When her oncologist found a “questionable spot,” Lorene Freuer had already survived cancer once — just six months before. “The biopsy came back positive for pancreatic cancer,” she recalls. “Once again, I was devastated and even more frightened.”
Fear is a sensible response to pancreatic cancer. While it’s relatively rare (it accounts for just 3 percent of all cancer diagnoses), it’s extremely lethal, leading to 7 percent of all cancer deaths in this country. Luckily for Freuer, she was referred to Dr. Richard Bold, physician-in-chief at the UC Davis Comprehensive Cancer Center.
“The oncologist who treated her knew that her care was going to be best delivered at UC Davis because of our high volume status,” Dr. Bold says. “She is doing wonderfully well, her cancer was removed completely. I’d say right now things look good.”
The power of five
Because pancreatic cancer is so rare, most oncologists lack expertise in treating it. “The oncologist may be treating lung cancer, prostate cancer, pancreatic cancer, colon cancer, and breast cancer,” notes Dr. Bold. “It is so hard to be an expert in 10 different cancers.”
But California has some unique advantages in this fight. Of just 71 comprehensive cancer centers designated by the National Cancer Institute (NCI) in the United States, California has five — and these see more pancreatic patients than most facilities. In 2017, for example, they treated about 14 percent of all pancreatic cancer patients in the state.
The potential in combining these resources became clear. “About two years ago, the office of the president of the University of California looked around and said, you know, we have significant strengths in each of the cancer centers, for research, for clinical care, for outreach, for education, and prevention,” Dr. Bold recalls. “So they created the University of California Cancer Consortium. And the thought behind this was as was a very simple phrase: ‛the power of five.’”
The five cancer centers began meeting to discuss how they can share resources. Because the centers see such a high volume of pancreatic cancers, it made sense for one of its first formal groups to focus on it.
“We began sharing genetic and genomic information,” Dr. Bold says. “About 20 percent of pancreatic cancer has an underlying genetic event. Most of the studies to date have not taken a deeper dive into the ethnic, socioeconomic, and genetic differences involved in pancreatic cancer. But California is an extremely diverse state, so California can do that, allowing us to expand on the database and begin to answer questions.”
Another arena where the consortium is having an impact is with clinical trials. Typically, pancreatic cancer is a challenging disease to conduct trials on because of its rarity. But the volume of patients in California, enhanced by the partnership between the cancer centers, changed the metrics. UC Davis is also exploring allowing patients to integrate into a clinical trials network that would allow them to access any trial being conducted at any of the consortium’s sites.
Ultimately, the combined resources of the University of California Cancer Consortium will benefit those who need help most: the patients. “Outcomes are better from the surgical standpoint, and probably the medical and radiation standpoint, when those doctors are treating patients with rare diseases frequently,” notes Dr. Bold. “Those better patient outcomes mean patients are more likely to receive the chemotherapy that they need, patients are more likely to live longer.”
For her part, Freuer agrees. “I am profoundly happy with the results of my surgery,” she says. “Dr. Bold gave me my life back!”