Last fall, City of Hope® opened the Cherng Family Center for Integrative Oncology, a first-of-its-kind national program bringing the best of eastern and western medicine to cancer treatment. The Cherng Family Center was launched thanks to a transformative gift from Andrew and Peggy Cherng.
We spoke with Richard Lee, M.D., the Cherng Family Director’s Chair at the Cherng Family Center for Integrative Oncology about the incredible progress being made at the Center in the one year since its launch. This conversation has been condensed and edited.
An Incredible First Year
Can you talk about what you and your team have been doing over the past year to build out the Cherng Center and grow the team?
We’ve been hard at work really laying the groundwork, trying to be thoughtful and deliberate about how we create the foundation and infrastructure, from leadership and how that leadership looks. We’ve been setting up our internal advisory board, external advisory board and then really setting up our administrative core.
Clinical services. We’ve been piloting a lot of things here in Orange County. We have hired an acupuncturist, a massage therapist, we have a mind-body specialist; he’s a chaplain by training but specializes in teaching meditation and guided imagery and hypnosis and these techniques. We just hired our first full-time music therapist and we also have a nurse practitioner. Our second physician, Dr. Krisstina Gowan, started October 1.
Most of these clinical positions are the first ones ever in the entire history of City of Hope. We envision every year we will be continuing to expand our services.
Research. We have opened clinical trials on meditation here in Orange County for cancer survivors. We opened an aroma therapy clinical trial. I also have two National Institutes of Health grants; one is on cannabis for the treatment of chemotherapy-induced nerve damage. We also have another grant looking at the benefits and harms of cannabis during treatment for multiple myeloma.
Education. We held the Society for Integrative Oncology conference Oct 25 to 27. City of Hope hosted that, I was the chair of that meeting. We had probably 500+ visitors from around the world. Now that Dr. Gowan is here, I think one of our priorities will be setting up the fellowship. I think we will have both a clinical fellowship and probably a research fellowship.
What’s been the response from patients so far?
We can’t grow the services fast enough. Patients are clamoring for it. There’s growing wait times. I put that on my wall just to remind myself that we’ve got to keep things moving forward, and patients are waiting for these services.
Patients go to these alternative clinics in Tijuana or down the street in Irvine (they’re everywhere), and they’re getting bad advice, to be frank. Patients want to use these things, and they don’t know where to go to get good advice and advice that’s based on good science and evidence. Patients tell me “This is much more evidence-based, and it’s in line with what I want for my treatment.”
Moving Quickly, Guided by Scientific Rigor
Can you talk more about your research program and where you hope to grow it?
Research is really important. The vision of the center is to change the standard of care, incorporating holistic practices like those from eastern medicine together with modern western medicine, in a scientifically rigorous way.
There are three major buckets.
Natural plants as a source of drug discovery for treatment of cancer. We want to look at Chinese herbs and see if there might be another Taxol. Given the resources here, with Translational Genomics Research Institute and the Beckman Research Institute, and all the great basic scientists here, I think there’s a real possibility we can be identifying the next great therapy derived from plants.
Interventional trials. For example, we know things like meditation help patients, but we actually don’t know the most efficient way to deliver meditation. Mindfulness-based stress reduction (MBSR) has been studied, it has a high level of evidence. But it takes eight weeks and 30 hours to learn. What cancer patient undergoing treatment has 30 hours to spare in an eight-week time frame? Can we deconstruct the therapy and then optimize it in a way that is more efficient and more effective?
Health services research. We do a lot of survey work. For every service line we want to build out a data infrastructure where we are collecting data on every patient who receives acupuncture or every patient who gets meditation or massage. In two to four years down the line, I am going to have 10,000 patients within the database and so we can query the database and figure out, OK, this is where acupuncture is most helpful for this type of pain, for this type of patient. Nobody is really doing that kind of work.
Can you talk about the value and partnership of philanthropy as you’ve experienced it?
Without this gift of the Cherngs, it would take us 10+ years to get even close to the level of the program at another top-ranked cancer center. Now we’ll be able to do that in two to three years. In terms of how quickly we can get these services up and running, do the research and move the field forward, it’s not only transformative for City of Hope, but it’s very transformative for the field of integrative oncology. We’re really poised to be the premier integrative oncology program in the nation, if not in the world.
Not Like Any Other Program
What are the top things you want us to know about the Cherng Family Center?
1. We are implementing a comprehensive program that is part of the ethos of City of Hope. A lot of programs have an integrative program, but it’s very separate, and it’s in a different building down the street. It’s not really interwoven into the care they provide. We’re doing things very differently. It is going to be interwoven together with supportive care medicine from palliative care to chaplaincy to social work. This is not like any other cancer program.
2. We are going to be doing leading-edge translational research that gets down to understanding the mechanism and optimizing the delivery. Right now, the Society for Integrative Oncology and ASCO have been publishing practice guidelines for the first time for integrative therapies. They will be updated, say, in five years and when they get updated, I want our research to be cited in the guidelines. We want clinical trials at City of Hope to inform others about the standard of care and why insurance companies may be covering these therapies.
3. We are going to be educating the next generation of integrative oncologists. Nobody is focused on this. We are going to be doing that work here. We want our graduates from our fellowships to be starting and leading other programs around the country. Maybe in 10 years, half the programs all lead back to us. That would be awesome to say: hey, 50% of every integrative oncology program in the nation actually trained at the Cherng Family Center for Integrative Oncology. That would be a huge impact.