We had a very encouraging External Advisory Committee meeting on Wednesday, and came away with many useful suggestions as we gear up for our CCSG Site Visit on September 12. Another group of external advisors will hear our revised presentations on September 1.
Many of us see the cancer center as a home for cancer research. It is. Others view it as a home for cancer patient care. Of course, that is true as well. However, I have been and remain convinced that Georgetown Lombardi’s efforts in Community Outreach and Engagement define the range around which our final score will be determined. Moreover, I believe that this is as it should be.
Like the larger society, the impacts of cancer centers are defined by their towering achievements. Their many laudable activities such as outstanding research, cancer research training and excellent patient care make our region and our world better. But, in a very real way, we are all stitched together and, like any piece of cloth, our community is only as strong as its most vulnerable threads. In our catchment area, our impact is ultimately determined by how well we address the cancer needs of our medically underserved neighbors. That is where Community Outreach and Engagement comes in, and we have a great story to tell.
We are so fortunate to have a team, led by Lucile Adams-Campbell, that has been at the forefront of this work, long before COE became a CCSG evaluation component. But until recently, I never considered just how impactful COE has been, and in fact how we at Georgetown Lombardi have contributed to an historic improvement in cancer mortality in the District of Columbia. Lucile and Chiranjeev Dash are no doubt going to fret about the numbers I am providing you, but they tell an important story, even if the narrative might be a bit more nuanced and complex.
This fact is true: cancer mortality rates in D.C. have declined by 61% since 2003, dropping from nearly 300 per 100,000 people to about 140 per 100,000 in 2023. In 2008, when I started at Georgetown, the rate had declined to about 200 per 100,000 (source). This is not just a function of demographic changes, as the most prominent improvements have been in Black males. We cannot and should not claim that we are solely responsible for this drop, but there can be no question that we have contributed our fair share. To begin with, the combined tumor registries of MedStar Georgetown University Hospital and MedStar Washington Hospital Center, our two clinical sites in D.C., contain about 4,700 new analytic cases (cancer surgery specimens) yearly; they are by far the largest hospitals in the District. So, we care for the largest number of cancer patients, we have provided better care over time, and this has contributed to reduced mortality.
Of course, it’s not that simple. Exciting and highly effective new treatments, such as immune checkpoint blocking antibodies, signaling inhibitors and CAR-T cell therapy, have favorably altered the therapeutic landscape, driven by transformative research here and elsewhere. Regrettably, many of these advances have been slow to trickle down to benefit our less-advantaged neighbors, who have more comorbidities, more severe financial challenges, and other social determinants of health that limit their access to life-saving care.
That is where Georgetown Lombardi’s COE comes in and makes its impact. With its focus on underserved minorities, COE has implemented screening and facilitated navigation for underserved people to obtain early detection and care for breast cancer and lung cancer, with expanding capacities for prostate and colorectal cancer screening, thanks in part to our new Ralph Lauren Center for Cancer Prevention. COE events have touched the lives of 34,000 — yes, you read that right — 34,000 people over the past five years, despite the COVID-19 pandemic. COE listens to our community, and shares our work with them, sharpening our work and building trust in the process. COE helps our scientists and clinical investigators understand both the perceived needs of our community and the cancer types that disproportionately affect our catchment area.
COE makes our clinical trial enterprise accountable to the needs of our community. For example, Blacks account for 34% of cancers in our catchment area, and for 39% of our accruals to therapeutic clinical trials. This has improved significantly over the past five years. COE co-leads Georgetown Lombardi’s Minority/Underserved National Cancer Institute Community Oncology Research Program (NCORP), which has enrolled hundreds of people onto clinical trials over the past few years. COE addresses social determinants of health as they relate to cancer by supporting the CancerLAW project of Georgetown’s Health Justice Alliance, which has embedded Georgetown Law Center attorneys in the oncology clinics at MedStar Washington Hospital Center, providing legal services to 220 Georgetown Lombardi patients/clients since March 2020, so they can more effectively navigate their cancer patient journeys. Interestingly, 14% of these people have participated in Georgetown Lombardi interventional clinical trials, suggesting that trusting relationships break down barriers to clinical trial participation. That is a big deal.
All of this represents important progress, and we have good reason to be proud, though much remains to be done. We have contributed our fair share of towering achievements, and certainly have contributed through our science and clinical care. I thank Lucile, Dash, their colleagues in D.C. and New Jersey for doing the work that tends to the neglected threads in the fabric of our community, strengthening everyone in the process.
By the way, as you know, there is an upward tick of COVID, so please take sensible and appropriate precautions.
Stay safe and be well.
Lou
The views, thoughts, and opinions expressed in the text belong solely to the author, and not necessarily to the author’s employer, organization, committee or other group or individual.