Long Island Cancer Center to Partner With Community

STONY BROOK, NY—The 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, California.

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 protein structure).

Community Collaboration

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 causation.

"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 cancer.

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 national level.

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," he said.

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 director.