“Decreasing the burden of cancer” is central to the mission of Mays Cancer Center at UT Health San Antonio. The center’s Executive Director Ruben Mesa, MD, FACP, shared that sentiment during a recent San Antonio Business Journal “Table of Experts” panel discussion on cancer research.
The Business Journal’s June 17, 2022, issue includes a special section based on that exchange, which details the broad scope of cancer patient care and lifesaving research taking place daily at Mays Cancer Center. The moderated panel conversation — available to view online — features Mays Cancer Center experts discussing the value to the local community and regional economy of having a National Cancer Institute (NCI)-Designated Cancer Center in the city’s backyard.
Among the benefits identified: the availability of comprehensive care close to home and ready access to participate in important clinical trials that can lead to breakthrough treatments. Those innovative therapies can likewise benefit others far beyond the nearly 5 million individuals across 38 counties throughout South Texas who comprise UT Health San Antonio’s service area.
Also worth considering are the direct and indirect economic impacts, stressed Dr. Mesa during the panel discussion. “Companies really look at San Antonio, either to remain as their headquarters or expand to bring new business here. They know their family and employees will have access to world-class cancer care, eliminating the need to leave our community.” Likewise, the recruitment of top scientists and national leaders in areas of drug development and other critical research brings grant funding and investment in start-up companies that help grow the economy, suggested Dr. Mesa.
Joining Dr. Mesa in the conversation were Mays Cancer Center experts Kate Lathrop, MD, breast medical oncologist, and Mark Bonnen, MD, chief medical officer. As a preview to the full Business Journal discussion, included below are a handful of the insights each shared.
Broad and focused research
Dr. Mesa discussed the research goals of Mays Cancer Center.
“Our goals in research are very broad as is the cancer journey. The Mays Cancer Center focuses on four key areas. The first is understanding the biology of cancer. Why does it occur, why does it develop? Why does it progress? We use that and look at that data through a south Texas lens given the unique needs of our population of the region. There are certain cancers that occur more often in our area, such as liver cancer, which is the most overrepresented cancer in our region. We ask ourselves why is that the case? Can we prevent it or screen for it more effectively?
A second key area of focus is advancing the science of cancer in Hispanics/Latinos. Our community is 69% Hispanic/Latino. The Rio Grande Valley is almost 90% Hispanic. We care deeply about the whole region. So, we ask questions like how do culture, ethnicity, race, challenges in terms of social determinants of health impact the whole cancer journey? How does it impact prevention, screening or predisposition, or the effectiveness of therapies that we have and even survivorship?
Third, we focus on both the development and testing of new therapies. … Finally, we persist in asking ourselves how we can advance new therapies. And then, how do we deliver that complex cancer care in a patient-centered way. We study that whole range of topics with a singular purpose of trying to decrease [the] burden of cancer in our community.”
Dr. Lathrop discussed the value of having a National Cancer Institute-Designated Cancer Center serving San Antonio and South Texas.
“From my perspective, mainly as a physician treating women with breast cancer in our community … I see that value in a few ways. One would be, obviously, the value of having high quality, integrated, compassionate care close to home. … Having those high-quality physicians and care teams down the street is important as opposed to having to travel outside of your community for that care.
I also think part of the value is working to educate our community. And that represents both educating our potential patients … but also educating the potential future workforce in San Antonio and South Texas. We collaborate with many local universities and high schools to try to bring in new learners into the health care system. … Reaching out to populations that may have been underserved in medical schools is of high importance to us. Getting those students who may not have seen themselves as a traditional researcher into research and showing them the value of that in their career choice is meaningful. To watch how passionate they become about their work while at the same time diversifying our workforce, too, is rewarding and valuable. That is a significant value that sometimes may not be readily seen.
Another important aspect is that the Mays Cancer Center participates in multiple, large clinical trial networks. As part of an NCI-designated Cancer Center we are members of this network. Larger trials that would be very difficult to do in individual centers are conducted across the U.S. and across the world. We have investigators here in San Antonio that run some of those national and worldwide trials.”
Multidisciplinary, evidence-based care
Dr. Bonnen discussed the value of evidence-based patient care.
“If you look at what we spend as Americans on cancer care, it is over $200 billion annually, of which about $21 billion is actual patient out-of-pocket expense. You can start imagining exactly what this means to the individuals involved, to the patients and their families.
Things that can drive up the cost of cancer care are unnecessary or duplicate procedures. … Another issue is poor symptom control or supportive care, meaning that when a patient may exhibit side effects from their treatment, the team has not planned adequately or given the patient the supportive medicines and care that would help prevent them from having to visit the ER or even be hospitalized.
And then finally, something that we are very concerned with in the U.S. is what we call non-evidence-based care. … If you took panels of experts from around the world that were knowledgeable in a particular type of cancer, 97% of the time, they can come up with a very clear recommendation for those specific cancers. Non-evidence-based care occurs when a patient’s recommended care pathway does not follow these recommendations.
Mays Cancer Center follows evidence-based care. The principal way that we ensure that every patient has evidenced-based care is we organize multidisciplinary care teams of specialists who come together and focus on the details of care for specific disease sites. This cohesive multidisciplinary integrated care team comes together to provide a seamless all-encompassing plan of care for each patient. … The goal is to provide each patient with the very best chance of a cure and the least chance of side effects.”
Cancer survivorship and life-extending therapies
During the Business Journal conversation, Dr. Mesa also discussed the importance of the long-term care and monitoring of cancer survivors. “Increasingly important in national discussions is including the recognition of the significant impact on cancer survivors. Cancer survivors are going to be a very significant group of individuals in the U.S., totaling in the tens of millions of people. This is wonderful news, and it certainly reflects the advances that we have made in cancer care. It also shows us that what we do in terms of the ongoing health management and maintenance for cancer survivors, as well as what we do during treatment, has an echo that radiates through the rest of the patient’s life.”
Dr. Mesa also shared that Mays Cancer Center — an NCI-Designated Cancer Center since 1991 — is on the path to seeking the next level of designation as an NCI Comprehensive Cancer Center, which requires meeting additional standards for cancer prevention, clinical services and research. “The development of our new cancer-focused UT Health San Antonio Multispecialty and Research Hospital will be an integral piece of that, with unique capabilities both in terms of care, new program development in cellular and stem cell therapies, as well as the ability to have complex inpatient cancer clinical trials that are not readily available in our community,” said Dr. Mesa.
The 144-bed hospital is on schedule to open in late 2024, with projections to employ approximately 1,000 people and provide 150 training positions for residents.