On Sept. 5, 2018, the UT Health San Antonio MD Anderson Cancer Center hosted a roundtable discussion with esteemed cancer leaders from UT Health San Antonio and MD Anderson Cancer Center to talk about the impact of cancer in San Antonio and how collaboration in patient care and research is essential to improving not only the outcomes for patients, but how creating a streamlined system of care using proven protocols and processes can best support families and caregivers. These thought leaders and clinicians walked through the rising incidence of the disease in San Antonio. They also laid out plans for how their work together will positively impact patients and their families while focusing on overall cost or “value” of health care spend for this disease that strikes aging and Hispanic populations disproportionately.
From left to right: Michael Kupferman, MD; Peter Pisters, MD; William Henrich, MD; Reuben Mesa, MD; Stephanie Shelton
Panelist Questions & Answers
William Henrich, MD, MACP
Question: You have stated many times publicly based on your own personal experience, the importance of having accessible cancer care at home. Share your vision for the university and how it impacts patients related to local access to advanced cancer care and research?
William L. Henrich, MD, MACP
President and Professor, UT Health San Antonio
Answer: UT Health San Antonio is nexus of teaching and education, health-related research and innovative clinical care matched only by a handful of other academic health centers in Texas, and in numerous areas of disease, matched only by few in the United States. Cancer is one of those diseases. We exist to serve this community and bring our collective expertise, extensive knowledge and advancements in health care to make lives better for all those we serve. Part of that mission is to deliver the most robust cancer care system to San Antonio and South Texas. By bringing together two NCI-designated cancer centers, this partnership is most able to advance cancer care in a profound way.
Research has demonstrated that receiving cancer care closer to home can improve outcomes. Traveling to receive care can be extremely stressful and expensive for the patient and their family/caregiver. By offering robust patient care here in San Antonio with the latest treatment protocols, access to advanced cancer research and more than 200 cancer clinical trials, as well as the world’s most experienced, multidisciplinary care teams that includes our colleagues at MD Anderson who collaborate on the most complex cancers, the level of service here at home is unequaled.
The health needs of our community are increasing. We have looked at the projected need for cancer care in our region, and over the next 10 years we are expecting a significant growth in population. Unfortunately, with that growth will come many more cancer cases. This partnership combines the strengths of each of our institutions to improve cancer care and to be ready to serve the increasing needs of our region with better outcomes and an improved patient experience.
Peter WT Pisters, MD, MHCM
Question: Having previously served The University of Texas MD Anderson Cancer Center (ranked No. 1 for cancer care by U.S. News & World Report in its “Best Hospitals” survey), for more than 20 years and returning to the organization as its president in December 2017, how do you see partnerships between MD Anderson and UT Health San Antonio complementing both your organization and the battle to eradicate cancer?
Peter WT Pisters, MD, MHCM
President, The University of Texas MD Anderson Cancer Center
Answer: Most importantly, this partnership will benefit patients who seek innovative care close to home. By leveraging each organization’s unique strengths and our collective experience, we can advance groundbreaking research, promote prevention strategies, improve clinical care and educate future cancer experts. That is the power of this partnership: working together to serve patients, learn from each other and achieve our shared mission to end cancer.
At MD Anderson, we are committed to team-based science, which is an approach that has proven critical to our patient outcomes and their overall experience. We believe strongly in sharing our approach with partners as well as new research and treatment concepts because that’s the only way we will collectively advance our understanding of this complex disease and fulfill our promise to patients.
The UT Health San Antonio MD Anderson is focused on clinical trials, drug development, prevention efforts and patient care. Its team of experts also has a tremendous connection to the community and region. That track record of clinical expertise and community service combined with MD Anderson’s 76 years of innovation, quality care and compassion is a strong force. The opportunity to learn from each other is great, but to see that knowledge translated into better clinical care practices, new research and treatment innovations for San Antonio and South Texas is the ultimate goal of our partnership.
Michael E. Kupferman, MD, MBA
Question: The MD Anderson Cancer Network® is designed to advance MD Anderson’s mission of eliminating cancer through collaboration. What are the key elements of the MD Anderson Cancer Network® that drive greater value or make it most effective — a national model, if you will — in elevating the quality of cancer care?
Michael E. Kupferman, MD, MBA
Senior Vice President of Clinical and Academic Network Development, The University of Texas MD Anderson Cancer Center
Answer: In February 2018, we launched the partnership between UT Health San Antonio and MD Anderson Cancer Network® to provide greater access to the most advanced cancer treatments for patients in San Antonio and the surrounding communities in South Texas. Our network teams collaborate with leading hospitals and health systems, including academic health centers like UT Health San Antonio, to integrate patient care, research and prevention to improve the quality of cancer care. Today, more than 100 million people have access to an MD Anderson location and the opportunity to benefit from our expertise, technologies, treatment protocols, education, research and multidisciplinary approach to care.
One major advantage of the MD Anderson Cancer Network® is access to and alignment of multidisciplinary care models (or protocols) that reduce variability and lead to better treatment outcomes with a lower cost of care. Partner members, like UT Health San Antonio, are fully integrated clinically and operationally with MD Anderson for care and research. The goal is to replicate the MD Anderson multidisciplinary and sub-speciality model so patients can receive best-in-class care close to home.
Members of the MD Anderson Cancer Network® follow an extensive evaluation process to ensure they meet the highest standards for clinical quality, safety and patient care, which all correlate to value. Network members have access to MD Anderson’s cancer treatment regimens, prevention approaches, education and training opportunities, select clinical trials and multidisciplinary consults.
More than 94,000 newly diagnosed patients are cared for by a network physician every year. Our collaborative efforts work in parallel to fight cancer through prevention, early diagnosis, effective therapies and scientific breakthroughs. MD Anderson’s sole mission is to end cancer for patients and their families around the world.
Cynthia Sickora, DNP, RN
Question: UT Health San Antonio MD Anderson Cancer Center uses the term “patient- and family-centered care.” What does that term really mean, what is the benefit, and how do your nursing programs and supportive care programs bring that to the forefront for cancer patients specifically?
Cynthia Sickora, DNP, RN
Howard & Betty Halff Endowed Professorship in Nursing Excellence for Patient Care Vice Dean, Practice and Engagement UT Health San Antonio School of Nursing
Answer: Our approach to patient- and family-centered care is to have the patient and family members as equal partners in their care journey. Multidisciplinary care teams work to help patients and families understand care options and to help plan treatments that best meet the needs for them uniquely. In patient- and family-centered care, patients and families define their “family” and determine how they will participate in care and decision-making processes together, which leads to better outcomes and higher satisfaction because we ask what is important to our patients. This also fosters deeper connections with the care team as we learn more about the person we are treating rather than focus on the disease we are fighting. This type of approach to care delivery also cultivates increased communication with the care team. We’re able to collaborate more with our patients and families, which helps to identify challenges earlier and remedy them before escalations may occur which could lead to costly additional treatments.
Our approach to care delivery takes into consideration the changing nature of cancer care and the belief that fighting cancer is a “team sport.” Our teams of scientists, physicians, nurses, advanced practice providers (nurse practitioners and physician assistants) and allied health professionals that include physical therapists, occupational therapists, social workers, nutritionists, etc. all work and train together in our mission to reduce the burden of cancer for San Antonio and South Texas. We are also growing robust supportive services for our patients and families, stewarded by teams focusing on advancing cancer prevention, screening, palliative care and symptom management and on to survivorship care. Another key focal area for the coming year will be to grow patient educational activities and materials in partnership with MD Anderson. Areas will range from high-quality education materials for our patients and families to in-person classes for cooking and nutrition in our newly constructed Family Center. On Jan. 12, 2019, we will host our very first “Living with Cancer San Antonio,” event for 700+ cancer patients and family members to showcase our cancer program with both general educational sessions and disease specific breakout groups.
Ruben A. Mesa, MD, FACP
Question: As a physician, you have undoubtedly seen the impact of a cancer diagnosis on patients and their families. Not only must patients and families deal with the emotional aspects, but there is often a devastating burden of cancer on patients, caregivers and families related to managing the disease, care coordination and expenses. How does the partnership with MD Anderson Cancer Center bring value to cancer care for patients in San Antonio?
Ruben A. Mesa, MD, FACP
Director, UT Health San Antonio MD Anderson Cancer Center Mays Family Foundation Distinguished Presidential Chair; Professor of Medicine, UT Health San Antonio
Answer: As a physician — one of the many partners in treating cancer — we see all aspects of the devastation cancer can bring, which fuels my relentless desire to end this disease. It is a privilege to work among many of the greatest minds in cancer research, treatment and prevention both at UT Health San Antonio and at MD Anderson. This partnership between our organizations provides a unique environment between two NCI-designated cancer centers that accelerates our ability to impact the burden of cancer and allow us to better deliver cancer care to patients in this community.
One of our major efforts will be to reduce the cost of care while continually improving the quality of treatment, also termed “value.” We continue to see payer scrutiny for all types of health care, including cancer care, and the shift to value. For us, our programs must seamlessly integrate research and technology, the brightest minds in cancer (our faculty and staff), and our full continuum of patient care services while eliminating inefficiencies and unnecessary services. Our efforts focus on less random variability and evidence-based treatment intensity such as new hypofractionated radiation therapy, a process by where therapy is given over a shorter period of time (fewer days or weeks) than standard radiation therapy.
As part of an academic health center, we are uniquely able to integrate cancer care with innovative clinical science, research and education. We are responsible for new drug development and research that allows for greater treatment options. In fact, this cancer center is responsible for more than 20 chemotherapy drugs used in treatment today worldwide.
A significant emphasis of our partnership with MD Anderson is to deliver the “MD Anderson model” of cancer care. Central to this model are evidence and guideline-based care. There are also multi-disciplinary clinics we have opened and plan to open, which are team-based with careful treatment planning for each new cancer case taking advantage of all the disciplines involved in cancer care including surgical, radiation and medical oncologists, radiologists and pathologists. The treatment care plans follow MD Anderson’s protocols and patient care guidelines. This next year we will focus on closer alignment on disease group activities, molecular diagnostics, early phase clinical trials and post-therapy care.
There are many more action steps we are taking to drive value and expand services to include continuing the steady adoption of precision medicine (molecular diagnostics, genetic profiling) and we are improving care delivery and adding new lines of therapy through patient-specific approaches to screening, diagnostics and treatment. As Dr. Sikora mentioned, we are creating a patient-focused program through navigation, ancillary support services, survivorship clinics and integrated palliative care.
UT Health San Antonio MD Anderson Cancer Center continues to make strategic recruitment and technology investments that support growth, improve expertise and differentiated service offerings. We deliver tumor-specific multidisciplinary care by using opportunities such as tumor boards and multidisciplinary clinics that ensure collaboration with community providers and university providers to broaden the services for our community. We must continue to lead in cancer treatment education.
Our sole mission is to end cancer for patients and their families in San Antonio. In South Texas. And around the world.
To learn more, call 210-450-1000 or visit UTHealthSAMDAnderson.org.