difficult to manage for individuals and families facing these circumstances, and — as William Miller, a retired veteran from Chestertown discovered after a fire destroyed his home — even more so for someone who is unhoused.

Miller is a familiar face in Chestertown—he worked for several years as the janitor at Chestertown Middle School. His 13 years of service in the National Guard included work as a cook, a skill he later put to good use at the former Old Wharf restaurant, where he was proud to prepare their crab bisque, a local favorite.

Even before the fire, Miller experienced serious health issues. After, he struggled to find a permanent place to live, staying for long periods in motels. “I’d been ill for a long while and in the hospital many times,” he said. “I had seizures, then surgery on the brain. I had a pacemaker put in. Once out of the hospital, I needed help to keep recovering.”

Fortunately for Miller and other folks experiencing health issues and personal hardship, University of Maryland Shore Regional Health (UM SRH), a member organization of the University of Maryland Medical System, offers Shore Community Outreach Teams (SCOT)  in both Kent and Dorchester counties. Serving patients in home and community settings, SCOT helps patients overcome barriers to health care.

The Kent County SCOT team includes Nurse Coordinator Emily Welsh, MSN, RN, Social Worker Michelle Matthews, LCSW-C and Community Health Advocates Serenity Kelly, CCHW, and Amanda Webster, CCHW. The team provides medical case management and conducts outreach events that include free screenings for conditions like high blood pressure and diabetes. By finding physicians and making appointments, connecting with resources through community partners, and securing transportation, meals, housing or phones, the team provides comprehensive support for patients navigating health challenges. Patients’ limited finances are not an obstacle—SCOT’s services are provided free of charge.

Patients may be referred to SCOT by their health care providers, family members, neighbors or friends, and they may also self-refer. Then SCOT swings into action, visiting the individual to conduct an assessment that includes medications and health needs as well as information about his or her support network and resources. With the patient’s input, they create an individual plan to help overcome barriers to care.

“Our patients face health disparities like not having access to food, not being able to afford utilities, lack of transportation, not having health insurance, not understanding information they’re getting from their doctor and even not having a primary care doctor,” said Matthews. “And of course, not having a home is a huge disparity. The health care system is complex, and for someone who doesn’t have stability, navigating it is even harder.”

Although SCOT wasn’t created specifically to address homelessness, recently the team has worked with Miller and three other community members who needed housing. All four have been successfully rehomed.

“These individuals weren’t referred because they were homeless — it was something we learned while working with them,” Matthews said. “If your basic needs aren’t being met, you’re not focused on getting to your doctor, doing preventive health screenings or maybe even keeping up with your medications, especially if you don’t have access to the internet or a smartphone. While following up on issues like their needing a doctor and problems accessing medication, we saw that their lack of housing was something we needed to help them resolve.”

Today, with its needlework pillows and family photos, Miller enjoys a cozy and comfortable home, thanks in no small measure to SCOT’s collaboration with other local organizations. Working with Upper Shore Aging, the team applied for senior housing and energy assistance on Miller’s behalf. They coordinated with Social Services for help in funding his first month’s rent and with Tides of Grace, a Stevensville nonprofit, for help furnishing Miller’s new apartment in Centreville. The team also contacted County Ride to ensure Miller had transportation, and arranged for his prescriptions to be transferred to a Centreville pharmacy and for home meal delivery to come from a local service.

In the case of another patient the team helped to rehome, Father Henry Sabetti at Kent County Coalition for the Homeless was an active partner. “Collaboration with community partners is critical to our success in getting patients the full complement of help they need to manage their health challenges and achieve a better quality of life,” said Welsh. “It’s a team effort that includes a wide network of key staff members in health and social services departments and in local organizations.”

When Miller’s apartment was ready for occupancy, members of SCOT moved him in and got him settled. “I love it right here, I’m so glad they got it,” Miller said of his home. “Michelle, Amanda and Emily helped me out. I had been ill and they got me help from home care workers after a couple of my surgeries. Since then, they’ve been with me quite a while.”

Team members continue to check in on Miller via phone – Welsh monitors his medication, Matthews keeps up with his VA transportation and paperwork, and Webster makes contact to be sure he remains safe and comfortable. This kind of above-and-beyond patient care is the norm for SCOT members, who smooth the way forward for patients to achieve their best quality of life and a foundational standard of health care.

“It’s rewarding to see a situation improve for someone—and to know that we are filling a void where otherwise, there wouldn’t be support,” said Matthews. “Our team is small but mighty, and when everything comes together, we see the difference we’re making and that’s a good feeling.”

Domestic violence isn’t always evident; it’s more common than you think, and often those experiencing it suffer in silence.

October is Domestic Violence Awareness Month. The Spy recently sat down with Angie Price, CRNP, DNP, WHNP BC, RNC OB/C EFM, a nurse practitioner with University of Maryland Shore Medical Group (UM SMG)-Women’s Health and Jeanne Yeager, who is executive director of the Mid-Shore Council on Family Violence in Easton. Price and Yeager discussed the importance of domestic violence screening during annual well-woman exams and the partnership between women’s health providers at UM SMG-Women’s Health and the Mid-Shore Council on Family Violence.

That partnership includes collaboration and communication to other providers, as well as referrals to ensure patients receive the assistance they need to find resources like transitional housing, pet assistance, legal assistance, medical and mental health assistance, and safe transitions for children, including school enrollment.

Domestic violence is a tragic and traumatizing experience. But you can get through it with a strong support system and a solid plan. If you or someone you know experiences domestic violence, having a safety plan can save your life. Learn more about the Mid-Shore Council on Family Violence at mscfv.org. Help is also available via the National Domestic Violence Hotline at 1-800-799-7233.

This video is approximately 10 minutes in length.