Tag Archive for: FirstHealth Carolinas

FirstHealth Breaks Ground at New Cancer Center

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.

FH Cancer Center rendering
FirstHealth Cancer Center, rendering courtesy of CPL Architecture

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.”

FirstHealth Is World Leader in Lung Cancer Care Through Use of Robotic Technology

From ThePilot.com
June 4, 2020

Jane Sandor FirstHealth Carolinas beneficiary of clinical trial success

Dr. Michael Prichett and Jane Sandor

World-class advancements in health move fast in a community known for a slower pace. In early 2019, Pinehurst-based FirstHealth of the Carolinas was chosen as the nation’s first site to host clinical trials for a robotic technology that could diagnose lung cancer earlier, more accurately and less invasively than ever before. That turned into FirstHealth becoming North Carolina’s only provider of the procedure. Then FirstHealth was designated as the world’s first site to train other doctors on the technology. All from a community hospital in the Sandhills.

Jane and Andy Sandor have been married for 56 years and finish each other’s sentences.

“We moved here in 2001,” Andy starts “to be near a great hospital,” Jane finishes. That turned out to be a wise move when the unthinkable happened and nonsmoker Jane was diagnosed with lung cancer in March 2020.

A new technology offered by FirstHealth enabled her to get an early diagnosis — resulting in a greater ability to treat and cure it. The Ion endoluminal robotic bronchoscopy platform is a robotic-assisted, catheter-based technology designed to access hard-to-reach areas of the body through natural openings, like the mouth. When applied in the lungs, it aims to enable early lung cancer diagnoses by accessing and sampling tissue from small nodules in difficult-to-reach areas.

Jane Sandor was the 100th patient at FirstHealth to be diagnosed using this groundbreaking technology.

Jane’s Story

In early 2020, Jane had the flu, followed by a pain in her side. Her primary care physician was suspicious of a kidney stone and ordered a computed-tomography scan (CT scan) of her abdomen. Jane’s scan indeed found a kidney stone — and more.

Abdomen scans often capture the lower portions of the lungs, and Jane’s scan showed a nodule in her lung. A subsequent CT scan of the entire chest revealed the need for a biopsy to see if it was lung cancer. Although she had never smoked, she previously lived in an area with high levels of radon gas, a known carcinogen.

Jane’s primary care physician referred Jane and Andy to Michael Pritchett, D.O., MPH, a pulmonary specialist at Pinehurst Medical Clinic and director of the Chest Center of the Carolinas at FirstHealth.

“My doctor mentioned that Pritchett has a special way to see and test for cancer with robots,” Jane says. “She said he’s also a good listener, and I appreciated that.”

Using the Ion endoluminal system, Pritchett and his team performed a robotic navigation bronchoscopy to reach, see and snip a sample of Jane’s lung nodule to test it.

To be sure, Pritchett performed the procedure — not a robot — but a robot assisted him to see deep inside the lung and reach the nodule to biopsy it.

Specifically, he inserted a catheter with a tiny camera and instruments into Jane’s mouth and steered the scope robotically all the way out to the nodule. He controlled the instruments’ movements through a console right beside Jane and saw all activity through a high-definition monitor.

“The catheter that the instruments and camera go through is only 3.5 millimeters wide and can easily fit into some of the smallest airways in the lung. More than 70 percent of lung cancer is in the farthest reaches of the lung, so this technology allows us to reach nodules we never could before — and without invasive tactics,” he says.

Before robotic navigation bronchoscopy, Pritchett says to test Jane’s lungs he would have either used traditional navigation bronchoscopy, which may not have reached as far in the lungs, or perhaps refer her to get a CT-guided needle biopsy in which “a needle is inserted from the outside, between the ribs and into the lungs. This has a high rate of lung collapse and we didn’t want her to go through that.”

Also, before this technology, Pritchett says there was no minimally invasive and reliable way to find and biopsy small lesions that often represent early-stage lung cancer — a most frustrating ordeal for both patients and physicians.

“Imagine a doctor telling you that through a CT scan he found a 10-millimeter nodule that is likely early cancer, but he has no way to accurately test it right now, so you’ll have to wait another three months until it gets bigger,” says Pritchett. “That’s absolutely excruciating. But now we don’t have to wait.”

Immediately after Jane’s biopsy — as in right in the operating room with Jane — Pritchett diagnosed her nodule as lung cancer in a protocol called “rapid on-site pathologic examination.”

Armed with that information, he conducted a second procedure, an endobronchial ultrasound, to see if the cancer had spread to her lymph nodes.

“Both of these procedures were completed on the same day under the same anesthesia,” says Pritchett.

After the short procedure, Jane reported a mild sore throat and minor cough, but that was the extent of her discomfort.

Also, the same day, Andy and Jane were able to learn Jane’s initial diagnosis—Stage 1 lung cancer that had not spread to the lymph nodes.

“I was able to share our findings with Jane and Andy that same day and get started on her next steps,” says Pritchett.

Becoming a World Leader

A tremendous amount of talent and work comprise the events leading to Jane being named FirstHealth’s 100th patient to receive a robotic navigation bronchoscopy using the Ion robotic system.

The Ion robot is produced by a California-based company called Intuitive. When the Ion’s development was at the stage of testing on patients, Intuitive contacted Pritchett.

“Based on the work that we have previously done in the lung cancer space and at the recommendation of a friend, Dr. Tom Gildea, with the Cleveland Clinic, FirstHealth caught the eye of Intuitive and they asked us to conduct clinical trials here,” Pritchett says.

Applying to be a clinical trial site is no easy task. However, bringing the latest technology to patients in the Sandhills is a top priority for FirstHealth and the team worked together to make it happen quickly. “FirstHealth’s amazing clinical trials team was able to gain approval of the protocol and finalize contracting issues in record time,” says Pritchett, resulting in FirstHealth being the nation’s first clinical trial site for the Ion.

Additional clinical trial sites included Massachusetts General Hospital, Beth Israel Deaconess Medical Center, MD Anderson Cancer Center, the Mayo Clinic and Henry Ford Hospital. Dr. Pritchett completed the first procedure in the U.S. on March 29, 2019.

“The clinical trial was also important because it helped us determine if we wanted to purchase the Ion system for FirstHealth after the trial ended — and we did,” says Pritchett.

To date, FirstHealth is the only health care system in North Carolina offering this technology.

Because FirstHealth got a head start on using the Ion, Pritchett has completed more robotic navigation bronchoscopy procedures using this system than anyone else in the world. As a result, Intuitive selected FirstHealth as the world’s first Ion mentor site.

Since August 2019, Pritchett has trained more than 50 physicians from 15 hospital systems across the nation.

“It is such an honor to work with these talented physicians to expand the use of this technology,” he says. “I’m eager to see the positive outcomes we can achieve together for our patients.”

Next Steps for Jane and Others

Jane’s left upper lobe was removed on April 2 by cardiovascular and thoracic surgeon Peter Ellman, M.D., and she was back at home with Andy by April 5.

“A final pathology report proved her cancer was Stage 1, which suggests she has the best possible chance for a cure,” says Ellman. “The fact that Dr. Pritchett was able to reach and biopsy Jane’s nodule so it could be tested at such an early stage made all the difference.”

Pritchett says he and Ellman had many conversations about whether it was the right time to proceed with Jan’es surgery given the current pandemic.

“In the end, cancer doesn’t care about pandemics,” he says. “We at FirstHealth are dedicated to aggressively and safely treating our cancer patients, even in light of this pandemic. Additional safety precautions were taken for the patient as well as for staff. While elective procedures were placed on hold, we don’t consider treatment for an aggressive form of cancer to be elective; therefore, we decided the benefits outweighed the risks and chose to proceed.”

For the next 100 patients and beyond for whom Pritchett uses this technology, he says his goal is to have a fully integrated platform with Ion that works in harmony with additional advanced technologies owned by FirstHealth, including the daVinci robotic-assisted surgery system, also by Intuitive, and the Philips cone-beam CT system.

“Beyond the ability to scope and biopsy lung cancer with this device, in the near future we also expect to be able to treat lung cancer for patients who are not candidates for surgery,” Pritchett says.

FirstHealth is already at the front lines of such therapies, as one of his patients, Sanford resident Terri Cook, was the first American in a clinical trial in which a flexible probe is inserted through the mouth, routed directly to the cancerous lesion and “zapped” with microwave energy. Now more than a year after the procedure, Cook is doing well, and scans reveal no cancer.

FirstHealth’s early adoption of advanced technologies means that “residents of the Sandhills can stay right at home and receive the most advanced care possible,” says Pritchett. “In particular, with FirstHealth’s position at the forefront of lung cancer diagnosis worldwide, patients can receive more advanced care here than they could at a large, academic medical center.”

The Sandors agree.

“It’s scary for cancer to have it hit home, but I feel that I am in good hands here,” says Jane. “People say I should go to Duke or UNC-Chapel Hill, but I politely decline, saying we feel very confident in the doctors and capabilities here at FirstHealth. Yes, Duke and UNC have good doctors, but so do we.”

Cancer Care’s One-Stop Shop

From BusinessNC.com

FirstHealth of the Carolinas’ four-story, $60 million cancer center is set to break ground in early 2021 with an anticipated opening in November 2022. The new building, rendered above, will be a one-stop shop for cancer patients to get diagnoses, treatments and therapeutic support.

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.”


Clinical Trials Program at FirstHealth of the Carolinas Makes History

The clinical trials program at FirstHealth of the Carolinas is again making history, as the site enrolled the first patient into a worldwide trial testing the efficacy and safety of immune therapies designed to battle cervical cancer.

“We have crossed the frontier into treating patients with cancer with specific therapies designed to unleash an immune attack on malignant cells,” said FirstHealth gynecologic oncologist Michael Sundborg, M.D. “This is a pivotal time in cancer research and a seminal time for patients with cervical cancer.”

FirstHealth was chosen by The GOG Foundation, Inc. (GOG) and Agenus Inc. to participate as a center in a multi-national clinical trial. This is a randomized, blinded, non-comparative, two-arm Phase 2 clinical trial to assess the efficacy and safety of Agenus’ AGEN2034 (PD-1) administered alone or in combination with Agenus’ AGEN1884 (CTLA-4) for treatment of patients with advanced cervical cancer who relapsed or progressed after receiving first-line, platinum-based chemotherapy. Anti-PD-1 and Anti-CTLA-4 are immune therapies designed to enable the immune system to seek out and destroy cancer.

“One of the key benefits expected from the combination of anti-CTLA-4 and anti-PD-1 is the anticipated improvement in response rates and duration of response for patients,” Sundborg added.

Seventy sites are expected to participate globally with 50 of those in the United States, representing a total of approximately 200 participants. This is one of many clinical trials FirstHealth has participated in with GOG.

“When we see clinical trials with promise, we immediately determine which of our patients could be a match,” Sundborg said. “Our primary goal is the best possible outcome, and clinical trials offer a way to gain access to new, state-of-the-art treatments before they are widely available to the public.”

He added that because it is a randomized, blinded study, they do not know which test group the patient is in. Doctors do know the patient is receiving the proven standard for care, but do not know if the patient is receiving the additional drug.

The press release stated that throughout the two-year cancer treatment period, the patient will be monitored for potential side effects and response to therapy, using blood markers and imaging, such as CT scans. Those results will be shared with the clinical trial sponsors and aggregated with those of other trial participants as one step in many to help determine which treatment protocol is more effective.

The American Cancer Society estimates in 2019 that approximately 13,170 new cases of invasive cervical cancer will be diagnosed and 4,250 women will die from the disease nationwide. In North Carolina, that translates into 410 new diagnoses and 210 deaths.

“While our immediate goal is to find a cure for our own local patients, the collective results of this and all clinical trials will advance our knowledge and practice of medicine around the world. Women with cancer are the bravest soldiers I know,” Sundborg said, also a veteran.

The clinical trials program at FirstHealth started in the early 1990s with one doctor and one coordinator. Now numerous doctors oversee, and four coordinators manage, 25 to 30 active studies involving hundreds of patients. As many of the clinical trials at FirstHealth are related to cancer, the program is housed in the FirstHealth Outpatient Cancer Clinic in Pinehurst. However, FirstHealth is routinely approached by drug companies or research organizations to participate in studies involving medical conditions beyond cancer.

“FirstHealth offers a wide array of clinical trials that far exceeds the average for regional community medical centers,” said Charles S. Kuzma, M.D., institutional principal investigator of clinical trials at FirstHealth of the Carolinas. “Patients in the Sandhills oftentimes do not need to travel to larger institutions to participate in trials that could potentially help themselves and others with the same condition.”

The Anson Record

Dynamic Duo in Pinehurst Appreciates Opportunity to Participate in Clinical Trial

Ken & Betty Hill cancer clinical trial FirstHealth CarolinasPINEHURST– While FirstHealth of the Carolinas has earned widespread acclaim as a national leader in community health, Sandhills residents may not know of a superpower within the system that offers opportunities for patients in the region and worldwide: its extensive clinical trials program.

“FirstHealth offers a wide array of clinical trials that far exceeds the average for regional medical centers,” said Charles S. Kuzma, M.D., institutional principal investigator of clinical trials at FirstHealth of the Carolinas. “Patients who choose to participate in a research treatment opportunity at FirstHealth gain access to new, state-of-the-art treatments before they are widely available to the public. On a broader level, the advances in medicine we enjoy worldwide today are thanks in part to clinical trials as part of medical research.”

In January of 2012, removal of a melanoma from Ken Hill’s skin revealed an additional and different kind of cancer: chronic lymphocytic leukemia (CLL). “When the melanoma was removed, the leukemia cells were attracted to the incision like little Pac-Men,” said Hill, a retired salesperson with Union Carbide and father of three. “I’m lucky I had the melanoma so the CLL was found.”

Between then and 2015, Hill did not undergo treatment for CLL, a type of cancer of the blood and bone marrow, because everything was stable. However, a scan in 2015 discovered otherwise; his blood was 80 to 90 percent saturated with cancerous cells. To fight infection that could happen as a result of a weakened immune system brought on by the CLL, he started infusions of a blood product called intravenous immunoglobulin (IVIg) every 28 days.

His oncologist, Charles Kuzma, M.D., of the FirstHealth Outpatient Cancer Center in Pinehurst, told Hill and his wife Betty of a treatment clinical trial that he might want to consider adding to his IVIg infusions. The clinical trial’s purpose was to determine the efficacy of combining two drugs – a non-chemotherapy drug called ibrutinib taken orally each day and rituximab, a drug administered by infusion.

Ken and Betty determined this would be a good course of action and Ken started the trial. He took ibrutinib every day for a month. Then he added eight infusions of rituximab — one each week for four weeks and then one each month for four months. The rituximab was incorporated into his regular IVIg infusion regimen. Eight months after the last rituximab infusion, a bone marrow scan showed that cancer cell saturation in his blood had reduced to 40 to 50 percent. Now 27 months later his saturation level is 20 to 30 percent. He continues his daily dose of ibrutinib and infusions of IVIg every 28 days, and he will maintain this regimen until his condition changes or the end of the clinical trial in 2025.

“We don’t know the results of the clinical trial, but something is working for him,” says Betty, 80, of her 81-year-old husband.

“We feel blessed that this clinical trial was available in Pinehurst and that Ken was chosen for it,” said Betty, a dynamic partner in Ken’s health. The sponsor of the trial, Alliance for Clinical Trials in Oncology, funded the cost of the ibrutinib.

“When Dr. Kuzma recommended this clinical trial, Betty and I read all the research and I knew it would be good for me,” said Ken. “We’re now advocates for others to participate in a trial.” He and Betty are training to serve on FirstHealth Cancer Services’ Cancer Advocacy Advisory Board, a peer support group sponsored by the Southeast Clinical Oncology Research Consortium.

“We want to be an encouragement for others,” said Betty.


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 the patient’s physician.