Rural outreach: Taking chemotherapy to Trinidad to support patients who have cancer

Nov. 29, 2022
Richard Columbo is grateful that he only has to drive a couple of miles to receive chemotherapy. UCHealth and Mt. San Rafael Hospital in Trinidad have teamed up to provide care closer to home for patients in southern Colorado who need chemotherapy. Photos: UCHealth.
Richard Columbo is grateful that he only has to drive a couple of miles to receive chemotherapy. UCHealth and Mt. San Rafael Hospital in Trinidad have teamed up to provide care closer to home for patients in southern Colorado who need chemotherapy. Photos: UCHealth.

The way Richard Columbo describes his journey with esophageal cancer borrows from a famous song by the Beatles.

“It’s been a long and winding road,’’ says Columbo, an artist who lives in Trinidad, Colorado, with his wife, Debi Hoyle.

In the months since he learned in May 2020 that he had esophageal cancer, Columbo has had a whirlwind of doctor’s appointments in Arizona, where he lived part of the year, and Colorado. Fortunately, the road to his chemotherapy treatments is now only about 1.5 miles.

Access to cancer treatment in rural southern Colorado

In the springtime, UCHealth Memorial Hospital Central and Mt. San Rafael Hospital in Trinidad teamed up to provide chemotherapy treatment in Trinidad, eliminating a 129-mile, one-way drive to Colorado Springs. UCHealth prepares chemotherapy in Colorado Springs, couriers the medication to Trinidad, where nurses at Mt. San Rafael infuse the therapy.

When Columbo arrives at the Trinidad hospital, a staff member opens the door for him and announces: “Here’s our VIP.’’

Dr. Robert Hoyer provides rural medicine in Colorado.
Dr. Robert Hoyer

Columbo appreciates the 5-star treatment. He’s spent a lifetime teaching art – drawing, painting and sculpting – to children and college students because he believes it’s important to develop the creative brain. When he lived in California, Columbo worked with the Children’s Museum of San Diego to present a program titled: Alternative Materials in Art. He taught children how to turn recyclables into eye-catching art pieces.

Columbo is proud of his work, and he recognizes when people are good at that craft, even if it unfolds in a clinical setting.

“Our people at this hospital have been extraordinary, so caring,’’ Columbo says.

The collaboration between the two hospitals began in the springtime. Dr. Robert Hoyer, an oncologist at UCHealth’s Cancer Center in Colorado Springs, goes to Trinidad twice a month and sees patients from Trinidad, Walsenburg, the San Luis Valley and Raton, N.M. Hoyer also visits Lamar five times a month, caring for patients from the Arkansas Valley and western Kansas. The outreach, which includes numerous specialties in Lamar, is part of UCHealth’s effort to improve access to health care for patients in rural Colorado.

“It’s the right thing for patients,’’ Hoyer said. “I really think it is a special thing.’’

Cancer care close to home reduces the burden of travel

Hoyer said that patients coming from Trinidad to Colorado Springs for care could spend two to three hours driving one way, for a visit that could last 30 minutes.

A lifelong artist, Richard Columbo shows some of his work. Columbo has esophageal cancer and does not have to drive two hours to Colorado Springs for chemotherapy treatments.
A lifelong artist, Richard Columbo shows some of his work. Columbo has esophageal cancer and does not have to drive two hours to Colorado Springs for chemotherapy treatments.

“The time and expense really add up quickly, and if a patient is not feeling well after a visit, to be in a car for 2-3 hours on the way home, from a quality-of-life perspective, it makes a lot of sense to bring the clinic and the medicine to them,’’ Hoyer said.

Some regimens for chemotherapy can last from two to six hours, and some of the regimens are Day 1, Day 2 and Day 3. You can see how this can rapidly add up,’’ Hoyer said.

In his travels to Trinidad and Lamar, Hoyer has seen the difficulty for patients in rural communities to access care.

“There is a huge need throughout the state of Colorado and doing these outreach clinics has really opened my eyes to the situation of rural medicine in our country and our state,’’ he said. “There are very few primary care doctors in communities, so it is a very good thing for patients to have that access and to improve that access.

“When patients can receive the majority of their care close to home it helps to improve quality of life for the patient and for their families as well. They don’t have to take more time off work, they have more time with family, and less driving.’’

Cancer diagnosis when you live in a rural area

Columbo’s cancer journey began with bouts of eating troubles. He’d swallow food, but it would come right back up. Imaging showed he had a tumor at the junction of his esophagus and stomach. He has sought treatment in Colorado and Arizona, and has incorporated acupuncture, Chinese teas, and other alternative medicines into his care. Over time, he’s lost about 50 pounds.

He has completed five of seven courses of chemotherapy at the Trinidad hospital to stem the Stage IV cancer, which has spread to his liver.

As Richard Columbo says, his journey with cancer has been "a long and winding road.’’ He is seated with his wife, Debi Hoyle.
As Richard Columbo says, his journey with cancer has been “a long and winding road.’’ He is seated with his wife, Debi Hoyle.

“It takes me down,’’ he says of chemotherapy treatment.

Hoyle is grateful for the care her husband receives at their local hospital.

“They put him in a bed; they give him comfort. They watch him like a hawk, whether it is a transfusion or chemo, they’re watching him constantly,’’ Hoyle said.

Joe Vigil, a nurse at Mt. San Rafael who takes care of patients, said it’s been a gift to provide the treatments in Trinidad.

“It’s been really good for the patients to be able to receive chemotherapy and immunotherapy, and to get to know them on a personal basis. We get to know their family and their stories, and they get to know ours,’’ Vigil said.

The infusion center is in a newly remodeled part of the hospital.

Building community in rural counties

Casey Peat, a nurse manager in the infusion unit at UCHealth Memorial Hospital Central, said the collaboration between Mt. San Rafael and UCHealth has helped to build community.

“This is bringing a service to that community that wasn’t there before,’’ Peat said. “Patients don’t have to drive so far away to get services, and the nurses at San Rafael have the support of excellence. We are available to them. If it is a new medication, or they need some assistance or have questions, they can reach out to us for that support.

“We are also happy to make the trip there to be there in person. Overall, we’re helping people and we’re helping in growing nursing, what they can do. It’s a great partnership that we have with them,’’ she said.

For patients like Columbo, it makes the long and winding road a little more pleasant.

About the author

Erin Emery is editor of UCHealth Today, a hub for medical news, inspiring patient stories and tips for healthy living. Erin spent years as a reporter for The Denver Post, Colorado Springs Gazette and Colorado Springs Sun. She was part of a team of Denver Post reporters who won the 2000 Pulitzer Prize for breaking news reporting.

Erin joined UCHealth in 2008, and she is awed by the strength of patients and their stories.