HJBR Jan/Feb 2022

CANCER WARS 14 JAN / FEB 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE   OLOL continued... How are we going to hit it as fast as pos- sible, because lives are lost daily because of this. We’re all really excited. In fact, I was just speaking in a meeting earlier about all the energy and all the excitement around succeeding quickly in these goals. Editor: Do you have these goals written down? Is it something you can share with us? O’Neal: The strategic goals for the cancer center? No, we cannot share the strategic goals yet ... the system has not gone through their [the new leaders’] final approval. Obvi- ously, some of it has to do with the build- ing, and we met withmultiple architects this week about the building. Some of that has to do with time lines of bringing in that programmatic growth; not all of that is finalized. It depends on if you want high level or details. I’m in the weeds. But if you want just high-level goals of the Institute, they could definitely share those with you. In the end, the biggest high-level goals and the things that you’re going to see open up almost every mission statement for the Institute is that we’re going to offer world-class service — the most advanced service that is provided in the state — at our doorstep to all patients in the state. As a secondary goal, we are going to make sure that your ZIP code does not determine your survival rate. Right now, in the State of Louisiana, your ZIP code actu- ally does, and that’s because of access to a comprehensive care center, and we have to turn that around. That’s our main mission. Editor: Speaking of ZIP codes, do you think Cancer Alley is an apt description for the chemical/industrial corridor between Baton Rouge and New Orleans, and what is actu- ally happening to our citizens in those areas? O’Neal: I actually can’t speak to that. I think that’s a really complex research question. What we are looking forward to is being able to contribute to the answer. The science is unclear on whether or not that’s an apt description, but the best way to make that clear, and what we fail to do as researchers in Louisiana, is rush to the answer. So, it’s time to start to gather that. The only way you can really do that — other states have better systems and databases for this — is to become an NCI-Designated Cancer Center to really start to study and treat this disease. We’ve been treating; we have some phe- nomenal providers. We’re not studying cancer enough. That’s part of our goal — to become an NCI-Designated Cancer Center — to help to answer the question that you just posed. Editor: How will that help you answer that question? O’Neal: When you look at outcomes for patients, for anything — whether we’re talk- ing about strokes, heart disease or cancer — your outcome is multifactorial. It’s not just about what’s contributing to your environ- ment, it’s about what’s contributing to the way you were raised, what you eat and ulti- mately your access to close care. We cannot begin to define people by where they live alone, and we don’t have the information about the rest of it in one database. We just don’t. When you become an NCI-Designated Cancer Center, you pledge that through your goals. You also pledge that with the back- ing of a lot of money to make sure that you are looking at the patient and all of the things that land them in the cancer realm. And, then you start to work on prevention. I can’t work on prevention if I haven’t had a true study that shows me what the leading cause of death. Editor: I have another followup to that line of questioning, but there’s a lot of talk of those fence-line populations being affected by the chemical industry in our state. I smell chemi- cal releases early morning in Baton Rouge proper, and when flying in the other day, I could see a remarkable difference in the air quality between Lafayette and BatonRouge. The air actually started turning brownish after passing the Atchafalaya. The situation in Baton Rouge seemed larger than fence line. Do you think these releases are affecting our health and ultimately increasing cancer numbers? O’Neal: I think that the science is unclear. The first thing we’ve done is taken the step and already implemented it to add a social determinants of health package to our Epic platform. That means that any provider on our Epic platform enters the information necessary to start to data mine, whether where you live and your environment is something that we should target in pre- vention measures, and I think that build- ing on our program will only help to make those answers to the questions that you’re asking more clear, but we can’t address those causes as physicians. We need all of the information. What we can do is address treatment and foster research, and that’s what we’re going to do. Editor: Do you think that, and I know it’s a sensitive area because of the jobs and the money that’s pumped in through those chem- ical companies, but is this something that, as healthcare leaders in Louisiana, you thinkwe should be concerned about? Andwhat are we actually doing other than collecting data? O’Neal: I’ll tell you as a physician scientist, the way that you, as a physician, can impact change for your patients is to drive to the cause. The only way to drive to the cause is for us to finally be able to capture the data necessary to understand the disease, so from the healthcare perspective, if we want to contribute to finally understanding how our environment impacts disease, we have got to take those first steps of gather- ing the data. We’re not even there. So, that’s our pledge, is to begin to study it, and by working with a scientific process, we’ll find the answer. The worst thing that we could do right now is make assumptions and not work the scientific process. That’s what we’re doing. We’re really proud of the things we’ve done — adding prevention measures, adding social determinants of health and really starting to collect a database that we can begin to study through our research