It used to be a reality that if one was diagnosed with cancer and lived in Connecticut or rural communities surrounding the New York City metropolitan area, that to participate in an advanced clinical trial, they would more than likely have had to commute to New York City which can take many hours. Factor in illness, fatigue and financial considerations, and it was a non-starter for many. How things have changed! The clinical research as a care option movement propels forward with community hospitals, such as Nuvance Health’s Norwalk and Danbury Hospital. Those combatting cancer living in these communities now potentially have more options heretofore not possible.
Community Program Alternative
Major academic medical centers can be intimidating, especially when we face life-threatening illness. We ideally can find health care options that are close to home, connected to our community and facilitated by professionals we know and trust. Over the past handful of years, the National Institute of Health’s National Cancer Institute (NCI) Community Oncology Research Program (NCORP) has invested considerable time and capital to promote and help distribute important clinical research into communities across the U.S.
With a move toward patient-centricity, this makes sense. Rather than an institutional point of view, researchers increasingly step into the shoes of the patient—where do they live? How can we make it easier for them to participate in research? How can we collect higher quality data while improving the probability of successful outcomes? The major research centers will always be instrumental but over time they become hubs in a dynamic and engaging patient-responsive network.
What about the Community between New York and New Haven?
The Whittingham Cancer Center exemplifies the community clinical research movement. Located in Norwalk, CT, it is only about 50 miles from New York City but anyone that has lived or worked on the east coast knows that such a distance coming into NYC can represent hours of hellish commute—not at all a healthy or viable scenario for a patient struggling with cancer. Yale is not far to the north, but what if the residents could have Yale or Columbia like research right in their own community? Enter Norwalk Hospital’s Whittingham Cancer Center. Now designated as a primary clinical international research site, patients can take part in the most advanced clinical trials for breast and gynecologic cancers and the use of new radiation therapies to treat their situation, reports Jocelyn Maminta of New Haven’s News 8.
Clinical Research as a Care Option Leadership
Dr. Margo Shoup, Chair of Nuvance Health Network Cancer Services, oversees the initiative and reports to the local television station, “Being a community program, that’s really acting like an academic program in a lot of ways because we’re offering a lot of the same care, the same trials, the same kind of technology in the same kind of experts that you would get in an academic setting.”
Norwalk Hospital Oncology/Hematology Medical Director Dr. George Zahrah reports that many patients in the community are diagnosed as later stage of the disease—although, with today’s treatments, they are still potentially curable but they are now at a high risk of occurrence. It is of paramount importance that these patients have access to the most appropriate care—potentially investigational therapy—that affords them the highest probability of success. It literally can mean life or death at this point.
Hence, Norwalk Hospital, like many community providers across the country, are taking a more proactive approach by not only expanding patient access to promising treatments but also leveraging their assets and ties to communities to get the word out that this kind of care is even possible. Importantly, they are taking a nimbler approach than may be the case in big research centers—as Dr. Shoup noted, “We’re not having to go through a lot of different levels of bureaucracy to get things done.”
A Dynamic Community Laboratory
As cancer research moves deeper into the community in the form of clinical trials, study results help contribute to the body of medical knowledge that no only helps Norwalk but the entire nation and world. Each and every patient is unique; their lives matter and bring more data to our global war against cancer. This dynamic and evolving body of knowledge changes the standard of care over time for dangerous diseases from ovarian to uterine cancer,
Our health is something that we can all have in common. It is ultimately a great unifier of people. Community providers, such as Norwalk’s Whittingham Cancer Center, represent a new emerging dynamic hub that will garner more attention form global pharmaceutical sponsors to national and international patient advocacy groups.
Presently eight international level trials are available at Norwalk and Danbury Hospitals, both part of Nuvance Health.
Community and Consolidation: A Necessary Tension
At the same time that the community research option dynamically evolves and expands, the community health systems themselves must undergo their own consolidation and evolution across the country. At the community level, in the United States, a multiplicity of providers have offered health services often with a number of redundancies at an unsustainably high cost. Hence, a business dynamic continues to unfold within communities, at times painful, as in many cases health systems compete and then merge to drive efficiency and scale to improve service delivery and reduce cost. This is not a seamless nor easy process as a confluence of forces from government regulators to local politics and pressures for financial returns represent an inescapable reality. Ongoing community provider consolidation, often opposed in the community, may ultimately lead to greater community access options when it comes to state-of-the-art clinical trials.
Nuvance Health was born out of such conditions. A not-for-profit health system in New York State’s Mid-Hudson Valley area and western Connecticut, was the creation via a $2.4 billion merger of Health Quest and Western Connecticut Health Network. Employing about 2,600 doctors and 12,000 professional staff, the group serves approximately 1.5 million residents. The merged entity projected a saving of $100 million across fiscal years 2019-2021. State regulators required commitments to allow for the merger: for example, the Connecticut Office of Health Services required caps on cost increased and requirements for investment in community benefit program. Nuvance was required to add 14 community representatives to ensure a community focus continued while the merged entity also had to consider business continuity and growth. The community hospitals were key for a sustained growth strategy as it was purported that the parent company was in the red until the merger.
Member hospitals include Vassar Brother Medical Center, Northern Dutchess Hospital, Putnam Hospital in New York and Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut.
Cancer Research Operation at the Whittingham
In Norwalk Hospital, the Whittingham Cancer Center represents the research option hub for residents in this coastal area. Officially named the C. Anthony and Jean Whittingham Cancer Center, it is a centerpiece of cancer care programming at Norwalk Hospital. The 35,000 square foot facility includes an outdoor healing garden, contemporary consultation rooms, two private infusion suites, 18 light-filled infusion bays with views of Long Island Sound, a dedicated CT simulator and two state-of-the-art linear accelerators. With a number of important accreditations and certifications achieved, they publish a newsletter offer genetic counseling and testing, to name just a few services, while leveraging Nuvance’s membership in a premier regional cancer network. Clinical trials at the Whittingham will originate from a variety of sources from the NCI and biopharmaceutical companies to partnerships with nearby universities. A list of current clinical trials by therapeutic area can be accessed here.
Cancer care teams are organized by specialty from Gastroenterology to radiation oncology and palliative care. A range of other service providers for whole-person focused care teams including patient navigators which can be essential patients with economic challenges, for example.
Dr. Margo Shoup, Chair of Nuvance Health Network Cancer Services
Dr. George Zahrah, Norwalk Hospital Oncology/Hematology Medical Director
Call to Action: For those interested in cancer-based clinical research at the Whittingham Cancer Center Norwalk Hospital, they can call 203-739-7997. For those interested in learning more about research as a care option in their community, feel free to send TrialSite News a request to help.