Testimonial at Congressional Hearing on February 18, 2004.
Committee of Appropriations Subcommittee on Labor, Health, Human Services, Education, and Related Agencies
Thank you, very much, for giving me the opportunity to address your committee today.
I am a physician, specializing in the care of cancer patients. For the past twelve years, I have been associated with the Cancer Research Center of Hawaii through its clinical trials program. This association has enabled my patients and I to actively participate in clinical trials. The Cancer Research Center of Hawaii has been the focal point of cancer research in Hawaii for many years. Their commitment to the promotion of clinical studies has given hundreds of patients, over the years, access to new cancer treatments.
I am here today to provide a practicing physician’s perspective on having a comprehensive cancer center in Hawaii. I see three major advantages for the establishment and development of such an institution. Unlike many other diseases, optimal care of the cancer patient requires a coordinated effort by many different disciplines. First, having a comprehensive cancer center would provide a setting in which such coordinated, multidisciplinary care would be delivered. Secondly, a comprehensive cancer center would provide cancer patients access to new and innovative cancer treatments. Presently, the majority of “cutting edge” cancer treatments are administered in major academic centers and/or designated cancer centers throughout the country. Patients cared for at these institutions have the opportunity to receive “state of the art” treatment. The presence of a comprehensive cancer center here will make it much easier to attract and conduct such studies in Hawaii and, thus, give our patients similar opportunities. Lastly, a comprehensive cancer center in this community is likely to enhance the knowledge of the medical professional caring for cancer patients. Such an institution would attract notable researchers and academicians. This, in turn, may result in training programs for young physicians and paramedical personnel creating an environment, which nurtures learning and research. Continuing medical education programs would improve, all being focused and, hopefully, resulting in enhancing the medical professional’s knowledge base.
Finally and probably most important, Hawaii's unique and diverse ethnic population creates fertile ground for the study of cancer. According to the 2000 U.S. Census, Hawaii leads the nation with 41.6 percent of its 1.2 million people reporting an Asian heritage. This is significant because as a small state, Hawaii has the fourth highest percentage of foreign-born residents in the U.S. The National Cancer Institute's cooperative network of institutions conducting cancer clinical trials is always interested in the treatment responses and toxicities information contributed by Hawaii's ethnically diverse participants The development of a comprehensive cancer center would generate clinical research information on ethnic differences in treatment responses and toxicities that would not be available elsewhere in the nation and would thus have far-reaching implications both nationally and internationally.
Before closing, I would like to share a case of mine with you.
JM is a Laotian male of immigrant parents who attended a local high school and after graduation went on to attend a community college here in Honolulu.
During his first year in college, he was diagnosed with colon cancer. After the tumor was removed, he received six months of chemotherapy. At the completion of his treatment, he resumed his college education, but eight months later developed a recurrence of his cancer. Despite receiving additional chemotherapy, his cancer progressed. Inquiries were made to several cancer centers on the mainland. Although he was eligible for investigational therapy, he was not able to go due to financial restraints. He has received no further therapy.
I don’t know if JM would have benefitted from further therapy. However, it is unfortunate that he did not have the opportunity to be treated. This case is but one example of many patients not having access to innovative and potentially beneficial treatment. For those who can afford such treatment, most will absorb the cost in time and money to seek out treatment outside of Hawaii.
In closing, as a practicing community oncologist, I fully support any effort to establish and develop an NCI approved comprehensive cancer center in Hawaii as an extension of the Cancer Research Center of Hawaii. As I see it, the potential benefits clearly outweigh any potential risk but, more importantly, we owe it to our patients who truly believe, and rightfully so, that research brings them hope.
Thank you very much for your attention.
Jonathan K. Cho, MD
