scholarly journals Extending Comprehensive Cancer Center Expertise in Clinical Cancer Genetics and Genomics to Diverse Communities: The Power of Partnership

2010 ◽  
Vol 8 (5) ◽  
pp. 615-624 ◽  
Author(s):  
Deborah J. MacDonald ◽  
Kathleen R. Blazer ◽  
Jeffrey N. Weitzel
Keyword(s):  
Cancer Screening ◽  
Best Practice ◽  
Cancer Genetics ◽  
Community Setting ◽  
Research Participation ◽  
Cancer Risk Assessment ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Tumor Boards ◽  
Screening And Prevention

Rapidly evolving genetic and genomic technologies for genetic cancer risk assessment (GCRA) are revolutionizing the approach to targeted therapy and cancer screening and prevention, heralding the era of personalized medicine. Although many academic medical centers provide GCRA services, most people receive their medical care in the community setting. However, few community clinicians have the knowledge or time needed to adequately select, apply, and interpret genetic/genomic tests. This article describes alternative approaches to the delivery of GCRA services, profiling the City of Hope Cancer Screening & Prevention Program Network (CSPPN) academic and community-based health center partnership as a model for the delivery of the highest-quality evidence-based GCRA services while promoting research participation in the community setting. Growth of the CSPPN was enabled by information technology, with videoconferencing for telemedicine and Web conferencing for remote participation in interdisciplinary genetics tumor boards. Grant support facilitated the establishment of an underserved minority outreach clinic in the regional County hospital. Innovative clinician education, technology, and collaboration are powerful tools to extend GCRA expertise from a National Cancer Institute–designated Comprehensive Cancer Center, enabling diffusion of evidenced-base genetic/genomic information and best practice into the community setting.

Utilizing social media for cancer prevention.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13076-e13076
Author(s):  
Ana Maria Lopez ◽  
Jennyffer Morales ◽  
Garrett Harding ◽  
Donna Branson
Keyword(s):  
Social Media ◽  
Cancer Screening ◽  
Cancer Prevention ◽  
Health Care Access ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Prevention Education ◽  
Care Access ◽  
Mountain West ◽  
Screening Behaviors

e13076 Background: Cancer prevention and cancer screening behaviors are challenging to support. A myriad of variables including improved knowledge, language access, and health care access serve as facilitators for cancer screening behaviors. Utah is a vast state that is remarkably sparsely populated with more than 96% of the state defined as either rural (< 100 persons per square mile) or frontier (< 7 persons per square mile). Huntsman Cancer Institute is the only academic health center in the Mountain West and serves as the only NCI Comprehensive Cancer Center in the region. Methods: Access to the internet and to social media helps to bridge geography and support engagement. Facebook Live and Twitter Chats were used to deliver content. Language, Spanish, access was considered. Social media was also utilized to connect interested populations with in-person cancer prevention education events. Results: We will present our outreach results by intervention. Conclusions: Our work has successfully engaged rural and Latino populations in cancer prevention activities through social media.

Enhancing cancer survivorship through improved provider communication, care coordination, and professional education.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 104-104
Author(s):  
John M. Daly ◽  
Alan G. Howald ◽  
Kelly Ann Filchner ◽  
Bonnie J. Miller ◽  
Leanne Lyons ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Care Coordination ◽  
Professional Education ◽  
Primary Care Physicians ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Providers ◽  
Pilot Phase

104 Background: Care coordination among oncology and primary care physicians (PCPs) is an essential element of survivorship care. Providers at an NCI-designated comprehensive cancer center noted gaps in coordinating care with PCPs. We sought to develop a program that enhances communication and education between provider groups to ensure a seamless continuum of care thereby improving overall survivorship care. Methods: The Fox Chase Cancer Center (FCCC) Care Connect program was created to comprehensively connect PCPs in the regional service area with cancer center providers. Program participation requirements for PCP’s include attendance at 2 of 4 targeted professional education programs and participation in quality measures for breast, cervical, and colon cancer screening. Formalized processes to efficiently move patients between oncologists and PCP’s were established. Communication gaps were addressed by providing electronic access via a secure physician portal, access to FCCC disease navigation services, and establishment of designated referral navigators to coordinate clinical needs between provider groups. Results: FCCC initiated the Care Connect program with 5 PCP practices. During a 3 month pilot phase, FCCC directed 19 patients to Care Connect PCP’s to manage ongoing clinical needs and implement survivorship plans. Eight-six percent of referrals were classified as non-urgent. Median time from referral to PCP appointment was 16 days, 24% below regional average. One CME education program was conducted during the pilot phase. Of the attendees, 91% reported an intent to change current practice by implementing a new procedure, discussing new information or seek additional information. Attendees identified potential care barriers which will be included in future program development. Post-education, one practice referred 3 patients to the lung cancer screening program. Conclusions: A formal program that aligns PCPs and oncologists is an effective initiative to improve communication and awareness of cancer patient survivorship needs in oncology and primary care settings.

A virtual tumor board-driven synaptic knowledge network.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 89-89
Author(s):  
Laurence J. Heifetz ◽  
Ahrin B. Koppel ◽  
Elaine Melissa Kaime ◽  
Daphne Palmer ◽  
Thomas John Semrad ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Rural Areas ◽  
Cancer Care ◽  
Knowledge Network ◽  
Tumor Board ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hospital District ◽  
Number Of Patients ◽  
Tumor Boards

89 Background: In 2006, Tahoe Forest Hospital District—a 25-bed hospital in Truckee, CA, a mountain resort community one hour from regional and two hours from academic cancer services—designed and implemented an oncology program utilizing effective telecommunications with a committed academic partner, the UC Davis Comprehensive Cancer Center in Sacramento. Methods: The UC Davis Cancer Care Network was established with four remote cancer programs, enabling participation in daily virtual tumor boards, clinical trial enrollment, and quality assurance assistance. (Richard J. Bold, et. al., Virtual tumor boards: community-university collaboration to improve quality of care. Community Oncol 10(11):310-315, November 2013.; Laurence J. Heifetz, MD, et. al., A Model for Rural Oncology. J Oncol Pract, 7:168-171, May 2011.). An increasing number of patients were observed to in-migrate to Truckee from even more remote rural areas in the mountains. In 2013, the now Gene Upshaw Memorial Tahoe Forest Cancer Center developed four remote telemedicine clinics to allow even more physically distant patients the capacity to be followed locally. Results: Since we opened the remote telemedicine clinics, our Sullivan-Luallin patient satisfaction scores have averaged 4.82/5.00 for “overall satisfaction with the practice” and 4.90/5.00 for “recommending your provider to others”; our in-migration rate of patients from outside our primary catchment area increased from 43% to 52%: and clinical trial accrual rate averaged 10%. Conclusions: Reducing cancer health disparities is an ASCO mission. (cover, ASCO Connection, July 2014; Laurence J. Heifetz, MD. Country Docs with City Technology Can Address Rural Cancer Care Disparities. Oncol, 29(9):641-644, September 2015.). We believe this synaptic knowledge network effectively addresses that mission for rural communities. This model can be scaled in many configurations to address the inherent degradation of quality care as a function of physical distance to an academic center that rural doctors and patients deal with on a daily basis. The key is to insist on a cultural shift – Do something smart at lunch every day. Attend a virtual tumor board.

scholarly journals Otolaryngology in the Time of Corona: Assessing Operative Impact and Risk During the COVID-19 Crisis

2020 ◽  
Vol 163 (2) ◽  
pp. 307-315 ◽  
Author(s):  
Hannah N. Kuhar ◽  
Ashley Heilingoetter ◽  
Maxwell Bergman ◽  
Noah Worobetz ◽  
Tendy Chiang ◽  
...  
Keyword(s):  
Best Practice ◽  
Elective Surgery ◽  
Neck Surgery ◽  
Academic Medical Centers ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Policy Changes ◽  
Data Set ◽  
Medical Centers ◽  
Academic Medical

Objective Limited research exists on the coronavirus disease 2019 (COVID-19) pandemic pertaining to otolaryngology–head and neck surgery (OHNS). The present study seeks to understand the response of OHNS workflows in the context of policy changes and to contribute to developing preparatory guidelines for perioperative management in OHNS. Study Design Retrospective cohort study. Setting Pediatric and general adult academic medical centers and a Comprehensive Cancer Center (CCC). Subjects and Methods OHNS cases from March 18 to April 8, 2020—the 3 weeks immediately following the Ohio state-mandated suspension of all elective surgery on March 18, 2020—were compared with a 2019 control data set. Results During this time, OHNS at the general adult and pediatric medical centers and CCC experienced 87.8%, 77.1%, and 32% decreases in surgical procedures as compared with 2019, respectively. Aerosol-generating procedures accounted for 86.8% of general adult cases, 92.4% of pediatric cases, and 62.0% of CCC cases. Preoperative COVID-19 testing occurred in 7.1% of general adult, 9% of pediatric, and 6.9% of CCC cases. The majority of procedures were tiers 3a and 3b per the Centers for Medicare & Medicaid Services. Aerosol-protective personal protective equipment (PPE) was worn in 28.6% of general adult, 90% of pediatric, and 15.5% of CCC cases. Conclusion For OHNS, the majority of essential surgical cases remained high-risk aerosol-generating procedures. Preoperative COVID-19 testing and intraoperative PPE usage were initially inconsistent; systemwide guidelines were developed rapidly but lagged behind recommendations of the OHNS department and its academy. OHNS best practice standards are needed for preoperative COVID-19 status screening and PPE usage as we begin national reopening.

Current Approaches in Familial Colorectal Cancer: A Clinical Perspective

2006 ◽  
Vol 4 (4) ◽  
pp. 421-430 ◽  
Author(s):  
Patrick M. Lynch
Keyword(s):  
Colorectal Cancer ◽  
Cancer Genetics ◽  
Human Cancer ◽  
Clinical Syndrome ◽  
Colorectal Adenomas ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Inherited Cancer ◽  
Risk Estimates ◽  
Increased Risk

Individuals with a family history of colorectal cancer or colorectal adenomas have an increased risk for colorectal cancer. When no hereditary syndrome is evident, screening is based on empiric risk estimates. The risk is greatest for individuals with specific inherited cancer-predisposing disorders. When conditions such as familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer are diagnosed, specific neoplasm risk estimates can usually be performed based on advances in molecular genetics. These estimates lead to more straightforward and cost-effective approaches to surveillance and management. The National Comprehensive Cancer Center Network (NCCN) and other groups have provided detailed guidelines for evaluating patients based on recognition of clinical syndrome characteristics, followed by appropriate genetic counseling, genetic testing, and optimal surveillance. The NCCN guidelines are used as a frame of reference for this discussion of selected recent advances in human cancer genetics as they apply to clinical practice.

Mismatch of available cancer therapeutic trials to patient populations in community practices.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 84-84
Author(s):  
Lily L. Lai ◽  
Doni Woo ◽  
Yvonne Chapman ◽  
Nimit Sudan ◽  
Christina Haeyoung Yeon ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Community Setting ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Cancer Research ◽  
Therapeutic Trials ◽  
Time Period ◽  
Medical Oncologists ◽  
Accrual Rate ◽  
Barriers To Enrollment

84 Background: Clinical cancer research has consistently been associated with improvements in the quality of cancer care in community practices. We initiated a project to better identify the barriers to enrollment into adult oncology therapeutic trials in a community setting. Methods: Over a 12-month period from June 2013 – May 2014, all consecutive new patients presenting to medical oncologists at two community practices (CP1 and CP2) affiliated with an NCI-designated Comprehensive Cancer Center (NCI CCC) were screened by trained clinical research nurses. Data captured included demographics, diagnoses, stage of disease, previous treatments. Therapeutic trials available through the NCI CCC were matched to the patients. Actual enrollments rates into the trials were calculated. Results: A total of 1,430 new patients was seen in the time period studied (CP1, n=1,088; CP2, n=342). Of these, 912 (CP1, n = 667; CP2, n = 245) patients had a cancer diagnosis. At CP1, 63 therapeutic trials were available through the NCI CCC. 64 (8.3%) patients matched the criteria for any of the available trials, 33 enrolled, 18 declined, 13 failed screening. The accrual rate was 51.5% (33/64) of the patients who matched available trials and 4.9% (33/667) of all new cancer patients. At CP2, 32 (13%) patients matched available trials. The factors associated with the inability to match therapeutic trials with the new patients included: adjuvant treatment status, disease sites, prior treatment requirements, protocol specific tests, protocol specific requirements for correlative studies. Conclusions: Of the 912 new cancer patients treated at 2 community sites affiliated with an NCI CCC, only 10.5% matched available therapeutic trials. Although the enrollment rate into therapeutic trials is high in patients who matched available trials (51.5%), the overall accrual rate of all new cancer patients is 4.9% and consistent with previous studies. Our study highlights the significant mismatch between available trials and clinical populations treated at community sites. We suggest that an improved process to better match patient populations and available trials will improve on clinical trial accruals and efficiencies.

scholarly journals Clinical research participation among adolescent and young adults at an NCI-designated Comprehensive Cancer Center and affiliated pediatric hospital

2017 ◽  
Vol 25 (5) ◽  
pp. 1579-1586 ◽  
Author(s):  
Stacy D. Sanford ◽  
Jennifer L. Beaumont ◽  
Mallory A. Snyder ◽  
Jennifer Reichek ◽  
John M. Salsman
Keyword(s):  
Young Adults ◽  
Clinical Research ◽  
Research Participation ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Pediatric Hospital ◽  
Adolescent And Young Adults

scholarly journals The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations

2020 ◽  
Vol 9 (7) ◽  
pp. 2125
Author(s):  
Marilena Melas ◽  
Shanmuga Subbiah ◽  
Siamak Saadat ◽  
Swapnil Rajurkar ◽  
Kevin J. McDonnell
Keyword(s):  
Precision Medicine ◽  
Cancer Genetics ◽  
Medical Center ◽  
Academic Medical Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Academic Center ◽  
Community Oncology ◽  
Academic Medical ◽  
Genetics And Genomics

Recent public policy, governmental regulatory and economic trends have motivated the establishment and deepening of community health and academic medical center alliances. Accordingly, community oncology practices now deliver a significant portion of their oncology care in association with academic cancer centers. In the age of precision medicine, this alliance has acquired critical importance; novel advances in nucleic acid sequencing, the generation and analysis of immense data sets, the changing clinical landscape of hereditary cancer predisposition and ongoing discovery of novel, targeted therapies challenge community-based oncologists to deliver molecularly-informed health care. The active engagement of community oncology practices with academic partners helps with meeting these challenges; community/academic alliances result in improved cancer patient care and provider efficacy. Here, we review the community oncology and academic medical center alliance. We examine how practitioners may leverage academic center precision medicine-based cancer genetics and genomics programs to advance their patients’ needs. We highlight a number of project initiatives at the City of Hope Comprehensive Cancer Center that seek to optimize community oncology and academic cancer center precision medicine interactions.

Analysis of the results of implementation of a pregnancy screening policy at a comprehensive cancer center.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 256-256
Author(s):  
Gloria Trowbridge ◽  
David Cleveland ◽  
Alma Yvette DeJesus ◽  
Lee Cheng ◽  
Elizabeth Ann Wagar ◽  
...  
Keyword(s):  
Best Practice ◽  
Age Groups ◽  
Screening Tests ◽  
Fiscal Year ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Trend Test ◽  
Clinical Indicators ◽  
Female Patients ◽  
Screening Policy

256 Background: Institutional implementation of a standard pregnancy screening policy for women will enhance the safe and timely delivery of treatment throughout the care continuum. In 2012, we developed and implemented an initial policy on pregnancy screening test (PST). The policy indicated that all providers should fully discuss with their female patients of child bearing potential regarding the potential risks of cancer treatment on fertility and the adverse effects on the fetus. The providers should also discuss the contraceptive options with female patients and their partners prior to diagnostic studies and/or treatment. In 2015, we revised the initial policy to further clarify timeframe for PST and clinical indicators and also developed an algorithm to support this best practice. We assessed practice changes as a result of the policy changes regarding PST at our institution. Methods: A retrospective data review was conducted to assess the number of PST over a 5 year period at The University of Texas MD Anderson Cancer Center. The timeframe includes both baseline and post-implementation policy and reflects annual changes from fiscal year (FY) 2010 to 2015. The pregnancy test was defined as measuring human chorionic gonadotropin (hCG) level in a urine sample. Results: We observed a significant increase in PSTs over time among female patients between ages 10 to 55 years. Over 5 years, there were 23,793 urine pregnancy tests performed. The number of urine pregnancy tests performed per FY were as shown on table below (trend test, p< 0.01). The percentage of PST performed among age groups (years): 1.8% of 10 to 15, 11.6% of 16 to 25, 22.3% of 26 to 35, 34.7% of 36 to 45, and 29.5% of 46-55 years old. Conclusions: Wedemonstrated that developing a standard institutional policy on pregnancy screening tests with further enhancements contributed to a significant increase in the number of PSTs performed over 5 years at our comprehensive cancer center. The majority of PSTs were conducted among female patient between the ages of 26 and 55. [Table: see text]

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