Women's cancers constitute nearly 50 percent of all malignancies in India (ranging from 44 percent in the Mumbai area to nearly 54 percent in the Bangalore region). In addition, breast and cervical cancers constitute approximately 50 percent of all cancers in women in India, with an estimated annual incidence of 100,000 and 125,000 cases, respectively. Given the fact that both these malignancies are, to some extent, amenable to early diagnosis and primary prevention through population-based screening programs and now, vaccination programs, it is unfortunate that significant proportions of women continue to present in advanced stages in India.

To address health and information gaps, the Foundation is providing a grant of $510,000 to WCI-TMH to pilot a toll-free helpline for women's cancers that can be replicated nationally and also expanded to offer information on many cancers. This pilot will be focused on Mumbai. The helpline will offer counseling and navigation services to women who have already been diagnosed or who are suspected of having a malignancy.

Emotional issues, health care as well as financial constraints will be available for discussion and support to women, their loved ones and health care professionals. Over a five year period, it is expected that this program could be rolled out across India. Counselors will help patients move through the complexities of the health care system to get them more timely treatment and information about treatment options and preventive behaviors.

The Creative Center brings art therapy to cancer wards in hospitals and holds classes for female cancer survivors in its New York loft space. In order to expand the impact and adoption of the center's proven models of art therapy beyond the New York area, the Foundation has provided the center with a grant of $50,000 to support a national training institute. Groups of 15 artists and art therapists as well as hospital and program administrators participate in an intensive, weeklong training session. Foundation support has enabled the Center to train more than 70 artists in week-long programs that have provided the skills, experience and knowledge necessary to work in hospitals and hospices.

Since research indicates that only 10 percent of cancer patients who require emotional support are adequately referred for psychosocial care, Bristol-Myers Squibb, in partnership with the Alliance for Children and Families, Cancer Care, and the MoffittCancer Center, established a model program to enhance affordable and accessible counseling resources available to cancer patients at the community level. Called ICAN (the Individual Cancer Assistance Network), this demonstration project was first initiated in 2001 in the Tampa, Florida, area and then spread to 24 other Florida counties. It brings a resource for individualized, comprehensive cancer treatment and care to the community setting, where most cancer treatment in the United States is delivered. While many of the country’s comprehensive cancer centers provide a variety of services and support in the hospital, these are not following the patient to the community and are certainly not being coordinated centrally.

The ICAN demonstration project has sought to be a model to change that. It has tapped into the existing resource of community mental health workers and has given them special training in cancer so they can become part of the patient's comprehensive cancer team. It provides a clear alternative and supplement to group-based support. Some people will not discuss issues of intimacy, for example, in a group setting. This leaves issues unaddressed and ongoing causes of distress. With ICAN, the company has sought to test a new model for building an individualized, community-based resource for patients.

From 2005 through 2006, ICAN crossed state lines and jumped onto the web and into communities in order to make its training courses broadly available to social workers and mental health professionals. In March 2004, Cancer Care and the National Association of Social Workers launched an introductory two-hour, web-based course. To date, over 24,000 participants from 81 countries have take the course. A second level of in-depth training has also been made available through NASW chapters led by experts from Cancer Care and Moffitt. The American Psychosocial Oncology Society has also provided a second level of on-line training with an in-depth course that was launched in the spring of 2005. More than 600 social workers were trained in face-to-face sessions in 2005 and 2006. The program also provided train-the-trainer training to 20 social workers. To date, more than 400 social workers have been trained as a result in their communities. The Bristol-Myers Squibb Foundation was recognized by the American Psychosocial Oncology Society with its Partner of the Year award in February 2006 for its ICAN collaboration. In 2007, a web-based course on Understanding Cancer Caregiving: The Social Worker’s Role was launched, with about 3,800 registrants already having taken the course.

Finally, advocacy efforts by ICAN partners in Washington, D.C., helped lead to a $1 million appropriation by the U.S. Congress in 2004 for the creation of an Institute of Medicine report on best practices for addressing the need for community based psychosocial support for cancer patients and their families, particularly among populations experiencing health disparities.

The incidence of breast cancer in Japan has been on the rise, with breast cancer the leading cause of all female cancers. Upon diagnosis, patients with breast cancer must choose either mastectomy or breast conservation therapy. Though chemotherapy is gradually becoming a more common choice in Japan, many patients choose mastectomy. The recurrence rate of breast cancer at 10 years is approximately 30 percent, and the possibility of recurrence remains thereafter. Therefore, these patients require long-term follow up and support after surgery. Chemotherapy patients need support as well to manage side effects.

To address these issues, the Foundation has provided a grant of $340,000 to the Chiba University School of Nursing to establish an accredited breast care nurse training program in partnership with the Japan Nursing Society. At least 80 nurses will be trained through the program and the curriculum will be published for utilization in nursing education programs throughout Japan.

To date, a total of 20 nurses have received certification as expert breast cancer nurses. Of the 20 graduates, three work in outpatient clinics and 17 work in hospital wards. Of the nurses working in hospital wards, some also counsel patients on an outpatient basis once a week. The nurses are involved in improving information on treatment and demonstrating the use of breast prostheses to patients.

Aside from their work at medical institutions, the nurses are also involved in reporting activities to academic seminars and workshops, and attending seminars to explain the role of breast cancer nursing to the general public.

The Foundation provided a grant of $152,000 for CancerCare to build on its Caregivers program by establishing two crucial components: a comprehensive outreach program that reaches an ethnically diverse, underserved community on the Lower East Side in New York City; and a national education and support program for healthcare/social service professionals who work closely with the chronically and seriously ill. The Lower East Side program will serve as a model for reaching out to underserved geographic areas in cities throughout the U.S. The knowledge gained will help the dissemination of vital information, training, and technical support to social service and healthcare professionals throughout the country on the specific issues and distinct needs confronted by caregivers.