When Edie Hapner began working with patients with head and neck cancer early in her career at the Veterans Health Administration in St. Louis, she had no idea her job would grow into such a passion. Now, 29 years later, she is leading a charge to bring head and neck cancer screenings to the general population.
Hapner wants to target those with the highest probability of risk factors and she found them at the Atlanta Motor Speedway. Hapner, along with her colleagues (Justin Wise, Marina Gilman, Kelly Carr, Sarah Wise, Howard Hapner, Steve Roser, and Meryl Kaufman) and dozens of volunteers, began to orchestrate large-scale screenings in 2006 during NASCAR race weeks—this year they have already screened 808 people.
"I fell in love with head and neck cancer patients, and I love working with them because it's such an opportunity to make a difference in a person's life," she said.
But it wasn't always so fast and furious. Hapner's enthusiasm for raising awareness about oral cancers had been building for years, and she always volunteered during Oral, Head and Neck Cancer Awareness Week (OHNACW), but the public was slow to catch on. Despite heavily funded media campaigns, people still were unaware of the screenings and the risk factors. For years Hapner and her cohorts set up screenings in malls and at Emory University, with dismal results.
"Nobody ever found us," she recalled. "The only people who found us were the TV people who someone rallied to come do a story and then the story ran after the week was over."
Discouraged after one such event, she told her husband of her frustration. A businessman, he offered a different perspective: "You may not like what I have to say," he told her. "But you guys are targeting the wrong people. You need to go to NASCAR."
The Racing Connection
Hapner knew nothing about NASCAR, except that auto racing is the most popular spectator sport in the country. What she hadn't realized, however, was that its audience was a potential hotbed for oral cancers.
According to the American Cancer Society, the use of smokeless tobacco doubles the likelihood of developing oral cancer; her own research showed the rate to be much higher. And compared to the 22% of the U.S. population who smoke or use smokeless tobacco, 39% of NASCAR spectators fall into that same category.
"Many of the tents [at the track] are from smokeless tobacco companies," her husband told her. "They're giving it away like candy."
And then the wheels started moving. With her husband's help, Hapner contacted the vice president of sales for Atlanta Motor Speedway, pitched her case, and in March 2006 the speedway gave her a tent, some tables, and chairs.
Hapner's group recruited 60 volunteers from the medical and communication sciences and disorders fields to help; on their first race day they screened 200 people.
"This whole effort sounds medical, but really it was spearheaded by a speech-language pathologist," Hapner said. "Most of our volunteers are SLPs and speech-language pathology students. They drive 80 miles for a bagel and coffee and to work in a tent for three hours on a weekend. They're very dedicated."
And their efforts are making a difference. Since that first race, they have set up shop at seven race-day events and have screened 1,400 people. They continue to have the support of faithful volunteers, including Lori Hamilton, the widow of racing champion Bobby Hamilton, who died of neck cancer in 2007.
Spreading the Word
The NASCAR connection also is paying off outside the racetrack. Hapner still participates in April OHANCAW screenings, which now attract a lot more attention. In 2008, 139 sites across the country participated in OHANCAW, screening 2,815 people—about 20 people per site. But 100 of them came to her site in Atlanta, five times the average.
"I think the NASCAR connection really got people's attention," Hapner said.
The success of this initiative is being recognized outside of Georgia. Bristol-Meyers Squibb has paid the Head and Neck Cancer Alliance to replicate the Atlanta program in Indianapolis, and even sent Hapner and her team to train them.
But equally important as spreading the program is the research that will come out of it. Hapner hopes that by tracking their numbers, they will be able to provide enough evidence to make routine oral, head, and neck cancer screenings part of the services recommended by the U.S. Preventive Services Task Force. Plus she wants this effort to be more educational for the public. But she needs to be careful—she might just work herself out of a job.
"As SLPs, we treat people after their diagnosis and treatment," she said. "I see people who [are suffering] and I just think the logical next step for an SLP is to say ‘I don't need any more patients.' I need to help people understand that head and neck cancer is preventable. If my work in the future is in prevention and early detection, I will be thrilled."