KAILUA-KONA — Community health providers mingled with cancer patients and survivors as well as the caregiving community Friday at Journey Together: Helping to Shape Cancer Survivorship Care in Hawaii — a Comprehensive Cancer Coalition initiative held at the Courtyard Marriott’s
KAILUA-KONA — Community health providers mingled with cancer patients and survivors as well as the caregiving community Friday at Journey Together: Helping to Shape Cancer Survivorship Care in Hawaii — a Comprehensive Cancer Coalition initiative held at the Courtyard Marriott’s King Kamehameha’s Kona Beach Hotel.
Mayor-elect Harry Kim delivered the opening address and Dr. Nathan Tomita, a Kailua-Kona surgeon connected to Kona Community Hospital (KCH), served as the keynote speaker.
The primary goal was to identify what Hawaii Island services are working well for cancer patients and survivors, and more importantly, what could be done to improve care across the county.
“As far as standard, uncomplicated cancers, we can handle all of those here,” said Judy Donovan, regional director of marketing at Kona Community Hospital. “If it gets complicated … we collaborate to move patients on to somewhere a little more advanced. We are very confident, comfortable and successful with (less) complicated cancers, start to finish.”
KCH is equipped with a full medical oncology clinic and also offers hematological services as well as radiation oncology.
North Hawaii Community Hospital (NHCH) has had a full-time hematologist-oncologist on staff for more than a year, who is assisted periodically by Advanced Practice Registered Nurses from The Queen’s Medical Center. The hospital also offers genetics counseling once per month.
Work needs to be done
In stark contrast to the needs of those suffering from cancer that Hawaii Island can service are the needs it can’t, as well as services it could improve.
Erin O’Carroll Bantum, PhD — who serves as an associate professor at the University of Hawaii Cancer Center and is a member of the Hawaii Comprehensive Cancer Control Coalition’s quality of life work group — said having access to all the quality care available on Oahu is at the top of that list.
“A lot of times, a certain size population justifies having certain treatment or machines, because a (certain) number of people need to use them to make them cost appropriate,” she said.
Based on information provided at the coalition meeting Friday, O’Carroll Bantum said specific examples of technology Hawaii Island lacks is that of 3D mammography, used in breast cancer screenings, and proton beam therapy for prostate cancer treatment.
She added one way to work around the lack of such medical access is to partner with nonprofits for funding to fly people to Oahu for treatment, as the volume of cancer patients on the Big Island may never necessitate the technology arriving here.
Another general problem O’Carroll Bantum mentioned is the identification of resources.
“People will end up hearing about (programs) that will be helpful, but it’s after they’ve happened,” she explained. “So it seems there is a fragmentation in terms of spreading the word about what does exist.”
Finances for such programs are also a concern, she said.
An issue more specific to Hawaii Island is transportation to and from treatments due to the rural quality of much of the island.
Donovan said KCH is currently working on a partnership with nonprofit Hui Malama Ola Na Oiwi to try and find transportation for cancer patients struggling with such needs.
The meeting also focused on the importance of bringing clinical trials to the island, something Heidi Roxburgh-Edstrom, a manager at NHCH, said is crucial.
“I think as we work toward our Coalition of Cancer certification, clinical trials is an area that is a must, is a need, if you’re going to go for that designation,” she said.
She added island health care centers are also working toward strengthening survivorship programs, which provide a guide for cancer survivors about daily living and continual follow up.
Finally, Donovan said there was significant conversation Friday about improving on-island education programs to help train and keep doctors on Hawaii Island. Tuition reimbursement was one solution discussed, provided those who apply remain in Hawaii for at least a few years to improve local medical care in the immediate.
Looking ahead
Richard Creagan, a non-practicing physician and State Representative for the Big Island’s 5th District, said the best way to address the county’s medical needs is to push for a University of Hawaii teaching hospital in Kona.
“I’ve been here 25 years, and the medical care has improved very little,” he said. “(KCH) is past its sell-by date, basically. There’s no room to expand, it’s hard to keep doctors there and it’s hard to bring good people in.”
The idea has been floated in Oahu, and $500,000 has been approved for a feasibility study to examine the proposal.
Creagan posited that not only would such a hospital bring more advanced technology as well as incentive for homegrown doctors to train and remain in Hawaii, specifically on Hawaii Island, but it would open up a world of new, better medical possibilities for local patients.
Furthermore, it would help alleviate what Donovan said was the primary complaint of doctors who treat cancer on Hawaii Island.
“Every step of the way, doctors feel there are delays because of our system, and they were unanimous on that,” she said, adding that streamlining the process is crucial to providing better patient results.
Among new opportunities a university hospital might provide is telemedicine, the remote treatment of patients electronically. Included in the practice are procedures such as remote robotic surgery, where a doctor operates on a patient without being physically present.
Creagan said one possibility to provide doctors for such treatment options would be to license the whole of the Mayo Clinic to practice in Hawaii.
He added that making the vision of a university hospital in Kona a reality will require substantial private donations from wealthy full-time and part-time residents, something he’s currently exploring.
In all, the consensus was that there’s much progress to be made treating cancer patients and survivors on Hawaii Island. Donovan said meetings like the one held Friday are the first step, connecting stakeholders from across the health care spectrum with information and ideas.
“We can do more,” she said.
