Celestina smiled and waved me in after my soft knock on the exam room door. She was back for her monthly check up at the breast clinic, where she was being seen for her Stage II breast cancer. She told me she had heard from her daughter in the Philippines, who was taking care of Celestina’s youngest son. Her daughter had called to confi rm that she had received the money Celestina sent to pay for his care and for her granddaughter’s college tuition. She smiled tiredly, pleased that they were okay. She told me that her arm was hurting, likely due to the lifting she had to do in her job as a caregiver for an elderly man. She had found the job through friends when she came to San Francisco the prior year. Celestina’s story is a little different than many of the other Filipina breast cancer patients I have interviewed and visited in the public hospital breast clinic over the four years of this study. She was not diagnosed after arrival; rather she came to San Francisco knowing she had breast cancer and that she would have to work here while receiving treatment. She felt she had no choice. She had tried to get access to cancer treatment through a clinical trial conducted by an international pharmaceutical company in Manila once diagnosed there, but was found to be ineligible. There was no way she could pay the fees associated with treatment in Manila, and her son’s increasing mental health issues were taxing the family’s already tight budgets. Moving to the United States, where she could get treatment through the safety-net system and fi nd work to support her family seemed the best option available to her.