San Joaquin Valley Gets Network : Advanced Cancer Therapy Reaches Out a Lot Farther

Cancer patients outside major cities once had a disheartening choice: uproot their lives to receive the best treatment at a distant hospital or hope for the best at home.

But a program sponsored by the National Cancer Institute has created a network of 12 hospitals and 43 doctors from Bakersfield to Merced that brings advanced cancer therapy to the San Joaquin Valley. It is one of 60 created nationally.

Since the community clinical oncology program accepted its first patients in 1983, Fresno doctors have won NCI backing for a new treatment for advanced cancer of the cervix and proposed another regimen for cancer of the esophagus.

“Not everyone has access to a major institution and yet wants quality treatment,” said DeAnn Lazovich, program coordinator. “We have a lot to learn, but at least we have a mechanism and a network.”

The program was designed to expand the number of cancer patients in clinical trials of experimental protocols, a detailed outline of long-term treatment.

Get Earlier Treatment

Patients receive treatment sooner than they would if the protocol had to flow through channels before adoption as a recommended form of treatment. Cancer researchers also expand their pool of participants, which can speed up study by signing up the chosen number of patients sooner.

The ultimate goal is simple, said the principal investigator, Dr. Phyllis Ager Mowry at Fresno Community Hospital.

“We’d like to cure more patients,” she said. “The optimal would be, with each new protocol, we’d gain a higher and higher percentage of cured patients.”

The program already is showing signs of success.

For patients with advanced prostate cancer, radical surgery is not recommended, and radiation alone is unable to control large tumors. One protocol prescribes a female hormone, either estrogen or progesterone, two months before radiation therapy begins.

Tumors Reduced in Size

“We do know from the number of patients we’re treating that there is a very exciting reduction in the size of tumors,” Mowry said.

With advanced cases of head-neck cancer, doctors found radiation or cisplatinum chemotherapy produced limited response, but a protocol that combines them has produced astonishing results.

“We have people who come here and their whole tongue is replaced with cancer. There is no normal tissue,” Mowry said. The new treatment has produced a cure rate of 70% in head-neck cases compared to a normal rate of 5% to 10%.

“Cancer just melts away,” she said. “For someone who’s been in cancer therapy for years, this is amazing.”

Another study examines patients with small cell cancer of the lung who received radiation to the brain to prevent spread of the disease. About 15% of the survivors develop organic brain syndrome in which their IQ drops. Researchers are trying to determine if radiation or chemotherapy caused the decline.

Experimental Drugs Employed

Meanwhile, experimental drugs are being used by patients with cancer of the prostate, lung, liver, pancreas and lymph glands.

“It’s exciting to bring the state-of-the-art therapy to the patient in the community, and I feel we’re going to have improved survival,” Mowry said. “It’s a relief to the patient, emotionally also, that they are being offered the latest treatment.”

About three-quarters of the oncologists in the study zone are participating by offering clinical trials to patients. They must sign a lengthy consent form describing their cancer, survival rates, side effects of treatment and alternatives, but patients can withdraw at any time.

“They’re thrilled with the amount of information they’re being given,” she said. “They seem to feel like they’re making a contribution.”