Winning battles: while recent advances have brought a cure for cancer closer, providers continue the fight on several fronts.

• Author: Blake, Kathy
• Position: SPONSORED SECTION: ONCOLOGY CARE

The National Cancer Act was enacted almost 50 years ago, creating the National Cancer Institute and effectively declaring war on cancer, the nation's No. 2 cause of death at the time. "Richard Nixon hoped we would whip cancer by the turn of the century' says Steven Limentani, head of cancer services for Winston-Salem-based Novant Health's four-state network of 14 medical centers and nearly 500 outpatient locations. "Obviously that hasn't happened yet, but we're far ahead of where we were five years ago."

Better cancer treatments stem from a deeper understanding of the disease's heterogeneous nature. "Saying cancer' is like saying car" Limentani says. "Nothing against Yugo owners, but a Yugo is not a Mercedes. If I asked how fast a car would go, you'd need a lot more detail. Decades ago, when we developed some of the first therapies, the hope was that [chemotherapy] would be a thing of the past, and all the negatives about chemo would go away. But critically important to the evolution of hematology and medical oncology is the development of a multiple-disciplinary approach to these disorders, and only by doing a coordinated effort do we get the best outcomes."

Oncologists, surgeons, nurses and researchers must collaborate to continue the trend toward better treatments. "Part of my role is to be the person who helps collaborate with a group of very skilled technicians to optimize what we deliver to the patient," Limentani says. "As medicine has become more of a business, there are some people who view the patient as being there for the business. Not so. At the center of everything we do, no matter what we do, is the patient. We are there for them, and that's critical."

The American Cancer Society estimates almost 1.7 million cases will be diagnosed and 600,920 people will die from the disease nationwide this year. North Carolina's Advisory Committee on Cancer says the disease has been the leading cause of death in the state since 2009, responsible for about 89,500 deaths from 2008 to 2012. Limentani says a cancer diagnosis can strike fear in patients. "I've had family members who have died from cancer. Part of being a compassionate physician is understanding that, and having taken care of many women who have breast cancer, in spite of the fear, most of them are going to be OK. When you're faced with something like that, the overwhelming reaction from most is that they're going to die. They're not. And that needs to be addressed."

Decreasing those numbers starts with early intervention, and reaching people in urban and rural regions is imperative. "[Novant Health has] a diverse and geographically broad footprint," says Limentani, who has offices in Winston-Salem and Charlotte. "There are limitations, but as much as possible we should provide care to a patient where they live. They also need other things, like social work and medicine."

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