Kyle Magin
Sierra Sun

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December 29, 2008
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Cancer treatment: Tahoe Forest Hospital System partners with University of California

To a cancer patient, the time it takes to cover the 114 miles between Truckee and Davis, Calif., means many different things.

It means leaving family for treatments, snaking your way down the Sierra Nevada, weaving in and out of Placer and Nevada Counties as towns like Colfax and Auburn pass by the window.

One hundred fourteen miles means negotiating through the vast, concrete interchanges of Sacramento on Interstate 80's cramped lanes, all the while wondering how you're going to pay for the chemotherapy and send your child to college and for an apartment in the city while you receive your treatments.

It means 114 miles worth of time wondering if the tumor inside you, and the lymph nodes it has infected, will take your life.

It's a long road. Or at least, it was.

Thanks to a partnership between the University of California, Davis, and the Tahoe Forest Hospital System announced in October, cancer patients in the Tahoe/Truckee area won't have to cover the 114 miles to Davis, Calif., for treatments and second opinions. They won't need to go to Sacramento or San Francisco. Cancer patients in this rural part of California and Nevada can now receive top-of-the-line care just a few miles from their home in Truckee.

"We've got a partner in UC Davis that is the best you could ever ask for," said Dr. Larry Heifetz, the Medical Director at the Tahoe Forest Hospital System's Cancer Center.

Davis, a National Cancer Institute-rated hospital system " one of only 60-plus in the country " is a name in cancer treatment and research, said Heifetz.

Once a week, each Wednesday, Heifetz and a team of specialists, from radiologists to pathologists to nurses, sit in a darkened room at the Tahoe Forest Medical Services building. Doctors from across the Davis network, across California, watch while Heifetz loads slides of his cancer patient's particular ailments and offer their opinions on the best way to treat it. The exchange between Heifetz and the doctors is called a virtual tumor board, an improvement on the concept of tumor boards, created in the 1950s. Technology now allows doctors to review cases without leaving their practice, saving time and valuable resources.

"It's a way for us to facilitate the day to day conversation about a patient's treatment," Heifetz said. "If I have a complicated case I know I can present it within a week to a group of experts and talk face-to-face about the best way to treat a patient."

Specialists in breast, prostate and a wide number of other cancers can offer their input on treatment plans from 114 miles away at Davis, 190 miles away in San Francisco or points further, something that wasn't available previously.

"Technology has enabled us to do that; it's more effective than sending a patient away for a second opinion when we can get it instantly," Heifetz said.

The National Cancer Institute designation for Davis is elite, said Pat Keast, Regional Outreach and Community Network Coordinator at UC Davis.

"There is a very rigorous review process to earn an NCI designation," Keast said.

Only three hospitals is Northern California" Davis, the University of California, San Francisco and Stanford University " have the National Cancer Institute designation, while none in Nevada have it.

Bringing better cancer care to rural communities " roughly defined as more than 30 miles outside a metropolitan area " stands at the heart of the partnership.

"We want to advance cancer care throughout the region," Keast said. "So our patients can stay in their communities."

The point isn't lost on Robert Frolich, a 53 year-old Tahoe City man who knows the importance of staying in his community for treatment. Frolich, who suffers from cancer of the appendix, said the stress factors cancer patients have" emotional, physical and concerns about how they'll pay the hundreds of thousands of dollars for care" would make a commute down the hill unbearable.

"There are enough stress factors involved with cancer without having to worry about fighting a snowstorm over (Donner) Pass to get your treatments," Frolich said.

The Davis-Tahoe Forest partnership is one of four Davis initiated in October in Northern California, including Fremont-Rideout in Marysville, Valley Care Health in Alameda County and Mercy Hospital in Merced.

Another facet of the partnership which may yield even greater results involves the ability for Heifetz to treat patients with experimental cures. Previously patients would have needed to travel to Reno, possibly as far as the Bay Area, to receive experimental drugs and treatments doctors call clinical trials.

"The only way to get access to investigational agents is through the clinical trial situation," Heifetz said. Clinical trials require a team of doctors and specialists to have their eyes on a patient. "Every 'I' must be dotted, every 'T' crossed," Heifetz said.

But, with the partnership, that group of researchers and specialists can treat a patient hundreds of miles away as if they were in the same room.

The partnership also allows those researchers to connect with front-line doctors like Heifetz.

"It let's the Ivory tower guys, the academics, to learn from the guys on the front-lines, and allows us to learn from them," Heifetz said.

That connection appeals to at least one person connected with both Davis and Tahoe Forest " Tom Hobday.

A former assistant dean of the Davis medical school and current senior advisor to the Tahoe Forest Health System, Hobday credits Heifetz's enthusiasm with establishing the partnership.

"Dr. Heifetz really put it together from the first day he was here( in 2006)," Hobday said. "He had extensive meetings with Dr. (Ralph) De Vere White, (head of the Davis Cancer Center) and helped to get this off the ground with his background and enthusiasm."

Two factors drove the need for the partnership, Hobday said.

"The National Health Institute was concerned that cancer funding was going into major medical centers and not rural areas," Hobday said. "And, rural residents couldn't participate in clinics."

Connecting the expertise of big-city hospitals with rural community practices was a big deal, Hobday said, as is developing models to provide top-flight cancer care to rural areas.

"I wouldn't be surprised to see more people staying here than getting out of dodge to get their treatments," Hobday said.

The model is attracting attention, Keast said. Davis has received inquiries on the program's mechanics and ways to join it from a number of hospitals in California and nationally. Davis plans to add more hospitals to the network in future years, Keast said.

The partnership will also bring medical students, at least two third-year medical students by July, Keast said, to the Tahoe Forest Hospital System. Heifetz said having medical students at the hospital is a positive step because doctors must become teachers and stay very current on medical advances.


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Tahoe Daily Tribune Updated Dec 29, 2008 07:47PM Published Dec 29, 2008 07:22PM Copyright 2008 Tahoe Daily Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.