Giving rural Texans a fighting chance against cancer

If you live in a rural area of Texas north of Amarillo, your life expectancy is 17 years shorter than in a rural area outside of Dallas. One of the major contributing factors to the disparity is cancer. According to the Centers for Disease Control, people in rural areas are 15.8% more likely to die than those in urban areas. Other leading causes of death — heart, respiratory kidney and Alzheimer’s diseases and diabetes— also carry a higher death rate in rural areas.

Several factors contribute to the disparity. A primary concern is the lack of specialized health care providers and diagnostic technology in rural regions, leading to delayed cancer detection. Additionally, patients in the western half of the state must travel six hours or more for advanced treatments or to participate in clinical trials that offer the latest therapies. This long-distance travel delays care, lowers survival rates and stresses families emotionally and financially. A 2024 study by The Perryman Group reveals that cancer costs Texas over $156.5 billion a year in production losses and impacts about 1 million jobs.

Sergio and Iriana Rangel understand the struggle. For the past two and a half years, they have traveled from their home in Pecos, Texas, so their 5-year-old daughter, Emmie, could receive cancer treatment. Emmie has spent nearly half her life battling high-risk neuroblastoma.

Her treatment has included chemotherapy, stem cell transplants and immunotherapy. At first, doctors in Pecos could not determine why Emmie was not getting over what appeared to be a stomach virus. Desperate for answers, the Rangels drove six hours round-trip to see a family doctor in Juarez, Mexico. That’s where they first heard the life-changing news: their daughter had cancer.

Dr. Mohamad Al-Rahawan, a pediatric oncologist at Texas Tech University Health Sciences Center (TTUHSC) in Lubbock, confirmed Emmie’s diagnosis and began her chemotherapy treatment. Later, she needed a stem cell transplant, which required a six-month stay in Dallas. Sergio had to travel back and forth for work while Iriana stayed with Emmie. Their son, Eli, who was just a baby at the time, stayed behind with his grandparents.

The Rangels anticipate their daughter will soon be able to ring the bell, a symbol that her cancer treatment is complete. For the last year, Emmie has been able to receive outpatient immunotherapy at home and make shorter trips—three hours each way—to Lubbock for weeklong inpatient immunotherapy treatments. The Rangels are grateful for the “closer” treatment options and a pediatric cancer expert to guide Emmie’s care.

TTUHSC serves 121 counties in the Panhandle, West Texas and North Texas, including Reeves County, where Pecos is located. The region represents 35% of the state’s population, 54% of its land mass and 75% of its rural area. It’s also home to many of the state’s cattle, cotton, oil and gas producers, who provide for the U.S. and the world.

As the first health sciences center west of I-35, TTUHSC has worked for decades to improve health care access in a historically underserved area of the state. The university seeks to bring more cancer services to the region through the Rural Cancer Collaborative to help people like Emmie. These services include better screening and diagnostic tools for prevention and early detection, specialized cancer doctors for timely interventions and clinical trials for advanced treatment options and improved patient outcomes.

Wishful thinking will not eliminate rural cancer disparities. Instead, the answer is to invest in a strong network to produce evidence-based solutions. Partnering with rural communities to build the Rural Cancer Collaborative ensures that a person’s zip code does not determine their access to life-saving cancer treatment.