With $200,000 of medical bills incurred in just two months, Arline Collins is not looking forward to more than four years of cancer treatment and the expenses still ahead.

Collins, 53, was diagnosed with small cell carcinoma, a form of lung cancer, during an emergency gall bladder surgery on March 30. Treatment began immediately.

"The good news is it is a limited cancer and totally healable," said Collins, who has undergone six sessions of chemotherapy already.

Her worries continue, however. With each monthly visit to the hospital and Albany Internal Medicine, she falls further behind in her bills. Hospital stays can last five days.

"The people in oncology have been wonderful. They keep telling me not to think about the bills," she said.

She has no insurance other than prescription coverage and was turned down for the Oregon Health Plan because her income was too high.

With a monthly income of under $4,000 supporting a family of five, hospital bills have had a shattering impact. Collins and her retired husband, Duke, are raising two neices and a nephew, whom they have adopted. She quit work at the Mennonite Home in 2001 to become a full-time foster parent.

Although care providers have not pressured her for payment, the mounting debt bothers her.

"We have many different plans to help people work out payments," said Karen Bohanan, Albany Internal Medicine manager.

Collins makes minimum monthly payments of $100.

Family support has been strong. The Collins have two grown children. Friends and family members recently shaved their heads to show solidarity. Her brother-in-law cooks for the family, her sister cleans the house, and most arrangements were made by her daughter.

Collins receives radiation and blood work monthly and has experienced sickness from the chemotherapy.

"The worst part is you start recovering and you have to go back," she said.

The no-pressure payment approach has been a great help and despite the financial problems ahead she feels she will get the care she needs.

"I don't regret going in and I don't regret owing the money," she said. "I just wish I could find a way to cover it all."