Breast Cancer Care for the Incarcerated

I’ve been part of a prison ministry for the past 20 years. As part of the ministry, I participate in a pen pal program. The goal of the program is to connect inmates with the outside world, provide lasting friendships and combat feelings of loneliness.

At first, writing to incarcerated women made me feel hesitant. The prison guidelines for the program were strict and I didn’t want to break any of the rules. I was randomly assigned an inmate and given her contact information. I could send mail via the postal service or, if the inmate was allowed the privilege of an email account, I could purchase digital stamps so we could correspond over the internet.

My first few letters were generic. I talked about the weather and gave a few details about my family. As her messages came to me, I learned she was a 40-year-old African American woman who’d once served in law enforcement. Slowly, over time, friendship and trust were established. Our conversations became deeper as we shared our lives.

One day, I received some sad news from her. My pen pal’s cellmate had been diagnosed with breast cancer. Both she and her “celly” were scared.

Months earlier, the cellmate had noticed a discharge from one of her nipples and reported it to the prison guard. A notation had been made in the woman’s record and a request had been submitted for a visit to the medical clinic. It took weeks for the woman to finally get an appointment. In the clinic, she received a quick medical exam and was scheduled for a mammogram, but that would entail a much longer wait.

While she waited months for the mammogram appointment, her health began to decline. She became extremely fatigued, lost weight and felt general malaise. The symptoms were reported to a guard by my pen pal friend, but nothing was done. Grasping at straws, the inmate reached out to me, but I didn’t know how to respond. All I could say was, “I’m so sorry.”

When the day finally came for the mammogram appointment, my friend was relieved. She had hoped her cellmate would finally receive the help she needed, but that was not the case. The mammogram results indicated the cancer had metastasized into the surrounding tissues and organs. The prognosis was not good.

Since the inmate was now stage 4 and had already served 30 years of her life sentence, my pen pal wondered if her friend might be released to receive treatment and eventually die in peace at home. With no experience in matters such as these, I had no answers. I tried to be sympathetic and hopeful. I agreed to research prison health care policies and report back as soon as possible.

As I began to look for helpful information, I found on the CDC’s website that breast cancer is the second most common cancer among women in the U.S., and of those women, Black women die at a higher rate than White women. I also found, in an article previously published by CURE®, that many inmates don’t receive prompt attention to health care issues. They’re treated as inmates first and patients second. That seemed unfair to me, but as my pen pal explained, that was “just the way the system worked.” 

As the cellmate’s health continued to decline, she was too weak to file the necessary appeals for release. With nothing but Tylenol (acetaminophen) to manage the pain, she had her cellmate (my friend) call family members to advocate on the woman’s behalf. Thankfully, after seven months, she was released to go home. She died shortly thereafter.

For those outside of the prison system, it may be difficult to understand how the incarcerated are treated with regard to health care. For those on the inside, it’s a double-edged sword. Sometimes, a history of crime may negate quality and timely health care.

Fighting breast cancer is a challenge in any circumstance, but for women in correctional facilities, shouldn’t mammograms be given regularly, especially since many of those women come from poverty-stricken situations and may not have financial means for the test?

If my friend’s cellmate had been able to receive immediate attention after discovering the discharge, she may have been able to undergo surgery and might still be alive today.

I’m thankful I was able to receive quality care after my diagnosis, but it hurts my heart to think about the thousands of women who don’t have the care they need or deserve.

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