The thousands of cancer doctors and researchers in the American Society of Clinical Oncology could not have picked a better place when they came together in Los Angeles last week.
The city is the site of high-level research at institutions such as UCLA, USC and, just to the east, the City of Hope. It is itself a frequent subject of research, a place where pioneering researchers started probing cancer patterns in the population nearly three decades ago.
It's also a hotbed of alternative therapies and legal controversies over who gets treated and who should pay.
"I think we're very well placed because of the scope and variety of research centers placed around the city," said Dr. Derek Raghavan, chief of medical oncology and associate director of USC's Norris Comprehensive Cancer Center, who recently came to USC from Roswell Park Memorial Institute in Buffalo, N.Y.
There are certain things L.A. is not, however. It's not a place of venerable research and clinical traditions, so its reputation may take some time to catch up with its achievements. It's not one of the national centers for commercial biotechnology. In California, such activity clusters more around San Diego and San Francisco.
And in such a big and sprawling city, with so many people vying for a piece of the public's attention, news about progress against cancer can get drowned out by the noise. Indeed, the ASCO meeting attracted much more national media attention than local.
But there's plenty of hopeful news on cancer, as the meeting showed, and some of the most significant news has Los Angeles links.
Research at UCLA, for instance, has paved the way for a major new advance in the treatment of breast cancer the first successful trial of a gene-based drug against one virulent form of the disease. Researchers at UCLA's Jonsson Comprehensive Cancer Center said the drug Herceptin reduced tumors substantially in more than half the women studied when combined with chemotherapy. UCLA and South San Francisco-based Genentech Inc. developed Herceptin.
Leading the research and early development of the drug was UCLA's Dr. Dennis Slamon, who called it "the first successful cancer treatment that targets a specific genetic alteration, as opposed to using a shotgun approach that kills both diseased and healthy cells."
Research and development of cancer treatments is such a global effort that no city can claim to be the world leader in it. The next big advance could come from any one of dozens of places. During the 1997 fiscal year, the National Cancer Institute awarded research grants in all but two states, Wyoming and Idaho. The NCI lists 58 hospitals and other sites, in 28 states and the District of Columbia, as official cancer centers, for their leadership in research, treatment and education.
That said, the L.A. region is well represented. Among the NCI's 34 comprehensive cancer centers designated for excellence on both the research and clinical sides are three in Los Angeles County: UCLA, USC and the City of Hope.
All four were among the 61 sites nationwide in 1997 that received more than $10 million in NCI research grants, which account for only a part of total private and public funding for cancer treatment and prevention. But the area's leadership is based on more than grant money. The diversity of research is itself a strength.
Raghavan noted Slamon's central role in the "Herceptin story," and said the city also has some of the world's most respected cancer surgeons, such as UCLA's Jean B. deKernion and USC's Don Skinner, both in urology.
In epidemiology, he said, "Los Angeles has led the world in the study of the causation of prostate cancer." Medical researchers work with leading-edge molecular biologists at the California Institute of Technology to apply genetic knowledge to cancer treatment.
Raghavan says this intellectual environment helps keep research from getting off track. Scientists and clinicians from various fields can gather to give each other reality checks as when an expert in epidemiology corrects a clinician's errors in using statistics. Such interaction is not as easy in smaller, more isolated areas.
This is also a good place for cross-fertilization. The recent work on breast cancer at UCLA builds on a solid local foundation of research into cancers linked to hormones.
USC's Dr. Brian E. Henderson broke ground in this field back in 1970 when he started collecting data on cancer cases in Los Angeles County.
Henderson, a Boston-trained internist who came to L.A. by way of Atlanta, spent four years studying yellow fever in Uganda. He wanted to apply the same techniques of epidemiology to cancer, and he found L.A. an ideal place.
Even then, the city's population was unusually diverse, he said, and that enabled him to find common threads in cancer cases across racial lines. He was trying, he said, "to learn what could steer us in the direction of what causes cancers," and breast cancer was one of the first areas he studied. Out of that, he said, "grew our whole program in hormone-related cancer."
Henderson said Los Angeles had little cancer research when he arrived in 1970, outside of some "good basic science" at UCLA and a program focused on leukemia at Children's Hospital.
Even now, he said, not everyone outside Los Angeles sees it "as the major resource that it is." Raghavan, on the other hand, thinks L.A. gets plenty of respect these days as a good place for a researcher to work. When he moved here, he said, "people from all over the country" congratulated him on his choice.
In the end, it makes no difference to a cancer patient whether Los Angeles gets bragging rights to the next breakthrough in fighting the disease. What matters is that the treatment be available, and that it work. But the roles that Los Angeles plays in the cancer war do say something about its broader health its ability to innovate, its power to attract the best and brightest, its ability to get its varied residents working together. In the following articles, we will be probing such issues with a look at how L.A. confronts the most feared of diseases, and how the city has joined the effort to conquer it.
For reprint and licensing requests for this article, CLICK HERE.
Stories You May Also Be Interested In
- USC Awarded Nearly $44 Million to Track Cancer in Los Angeles County
- Cancer Awareness & Prevention: Study Estimates Number of U.S. Women Living with Metastatic Breast Cancer
- UCLA Researcher Dennis Slamon to Share in $1M Prize for Cancer Research
- Top Women Leaders in Health Care: CARYN LERMAN, PhD