FirstHealth of the Carolinas is implementing strategic ways to increase access to innovative cancer care close to home. Dr. Daniel Barnes, president of FirstHealth Physicians Group, shares their journey from conception to construction, involvement of the community in design, unique longitudinal approach to oncology care that starts with prevention, and comprehensive approach to care under one roof.
By Laura Douglass, www.thepilot.com
May 27, 2021
FirstHealth of the Carolinas broke ground Thursday morning on its new $68 million comprehensive cancer center. The all-encompassing facility represents a major step forward for cancer treatment and patient care, from diagnosis to treatment, and most importantly, survivorship.
Construction of the four-story building is expected to continue through late 2022. The new structure and its adjoining parking deck on Page Road are located directly across the street from Moore Regional’s main hospital campus in Pinehurst.
Art Medeiros, chairman of Foundation of FirstHealth Board, said building the multidisciplinary cancer center was both a practical and pragmatic decision. FirstHealth has a long-standing history of providing exceptional cancer services, but has grown and expanded beyond the capacity of its current facilities.
“What we’ve got here today is a groundbreaking not just of a building. It is our community’s commitment to a line in the sand that we will fight cancer,” Medeiros said, in an inspiring message to the large crowd that included FirstHealth officials, local elected representatives, oncology staff and medical providers. “I believe we are building a haven of hope. We are building a haven of healing. We are building a haven of help.”
FirstHealth CEO Mickey Foster noted it was a “very special day,” and thanked his predecessor, former CEO Dave Kilarski, for his initial vision of the cancer center. Foster also expressed thanks to the Foundation for FirstHealth Board for their philanthropic efforts, and the FirstHealth staff for their dedication, especially throughout the challenges of 2020 and the COVID-19 pandemic.
“This will be a healthcare destination for decades to come,” Foster said.
Natalie Hawkins, executive director of Partners in Progress agreed. “I think this new cancer center that FirstHealth is building is just an incredible investment in our community. I think Mickey Foster and his leadership team have done a phenomenal job bringing first-class quality care for cancer patients here to Moore County that will benefit the entire region.”
Nov 20, 2019
PINEHURST—A routine physical in 2015 revealed lung cancer in non-smoker Terri Cook. A surgeon removed her upper right lobe and scans every six months for two years revealed no more cancer. Then in November 2017, the only time she went to a scan without her husband, the doctor reported “one, maybe two” concerning lesions on her lower right lobe. Cook held it together in front of her physician, but that brave face didn’t last when she told her husband.
Since Cook had a previous lobectomy, a second surgery was not an ideal situation, so her doctor offered two options: radiation or microwave ablation, the latter offered through a clinical trial to determine efficacy of a new type of lung cancer treatment. “When I heard ‘clinical trial’ I immediately thought ‘guinea pig,’” she said.
Her physician explained that colleague Michael Pritchett, D.O, MPH, pulmonary specialist at Pinehurst Medical Clinic and director of the Chest Center of the Carolinas, had just returned from the United Kingdom where he assisted with a bronchoscopy with microwave ablation, a procedure in which a flexible probe is inserted through the mouth, routed directly to the cancerous lesion and “zapped” with microwave energy. Dr. Pritchett had been selected as one of the few providers in the United States to offer this procedure through a clinical trial.
“My physician and I had developed a good rapport over the years, and he said if it were his wife, he would recommend the clinical trial,” said Cook. She and her husband acted on his recommendation and Dr. Pritchett performed the procedure on June 29, 2018.
Cook made national history that day in June, explaining, “I was the very first person in the United States to receive this procedure. Everyone was so excited and there were lots of people in the room watching.” She reported minimal discomfort after the procedure and after an overnight stay in the hospital, she recovered quickly at home.
The second of the concerning lesions initially reported also turned out to be cancerous, so Dr. Pritchett made a special request for Cook to be not only the first American to receive the procedure, but also the ninth. He was granted the second procedure for her and completed it on March 15, 2019. The United States received 20 slots for the clinical trial, and Cook was a good candidate to have it twice. The Mayo Clinic is the only other site for this trial.
“I feel wonderful now!” said the 64-year-old grandmother of two with a third on the way. “I can breathe!”
Cook is now almost a year and half out from her initial ablation, and the follow-up CT scans show no evidence of cancer.
Cook reported that everyone she worked with, including Dr. Pritchett and the entire staff at Reid Heart Center, was wonderful. “I felt truly cared for,” she said.
A substitute teacher from Sanford, Cook reflected on her participation in this clinical trial and reported, “I think it’s amazing what can be done now — and right in Pinehurst! Every time I teach in Pittsboro, my colleagues assume my medical care was in Chapel Hill. When I told them Pinehurst, they said, ‘really?’ and I replied, “Yes, really!”
Patients and their families seeking more information about clinical trials at FirstHealth of the Carolinas can visit https://www.firsthealth.org/reference/clinical-trials or talk with the patient’s physician. Find cancer clinical trials in your community by visiting https://southeastclinicaloncology.org/clinical-trials/
When Pinehurst-based FirstHealth of the Carolinas opens its one-stop shop cancer center in 2022, the 15-county medical network will have a centralized diagnosis and care center, a headquarters for its clinical trials and a check mark on the to-do list of priorities set by new CEO Mickey Foster.
Construction on the four-story, $60 million cancer center on Page Road North, near Moore Regional Hospital, will begin in 2021 following completion of a four-story parking garage. The target opening date is November 2022. Foster estimates about $30 million for the 120,000-square-foot center will be raised through a philanthropy campaign launching in January. However, people have already been donating to the project since November.
“The rates for cancer in our 15 counties is expected to grow, so we need to build a comprehensive cancer center,” says Foster, who joined FirstHealth in July after serving as president of Moses H. Cone Memorial Hospital in Greensboro. “I have had the opportunity to oversee several cancer programs in my career, and there is a need to have all the support services under one roof. It creates a one-stop shop for care for all of our cancer patients.”
Foster joined FirstHealth with three main goals: “First, we want to be the best place to work in the county. We are in the top 4% nationally [according to Hospital Consumer Assessment of Healthcare Providers and Systems], so we want to create the best culture. Second, we want to be a health system that is a zero-harm organization. There are still too many harm events in health care. We want to be a system with zero: no falls, no injuries, no infections. Third is to build a destination for cancer care.”
Informal talks about a centralized cancer center began four years ago but weren’t concrete until last summer.
“We have outstanding services, but they’re spread out across our campus,” says Dan Barnes, president of FirstHealth’s physicians group and vice president of oncology services. “This [new center] allows patients to be seen from diagnosis to treatment to survivorship and be patient-centered and patient-focused. It allows us to bring physicians and treatment under one roof and increase support services such as financial counseling and palliative care.”
The project received full support from the Pinehurst Village Council and the Village of Pinehurst, Foster says. Space will be reserved for meditation and support groups, as well as rooms designated for exercise. “We want to create a more healing and natural setting that will differentiate us from other places,” he says. “It’s a game changer for cancer care in this region.”
One floor will house research and clinical trials, such as those headed by pulmonary specialist Michael Pritchett, director of the Chest Center of the Carolinas at FirstHealth and an employee of Pinehurst Medical Clinic. Last April, Pritchett was the first in the world to demonstrate work with a robotic-assisted catheter-based device to collect samples for lung cancer diagnosis. Pritchett performed his first procedure last March and as of mid-November, he had seen about 60 cases.
“We have the pathologist sitting in the room, so they put it on a slide, and we get immediate feedback as to whether it’s malignant or not,” he says. “So when I wake you up, we will tell you what we found. We can biopsy multiple lesions, so it’s really a game changer for us.”
The future cancer center’s central location is imperative in reaching the 15-county area beyond the 16,000 people of Pinehurst, Pritchett says. “We don’t want them to drive past us and have to go to Duke or UNC.”
Pritchett isn’t the only one working on research at the new cancer center. On the same floor in the building, gynecologic oncologist Michael Sundborg will continue administering a Gynecologic Oncology Group Foundation trial to assess a chemo treatment for advanced cervical cancer.
Sundborg has two patients enrolled in the six-month trial designed to prompt the immune system to seek and destroy cancer. The GOG Foundation chose FirstHealth to test the therapies in a hybrid trial, meaning it’s sponsored by the National Cancer Institute and is an industry trial, so the medication is free. “We’re shooting smart missiles. We’re a sniper,” Sundborg says. “This is the evolution of cancer therapy.”
Sundborg says Moore County has seen a 7% increase in cancer diagnoses annually, compared with a national average of about 3%. It’s the leading cause of death, according to the 2018 State of the County Health Report. He attributes it to the region’s relatively older population and patients in nearby rural coastal areas without access to care. “But we’re doing something for them. We’re changing life spans.”
Both Sundborg and Pritchett have begun their research in their current roles, but the new cancer center will make “a substantial footprint” in care, Sundborg says.
Foster did not detail the number of jobs that may be created with the completion of the center but anticipates recruiting additional physicians, nurses, support staff and medical-office assistants for the new center. Health care and social assistance are listed by the N.C. Department of Commerce Labor & Economic Analysis Division as the top employers in the county with 9,457 workers, or 26.2% of the total workforce.
“I have plenty of offers all the time to go other places, and I have no desire to go anywhere,” Pritchett says. “I can do all these things, [including] publish research, right here in my own community.”
From: ThePilot.com, Jan 7, 2020
by Laura Douglass
Tucked into a corner of FirstHealth’s Outpatient Cancer Center in Pinehurst, Dr. Charles Kuzma’s unassuming office belies the important work that begins here.
As the institutional principal investigator of clinical trials for FirstHealth of the Carolinas, he spends his days collaborating with numerous doctors and four department coordinators who manage up to 30 active clinical trial studies involving hundreds of patients.
“The advanced medical treatments that we enjoy today are thanks in part to medical research,” Kuzma said. “Patients elect to participate in a research study that not only could improve their health or condition, but also could improve health care in the future for many others.”
“Everything we do with patient care is based on another patient going before them in the treatment.”
Advancing the Science
FirstHealth initiated its clinical trials program in the early 1990s with one doctor and one coordinator. But interest had waned prior to Kuzma’s arrival.
A medical oncologist/hematologist and U.S. Navy veteran, he was recruited by FirstHealth in 2009 to help reinvigorate the program. At the time, there were only three patients actively enrolled.
One of his earliest goals was to bring FirstHealth into the Southeast Cancer Consortium, a community network of private practices and public hospitals involved in cancer clinical research.
“There is strength in numbers,” Kuzma said, noting it can be challenging for a single institution to recruit enough patients for a study.
The National Cancer Institute (NCI) sponsors most of the clinical trials at FirstHealth Moore Regional Hospital. Pharmaceutical or drug companies also sponsor clinical trials, while others may be sponsored by cancer research facilities at UNC-Chapel Hill and Duke University.
FirstHealth’s trials focus primarily on breast cancer, lung cancer, colon cancer and prostate cancer.
“You don’t make money with this. What you do is advance the science and outcome of your patients,” Kuzma said. “But we also have a responsibility to the hospital to not be a money loser. It’s not about making money, but we try not to lose too much.”
However, “success breeds success,” and smaller trials conducted by FirstHealth attracted interest for bigger trials.
“With any clinical research you have to make sure the data is valid because it could lead to change of standard of care,” Kuzma said. “We are held to a very high standard to make sure the data that is turned in is pristine.”
Currently, there are 22 clinical trials underway at FirstHealth dedicated to cancer research, while the hospital as a whole is conducting approximately 10 non-oncology trials for other medical conditions.
Patients include folks like Pinehurst resident Ken Hill, who discovered he has chronic lymphocytic leukemia (CLL) in 2012, when he was being treated for skin cancer.
When a routine blood scan three years later revealed a saturation of cancer cells, Kuzma recommended Hill for a clinical trial of a drug that could be added to his infusion regimen. The sponsor of the trial, Alliance for Clinical Trials in Oncology, funded the cost of the treatment.
Within a few months, bone marrow scans began tracking a remarkable reduction in the cancer cell saturation in Hill’s blood.
Those positive outcomes have continued as part of Hill’s ongoing treatment in the clinical trials program. In addition, he and his wife, Betty, now serve on a peer support advocacy group sponsored by the Southeast Clinical Oncology Research Consortium.
One of the horrible things about cancer is it paints you in a corner,” said Kuzma. “This program gives patients another opportunity to improve.”
Importantly, patients in a clinical trial are all volunteers and they can expect to receive the current standard of care or a new treatment that the study sponsors believe is as good as or better than the standard of care.
Kuzma added that having a robust clinical trials program is also in the best interests of FirstHealth.
“Each clinical trial takes you farther down the road. For example, breast cancer treatment is so different now than in years past because some patients were selfless in their approach.”
Clinical trials are conducted in stages that are ranked within four progressive phases — from early investigative work to continuing research into long-term use and side effects.
Kuzma said most clinical trials conducted at FirstHealth are classified as Phase II or Phase III studies.
A patient’s eligibility for a clinical trial is determined by a participating physician and research nurse, but the final decision whether or not to participate is made by the patient themselves.
“Every trial has different eligibility criteria. And patients who go into a trial are generally healthier and a bit more motivated,” Kuzma said.
But it can be a scary process for patients because the selection is randomized to eliminate bias.
“There is an equal chance for the patient to be on either side of the treatment question. The patient doesn’t have a say and the hospital does not have a say,” he said. “We encourage participation but we are not insistent on it.”
Patients and their families seeking more information about clinical trials at FirstHealth of the Carolinas can visit www.firsthealth.org/reference/clinical-trials or talk with their own physician.