Panel against The state's Blue Ribbon Panel on Cancer Care, meeting for two years to determine the state's cancer treatment needs, yesterday recommended the state not build an outpatient treatment center.
new cancer center
A state committee says other
The ideas
needs are more pressingBy Lyn Danninger
ldanninger@starbulletin.comWhile the panel liked the idea of centralized treatment, it said more attention first needs to be paid to increasing cooperative efforts among existing facilities.
It also recommended the state Department of Health take the lead in building a consortium to address the full range of cancer issues from early detection to terminal care.
Among the questions debated by the panel was whether Hawaii needs a more comprehensive approach to cancer diagnosis and treatment incorporated into the existing Cancer Research Center of Hawaii.
Currently, only the Cancer Research Center, not a treatment center, is slated to be part of the state's plans for new medical school in Kakaako.
The 18-member panel was convened in 1999 after Gov. Ben Cayetano said he wanted Hawaii to be in the forefront of cancer treatment.
The panel is composed mostly of physicians, cancer survivors and officials from the state Department of Health, The Cancer Research Center of Hawaii and the American Cancer Society. Among the panel's tasks was to look at issues related to availability of information and services.
Cancer care has predominantly been provided by independent oncologists -- cancer physicians -- in conjunction with private facilities such as Kuakini, St. Francis and The Queen's medical centers. On the neighbor islands, much of the care is provided through state hospitals.
The current system has been criticized as fragmented, requiring patients to visit a number of individuals and facilities for care, said Dr. Scott Hundahl, a panel member and director of the Queen's Cancer Institute.
"To achieve multidisciplinary input patients have to travel to different offices," he said. "Not only does it slow the treatment or the time to start treatment, it can create a lot of anxiety for patients and their families."
Hundahl believes the current system also has an impact on the business community.
"It represents a tremendous loss of productivity for employers as patients and families have to make multiple visits," he said.
But Hundahl said while the panel found the decentralized nature of the current cancer care system makes it difficult for patients and their families, treatment outcomes still compare favorably with national norms.
At one time, some oncologists had been in favor of an affiliation with the world- renowned University of Texas MD Anderson Cancer Center and the construction of a private facility.
Others, such as Dr. Carl-Wilhelm Vogel, head of the Cancer Research Center of Hawaii, believe bringing together those already involved in cancer care, hiring some additional physician-researchers to help in clinical trials and building a new cancer research and treatment center would be preferable to paying for a prestigious name. That way, more needed clinical trials of promising treatments and drugs plus important federal funding would result.
It would also mean that fewer people -- and the money to pay for their care -- would leave the state to seek treatment in mainland specialty hospitals that offer a full range of services under one roof, he said.
While local hospitals and oncologists say they are all in favor of improving the quality of cancer care in Hawaii and are open to new ideas, they have been lukewarm to the idea of building a cancer treatment center, fearing loss of revenue in already difficult financial times if patients then receive care at another facility.
But Vogel believes a Hawaii outpatient center does not have to be in direct competition with the state's existing providers.
"You don't have to do it in competition, you do it as a partnership," he said.
In its recommendations, the panel held out some hope for an eventual outpatient cancer treatment center but not before the other measures it recommended are undertaken.
Dr. Virginia Pressler, deputy director of the state Department of Health and a panel member, said she is hopeful that a number of the measures recommended by the panel can be accomplished in relatively short time.
The department-coordinated statewide plan could be put together in six to eight months, she said.
But Pressler acknowledged other items covered in the panel's recommendations, such as determining where and how much money is spent on care now and the impact of an outpatient cancer treatment center on existing providers, will take time.
"We have to see what (financial) risk this really is to stakeholders," she said. "We really can't proceed without knowing the impact."
The panel's recommendations, which will now be presented to the governor, say the state should: The ideas
>> Develop a comprehensive cancer control plan for the state that would encourage participation in screening and early detection programs. Such a plan in place would then be eligible for further federal funding.
>> Have the Department of Health, partnering with others such as the Cancer Research Center and the American Cancer Society, create a coalition to address the full spectrum of cancer issues.
>> Allocate money to the department to pursue the goal of doing more on cancer prevention and screening.
>> Fund a business plan to study how a treatment center would affect existing revenue streams derived from cancer care currently being delivered by the state's hospitals and doctors.