Here is a Q & A on the pilot program with Andrew Salner, MD, director of the Helen & Harry Gray Cancer Center at Hartford Hospital.
Hartford Hospital is one of the 30 sites -- and the first facility in New England -- named recently by The National Cancer Institute (NCI), part of the National Institutes of Health, to participate in a three-year pilot for the NCI Community Cancer Centers Program (NCCCP).
The program recognizes the fact that 85% of cancer care is not delivered in the 63 NCI-designated cancer research universities in the United States. It’s delivered in excellent community and teaching hospitals like Hartford Hospital.
The NCI realizes that it can only advance the care of cancer by having some meaningful way of linking with these community hospitals and bringing innovation and discovery to those hospitals in a rapid fashion. That is innovation, not only in treatment of cancer patients, but in outreach for prevention and early detection, particularly relating to populations where cancer disparities exist. It’s innovation in terms of research studies related to all aspects of cancer, including prevention and detection and treatment and survivorship. It’s innovation in terms of how we handle biologic specimens and utilize them to study genetic and molecular aspects of cancer cells so that we can appropriately target personalized therapies for patients. It’s innovation in terms of information technologies where we look at databases in the hospital and doctors’ offices so that we can link them with research databases to know how patients might be eligible for certain research studies. It certainly is innovation in the quality of care we deliver and in the kind of survivorship support we offer to patients and families.
The NCI hopes that, in studying how it and its designated centers can link with these new NCCCP sites to move forward this kind of innovation and discovery, it will establish a model whereby, after this three-year pilot, a similar kind of linkage might occur to a much greater number of community hospitals around the country.
Why was Hartford Hospital chosen?
I believe that the NCI looked at hospitals and utilized certain criteria. One criterion was accreditation by the America College of Surgeons Commission on Cancer. We’ve had that accreditation in the teaching hospital division and, also, we’ve had commendations in that accreditation process and, actually, have had leadership in that regard.
They wanted to look at hospitals that had a minimum number of cancer patients over 1,000. We have 2,700 new cancer patients a year. We’re the second largest cancer center in the state and one of the largest in New England. They looked at hospitals that had had an historic commitment to outreach to the underserved. We have a history of providing free screening and awareness programs with community partners for the underserved for many years. And, in the last year, we’ve established a mobile mammography program where we offer free mammography to women who don’t have insurance and really brought mammography to places of comfort and trust for women, such as community centers and churches.
I believe also the NCI recognizes that we have a superb medical staff -- that we’re a teaching institution. We’re one of the main teaching hospitals for a medical school. So, for a whole series of reasons, I think we were chosen to be in this role and we feel privileged and, frankly, we feel the weight of the world on our shoulders a little bit. We realize that this pilot will set the tone for how the NCI links with the thousands of hospitals around the country in the future. If we can help to develop models that will provide innovation and discovery to those hospitals and enhance the diffusion of technology, then we will have been greatly privileged by our ability to participate.
What does it mean for cancer patients and their families in this region?
Participating in the NCCCP means that the NCI recognizes the expertise we already have in diagnosis, cancer care and support for patients and families. It also means that there is an infusion of funds, activity, enthusiasm and research that will even further embellish and enhance the comprehensiveness of the programs we already offer. We already are a leader in cancer care, but it will further enhance our leadership role in cancer care in the region and in Connecticut.
Is there a research component?
There is a large research component. And, actually, this pilot project enables us to further enhance our research efforts. We’re already one of the largest cancer research centers in Connecticut. Over 10% of our patients participate in cancer trials. The national average is 2%. We already actively participate in cancer trials of various kinds.
For example, we have been the coordinating institution for all of Connecticut for breast cancer prevention. So, we participate in lots of prevention studies. We are involved in some early detection studies. We have many cancer treatment trials that involve new and exciting therapies. We’ve had a relationship with Dana Farber/Partners Cancer Care, which includes Massachusetts General and Brigham and Women’s Hospital, that allow us to offer new agents to Connecticut patients without them having to travel to Boston, in some circumstances, for those studies.
The pilot will actually allow us to offer earlier-phase cancer research studies, that is, phase one and two studies. We’ve historically offered phase three studies to patients. Those are studies where we’re comparing the best possible treatment we know about with something new to see which one is better. Earlier phase studies will actually look at new molecules, new drugs, to see what their toxicity and effectiveness might be for a certain tumor type and we’ll be participating in earlier-phase research studies -- that’s very exciting to us. It will also enable us to establish certain linkages with other cancer centers around the country for the purpose of studying novel approaches, and we’re very excited about that. We also will continue exciting research in cancer communications and quality of life.
Is there a role in this program for community doctors who treat cancer?
Many of our medical staff are community doctors. They not only treat patients here, at the Gray Cancer Center and at Hartford Hospital, they have satellite offices in the communities around Hartford. Our medical oncologists also have offices, for example, in Windham, in Avon, in Southington and Wethersfield. Our surgeons see patients in lots of surrounding communities, our radiation oncologists take care of patients in several surrounding cancer centers. And so, I think we already have a fairly wide community base, but this new pilot does offer the ability for our referring and collaborating physicians to be part of this program and we look forward to exploring those opportunities with them.