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It's difficult to get health care services in many of Alaska's remote communities. Services may not be offered locally, so women need to travel to get routine screening tests such as their annual mammogram.

For the past 16 years, Alaska's original mobile mammogram program has been bringing this valuable breast cancer screening tool to remote communities in Southeast Alaska. Already this year more than 700 women have received mammograms from the program, and there's still one community left to visit.

The program is run by Juneau's Bartlett Regional Hospital, which owns the mobile mammogram van, in partnership with the SouthEast Alaska Regional Health Consortium Breast and Cervical Health Program. The "Mammovan" visits nine remote communities (Haines, Skagway, Yakutat, Angoon, Kake, Hoonah, Klawock, Craig and Metlakatla) each year that don't have local access to mammography equipment but do have a place where a ferry can dock.

"Basically this is a wonderful thing and that's why we're moving forward in our support for the program," said Ernest Wick, diagnostic imaging manager at Bartlett. "It's so highly thought of, and that's why we're paying to go digital next year."

"It is a successful partnership with Bartlett Regional Hospital," said Roz DeRensis, SEARHC Breast and Cervical Health Program director. "I think the reason why is that we all really care so much about getting this vital service out to our remote sites that we try to get beyond all obstacles. This really is the only option for some women to get screened if they don't have the means to travel, and I'm glad that SEARHC and Bartlett Regional Hospital administration feel strongly about this effort to support it."

Breast cancer is the most frequently diagnosed cancer and the second leading cause of cancer deaths among Alaska women. If caught early, breast cancer is easier to treat and survival rates are high. The mammogram, an X-ray of the breast, is considered an important tool for the early detection of breast cancer and women should begin this screening at age 40.

"The mobile mammogram program provides a potentially life-saving service to patients who in all likelihood would not receive it if they had to travel out of town for the service," said Dr. Russ Bowman, medical director at the SEARHC Haines Health Center.

"The Bartlett Mobile Mammogram program has been helping the women in Kake for several years with screening for breast cancer," said Mary Vincent, a physician assistant at the SEARHC Kake Health Center. "The van's visit definitely increases the number of women being screened. Small planes and bad weather discourage many residents from traveling to (the SEARHC Mt. Edgecumbe Hospital in) Sitka for routine medical care. We also use the Mammovan visit to encourage women to get their annual well-woman exams."

Bartlett radiology technician Rod Eriksen was with the program when it started in 1992, becoming Alaska's first mobile mammography program. He said Bartlett bought a portable mammography machine on wheels that they'd load into a van. When they got to a community, they'd roll the machine into schools, grocery stores or hotel rooms. He also said the first year Bartlett also went to non-Southeast communities such as Valdez, Copper Center, Tok and Cordova, but Providence Hospital in Anchorage started its own mobile mammogram program the next year and took over the non-Southeast communities. He said the communities donated meals, rooms and other services because they were so happy to have the mobile mammogram van come to their town.

SEARHC formally joined the program about 1997, when it received a National Breast and Cervical Cancer Early Detection Program grant from the U.S. Centers for Disease Control and Prevention, but Eriksen said Bartlett and SEARHC already were working together before the grant. Six years ago, Bartlett (with additional funding from SEARHC, the Waterfall Foundation and the Bartlett Regional Hospital Foundation) purchased a new van with better equipment and its own exam room, changing room and office. This year Bartlett added two new surgeons who specialize in breast and women's health, and the plan next year is to upgrade the mobile mammography machine from film to digital imaging.

"This year, for the first time ever, we'll do more than 700 mammograms and we still have Metlakatla to go," said Gail Spensley, the Bartlett radiology technician/mammographer who has taken the van into each community the past six years. "We've been just under 700 the last few years. This year we'll probably finish with about 730 mammograms."

Spensley puts together two schedules each year, one in the spring/early summer and another in the late summer/fall, to make sure she spends anywhere from 3-10 days in each community. She checks ferry schedules and works with the local clinics and the SEARHC Women's Health programs, who will provide support staff to handle medical records, insurance billings and other duties needed to make the program run smoothly.

"The mobile mammography program also supports the integration of other women's health services as well," DeRensis said. "Women are required to get a clinical breast exam (CBE) prior to the mammogram, so we work hard to make sure they not only get a CBE but are screened for their next health need, which may include a Pap test and cardiovascular screening with blood pressure, cholesterol and glucose levels tested."

A two-week trip to Klawock and Craig ended on Oct. 13, and Spensley said they saw 163 women between the two communities (138 through the SEARHC Alicia Roberts Medical Center in Klawock). Spensley said a local volunteer in Hydaburg drives several women into Klawock for their mammograms (SEARHC pays for the gas). Spensley said she frequently receives thank you cards and hugs from women whose cancer was caught early.

"Many women would not have been screened without this service," said Dr. Ron Fribush, medical director at Alicia Roberts Medical Center, who added that SEARHC women's health nurse Mary Dinon played a key role in organizing the Klawock visit. "Early detection is still the best way to cure breast cancer."

To read this and other articles celebrating Breast Cancer Awareness Month, visit juneauempire.com/breast_cancer.