Thursday, March 25, 1999

UC cancer center's new chief thinks big

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BY TIM BONFIELD
The Cincinnati Enquirer

        After several years of little progress, major pieces are coming together to transform cancer care in Greater Cincinnati.

        The University of Cincinnati and the Health Alliance of Greater Cincinnati have assembled the leadership, facilities and money to launch a campaign to win designation as a comprehensive cancer center from the National Cancer Institute.

        Officials say the designation can bring money and prestige to the local cancer center, which in turn attracts researchers and physicians, who in turn provide cutting-edge care right here in Cincinnati.

        In past years, cancer patients frequently left town to get the latest cancer treatments. UC's Barrett Cancer Center — hailed when it opened in 1988 as the keystone of local cancer care — has languished without a full-time director for nearly six years.

        Tuesday evening, UC officials revealed that the largest gift the university has ever received — more than $70 million from the French family trust — will be dedicated entirely to building up cancer research.

        In an exclusive interview with The Cincinnati Enquirer, Dr. Kenneth Foon, the incom ing director of the Barrett Cancer Center and UC's newly named French Cancer Institute, outlined his goals for cancer care in Greater Cincinnati.

        Those goals include more than doubling the number of patients participating in clinical research trials within two or three years, and creating at least three new multidisciplinary clinics within a year to focus on specific types of cancer.

        Dr. Foon, 52, had been di rector of the Markey Cancer Center at the University of Kentucky since 1993. He is recognized as a national expert in the emerging field of cancer vaccines.

        What are your key goals and plans for the Barrett Cancer Center?

Dr. Foon: It's hard to become an NCI-designated cancer center without a strong backbone of basic science. ... So coming to UC, where you have a university that is already in the top 25 or 30 in the country in terms of NIH (National Institutes of Health) funding, you have a real opportunity to build a large program and become an NCI-designated cancer center much more quickly. ...

        So, why isn't the Barrett Cancer Center a great cancer center? Mainly because they haven't had a real strong clinical research program and what we call a translational research program ... that is taking agents from the lab to the clinic. ...

        What is the strength? The strength is that there is an enormous patient population here. What they've done rather uniquely here is that the University Hospital is privatized and part of the Alliance (the Health Alliance of Greater Cincinnati, along with Christ, Jewish, St. Luke and Fort Hamilton hospitals). And (doctors) who practice oncology in this region are extremely strong, high-quality people. They're delighted to put their patients into clinical research programs — if they're there and available to them.

        What is an NCI-designated cancer center, and what does that bring to Cincinnati that wouldn't otherwise be here?

Dr. Foon: I view the NCI-designated cancer centers as kind of a club, a very difficult club to get into. It not only brings in funds, beginning at about $1 million a year, but it also brings prestige.

        What do you see as two or three of the most important lines of cancer research, and how will UC be involved in those research areas?

Dr. Foon: There will be some new drug development, but I'm very biased toward vaccines. I think with most cancers, we've pushed the envelope almost as far as we can with chemotherapy. We get minor breakthroughs, but we rarely see huge breakthroughs with chemotherapy. I think (cancer vaccines) are going to lead to more cures.

        What would you say is Greater Cincinnati's biggest cancer problem?

Dr. Foon: I don't think Cincinnati is different than any other city. Each city has some of its own unique statistics, but you start off with lung cancer. That's going to be the No. 1 cancer in men and women. After that, it's going to be prostate cancer in men, breast cancer in women, and colorectal cancer in both. Right there, you probably have 75 percent of the cancers in the state of Ohio and the city of Cincinnati.

        It makes perfectly logical sense to target those diseases, and we will. I expect a multidisciplinary clinic in the next year in each of these diseases. How much of an expansion of clinical research are we talking about?

Dr. Foon: Right now in the Alliance hospitals, they are doing in the range of 200 new patients a year (enrolled in clinical trials). With the patient population we have, we should be able to easily put 500 patients on clinical trials annually. That's being conservative. Why are clinical trials important?

        Dr. Foon: For these diseases where we don't have cures, we're never going to know whether we have a better therapy unless we test new things. Having access to those trials is very important.

        What made you want to specialize in cancer research?

        Dr. Foon: Because I'm a masochist. No. When I was finishing my internship, it was near the end of the Vietnam War. I took a position at the National Institutes of Health as a public health officer, and spent three years doing lab work. I was interested in immunology and was fortunate enough to get into a very world- renowned scientist's lab. When I went back into internal medicine, I wanted to apply immunology research to what I did.

        Have you had any personal experience with cancer through family members or other loved ones?

Dr. Foon: My closest cousin died in his 30s of an unknown primary, widely metastatic tumor. ... My uncle had lung cancer. He was a smoker.

        And most recently, my mom had breast cancer. It looks like she's going to be fine. But she's a perfect example of what one goes through with cancer.

        My mother, she's in Detroit, she's 75 years old and she gets diagnosed with breast cancer. And she goes back and forth, back and forth, to see the medical oncologist, to see the radiation oncologist, to see the surgeon. It was so frustrating to see her go through this.

        It took months before we actually had a final diagnosis and a plan of therapy — which is exactly why I support the multidisciplinary approach. What my mother went through that took two months could have been done in two hours in a multidisciplinary clinic.

        As you know, many states, including Ohio, Kentucky and Indiana, are beginning to debate what do with the money they get from settlements with the tobacco industry. How do you think the states should spend the money?

Dr. Foon: I would hope that tobacco money would be focused predominantly on tobacco. What's the No. 1 cancer killer in the United States? Lung cancer. What's the No. 1 cause of lung cancer? Cigarettes. And who's smoking? It's kids who get started in high school. Even kids who are athletes are smoking up a storm. It's just an awful problem.

        And here you come from a cancer center in Kentucky, where tobacco is a major part of the economy. What was that like?

Dr. Foon: It was bizarre. One day, I go to visit one of my congressmen. He wasn't there, so I meet with his No. 1 person in his office. And he sits there in this little tiny room, chain-smoking, blowing smoke in my face. What's wrong this picture?

        The fact is, in a state like Kentucky, there's not much you can say. I was actually asked not to say things about tobacco. A lot of our donors, the people who support our cancer center, the politicians are all pro- tobacco.

       

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