By Liz Szabo, USA TODAYHarvey Stern has returned to his home in New Orleans.

But, like many cancer patients in this storm-ravaged city, he must leave to receive treatment.

Before Hurricane Katrina, Stern received treatment for advanced colon cancer at Charity Hospital, just a few miles from his home. Charity, which treated many of the city's poor and uninsured, has been shut down since the storm, forcing Stern to drive almost 1½ hours to receive chemotherapy at a hospital in Independence, La.

Nearly nine months after the storm, many New Orleans cancer patients still struggle to get care, says Donna Williams, director of the Louisiana Cancer Control Program. "Our medical care is still just really devastated," she says.

Cancer centers at Tulane University, Memorial Medical Center and University Hospital also were badly damaged during the flood. Most of their cancer patients are being treated outside the city.

Some cancer patients have to leave Louisiana. Veterans who need radiation therapy — and who once were seen at the New Orleans Veterans Affairs Medical Center — are typically sent to VA hospitals in Houston or Jackson, Miss., says Robert Lynch, director of the VA network for the region. The VA provides housing and transportation for these patients.

Stern, 53, considers himself more fortunate than many. Although he and other former Charity patients lost their medical records, Stern says he missed only one chemotherapy treatment during the hurricane. He knows that some patients missed weeks of therapy.

And unlike many patients going through chemo, which can cause crushing fatigue, anemia and dangerous infections, Stern says his new medications leave him relatively energetic. He also has his own car, a blessing even without air conditioning and high gas prices.

Signs on 'piles of rubble'

Judith Dave, who is undergoing follow-up treatment for breast cancer, says she wonders how patients without cars will get to their doctors. "These are the same people who couldn't evacuate during the hurricane," she says.

Dave, 60, and her husband lost both their house and their jobs because of the hurricane. The couple, who now rent an apartment in Gretna, just outside New Orleans, pay more than $1,000 a month for private health insurance. A cancer charity pays her rent.

More than a quarter of evacuees who have not been able to return home are unemployed, according to the Bureau of Labor Statistics. The bureau did not survey evacuees living in hotels or shelters, so the true unemployment rate may be even higher. About 38% of New Orleans residents are now uninsured, Williams says.

Williams and her staff have gone door to door since the hurricane to locate as many cancer patients as possible. With no central list, Williams resorted to calling doctors to ask them for the names of cancer patients. Then, she and her staff looked up patients' last known addresses and phone numbers.

"We put signs on whatever was left of their homes, on piles of rubble sometimes, hoping people would come back," Williams says. "If they didn't come back, hopefully a friend or neighbor would see it."

Many patients are still living in the cities to which they evacuated. Some have found new doctors. Although Williams has located hundreds of patients, she worries about those she can't find.

'They are absolutely heroic'

Paula Achord, whose 2-year-old daughter, Loran, has a facial tumor, lost her mobile home after it was hit by a tree during Katrina. Achord and her extended family live with her mother in Maurepas, nearly 70 miles away. She drives Loran to appointments at the Ochsner Health System in New Orleans.

Roy Weiner, director of the Tulane Cancer Center, says he's concerned that some cancer patients may neglect their health because they face so many other crises. "These people are coping with unbelievable stresses," he says. "They are absolutely heroic."

Tulane doctors now treat cancer patients at facilities in Covington, about 40 miles from New Orleans, and in Metairie, just outside the city. In rare cases, patients who can't find a way to get to Covington can be seen at Tulane's New Orleans' campus, Weiner says.

Tulane plans to begin offering regular cancer care in New Orleans this summer, Weiner says. Tulane is already offering bone-marrow transplants at a medical center in nearby Metairie.

Other hospitals also are making progress.

The VA Medical Center has been offering chemo in a clinic atop the parking garage of its former building since April 19, Lynch says.

On May 4, the American Cancer Society dedicated a Hope Lodge, society spokeswoman Laura Bellinger says. Cancer patients and their caregivers will be able to stay for free beginning this summer.

Weiner notes that Tulane doctors plan to continue seeing patients in Covington even after its main center reopens, making cancer care accessible to a wider area. "A lot of what we rebuild will be better than what we had before," Weiner says.