Talk to oncologist Dr. John F. Deeken, acting CEO of the Inova Schar Cancer Institute, and you’ll feel revitalized by his energy and hope in the fight against cancer here in Northern Virginia. In recent interviews with Northern Virginia Magazine, Deeken laid out Inova’s vision for the new Schar Cancer Institute—set to open in April in Fairfax after two years of construction.
“It’s a large, beautiful new cancer center for clinical care and treatment and diagnostic testing and radiology and chemotherapy,” he says. Though at press time an exact opening date in April had not been announced, over 300 employees will work at the 336,815-square-foot building located at 8081 Innovation Park Drive, the site of the former Exxon Mobil campus, and will include 54 chairs, 124 exam rooms in the clinics, kiosks and tablets for check-ins, new radiation technology, ninth-floor infusion rooms with views of pastoral Virginia on one side and DC on the other, genetic counseling and a Life with Cancer program for psychosocial support.
None of the oncology units at Inova’s other hospitals—and a radiation oncology venture with Sentara in Woodbridge—will be shut down. Patients will still be able to get treatment there if they prefer.
For the Northern Virginia region, Schar means cutting-edge treatments are available in their backyard. “You don’t have to go to Houston or New York or Baltimore,” says Deeken.
A Comprehensive Approach to Cancer Treatment
Newly diagnosed patients will see their team of specialists at the same meeting to form a consistent treatment plan.
Inova’s plans are to see patients in a multidisciplinary way. Medical oncologists, surgeons, radiation oncologists and others will coordinate together at the Schar Cancer Institute. “Currently at Fairfax Hospital, our largest hospital, care is providedat different locations: medical oncologists are at one clinic, surgeons are 4 miles down the road the other way; hematologists and genetic counselors are at a different location,” says Deeken.
Such scattered services prove frustrating to patients. “If a patient is newly diagnosed in places around the country, you’re told to make an appointment with this doctor and that doctor, go here and there. But what we’re setting up here is when one patient is newly diagnosed, they will see all the specialists at the same meeting. Their case will be reviewed by those doctors at the same time, and the care plan—the recommendations for the best treatment—will be given to that patient at that time,” explains Deeken. “The plan is put together for them in one day; that’s the model we’re pushing for. That way, they’re not stuck figuring this out on their own. Navigators will help them coordinate.”
Diagnosis is stressful enough, but then, he says, a patient discovers, “‘I’ve got to make all these appointments and find the different locations and try to fit it in and wonder if the doctors are talking to each other?’ Here it’s fundamentally different … they go home with their plan and care coordinated by the staff, that’s the operation we’ll have in place here.”
Deeken calls the concept a “game-changer”—not only more convenient for the patient, but by being seen by experts, outcomes and survival rates are higher because patient treatment is better, he says.
The new institute is just one part of Inova’s Center for Personalized Health. “We’re finding out cancer is not one disease; it’s probably 100 different diseases. And each patient is different, their other medical problems are different, their tumors are different, their tumor genetics are different, so we want to make sure each patient is treated with a personal plan that’s meant for them and their specific type of cancer.
We want to ensure personalized care is what they’re being treated with,” says Deeken.
A Focus on Clinical Research
Schar is working to grow NoVA’s participation in clinical trials—and bring world-class cancer researchers to the region.
Inova, and specifically Schar, is focused on clinical trials, giving patients access to cutting-edge treatments and research, says Deeken. In the past five years, Deeken, who was recruited from Georgetown Lombardi Comprehensive Cancer Center and trained at the National Cancer Institute in Rockville, Maryland, says they’ve recruited investigators from University of Chicago and Roswell Park Comprehensive Cancer Centers as well, to have clinical and translational research as part of patient care.
“When I first got here, we had a handful of studies and didn’t enroll many patients, and now we have over 46 open clinical studies in cancer care, enrolling over 400 patients a year, and that’s something we expect to grow dramatically in the years ahead. All those exciting new treatments you read in the paper, we’re able to offer here.” He cites the recent FDA approval of a breakthrough cancer drug, larotrectinib, based on a mutation in an individual’s cancer. “We participated in that study, which led to that drug being approved; it’s something we wouldn’t have done five, 10 years ago. … We have disease experts helping lead our programs here and bring those innovative treatments here, so patients don’t have to go far.”
It’s Personal
Inova’s focus on personalized medicine spells hope through molecular and immunotherapy drugs.
Deeken says two exciting areas of treatment, genomics-based molecular targeting drugs and immunotherapy drugs, are “front and center” in Inova’s research and clinic, “revolutionizing” cancer treatment.
In molecular advances, the medical community is diagnosing cancers based on genetic makeup of a patient’s tumor, and finding the right drug for them, he says. “So we don’t treat lung cancer as just lung cancer, but we’re figuring out from a genomics level what’s driving these patients’ individual tumors, matching their tumor to the right drug … as regular care for some cancers, clinical trials for many cancers and also from Inova that we have the capability to do this from a testing standpoint.”
Immunotherapy, using a patient’s immune system to target their cancer, is hopeful; the Nobel Prize was given for medicine in 2018 to the researchers who launched the field. He says they’ve seen dramatic results in cancer shrinking in diseases like melanoma, gastrointestinal and head and neck cancers, his specialty. He points to 94-year-old former President Jimmy Carter, diagnosed with metastatic melanoma, whose tumors were eradicated after immunotherapy. A decade ago, the success rates for treating stage 4 melanoma were nearly nonexistent.
New Technology Combined with Research Collaborations
A slate of new technologies and university-backed partnerships offer additional avenues for treatment.
Inova is using new technologies in the Institute, like Vectra 360, a 3D whole body imaging of skin, and TrueBeam radiation, which is designed for complex cases of lung, breast, stomach and brain cancers, as well as on the liver and prostate, to treat cancer with speed and accuracy while avoiding healthy tissues and organs. Proton therapy radiation is slated there for the end of 2019.
In 2020, Inova will open a laboratory building there, called the Global Genomics and Bioinfomatics Research Institute—an effort between the commonwealth and the University of Virginia and George Mason University to do translational research to make discoveries, improve treatments, find new therapies and understand cancer better. “You see this at top-notch universities but you don’t often think of community hospital systems. That’s part of our vision here.”
Deeken hopes it serves as a genesis to spur economic development, recruit small companies and help create a robust biotech corridor. “The vision of what we’re building here, biotech and university collaborations with state support, are a really innovative, interesting thing you’ll be seeing in the years ahead, starting in 2020 and the decades after. … Our hope is for great synergy, research collaborations at the water cooler about discoveries both are making and how we can help George Mason spin out other opportunities.”
Helping Patients Live Longer
Advancements at every stage give new hope.
Deeken says advancements in prevention, screening, early detection, genetics and new therapies give “incredible reasons for being hopeful and optimistic.” Yet despite being the acting CEO for Schar, he doesn’t lose sight of the oncologist-patient relationship; his passion for helping patients fight the good fight is evident. “Treating cancer is special, intense, intimate treatment, a matter of life or death. We put patients through serious things, but we are with them every step of the way, to help them live longer with better quality of life, to help them live better. It’s an incredible privilege to have close and supportive relationships with patients, incredibly rewarding. I’m not immune to cancer winning, but my hope is to treat patients with the best science and the best heart. If we cure them and wish them well, it’s an incredibly meaningful calling.”
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