Downtown Louisville traffic cited as barrier to care

BY: SARAH LADD

 Margie Baylis (photo provided)

LOUISVILLE — One morning in 2019, Margie Baylis awoke to her right breast swollen up into her shoulder.

The Owensboro photographer then got some shocking news: she had lung cancer at age 45.

The first in her family to be diagnosed with cancer, Baylis, now 50, needed to come to Louisville for care at UofL Health’s Brown Cancer Center.

She would have gone “out of my way” anyway for the care she got, she told the Lantern, but driving into downtown was daunting.

“Louisville is a scary city,” she said. “I was 45. Trying to navigate that was scary. I can’t imagine being 70 and trying to navigate it.”

For this reason and others, UofL Health is seeking $25 million from the Kentucky Legislature to build the Center for Rural Cancer Education and Research in Bullitt County off Exit 121.

The money was not allocated in either the House budget or Gov. Andy Beshear’s proposal, but UofL hopes the Senate will add it. A Senate Majority spokesperson confirmed to the Lantern that the hospital system had requested the money but said it was too soon to know if it would make it into the Senate’s budget.

Positioning this center in Bullitt County, UofL Health says, would allow better access to people coming from rural West, Western and South Central Kentucky.

Worry over downtown traffic plagues many patients who need care, said Dr. Jason Smith, UofL Health’s chief medical officer.

 UofL Health chief medical officer Dr. Jason Smith.
(Kentucky Lantern photo by Sarah Ladd) 

“People … don’t mind driving but they don’t want to come to downtown,” Smith said in an interview last week with the Kentucky Lantern. “It’s hard. And you’re talking about patients that are older, patients that are sick. Patients are having to come to the hospital five times a week sometimes for chemotherapy or radiation.”

Some, Smith said, will even forego the care they need.

“The problem you run into is that ‘Okay, well, if I know I have to have cancer care, and I’ve got to overcome traffic and parking and anxiety, I’m just not going to go,’” Smith explained. “‘I’m just not going to get tested.’ What could be a little problem becomes a really big problem.”

Kentucky suffers dismal cancer rates. In 2021, more than 10,000 Kentuckians died with cancer, according to the Centers for Disease Control and Prevention. Kentucky has the nation’s third highest rate of cancer deaths, better than only Mississippi and West Virginia. Cancer is the second leading cause of death in the state and nation, behind heart disease.

In 2023, UofL Health said the Brown Cancer Center cared for more than 70,000 patients from 115 of Kentucky’s 120 counties.

Margie Baylis’ story

After her 2019 Stage 2 lung cancer diagnosis, doctors removed the left lower lobe, leaving Baylis with one and a half lungs and a lower threshold for getting winded.

Her surgeon, she said, “really thought he left the cancer in a bucket in the operating room.”

That was not so.

The cancer returned and spread to her brain. Her body did not respond to chemotherapy.

 Margie Baylis (photo provided) 

In January 2022, doctors told her the cancer had progressed so fast and far that it could take over her body by the end of summer.

She could soon “expire,” she recalled hearing. “In the cancer world, we don’t say ‘die.’”

But staff at the Brown Cancer Center offered her a tumor-infiltrating lymphyocytes — or “TILs” — treatment through a clinical trial. This treatment involves taking a patient’s immune cells, modifying them outside the body and putting them back into the body, thus teaching the body how to “recognize and kill” cancer cells, according to UofL.

“Obviously chemo wasn’t going to work because we had been doing chemo for … years now and it wasn’t working,” Baylis said. “So we did this TILs thing. It wasn’t easy. It was hard.”

Baylis’ hair thinned — and then she lost it all. She shed muscle mass and dropped weight during the TILs treatment process.

But, it worked in killing the cancer in her body. She is now cancer-free.

Still, Baylis needs to continue driving to Louisville every 21 days for immunotherapy treatments, a drive that can take her up to two hours in the car each way.

“Good music on the radio helps” with these long days, she said. But it’s still draining. She’d like a facility closer to home.

“I have good days and bad days,” she said. She lives with depression. But: “I feel like I’m finally starting to get to do what I used to love to do and that there’s help, and give back.”

Her big passion is fundraising for her community, Baylis said, including through March of Dimes. She used to use her photography business to raise money for scholarships for children, but the cancer that weakened her muscles has made it difficult to get back into that physically demanding work full time.

The Center for Rural Cancer Education and Research

Smith said people come from all around Kentucky for care at UofL, but in particular a 14-county area in the western and southcentral parts of the state needs better access.

“We’re looking for ways to increase access across the health care system,” Smith explained. “And cancer, obviously, is one of the areas from our health care system that we’ve put a lot of effort in.”

After speaking with patients who cited downtown traffic as an impediment to physically reaching care, Smith said, UofL realized it needed a cancer center right off the interstate.

 Dorie Shelburne, the CEO of South Hospital (Photo provided) 

“We started looking through the numbers and, great, we can get this done by about 2029 based off of all the other stuff that we’ve got going on,” he said.

UofL is expanding its downtown hospital as well as opening a hospital in Bullitt County in March. The proposed Center for Rural Cancer Education and Research would be built on the South Hospital campus. In addition to treating patients, UofL said, the center would also conduct clinical trials and research.

But: “The idea came up that if the state could help us do this, could we pull this off earlier?” Smith said.

Dorie Shelburne, the CEO of South Hospital, said with state help UofL could begin work 12 to18 months after contracts are signed, putting the project several years ahead of where it would be without that help.

Shelburne also sees a Bullitt County campus, about half an hour from downtown and outside the outer loop of Louisville, as a way to recruit “world class physicians” who have access to the  nearby city but also can better serve the often underserved rural population.

 Margie Baylis (photo provided) 

“If we can do this early, pull this off early, it would be fantastic,” Smith said. “It just brings cancer care out to a different area and a different level of population than we typically serve on our downtown campus. And it makes it easier for the folks to get in.”

Legislative budget-writers are working with a record state surplus. The budget reserve trust fund reached $3.7 billion in the last fiscal year. In addition to approving a $130 billion state budget, the House also approved $1.7 billion in one-time spending to pay down pension liabilities and build infrastructure.

If Baylis had been able to access a facility like what UofL is proposing during her treatments, it would have made her life easier, she said.

“I wouldn’t have to maneuver downtown as much and try to figure out the ins and outs of that,” she said. “The benefit of having another facility for people that do live in a more rural area that find downtown hard to navigate is a tremendous benefit not just for us Kentuckians but for some surrounding states.”

Baylis is focused on loving every day of her life and cherishing the years she feels like she was gifted by her doctors.

She’s become a self described “concert junkie” (Pink is her favorite). She’s traveled to Hollywood, Egypt and other places.

“I guess,” she said, “I’m just happy that I get to live.”

 

Sarah Ladd
SARAH LADD

Sarah Ladd is a Louisville-based journalist from West Kentucky who’s covered everything from crime to higher education. She spent nearly two years on the metro breaking news desk at The Courier Journal. In 2020, she started reporting on the COVID-19 pandemic and has covered health ever since. As the Kentucky Lantern’s health reporter, she focuses on mental health, LGBTQ+ issues, children’s welfare, COVID-19 and more.

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