CancerLINC Executive Director Julianne Duvall (center) with co-founders Ann Hodges (left) and Phyllis Katz (Photo by Jay Paul)
After a cancer diagnosis, patients face an endless series of serious questions that extend beyond their medical concerns. “What will I do about work? How will I pay rent? When should I make a will? Where should I start?”
Like a tumbling row of dominoes, these problems quickly become roadblocks on the path to progress. Ann Hodges and Phyllis Katz know this well; the employment lawyers — the former a professor at the University of Richmond School of Law and the latter the director of the state’s Department of Employee Relations — both went through cancer treatments and heard such questions from fellow patients.
The two met in the early 1990s, connected by their careers and medical journeys, and Katz, with Hodges’ help, identified a missing support system for Richmond’s cancer community. After hosting a conference at the law school in 1996 about the nonmedical issues cancer patients face, Katz and Hodges launched the Legal Information Network for Cancer (now called CancerLINC), a first-of-its-kind nonprofit — now in its 30th year — that connects patients from Central, Eastern and Southside Virginia with volunteer lawyers and financial advisers to tackle unexpected questions.
“To me, it was just this great idea of a way I could take something negative that happened to me and try to turn it into something positive and to help other folks who are dealing with those issues,” Hodges says.
Legal and financial advice for patients remains a crucial but oft-forgotten resource as medical expenses rise, insurance coverage shrinks, and housing and employment insecurity intensifies in the United States. Now, with three decades of patient advocacy behind them, CancerLINC’s leaders are preparing for a future with an ever greater need for their services.
A Team Effort
“Everybody’s got a cancer story, whether it’s their own [or] a parent, a sibling, a child, somebody in that close circle ... you know how disruptive it is to a life,” says Julianne Duvall, CancerLINC’s executive director. She joined the organization in May 2024, coming to the role with personal and professional experience as a cancer survivor and a nonprofit leader.
“When you first introduce the idea of cancer, people are like ‘Gosh, I’ve never really thought about those legal and financial issues.’ And the minute you start talking about those, you start talking about employment and housing, medical bills and insurance, and public benefit denials. It’s overwhelming,” Duvall says.
More than 200 attorneys and financial planners in the Richmond region volunteer to work with patients and their families to tackle tasks that often arise after a cancer diagnosis, including drafting wills, establishing power of attorney, collecting disability benefits and more.
“A lot of times there are administrative things, paperwork that just doesn’t get done, and people get kind of caught in a bunch of red tape,” says Colin McCarthy, a health care regulatory attorney with Kaufman & Canoles and a CancerLINC volunteer for 10 years.
I explained that I was with [CancerLINC] and that this woman’s husband really was dying, and they canceled the audit. ... For me, it was a phone call, but for her, it was like a miracle.
—Ann Hodges, Co-Founder, CancerLINC
CancerLINC also relies on frontline medical professionals, including doctors, nurses, social workers and other hospital staff, to connect patients with the organization. Bon Secours, HCA Healthcare, Virginia Cancer Institute, VCU Health and the Richmond VA Medical Center all partner directly with CancerLINC to turn patients into clients.
VCU Health works with nonprofits such as CancerLINC through a medical-legal partnership, one of only five in the state, acting as an in-house legal advocate to proactively refer new cases to the organization.
“I didn't know about medical-legal partnerships when I had the idea, and it turned out that there may have been only one or two in the country at that time.” Katz says. “It became a model, if you will, for medical legal partnerships, particularly those dealing with cancer.”
Since its early days, CancerLINC’s network of experts has helped with common problems, but their strong suit has been reacting to the unexpected. “When we started, of course there were things that came up that we hadn’t even thought of,” Hodges says.
“One case I remember was somebody who called and said, ‘My husband has cancer. He’s dying. He has two weeks to live, and the IRS is trying to audit us, and all I want is to put off the audit until after my husband dies,’” she says. “I just picked up the phone and called the IRS and explained who I was, that I was with [CancerLINC] and that this woman’s husband really was dying, and they canceled the audit. … For me, it was a phone call, but for her, it was like a miracle.”
Duvall views those unique cases as a testament to volunteers’ efforts.
“Our work is very human,” she says. “We’re not giving away anything other than our time and expertise and care.”
Considered Care
CancerLINC’s growth coincided with the health care industry’s increasing adoption of the social determinants of health — nonmedical factors such as living conditions, wealth, employment and more that have a direct impact on public well-being.
“Our integrative medicine program, which I’ve been involved in building, includes things like financial and legal support, exercise, stress management, nutrition, and all the other things that are affected while you’re getting cancer care,” says Dr. Mary Helen Hackney, an oncologist with VCU Massey Comprehensive Cancer Center.
Hackney was an early advocate for VCU Health’s medical-legal partnership, through which she learned about CancerLINC; she later held a seat on the nonprofit’s board of directors. She considers the problems CancerLINC addresses to be immediately impactful to a patient’s quality of life in treatment.
“You know, we’ve seen people start care and then drop out because they couldn’t get transportation, or they were not able to make money to support their family during treatment,” Hackney says. “A lot of people don’t necessarily see what [CancerLINC] can do to link preventing an eviction or getting your power turned on to your health. Sometimes you’re working so hard to just keep a roof over your head, you forget about how others can help you with that.”
McCarthy notes that as research on social determinants of health advances, CancerLINC and similar organizations could benefit from the increased acceptance from government agencies and health care providers.
“In my experience, health care providers understand that those social determinants of health are really important and can lead to better outcomes when people have stability; they’re already dealing with a diagnosis and trying to put all their effort towards fighting physically and mentally,” McCarthy says. “But if you can take some of those other pressures off of people, they’ll do better in treatment.”
Despite growing recognition of their benefits, legal and financial nonprofits for cancer patients at the local level remain rare; Duvall, Hackney and others attribute CancerLINC’s longevity in part to the support shown by Richmond’s community of cancer advocates, nonprofits, hospitals and more.
“It’s very much the case that we’re all here to help a cancer patient,” Duvall says, “and if one can’t, another will, or we’ll work together, and that’s been an amazing gift.”
Facing the Twists and Turns
Three decades after Katz and Hodges’ diagnoses, patients’ needs and questions haven’t changed significantly, but the stakes have. From 1996 to 2023, medical spending in the United States rose 160%, from $1.87 trillion to $4.87 trillion, while out-of-pocket costs per capita increased 60%, according to health policy research firm KFF. In that same period, housing costs for buyers and renters have risen sharply while wage growth has stagnated for 90% of earners.
A new wave of federal cuts to Medicare totaling an estimated $500 billion over the next decade, expired Affordable Care Act subsidies and reduced federal contributions to Medicaid could drive a surge in demand for CancerLINC’s services.
“I’ve seen an uptick in the number of referrals coming from CancerLINC, which is partially driven by ... people that are just getting caught in the middle between insurance companies and changes in Medicare and Medicaid,” McCarthy says. “I expect it’s going to continue. I don’t see any signs that that’s ever going to go away.”
This year, Duvall and the CancerLINC team plan to recruit additional volunteers to combat the expected increase in need, strengthen relationships with health care companies and focus on shifting their interventions earlier in patients’ cancer journeys to address problems before they arise.
“Everything we do is in response, typically, to a crisis. That’s why we get a referral. People are at the end of the road,” Duvall says. “If we’re more proactive, if we can embed that as sort of a normal part of the cancer diagnosis and treatment journey, we can increase positive outcomes for patients so that they’re not having to choose medicine over food or food over medicine.”
Even facing a future full of twists and turns, Duvall sees every challenge as a chance to improve the lives of cancer patients in the region.
“One of our goals is really to become a household name among the entire cancer community,” Duvall says. “The more people know that we’re here, the more we can help.”
Illustration via Getty Images
Chain Reaction
Services for cancer patients form a wide-reaching network in the Richmond region; here's a sampling of resources and organizations:
Behavioral Health Support
Cancer Retreat Centers’ 2024 restoration of Blanton House in Richmond’s Byrd Park transformed the historic home into a resort-like destination for support groups and individuals with cancer.
Food Support
Colorectal cancer patients and survivors living in the Richmond area can receive a Healing Belly Basket from nonprofit Hitting Cancer Below the Belt. The baskets are full of gut-friendly foods and resources for restoring the gut microbiome.
Survivorship Support
LIVESTRONG at the YMCA is a free fitness-focused community program designed to help cancer survivors improve strength and wellness. Instructors lead workouts and supportive conversations over 12 weeks.
Monetary Support
The Hawthorne Cancer Foundation’s Weersing Family Grant Fund delivers funds for nonmedical purposes to qualified individuals who are currently undergoing cancer treatment in the Richmond metropolitan region.
