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Carrigan’s Essay - transcript

April 20, 2020

Carrigan's Essay

Hello, this is Carrigan Wasilchenko. I'm a Human Health Sciences Pre-med Major at the University of Kentucky. And this is my cancer story:

Fighting cancer in my old Kentucky home.

As I'm driving down the narrow road I grew up on. It seems as if nothing has changed; the trees, the landscape and the livestock all appear the same as they were when I was a child many years ago. The smell of the air is even the same; a little musty with a hint of pine.

I pull into my old driveway and make my way to the porch swing. The house is empty now, but I can almost believe that my mother is just inside about to prepare dinner.

I become nostalgic when I realize how everything has stayed the same as I have grown tremendously. I begin to think about my life, where I came from and how far I've come. And I'm overcome with emotion.

For the entirety of my life, I felt a deep connection to the rolling hills of Kentucky; I love the culture, the location and most of all, I love the people. The people of Kentucky are those who adopted me as their own, even though I was born in another country. Kentuckians taught me the importance of family tradition and determination. Most importantly, my beloved fellow Kentuckians inspired me to become a physician.

My name is Carrigan Wasilchenko, and I grew up in Stanton, Kentucky. When I was a child growing up in Eastern Kentucky, Loretta Lynn, L.A. and Quilting were all staples in my household. On any given day, I could expect to come home from school with a full home-cooked meal on the table, followed by the matriarchs of the family gathering together in the living room to quilt.

As they progressed, they would reflect on old memories and sing songs such as Loretta Lynn's Blue Kentucky Girl. These seemingly mundane experiences are actually the ones I remember the most vividly as they truly encapsulate the heart of Appalachia.

Over the years, I've received numerous quilts from my great aunt and grandmother. Every time I use a quilt they made for me, I'm reminded of the love that was sewn into every stitch, and I'm comforted that they live on through some of the best traditions of Appalachia.

While I've experienced the best of Appalachian culture, I've also experienced the socioeconomic struggles that many of my fellow Kentuckians face. The town of Eastern Kentucky, where I grew up, struggles with unemployment, low incomes, the inability to attain higher education, low access to health care and lower life expectancies.

Due to these socio-economic stressors, Kentuckians experience some of the worst health outcomes in America. Kentuckians experience higher rates of diabetes, heart disease, obesity and even cancer when compared to the national average.

Although all of the aforementioned diseases can be fatal, cancer evokes the most heart wrenching emotions. And for good reason. Cancer is a disease that has ravaged Eastern Kentucky for as long as I can remember. Whether it be will lung, breast or even colon cancer, one thing is for certain, it discriminates against no one. Cancer knows no age, no gender. And it certainly doesn't know how much you love a person diagnosed with it.

One of my earliest memories is going to visit my grandmother in the hospital. Although I was only 7 years old, I can still remember the smell of the hospital, the visitors in the hallways and the doctors in their white coats moving from room to room to care for their patients.

My grandmother had just had surgery to remove a malignant tumor, but of course, I didn't know that at the time. I can remember the surgeon regretfully shaking his head, telling my family that they were unable to fully resect it. He went on to explain other treatments that my grandmother would be eligible for. We followed his recommendations, but unfortunately, they were not enough; my grandmother passed away less than a year later.

As a young child, I had difficulty in coping with the grief of losing a loved one, especially to a disease I didn't understand. In the years following my grandmother's death, more members of my family were diagnosed with varying forms of cancer, including my mother. I wish I could say the cases and emotions I've experienced in my own family were unique, but they were not.

My personal experiences with this disease inspired me to delve into the research that has been conducted in Kentucky. The data I found was startling. On average, Kentuckians experienced some of the highest rates of lung, breast, colorectal and cervical cancers in the nation. In addition, the statistics worsen the farther into Appalachia you travel.

According to the National Cancer Institute's Incidents Rates Table, my hometown of Pal County has the highest incidence rate of cancer in Kentucky when elected for all cancer sites, all races, all sexes and all ages.

Prompted by my interest in and concern for the cancer epidemic of Kentucky, I applied for the Appalachia and Career Training and Oncology Program known as ACTION. With the ACTION Program, I've had the opportunity to observe surgeries, shadow oncologists, conduct cancer focused research and participate in community outreach.

While shadowing at the UK Markey Cancer Center, I observed the direct impact of socio economic and geographic disparities on cancer patients. Many of the patients treated at the Markey Cancer Center experienced transportation barriers and immense financial hardships.

For example, a few months ago I spoke with a patient who told me that they were afraid of not being able to continue their chemotherapy treatments. When asked why they were afraid, the patient told me it was very difficult to find transportation to Lexington from their home two hours away.

In another instance, I witnessed a phone call in which a patient was informed that their insurance would not cover their treatment and that their current medical bill stood at more than $400 thousand.

Eye opening experiences such as these have enabled me to envision my goals for the future. I dream of a world where no one ever has to hear the words, “You have cancer.” However, as a realist, I understand that this world is many years away, but there are still things that we can do to help decrease the cancer burden in Kentucky.

First and foremost, we as Kentuckians must work together to advocate for and implement lifestyle changes, starting with smoking cessation. According to the Northern Kentucky Tribune, more Kentuckians have died from lung cancer than all of the other seven leading cancers combined.

Additionally, Kentucky suffers from high obesity rates, poor nutrition and the consumption of potentially hazardous material in our water supply due to coal mining. Many Kentuckians do not realize that these unhealthy behaviors can actually increase their risk of developing cancer.

In addition to partaking in unhealthy behaviors, many Kentuckians do not undergo regular cancer screening. According to the Centers for Disease Control and Prevention, it is estimated that only 65.5 percent of age-eligible Kentucky residents had undergone colorectal cancer screening in 2012.

This statistic has improved in the years since, but the geographic disparities in Eastern Kentucky are still apparent. For many of the eastern counties, the use of a colo-rectal cancer screening test lies between 40 to 60 percent or 61 to 64 percent. It is of the utmost importance that we begin assiduously educating Kentuckians about the importance of a healthy lifestyle, smoking cessation and cancer screening.

However, it is not enough to educate Kentuckians on what behaviors to partake in and which ones to avoid. Kentuckians deserve better access to high-quality and reliable cancer care. Of all the cancer centers in the state, only one is designated by the National Cancer Institute.

This designation means that a facility possesses strong scientific leadership, numerous resources and a drive to develop cutting edge approaches to prevent, diagnose and treat cancer.

There is a reason that people from all over the state come to the UK Markey Cancer Center for care. There is a reason that they bypass treatment facilities closer to home. Patients want the best care possible. So, they make the long trek to Lexington in order to receive it.

Although having an NCI designated cancer center is something to be proud of, I believe it is also something that we need to expand on. According to the CDC, Kentucky is ranked number one in cancer mortality rates, yet we have only one NCI-designated cancer center. California, on the other hand, is ranked number 45 in cancer mortality rates and has 8 Comprehensive Cancer Centers, which are even more advanced than designated cancer centers.

It is not only necessary, but logical for Kentucky to be home to more than one NCI-designated cancer center. The state of Kentucky needs to place an emphasis on funding for the development of more advanced facilities throughout the Commonwealth.

Kentuckians deserve the best care possible, and the best care is impossible to give when patients must travel unreasonably long distances to receive it.

I aspire to become an oncologist, so I may one day be in a position to improve health outcomes and patient satisfaction for all Kentuckians. Ultimately, I hope to advocate for the construction of a specialized cancer treatment center in my hometown and other underserved rural areas.

The people of Kentucky would benefit greatly from the establishment of specialized cancer facilities in these areas. It would allow patients to obtain treatment closer to home, accompanied by friends and family, eliminate barriers to central preventive screenings, and provide excellent opportunities for coordinated cancer awareness and prevention campaigns across the bluegrass.

In order to ameliorate the issues in our great Commonwealth, we as health care professionals must provide the resources to treat, educate and advocate for the improvement of health so that our unbridled spirit may write on.

Eastern Kentucky is the place that I've called home for the past 20 years. I will never grow tired of the rolling hills, the thick accents or the ever-present availability of elite.

My experiences in this amazing state will continue to be the driving force behind my determination and will to fight for the care that all Kentuckians deserve. One day, I hope to become a physician who can help change the health landscape of the bluegrass, a place I'm so proud to call home for the better.