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Physicians Update

 
Summer 2007 Oncology

UCLA Revamps Oncology Treatment Process

Accessing treatment and other services at a sprawling academic medical institution can be daunting for patients dealing with a diagnosis of cancer.

Still reeling from the news, patients referred to UCLA for treatment often find the large Westwood campus and the sometimes complex healthcare system as difficult to navigate as the 405 Freeway during rush hour.

To make things easier for patients and referring physicians, administrators and physicians have made sweeping changes in the way UCLA delivers its cancer care.

Community oncology practices were created in three Southern California cities to bring UCLA-caliber care to patients in their own backyards. Expanded hours at the community oncology practices in Santa Clarita, Santa Monica and Pasadena will enable patients to receive treatments before and after work, and a pilot program at the Santa Monica site will offer treatment on Saturdays and Sundays. UCLA officials launched a far-reaching translational research network with affiliated oncology offices throughout California and in six other states to offer leading-edge clinical trials to patients, studies that generally are available only at large academic medical centers.

Additionally, a patient-services office was established to help patients with any problems they may encounter, from making appointments to accessing labtest results to billing and insurance issues. The wait time to see a UCLA oncologist also has been cut—patients referred to a community practice are seen within one week. And a patient hotline, 1-888-ONC-UCLA, has been established to make contacting the practices easier.

Administrators and physicians are dedicated to treating the whole patient and now offer in the Santa Monica practice various psychosocial services and other integrative medicine provided to Westwood patients through the Simms/Mann–UCLA Center for Integrative Oncology. Simms/Mann Center professionals currently staff the Santa Monica practice providing counseling groups, resources, as well as classes in nutrition, dietary supplements, exercise and complementary and alternative medicine. Those services also may be offered in the Santa Clarita and Pasadena offices soon, says Farah Elahi, chief administrative officer for the Department of Medicine at the David Geffen School of Medicine at UCLA.

Elahi and Dennis Slamon, M.D, Ph.D., director of clinical/translational research at the UCLA Jonsson Comprehensive Cancer Center and chief of the Division of Hematology/Oncology, are the point people behind the changes.

“This is a very difficult time for patients and we want to help them as much as we can,” Elahi says. “We want to provide them with the best care, from initial diagnosis through treatment, and make the experience as bearable as possible.”

The community practices were set up to provide top-notch cancer care by UCLA faculty to patients in their own neighborhoods so they can avoid the commute to Westwood. The drive can take hours at times and adds to a patient’s stress and frustration level.

“It’s hard for a patient to travel a long distance to get to UCLA,” Elahi says. “Through the community practices, they can access UCLA oncologists and enroll in clinical trials without traveling so far from home.”

Staffed by UCLA faculty and administrators, the community oncology practices provide a wide range of cancer services.

The first community practice, the UCLA/Santa Clarita Valley Cancer Center, was launched about 10 years ago and is directed by John Barstis, M.D., UCLA clinical professor of hematology/oncology.

Dr. Barstis says the oncology practices provide the same level and caliber of care as the Westwood campus, but operate more like private practices —they’re smaller and easier to navigate. The community oncology practices also serve as a portal to UCLA—if a patient needs a complicated procedure not offered in the community practices, Dr. Barstis says, the oncologists make sure the patient gets to the right expert at UCLA Medical Center.

“We take responsibility to make sure they get the best possible care, either in the community or inWestwood,” Dr. Barstis says. “We have the best clinical faculty on our team and access to all of UCLA’s vast resources.”

About 10 clinical trials currently are open in Santa Clarita, many of them breast cancer studies. UCLA faculty members on site include a surgical oncologist, a breast reconstructive surgeon, a pediatric hematologist/ oncologist and a radiologist specializing in women’s imaging. Adjacent to the Santa Clarita cancer center is a radiation-therapy facility offering the latest in treatment, TOMOTherapy, which delivers image-guided intensitymodulated radiation therapy.

Most of the doctors in the community practices work at more than one site, further strengthening the consistency of care. Dr. Barstis, for example, works in Santa Clarita as well as the UCLA/ Santa Monica Cancer Center.

When Stephanie Grimes, a single mother of a teenaged boy, was diagnosed with aggressive breast cancer, she sought care at the Santa Monica community oncology practice. She took part in a clinical trial that tests the molecularly targeted therapies Herceptin and Avastin together without chemotherapy.

A personal trainer, Grimes was happy to be able to receive her care in the city in which she works and near where she lives. A trip to the Westwood campus could take up to 45 minutes. After her treatment in Santa Monica, she can be back in the gymin less than 10minutes to teach a step aerobics class.

“The quality of the care I receive in Santa Monica is excellent,” Grimes says. “It’s been phenomenal. The people there are like family, and that helps a lot when you’re getting poked and prodded during treatment. It’s been a really, really wonderful experience, considering.”

In addition to being offered in the community oncology practices, studies also are available through Translational Oncology Research International (TORI), a nonprofit research network affiliated with theUCLA Jonsson Comprehensive Cancer Center, a top-ranked research institution.

The TORI network consists of 26 community-based oncology practices in 69 offices representing 152 physicians throughout the United States. The network has conducted trials that have led to the approvals of such molecularly targeted therapies as Herceptin, Avastin, Tarceva, Iressa, Gleevec and Sutent for breast, lung, kidney and colorectal cancers, as well as chronic myelogenous leukemia and gastrointestinal stromal tumors. TORI has affiliated offices in California, Nevada, Texas, Illinois, Indiana, Georgia, Florida and Maryland.

The TORI network gives patients in cities like Terre Haute, Ind., Peoria, Ill., and Lawrenceville, Ga., access to promising clinical trials usually only available to patients in larger cities such as Los Angeles. It also helps speed the oftenlengthy drug-approval process—more patients are put on studies more quickly, allowing researchers to more rapidly determine whether an investigational therapy is safe and effective.

Accrual to UCLA studies has increased dramatically since the network was established.

“We are certain this is the most effective means to deliver the latest and best that American medicine has to offer to patients,” Dr. Slamon says. “We have very carefully selected the finest cancer physicians and clinics to affiliate with, so we can offer patients the stateof- the-art in cancer care.”

For more information on the TORI network, or to refer a patient to a study, call 888-798-0719.





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