Hearing on Discussions of Labor, Health, and Education Issues in the State of Hawaii February 18, 2004 Dew-Anne Langcaon, Executive Vice President, Hawaii Pacific Health
Honorable Committee Chair, Members and Guests:
The Cancer Research Center of Hawaii plays a vital role in cancer treatment today by making available cooperative clinical trials and research leadership to physicians and local hospitals. While already an important contributor to the national cancer scene as one of only 61 NCI designated cancer centers, the Cancer Research Center of Hawaii has the potential to be a national role model for cancer research with an expansion of the Center to comprehensive status and the addition of a centralized outpatient clinical cancer facility. To understand the tremendous research potential the Cancer Center has, we can look to the priorities set forth by the National Cancer Institute (NCI) for 2004.
The NCI plans to redouble its efforts to eliminate disparities in cancer research and treatment related to gender and race. Hawaii can play an important role in accomplishing this goal via the study of the differences in effects of therapies and drug treatments between ethnic groups. Progress in the treatment of cancer depends largely on the development of new drug therapies, and the FDA has already begun to recognize the importance of studying such ethnic differences. Historically, the FDA approved drugs on the assumption that those found safe and effective in Caucasian males would be equally safe and effective in other humans including women, children and people of other ethnic origins. Today, however, it is widely accepted that a person’s response to a medication does indeed vary according to gender, age and ethnicity. Increasingly, the FDA requires ethnic diversity among clinical trial participants. Hawaii is a unique location for such clinical trials because of its ethnically diverse population that is also clustered within a close geographical area. It is just about the only place in the world where a physician researcher can simultaneously study the treatment of Japanese, Chinese, Filipino, Korean, Hawaiian, or patients of other ethnic origin as compared with Caucasian patients. Expanded research capabilities in Hawaii would improve worldwide cancer treatment by furthering the customization of therapy to the patient’s ethnicity.
Another priority of the National Cancer Institute is increasing the understanding of genes and the environment on the effective approaches to cancer prevention, early detection, and treatment. The study of family registries and environmental risk factors for susceptibility of cancer genes are high priorities in the national cancer agenda. To accomplish such, researchers require a stable population in order to have a stable gene pool to study. Hawaii’s population is very stable with low rates of in and out migration and often times multiple generations of the same family living in the same area. Next to Utah, Hawaii offers the most robust concentration of multigenerational families who have lived in the same environmental area - both factors are critical to effective genetic cancer research studies.
Thirdly, the National Cancer Institute’s vision is to strive to more fully integrate discovery activities by bringing basic scientists and clinicians together to find the answers. The vast majority of cancer centers in the country are based in university hospitals with closed faculty physician groups. While the translation of new discoveries into the university’s own primary care clinics is relatively easy in such a closed system, dissemination of the knowledge to community based private practitioners is very slow and often impossible. Cancer centers across the nation struggle to get new discoveries and clinical trials into mainstream medicine in order to reach a large number of patients. Here again, Hawaii us unique. Rather than a single dominant university hospital, Hawaii has adopted a community-based network of affiliated teaching hospitals and physician faculty. With an expansion into a clinical facility via a public/private partnership, the Cancer Research Center of Hawaii must develop a model that works within our community-based framework. Rather than competing with private hospitals and physicians, the clinical facility must serve all providers and connect the community as the hub with many spokes into the cancer care delivery network. Few cancer centers across the country have achieved such close integration with community providers. Hawaii’s comprehensive cancer center can serve as a template for a system that quickly moves new discoveries into mainstream medicine for faster benefit to patients.
Finally, the National Cancer Institute is interested in furthering the study of bioinformatics. The ability to capture electronic medical data for an entire community, trend it and study it through disciplined research is unprecedented to date. Hawaii has a unique, once in a lifetime, opportunity to create such a community-wide cancer data repository with three of the largest healthcare providers in the state having independently selected the exact same vendor for their future electronic medical record needs. No other community in the country can currently boast a single information platform from which to collect data. Hawaii could be the first. Additionally, a community-wide electronic medical record would make it even easier for primary care providers to access clinical trials from their desktops thus increasing the speed of getting the latest in scientific knowledge to the patient bedside.
Hawaii is unique in so many ways, and its ability to contribute toward the advancement of cancer research throughout the country is immense. Funding for an expanded research and clinical facility can provide the needed fuel to accelerate Hawaii’s fulfillment of its potential by pulling together, academic, clinical, research and community cancer providers as a team in the fight against cancer.
Thank you for the opportunity to speak today.
