Separating Fact from Fiction at the UAB Comprehensive Cancer Center

Do you know how cancer innovations happen? Or what makes UAB’s Comprehensive Cancer Center different from any other cancer treatment facility in the Deep South? Or where exactly it’s located on UAB’s campus?

If the answers didn’t come easily, don’t worry. While most stories in Crossroads focus on facts about the disease, this one will clear up common misconceptions about the Cancer Center itself. You might be surprised at what you discover behind the breakthroughs and deep in the trenches of the fight against cancer.

 “Comprehensive” is just a name. It doesn’t really mean anything.
 FALSE. “Comprehensive” is key to understanding UAB’s Cancer Center, because it is a special status granted by the National Cancer Institute (NCI). UAB is the only cancer treatment facility to earn that designation in Alabama—and in a region stretching from North Carolina to Texas and from Tennessee to Florida.

When President Richard Nixon signed the National Cancer Act in 1971, one of his goals was to establish centers of excellence that would lead the way in the key areas of cancer research, treatment and education. UAB was one of the first 11 centers to be designated “comprehensive,” and it has never lost that status.

 In order to maintain its designation, the Cancer Center must undergo a rigorous, in-depth NCI review of all its clinical and research programs every five years. That review determines the size of the center’s NCI core grant—the funding source that supports its administrative and research infrastructure.  

The Cancer Center has millions of dollars on hand to spend.
FALSE. The Cancer Center has only three sources of income on an ongoing annual basis. One is the NCI core grant, which provides approximately $4 million per year—but all of that money supports the center’s infrastructure and established research programs. The second source of income is a $1-million “center grant” from UAB; the third is private donations.

“Nearly all of the funding that the Cancer Center receives for research from outside sources, such as the federal government, is earmarked for a specific purpose,” says Cancer Center director Edward Partridge, M.D. “We cannot use that money to start new research or expand existing programs unless the money was specifically granted for that purpose. So the amount that directly impacts the center is somewhat limited. The money for growth and development has to come from donations.”

Donating money to the Cancer Center helps Birmingham and Alabama.
TRUE. In addition to helping the Cancer Center save lives, donations help boost the Birmingham community’s financial health. Dr. Partridge says that while it is difficult to quote an exact dollar figure, the Cancer Center has an enormous impact on the Birmingham economy.

For example, the Cancer Center can recruit a scientist at a cost of $1 million, which includes the expenses of establishing a laboratory, hiring assistants and technicians and paying the scientist’s salary. “We make that investment up front to build the research program, so there’s no return on investment for two years,” he says.            

But by the end of the third year, that scientist can begin to apply for grants from outside sources, thus generating income. Over five years, one scientist can theoretically bring in anywhere from $5 to $8 million from outside Alabama, Dr. Partridge says. “That $8 million doesn’t go in the bank, but into the community” through purchases and additional salaries that benefit local people and local businesses.            

Dr. Partridge says that for every dollar that comes from a private donation, the Cancer Center can leverage it for eight dollars from federal sources.  

Because their work is so important, Cancer Center scientists can easily find funding for their research.            
FALSE. Unfortunately, the amount of federal funding available for cancer research is severely limited, and the competition for that money has grown fierce. Today scientists must rely on private donations to provide the foundation for research breakthroughs.            

Funding an endowed chair is one significant way in which individuals can impact cancer research, because this enables the Cancer Center to bring top scientists to UAB to establish novel research programs. For example, Bruce Korf, M.D., Ph.D., was recruited to UAB in 2003 from Harvard to hold the Wayne H. and Sara Crews Finley Chair of Medical Genetics. In five years, Dr. Korf has significantly expanded UAB’s genetics program and acknowledges the power of an endowed chair in doing so.            

“An endowed chair is of pivotal importance in our efforts to recruit the most talented and innovative faculty to UAB,” Dr. Korf says. “With an endowed chair, a faculty member has the freedom to take risks in developing new areas of investigation. It provides the leverage to build the faculty, enhance discovery and increase the national profile of UAB as a research institution.”  

It’s tough for young researchers to compete against more established scientists.
TRUE. Investigators who are launching their careers—at the UAB Cancer Center and other institutions—quickly discover that it is incredibly difficult to win federal research dollars over older, more accomplished scientists. “The average age for a scientist receiving an RO1 grant, which is one of the most prestigious grants available, is 47,” Dr. Partridge says. “Someone who is just beginning a research career can’t compete with a scientist who has been working for 20 years.”

Funding from individual donors can help the Cancer Center nurture this new generation of pioneers and help shape the future of cancer research. Unrestricted funds can play a critical role in financing young researchers whose work would otherwise not be supported. For example, the Cancer Center recruited hematology/oncology specialist Katri Selander, Ph.D., from Finland with funds raised by the Breast Cancer Research Foundation of Alabama, a Birmingham-based group that donates all the money it raises to the Cancer Center. Dr. Selander is grateful for the opportunity those dollars create.

“That kind of support is critical for new investigators to get going,” she says. “Also, during times like these when federal funding is unbelievably hard to get, even for established scientists, local support gives us hope and keeps us going. Without private donations, many of the promising studies would have to be halted.”  

The Cancer Center relies only on large donations.            
FALSE. “It is obvious, now more than ever, that every dollar can make a difference,” Dr. Partridge says. “You don’t have to give a million dollars, or even a thousand dollars. We appreciate every cent we receive. By donating directly to us, you help us invest in the programs we know are going to impact Alabama and the region.”  

If I enroll in a clinical trial, I am essentially a guinea pig for untested, last-resort treatments.            
FALSE. A clinical trial is actually one of the final stages of the cancer research process—and it can be the most valuable, helping researchers determine the best, most effective methods of treating certain cancers. However, these new therapies are thoroughly tested in the laboratory setting for several years before they are ever prescribed to patients. While the treatments are still considered experimental, they are nevertheless safe.            

“In the past, clinical trials were sometimes viewed as a last resort for cancer patients once they had run out of treatment options,” says Andres Forero, M.D., medical director of clinical studies at the Cancer Center. “Today, that is not the case. Many patients receive beneficial front-line therapy through trials when their cancer is diagnosed.”            

As a national research leader, the Cancer Center offers clinical trials for a wide variety of cancers. While there is no guarantee that a trial will be successful, study participants are among the first to benefit if a new treatment proves effective.            

“Clinical trials are essential to the progress and knowledge of fighting cancer,” Dr. Forero says. “Patients need to know that clinical trials are an option. They could possibly receive a treatment that is not available anywhere else, and the information we learn from that can save countless lives.”  

The Cancer Center has no “front door.”            
TRUE. The Cancer Center is spread across UAB, with good reason—a reason that distinguishes the Cancer Center from the area’s other cancer treatment facilities.            

The Cancer Center has specialists working in 12 clinical areas: breast cancer, gastrointestinal cancers, genitourinary cancers, head and neck cancers, neuro-oncology, thoracic oncology, surgical oncology, gynecologic oncology, medical oncology (for both solid tumors and blood cancers), radiation oncology, bone marrow transplant and palliative care. And within each of those specialties, there are subspecialists who concentrate on specific subtypes of those diseases.

“That is a benefit of coming to the Cancer Center,” Dr. Partridge says. “A general cancer physician may see five different types of cancer in one day. At UAB, if a patient has colon cancer, he or she is going to see someone who treats nothing but colon cancer and knows everything about that disease.”            

That wealth of knowledge, specialists and services means the Cancer Center cannot fit into one single building on the UAB campus. Most outpatients see their physicians at The Kirklin Clinic® in the UAB medical center, while gynecologic oncology patients are seen at nearby UAB Highlands; other patients go to The Kirklin Clinic® at Acton Road. Radiation oncology is currently situated at Wallace Tumor Institute, which also houses numerous cancer research labs. The Cancer Center’s administrative offices are located in the North Pavilion of UAB Hospital.            
“Since the Cancer Center is so spread out, it’s confusing to some because we don’t have a single building where all cancer services are located,” Dr. Partridge says. “And while that may seem unusual, we see it as a benefit. There are hundreds of scientists across UAB who are doing innovative research, and many of those are working with cancer. The Cancer Center is very fortunate to benefit from the great breadth and depth of that research.”