UW-Madison: Treating Wisconsin’s cancer patients, in Madison or just down the street

CONTACT: Linda Dietrich, 608-263-6585, [email protected]

MADISON – When Meg Gaines accompanied a patient to a recent appointment at the University of Wisconsin-Madison’s Carbone Comprehensive Cancer Center, she gauged the center’s impact right away.

“This patient had base-of-tongue cancer,” recalls Gaines. “He’d been to an oncologist in a regional center, asking how many of these cases the doctor sees a year. It was less than 10. When he asked the same question of the ear/nose/throat oncologist here at UW, the doctor said, ‘Hundreds.’ There’s very clear data saying that the more volume doctors have, you get better care.”

As a former cancer patient herself and founder of the UW-Madison Center for Patient Partnerships, Gaines knows that doctors are only one part of the cancer treatment puzzle – especially in a big state like Wisconsin, where patients may live four or five hours from experts at UW-Madison.

But the cancer center’s reach spreads far beyond Madison clinics. Its affiliate network allows patients to receive the state-of-the-art treatments and expertise in their own communities. The convenience and comfort this provides can help patients lower stress and heal with the support of friends and family nearby.

“The university has brought to our center a level of expertise that could not be possible for a rural community hospital to provide on its own,” says Celse Berard, CEO of Riverview Hospital in Wisconsin Rapids. “Most importantly, the care patients receive from our two nationally and world-renowned physicians, James Welsh, a radiation oncologist, and Ron Kirschling, a medical oncologist and hematologist, is enhanced by the collegial support they receive as faculty of the UW.”

The Carbone Cancer Center’s regional cancer network was established to share the experience and research of UW-Madison’s Carbone Cancer Center (UWCCC) with colleagues and patients throughout Wisconsin and northern Illinois.

The network, comprised of six officially affiliated community cancer centers, one standalone cancer center, and several medical oncology and radiation oncology outreach clinics, brings the expertise of Wisconsin’s only federally designated comprehensive cancer center to patients across the state.

This distinction is an important one. The National Cancer Institute (NCI) requires that an institution designated as a comprehensive cancer center meet strict guidelines distinguishing it from a program simply offering cancer care.

According to NCI, “A comprehensive cancer center has demonstrated reasonable depth and breadth of research activities in each of three major areas: laboratory, clinical, and population-based research, with substantial transdisciplinary research that bridges these scientific areas. An NCI-designated comprehensive cancer center must also demonstrate professional and public education and dissemination of clinical and public health advances into the community it serves.”

“Patients sometimes get scared of the cancer center, because they think of the hospital as a huge behemoth, but when you get sick, you don’t want to skimp on your care,” says Gaines.

“Ideally, patients should consult with the highest level of trained physicians available, and you know you get that here. Instead of being treated by a general surgeon who is simply authorized to treat cancer, you might see someone like a gynecological oncologist, who has an additional six years of specific training for women with gynecologic cancers. There is clear data that shows that people who are treated at comprehensive cancer centers are treated better and survive longer.”

George Wilding, director of UWCCC and Anderson Professor of Clinical Oncology, sees this every day. Whether patients get treated directly or simply ask questions before seeking treatment in their communities, the collaborations between local and university cancer care professionals have a tremendous impact on the patients in the state.

“Each year, through our affiliations and our care in Madison, the lives of more than half of all the cancer patients diagnosed in the state are touched by UW cancer experts,” says Wilding.

UWCCC oncologists work closely with local oncologists and other physicians, providing educational and research opportunities, offering forums to discuss treatment options, setting quality goals and measures and, in some cases, supplementing radiation or medical oncology services in the community.

Five Wisconsin affiliate partners in Appleton, Beloit, Johnson Creek, Oshkosh and Wisconsin Rapids bring the expertise of UW-Madison physicians to established cancer centers in local communities to provide on-site care.

Both the medical oncology and radiation oncology programs bring the expertise of their faculty to regional facilities and also attract patients to the cancer center. A full-time medical oncologist is also on staff at the freestanding UW Cancer Center in Johnson Creek.

In addition, UWCCC medical oncologists offer day clinics in Beaver Dam, Mauston, Monroe, Portage, Reedsburg and Richland Center, while radiation oncologists provide services in Antigo and Wausau. In 2006, regional clinics saw more than 3,500 radiation oncology visits and conducted more than 25,000 radiation procedures.

“There aren’t medical oncologists in some of these communities. Surgeons, family practice doctors, etc., will refer patients to the medical oncologist’s day clinic, and patients can be seen once every week or two,” says Stan Whitbey, director of the affiliate program. “This is a true service that wouldn’t be available without our help. If we weren’t there, there would be no cancer services in the community.”

The network also provides ongoing quality initiatives, particularly through shared experiences. A long-standing program connects oncologists via video conferencing so they can collaborate, discuss complex cases and gain valuable peer insights about charting a course of treatment.

These regional relationships expand the kinds of care available to patients. UWCCC partners can often offer interested patients opportunities to participate in clinical trials, frequently giving them a first chance to benefit from improved cancer therapies. Patients also have access to state-of-the-art equipment, providing options that can greatly extend and enhance quality of life.

Tomotherapy is one of those options. Developed at UW-Madison by researchers from the School of Medicine and Public Health, this latest form of radiation technology can offer more targeted treatment. For the patient with mouth cancer, tomotherapy offered a 50 percent chance that he would lose his salivary glands. That may not sound like much, but that’s 50 percent more than any other option on the table. The availability of tomotherapy – and highly trained radiologists – in Wisconsin communities means that patients can rest in the comfort of home instead of a hotel room.

“If you live up near the U.P., and you work full-time, and your family works full-time, it’s a huge asset,” says Gaines. “That mouth cancer – that’s five-day-a-week radiation. Many patients wouldn’t be able to drive to a more distant cancer center each day. Some patients might not hesitate to get something checked out because of the distance to a cancer center. So it’s important to have access, and more of it.”

For many Wisconsin residents, then, there’s no question: The best cancer care available is the one providing both cutting-edge therapy and hometown support.

“There are a lot of themes in the coordination of care,” says Gaines. “People have more of a tendency to follow the recommendations if they feel connected to the people making the recommendations. Filling prescriptions may be easier at a local pharmacy. Meanwhile, you may have surgery in Madison, but you’re tied into some of those experts as you have some care in your community. People’s lives depend on this.”

“To know that you’re part of something that is so well respected is a great thing,” says Whitbey, “but to hear a patient’s story and know that he can receive such good care in his local community where his friends and family could support him is really heartwarming.”

Editor’s note: This story is part of a series of stories about the Wisconsin Idea. Find more at http://www.wisconsinidea.wisc.edu.