With continuing support from the state Legislature and the National Cancer Institute, the University of Hawaii Cancer Center will reach its full potential as a world-class institution at the forefront of groundbreaking cancer research, prevention and clinical treatment. Committed investment during the next several years will bring a generous return to the Hawaii economy and to the health of the people of Hawaii.

After just four months on the job, Dr. Randall F. Holcombe, director of the Cancer Center, is acclimated and on the move. I interviewed Holcombe this week at the center, and he left me with every confidence that, given the necessary resources, he has the experience, passion and vision to lead. He hasn’t been here long, but he clearly understands the local landscape and naturally exudes the spirit of aloha with his humble, gentle yet commanding manner.

The Cancer Center, together with the Hawaii Cancer Consortium, has already done a great deal to understand and reduce cancer disparities in the islands and support the treatment of about 4,400 of the 6,500 cancer cases in Hawaii each year. The consortium includes the Queen’s, Hawaii Pacific Health and Kuakini medical centers and is affiliated with Tripler Army Medical Center.

“I think cancer centers should be immersed in the community,” Holcombe said. “We are doing it the right way. Without this effort, many in Hawaii who do not have the resources to fly to the mainland or social support to stay there would miss out on cutting-edge treatments.”

The Cancer Center also focuses on how ethnic and racial diversity influences who gets which cancers and how people respond to treatment based on genetic and behavioral factors. For example, Native Hawaiian men have a much higher mortality rate from colon cancer than the general population. This seems to be related to a combination of lifestyle, delayed detection and genetic factors negatively affecting response to treatment.

The Cancer Center, in addition, offers a uniquely local focus on research of natural medicines for cancer treatment. Noni extract, long considered beneficial for cancer treatment from the standpoint of indigenous laau lapaau (medicine), is now being studied.

So much of cancer research today is a question of translating the breakthroughs from basic science into new medicines. “We know so much more about genetic mutations than we have drugs to target them,” Holcombe said. To get there we need to find out which mutations affect the signaling pathways for cancer growth. It is also important to understand how novel cancer treatments affect a given cancer in a specific individual. This is the emerging field of personalized medicine that is revolutionizing treatment strategies.

The Cancer Center had been receiving $19.4 million per year from the tobacco tax fund. However, the combination of the tax itself as a deterrent, plus educational efforts toward tobacco cessation, have dropped this revenue source by about $5 million per year, and the Legislature is being asked to fill the gap. Without this funding, reserves will last only three more years.

The Cancer Center brings in about $20 million per year from various other sources, much of which is associated with its designation as a National Cancer Institute Cancer Center. These funds are to support research activities by filling essential positions, purchasing materiel and covering operations and infrastructure. These dollars result in a $55 million benefit to the local economy from biomedical research.

The chances of retaining this designation are good, but the Cancer Center needs to recruit more faculty and demonstrate support from UH and the Legislature.

Nationally connected and uniquely focused on the local community, the Cancer Center continues to reach out on prevention through education and screening. The Cancer Center is a dynamo that substantially benefits and diversifies the state economy. Additional funding is well warranted, and, with Holcombe at the helm, the health and wealth of the people of Hawaii stand to thrive.

Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.