Lung-cancer survivor Dr. Tim Mullett sees cancer patients with great empathy. As the University of Kentucky Markey Cancer Center Affiliate Network medical director, Mullett brings his firsthand experience with cancer to patients who are grappling with the disease.
His approach filters through to oncologists throughout the state via the network, which combines the skills of Mullett and hundreds of doctors, researchers and staff at 20 facilities around Kentucky who are all fighting the disease using shared best practices, procedures, expertise and clinical research. All of their thousands of patients have access to treatments that have earned Markey a prestigious National Cancer Institute (NCI) designation.
The network is especially important for Kentucky, where cancer rates are the highest in the nation, especially for lung cancer. Founded in 2006 with three member facilities, the system provides high-quality Markey cancer care closer to home for patients and lessens cancer’s impact through prevention and education programs, exceptional clinical care, and access to research.
Mullett, a cardiothoracic surgeon and colonel in the U.S. Army Reserve, is excited by the possibilities the network creates, partly because he experienced the benefit of targeted cancer therapy himself in 2012. He wants the same for others.
“How the network really started was Markey Cancer establishing clinical relationships with other facilities to deliver care in areas that didn’t have cancer care,” Mullett said. “As we have evolved, we’ve gone to facilities that are farther into Eastern Kentucky and in larger facilities. And since our NCI designation, things have really dramatically changed.
“We really began to look at how to help these programs increase their overall quality of care and make sure that the cancers that can be, are treated close to home. And for those who need to be treated at NCI-designated facilities or require advanced services at Markey Cancer Center, making sure those (services) are easy to obtain.”
Shared data improves care
What makes the network unique, Mullett said, is its mutually beneficial, two-way data street between Markey and its affiliates, which now are spread around the state. The newest source of data is in Northern Kentucky. Effective March 2018, St. Elizabeth Healthcare joined the Markey Cancer Center Affiliate Network, further expanding its growing relationship with UK.
“We are proud to team up with the University of Kentucky Markey Cancer Center, which is recognized as one of the nation’s leading cancer-care and research centers in the country,” Garren Colvin, president and CEO of St. Elizabeth Healthcare, said in a news release. “This affiliation fits well with St. Elizabeth’s vision of leading Northern Kentucky to become one of the healthiest communities in America. We expect this affiliation to enable us to deliver truly exceptional cancer care and better the lives of our patients, their families and the greater community we serve.”
St. Elizabeth operates six large facilities in Northern Kentucky and more than 115 primary-care and specialty-office locations in Kentucky, Indiana and Ohio. It serves more than 315,000 patients annually, 10,000 of whom seek treatment for cancer.
“We wanted to work with a system that has always put patient care first, and with one that shares our own vision of making our community one of the healthiest in America,” said St. Elizabeth Healthcare Oncology Services Executive Medical Director Dr. Douglas B. Flora. “We have shared patients with Markey oncologists for years, and have found their doctors to care about the same things we value here: personalized care, good communication, attention to detail.
Access to clinical trials, new treatment
“Like us, they value clinical research and are early adopters of technologies like molecular tumor boards and precision medicine. It really seemed to be a perfect fit for both groups, and evolved into a tight affiliation, giving both of our patients improved access to new drugs and trials, subspecialist care and ongoing community education.”
St. Elizabeth medical oncology serves 2,800 patients and has approximately 80,000 patient visits a year.
“Sadly, the number of patients needing cancer services continues to increase yearly and has increased almost 16 percent since 2000,” Flora said, adding that Northern Kentucky has an extremely high rate of death for cancer compared to the nation. “Lung cancer is the most common cause of cancer death and colorectal cancer is the second most common cause of death in Kentucky. Because of these grave statistics, St. Elizabeth Healthcare pursued this Markey affiliation, and is also investing heavily in a nearly 200,000-s.f. comprehensive cancer center slated to open in 2020.”
The new center is estimated to cost $130 million and aims to be the top regional cancer provider, offering patient-centered, early detection, comprehensive treatment services.
Markey Cancer Center is one of only 69 medical centers in the country with an NCI designation. That gives patients access to new drugs, treatment options and clinical trials offered only at NCI centers. Markey affiliates have this backing and provide crucial data in return. Members of the affiliate network are expected to maintain high standards and keep accreditation with the Commission on Cancer, which can be done with assistance from Markey staff.
NCI wants regional impacts
As of January 2018, Owensboro Health also joined the Markey Cancer Center Affiliate Network. They were already part of the Markey Cancer Center Research Network – having joined that network in July 2017 – and doing a great deal of work in connection with lung cancer. Owensboro Health’s Mitchell Memorial Cancer Center sees more than 1,000 new cancer patients annually.
Owensboro Health President and CEO Greg Strahan said the hospital’s relationships with Kentucky’s universities have always been integral to its mission. His own desire to help began in his 20s when his first wife died of cancer.
“We’ve tried to stay on the forefront in terms of working to identify options to reduce the mortality of lung cancer,” he said, noting the hospital’s extensive work in lung cancer screenings. “We’ve tried to do our diligence in spreading our lung-cancer knowledge, and the (Markey) relationship has been in a state of evolution for some time.”
Owensboro Health Director of Cancer Services Bonnie Roberts said the hospital’s partnership with research universities dates back to the early 2000s, when it partnered with both University of Louisville and Markey to develop a cancer network for clinical trials for lung cancer.
Tumor gene sequencing targets therapy
“Probably one of the most interesting and exciting things on the horizon for all of us in cancer is Markey’s molecular tumor board, or targeted therapies,” Roberts said. “That was one of the things we were going to gain through this affiliation and research partnership. Already we have patients that our physicians locally are presenting to the tumor board. It gives our patients the opportunity for us to send parts of their tumor to a place that will assess it and see if there are any FDA-approved drugs that will match it. We hope that some of those targeted therapies will change the face of cancer for many of our patients.”
UK also is beefing up its cancer programs, like gene sequencing individual tumors to find how best to treat them. Such cancer-care work is at the forefront of the institution’s mission, Dr. Robert DiPaola, dean of the UK College of Medicine said in a December 2017 Lane Report interview.
“One initiative we just launched called ‘precision medicine’ can do genomic gene sequencing on patients,” DiPaola said. “The majority of it is with cancer patients; they can get their tumor analyzed doing gene sequencing, and then a molecular tumor board meets to reason out the best option of therapy for the exact genes that are abnormal in that particular individual. When people talked about lung cancer in the past, they usually talked about three or four different types. Gene sequencing might see 200 different combinations of gene changes very specific to a particular individual, and in many cases we now have targeted therapies specific to those gene changes.”
Roberts also cited Owensboro Health’s recent purchase of a Varian TrueBeam radiology system, technology designed to support quicker and more advanced cancer treatment options.
Sophisticated tools and analysis
Strahan emphasizes the benefits of the vast knowledge gained through gathering and sifting affiliate data to solve problems, even one as difficult as cancer.
“It’s hard for us not to believe that with artificial intelligence and so much data gleaned through, compared and evaluated” that cancer could potentially be cured or at least its treatment continually improved through the answers found in this data.
“I go back to my late wife and think that cancer has the same outcome today as it did 35 years ago,” Strahan said. “Nothing has changed, but we are – in my mind – on the brink of technology that will revolutionize cancer treatment.”
Roberts said the hospital hopes to “roll out clinical trials for patients in the next few months. The molecular tumor board trial a big one. We really want to have as many trials that are appropriate to be run in this community. We have right now about 12 or 15 trials open.”
‘Making a huge difference in lives’
Markey’s all-new Precision Medicine Clinic is dedicated to providing patients with increased access to phase I and phase II clinical trials. DePaola cited UK’s solid metabolomics center, expertise in prevention, drug abuse and other cancer niches that can be carried out into its affiliate network communities.
Strahan called UK’s research involvement a “real blessing for the state of Kentucky” and noted that the cost of joining the Markey affiliate network is minimal.
“It has the capability of making a huge difference in the lives of people across the state, and we are a part of it,” he said. “We’ll have lots of future opportunities working together to change the face of cancer. If we can’t do something different tomorrow for cancer, then we’re not doing our jobs well.”
He pointed out that Markey and its affiliates represent 60 percent of the cancers diagnosed in the state, and the results are being examined.
“We’re seeing that our affiliation is associated with an increase in adherence to the standards that have been associated with better-quality care,” Mullett said. “I think over the next few years we’ll be able to demonstrate that the affiliate network is raising the care across Kentucky and is impacting lives. We’ve already seen it in many examples.”
Abby Laub is a correspondent for The Lane Report. She can be reached at [email protected]