Cancer patients are cured all the time at City of Hope not because the Duarte cancer center has some kind of miracle drugs stashed away in its laboratories, but because doctors and researchers work in tandem to provide patients with the maximum number of treatment alternatives.

In 1997, City of Hope had gross patient revenues of nearly $314 million. Its oncology network is the largest in the nation, with more than 750,000 covered lives. The center spends $1 million every week on biomedical research and is 90 percent dedicated to cancer.

In addition to patient revenues, City of Hope receives funding each year from National Cancer Institute grants, licensing agreements with drug producers, and philanthropic contributions.

By strongly focusing on cancer, the center aims to give patients a feeling of empowerment that City of Hope has the resources and knowledge to do everything possible to squelch the disease.

When Sherith Perez first arrived at City of Hope six years ago, she had just had a mastectomy and was balding from intensive chemotherapy. Her immune system had been overwhelmed by cancer. Doctors in her hometown of Oxnard had discovered tumors in her left breast and two kinds of cancer in 18 lymph nodes. They suspected that cancer had spread to her lungs and liver as well.

"I was told I had four to 12 months to survive," recalls 52-year-old Perez. "For long-term survival, I did everything I could surgically."

She contacted City of Hope and received a number of phone calls in return, from a social worker, a former patient and several doctors.

When she visited the center, doctors said they might be able to offer her a cure. Perez agreed to be tested for 11 weeks, just to see if she would qualify to participate in a clinical study involving the use of a new chemical. Experimental treatments are not unusual at City of Hope, where 40 percent of all patients take part in innovative protocols.

"With everything the doctors had to offer, I felt I'd be taking a greater risk if I didn't take the treatment," said Perez, who underwent two bone-marrow transplants back to back and is now "completely cured." Since 1992, she has been taking tamoxifen, a maintenance chemotherapy drug with no side effects.

"I know it sounds really Zen, but it has been the most incredibly rewarding experience with such a profound effect on my family, friends and myself. It has made my life better and has made me a better person," she said.

Today, Perez is one of 50 or so City of Hope "ambassadors" former patients who are teamed up with new cancer patients with similar backgrounds and diagnoses to provide support and encouragement.

Perez's experience, however, is far from universal. She has outlived several friends who were diagnosed with less severe cases of cancer during the same period.

Treatments that kill cancer can kill patients as well. Some people, for example, are not as receptive to chemotherapy or cannot withstand weeks of broken-down immunity.

This year, for the first time, cancer incidences and death rates have decreased, but there is a long way to go, according to Dr. Charles M. Balch, president and chief executive of City of Hope. High expectations may be false expectations.

"Cancer is a generic term for over 100 diseases. There will not be a single cure," said Balch, adding that the wave of the future is risk aversion through preventative medicine.

"We are learning to understand cancer and its genetic origins," he explained. "Some of our most promising research is focused on gaining a better understanding of the significance of inherited genes and how they mutate, and in developing methods of intervening before cancer develops. Through genetic screening, we can identify high-risk people and help them change their lifestyle and offer various forms of preventative treatment."

To further its cause, City of Hope has just completed a $75 million construction project at its 110-acre campus. The project includes a new ambulatory care center, a molecular medicine research complex, and a diabetes care and research facility. Plans for a new $163 million hospital are now underway.

Today's campus dates back to 1913, when two tents on 10 acres of desert at the base of the San Gabriel Mountains were set up for victims of tuberculosis. Organizers at the time believed that everyone, rich or poor, deserved good medical care.

For the past 85 years, that fundamental philosophy has remained the driving force of City of Hope National Medical Center and Beckman Research Institute (a biomedical research institute founded in 1983). City of Hope has a network of hundreds of volunteers and donors and its physicians have created treatment programs for more than 200 forms of cancer, including leukemia, breast and prostate cancer, as well as diabetes and other life-threatening illnesses.

City of Hope was the first of six medical centers in the country to begin treating leukemia patients with bone-marrow transplantation and is now the largest provider of BMT services in California.

Of the hundreds of thousands of patients who have been treated there, few are more memorable than Mushtaque Jivani, who was diagnosed with acute myeloid leukemia in 1976. Today, he is City of Hope's longest-living bone-marrow transplant survivor.

"The survival rate for BMT is significantly greater today than when I was transplanted. I like to go back to City of Hope and tell other patients my story and show them that 22 years later, I'm still cancer-free," said 49-year-old Jivani, who gave up anti-rejection medications over 10 years ago and beat the odds to run the L.A. Marathon. He is a regular participant in City of Hope's annual BMT reunions.

"Technology has changed tremendously," he said. "The transplant procedure has been made a lot smoother and more comfortable than when it was performed on me. However, the despair and fears and worries of the new patients are still the same. I am a living example that not only is there life after transplant, but it is as normal as it was before."

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