What's in a Name?

UAB has a true “comprehensive cancer center,” but what does that mean? It encompasses much more than the word “comprehensive,” which my dictionary defines as “so large in scope as to include much.” When the word is applied to a cancer center, does it just mean “big, complex and hard to understand”? Is it just a name pulled out of someone’s mind, or does it have a much more specific meaning? Can an institution just declare itself comprehensive?

When I came to UAB in 1968, there were no National Cancer Institute-designated comprehensive centers. In the public view, there were only three big cancer centers: Memorial Sloan-Kettering in New York, M.D. Anderson in Houston and Roswell Park in Buffalo, New York. At that time, if you as a patient wanted “the best,” you went to one of those places. Indeed, when Alabama Governor Lurleen Wallace developed cancer in the 1960s, she went to M.D. Anderson for treatment.            
Around that time, it became clear that care for patients with heart disease, cancer and strokes needed to improve. In response, President Richard Nixon created a government program devoted to those diseases. The money made available by that program, coupled with the tragic death of Governor Wallace, was enough to spark an interest in broadening our program at UAB. Institutions in other states also responded, which ultimately led the NCI to mount a new program for academic centers in order to stimulate research and care.            

The guidelines we had to follow in order to become comprehensive were extensive. We were required to have expertise, both in laboratory research and in clinical treatment, for many areas relevant to cancer. We had to have a variety of basic science projects good enough to have already received peer-reviewed research grants, as well as experienced clinicians. Most important, we were required to create an administrative structure.            

After going through all of this, we were reviewed on site by a team of government officials, who passed their review through the NCI. That led to a planning grant to move forward with developing a center. After getting that funding and other relevant grants, we could apply for comprehensive status. There was also money for construction, and it was that successful grant, along with local fundraising, that built the Cancer Center’s first building, now known as the Wallace Tumor Institute.            

It felt really good to be one of the first centers officially named “comprehensive,” and I am pleased that UAB has kept that designation without interruption. There are now 39 comprehensive cancer centers; some states have more than one, and others have none.            

“Comprehensive” means that the center has high-quality research, both basic and clinical, and that it maintains the necessary breadth and depth of programs to make an impact on cancer patients. It is, therefore, not easy to achieve and maintain, and definitely not something you can just name yourself.  

By John Durant, M.D.
UAB Comprehensive Cancer Center Founding Director