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The Honolulu Advertiser
Posted on: Monday, December 24, 2001

Cancer center must not be allowed to founder

For anyone diagnosed with cancer, a "blue ribbon" panel's report on cancer care in Hawai'i contains no surprises.

The report finds that while survival rates for cancer patients in Hawai'i are at or above the national average, there are many problems here with cancer care. The most overarching problem, the report said, is a fragmentation of care leading to a delay in service and a lack of support for newly diagnosed patients.

Cancer patients will not only agree but probably feel the report is not hard-hitting enough on the immense burdens -- many unnecessary -- they and their families face. This is a distressing enough diagnosis without added worries, concerns and uncertainly caused by delays and other issues.

The report was written by a group of experts in the healthcare industry gathered by Gov. Ben Cayetano, who has expressed the wish that Hawai'i be in the forefront of cancer-related care and treatment.

It is good news that the problems are being addressed.

But it is distressing that in a state that prides itself on being the health state that there is so much controversy within the healthcare industry over what to do.

Indeed, the report itself notes that improvements in caner care here will require "attitude shifts, system revisions and funds."

The report found a painful list of problems faced by cancer patients today, including issues of coordination, access to the latest treatments and clinical trials and multiple, confusing and conflicting appointments.

That's a painful list.

The report says an outpatient facility with multiple professionals involved in treatment and supportive care will dramatically improve the situation.

But, then comes the disagreement.

The Governor's Blue Ribbon Panel on Cancer Care has recommended that a consultant be hired to develop a business plan for an outpatient center.The plan would assess an outpatient cancer center that would centralize care and be a home for clinical trials.

But O'ahu hospitals are critical of such a plan because they would lose income from the cancer care they now provide.

We are not indifferent to the immense cost pressures faced by hospitals but it is unconscionable to hold improved care for cancer patients hostage to individual hospitals' profit interests.

It is incumbent on this "blue ribbon" panel and the health industry at large to do better by cancer patients. There are many fine medical specialists and medical facilities providing care to cancer patients today. That is not the issue. What must be changed is the fragmentation of care that sends cancer patients to multiple doctors and leaves them uncertain where to turn and burdened with questions.

It is time to get moving on an outpatient clinic, whether it is operated, as has been suggested, by the Cancer Research Center or collaboratively by all the hospitals that have cancer programs.

It is time to put the patients' interests first and find a way to make it work. The status quo is not acceptable.