STONY BROOK, NYThe new Long Island Cancer Center at
Stony Brook University is welcoming the community into a partnership in cancer
research, John S. Kovach, MD, founding director of the Center, told ONI
in an interview.
Dr. Kovach joined the Center in September 2000, bringing to it
his lengthy experience in guiding comprehensive cancer centers. He served as
director of the Mayo Comprehensive Cancer Center for 8 years and then for 6
years as executive vice president for medical and scientific affairs at City of
Hope National Medical Center and Beckman Research Institute, Los Angeles, and
as director of the City of Hope Comprehensive Cancer Center, Duarte,
Several factors prompted the founding of the Center, Dr. Kovach
said. One impetus was the long-standing concern about the presence and cause of
breast cancer "hot spots" on Long Island, he said. Long Island, like
other areas of the Northeast, has elevated breast cancer rates. The average
annual age-adjusted breast cancer incidence rate for Nassau County for 1992 to
1996 was 117.8 per 100,000 females, and for Suffolk County, it was 113.6 per
100,000. By comparison, the breast cancer incidence rate for New York State as
a whole during that time period was 101.6 per 100,000 and for the country as a
whole (SEER areas), 110.6 per 100,000.
Another impetus for establishment of the Center, Dr. Kovach
said, was the recognition that Stony Brook University now has the components
needed to be a comprehensive cancer center.
These components include excellence in multiple aspects of
science that will be needed for future biomedical research, expertise in
patient care, an outstanding epidemiology group, and key associations with Cold
Spring Harbor Laboratory (distinguished for its genome research) and Brookhaven
National Laboratory (distinguished for its imaging capabilities and work in
Collaboration between the Center and the Long Island community
will be essential, Dr. Kovach emphasized. The Center will be calling on the
community, including those who do not have cancer, to assist in the compilation
of a population database, he explained.
"We are going to ask people to share their medical
histories with us and their family histories and also, let’s say, a sample of
blood," Dr. Kovach said. "Everything will be kept confidential in
separate data files, but it’s going to be a real partnership between the
public and the scientific centers." The community, in turn, will look to
the Center to provide answers to questions on many topics such as individual
cancer risk and recommended screening, he said.
To ensure a successful collaboration, Dr. Kovach plans to
assemble and consult a lay advisory board. "Usually, researchers get
caught up in the wonderful excitement of the science and lose track of the
practical aspects and the demands they are making both on the patient and the
community," he explained.
The Center currently has a matrix organization, Dr. Kovach
said. But a planned addition that will be completed in approximately 2 years
will bring multiple clinical disciplines under one roof, enabling better
coordination of care and greater ease of use for patients.
The community has been enthusiastic about the new center, Dr.
Kovach commented. "There is a very concerned and active public on Long
Island interested in the problem of cancer and public health in general,"
he said. "The response has been, ‘Welcome, it’s about time. We would
love to have a center here.’"
Molecular Genetic Epidemiology
Much of the work at the Center will be in the field that Dr.
Kovach refers to as molecular genetic epidemiology, the relating of normally
occurring genetic variations to the risk of disease.
"We now have the opportunity in medicine to be able to
understand a number of things: the molecular and biochemical basis of disease,
how genetic variability in each of us increases or decreases our risk of those
diseases, and how our genetic inheritance affects the likelihood that we will
be affected by things in our environment and determines the effectiveness of
many therapies," he said.
Dr. Kovach anticipates that the national and international
sharing of this information will lead to a better understanding of cancer
"The single biggest confounder in epidemiologic research
is probably eth-nicity," Dr. Kovach said. "We want to develop a
detailed database here on Long Island and then become collaborators with others
with specialized populations whose incidence of disease may be much lower or
much higher, to see if we can then make sense of what genes are likely to be
important in disease occurrence."
Breast cancer and prostate cancer, which now account for almost
one third of all cancers in women and men, respectively, will be key areas of
research and patient care at the Center, Dr. Kovach said. However, the Center
will also study the pathogenesis of less common cancers for which treatments
have had a limited effect on survival, including pancreatic cancer and brain
Funding for the Center comes from several sources, Dr. Kovach
said. Research at Stony Brook University is currently funded with about $10
million a year from the National Cancer Institute and about $40 million from
the National Institutes of Health, ranking the institution fairly high on the
The University has specifically dedicated funds to getting the
Center started. "The institution has already committed about $20 million
over the next 5 years to bring this Center about," he said.
Additional financial support from donors and the state would
also be welcome. "We would like to encourage the New York State
legislature to consider annual support of this kind of effort, given the size
of the population on Long Island, the magnitude of the cancer problem, and the
almost unprecedented opportunity to develop a center here at Stony Brook,"
A long-term goal will be to establish the Center as a National
Cancer Institute (NCI)-designated comprehensive cancer center, Dr. Kovach said.
"The expectation is that we will certainly achieve that designation within
4 or 5 years," he said. The process will likely begin with the submission
of a planning grant to the NCI in February 2002.
Formalization of the Center will entail an integration and
focusing of existing programs and a modest addition of up to 30 staff members
over several years, Dr. Kovach said.
"We are developing predominantly a human genetics and
molecular genetics group. I am looking to recruit individuals in that area,
from a fundamental level all the way up through those who are engaged in
genetic counseling," he commented.
He said that the Center is also actively recruiting a deputy