Community Cancer Program Adopts Best Practices on Louisiana Medical News

Community Cancer Program Adopts Best Practices

By: TED GRIGGS

A national pilot program designed to improve cancer treatment in the community has resulted in thousands of screenings in the Baton Rouge area and assistance for hundreds of patients whose screening results were abnormal.

The goals of the National Cancer Institute’s Community Cancer Centers Program include making treatment advances at major academic-based cancer centers available at the community level, said Dr. Mitchell Berger, medical director for the cancer program of Our Lady of the Lake Regional Medical Center and Mary Bird Perkins Cancer Center.

“You know, 85 percent of cancer care takes place in the community, so by doing this program we’re making a difference in a lot of people’s lives,” Berger said.

After two and a half years of the three-year pilot program, 12,378 participants have been screened at 406 events, with 104 cancers diagnosed.

In 2008, the program began offering “patient navigators” to guide people with abnormal screening results through clinical care, social services and financial counseling. During the first nine months of 2009, the navigators helped 652 patients find their way through the complicated process.

The patient navigators were part of the Lake and Mary Bird’s effort to reduce cancer healthcare disparities for minorities and underserved populations.

Other program goals include:

Enrolling more patients into clinical trials in community-based settings. The Lake and Mary Bird are trying to make sure more underserved patients, such as the uninsured and underinsured, are enrolled in trials,
Linking to national computer networks for conducting research and sharing results. The Lake and Mary Bird are working on strategies to connect their information systems with physician practices into one system that contains all cancer-related electronic health records,
Exploring standards for collecting and storing cancer research specimens. The cancer program is participating in a study to individualize cancer treatment using genetic information unique to each tumor,
Enhancing cancer survivorship and palliative care services. The Lake and Mary Bird offer educational programs to support cancer survivors.

Berger said the Lake-Mary Bird team competed in 2006 with community providers nationwide for the pilot program’s 16 slots. In 2007, the selections were announced.

The idea was to capture the various models of community care, he said.

The NCI chose a diverse group of community centers, with some from larger cities, some from smaller, some slightly academic, some with private practitioners, some whose physicians are salaried employees, and so forth, Berger said.

Because each community center is so different, it’s difficult to compare “apples to apples,” Berger said. Instead, the centers measure their progress against where they were in 2007, when the pilot began, to where they are now.

Sometimes, a provider can find itself focusing on each little step being taken, Berger said. But a better measurement of progress is to take a look at the last 10 years of growth.

“I think we’re a better center for our involvement. We’re reaching for folks,” Berger said. “One of the reasons we were chosen is because of the extensive screening programs that Mary Bird does.”

By collaborating with the other participating centers, the pilot program members are taking community cancer care to the next level, Berger said.

However, Berger said the Lake and Mary Bird disagree with the most recent breast screening guidelines recommended by the United States Preventive Services Task Force. The group said most women should not begin getting routine mammograms until age 50.

Berger said the Lake and Mary Bird’s screenings resulted in early detection of breast cancer for a large percentage of women under 50.

If screening begins at 50, many patients will lose their lives, he said, and the women who can least afford screening services will have an even harder time getting them.

Meanwhile, the NCI has been pleased by the pilot program’s results, Berger said. In October, the NCI announced that the pilot would be extended through 2012 and that additional community centers would be chosen to take part in the second phase of the program.

The NCI has asked each of the first 16 centers to write a white paper on the lessons learned in the last two years in each of the major focus areas, such as information technology, Berger said. Those white papers will serve as guidebooks for the 14 new centers.

The NCI also asked the original community centers to make proposals on 18 projects, Berger said. The NCI will tell Lake and Mary Bird this spring which projects will qualify for funding.

There is $35 million available overall, through federal stimulus funds, for the first 14 centers, Berger said. The Lake and Mary Bird hope to secure $2.5 million to $3 million in additional funds; in order to do so, the team will have to put up $7.5 million to $9 million in matching money.

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