In this video, Margaret Tempero, MD, director of the UCSF Pancreas Center, discusses the new UCSF Health Cancer Diagnostics Service (CDS), which aims to expedite diagnoses and treatment for patients with symptoms and/or test results indicative of various types of cancer. The CDS streamlines referrals to appropriate clinics at the UCSF Helen Diller Family Comprehensive Cancer Center so that patients can begin treatment as quickly as possible. This approach leads to improved survival rates and quality of life for patients. The service is part of the Cancer Risk, Prevention and Early Detection program.
Hello, I'm Doctor Margaret Tempero. I'm a medical oncologist at UCSF. I direct the pancreas Center, but I'm also the director of a new initiative, the Cancer Early Detection and Interception Initiative at UCSF. As part of that initiative, we developed a new service called the Cancer Diagnostic Service, and that's what I'd like to talk to you about today. This is our team. I'm joined by Doctor Wat Lim and Doctor Shigu Arora, three amazing nurse practitioners, Angela Laffin, Patty Zendejas, and Lisa McNay. Their manager is Gabriel, who's shown in the lower left. The nurse navigator is Anna Ong, and Benita Smith is the practice coordinator. So why did we develop this service? As you might imagine, a patient who has a suspected underlying diagnosis of cancer is anxious, and they want to be seen right away, and they need to have their workup expedited so that if there is a serious underlying cancer they can get to definitive treatment. The cancer diagnostic service then has several goals. We want to minimize the diagnostic delays and bridge patients to definitive care as fast as we can. We wanna make sure the patient who wants to come to see us can get into our system if they're having symptoms we wanna provide supportive care and symptom management immediately. And if a patient has a signal that arose during a hospitalization, the patient can be discharged and then followed in our clinic to complete the workup. Our goal is to see all patients within 3 to 5 business days of initial referral. As you can imagine, the workup depends on where you think the cancer might be located. We work with all of our experts in imaging, biopsy acquisition and laboratory testing, and we have standard processes that we go through in working up malignancies of various origins. It's been shown in scientific studies that the time to treatment initiation when it's lengthened is associated with an absolute increased risk of mortality ranging from 1 to 3% per week in curative settings, even like early stage breast cancer, lung cancer, renal cancer, and especially pancreatic cancer. This is just one example of a patient. Bill saw the nurse practitioner in our cancer diagnostic service one day after the referral was made. Within one week, he had seen the appropriate specialist, had had the appropriate imaging, and had referrals to symptom management and nutrition. Within 2 weeks, he started his immunotherapy prior to the planned surgery. His workup and treatment were already under way by the time another local academic medical center called him to set up his initial appointment. So these are the types of things we're seeing now, uh, we are seeing referrals for imaging findings that are suggestive of cancer. So for instance, if a patient is hospitalized or goes to the emergency room for one problem and the workup uncovers another potential problem, then that workup can continue in the cancer diagnostic service. We sometimes see patients who already have a diagnosis of cancer, but before the treating team can really do their job, uh, the patient may require additional workup such as staging. Sometimes we get direct primary care referrals from physicians whose patients have some other clinical signal of an underlying malignancy. And then increasingly we're seeing patients who have blood tests done for early cancer detection. This might be something like Shield for colon cancer or the gallery test, which is being marketed as a test for multi-cancer detection. So we've now flipped the paradigm. In the past, you had to have a cancer diagnosis to get into the cancer center. Now we have the door open. And you can go through the cancer diagnostic service. This is particularly important for instance, for patients who do not have a primary care provider and are seen in the hospital or the emergency room and have a signal for an underlying malignancy, in this way we can get their workup expedited and they don't have to worry about finding a primary care provider to do those, that service for them. We can also provide the prompt supportive care and symptom management that many of these patients need so that they're comfortable and able to make good decisions about their care going forward. This particular service is part of a larger entity called the Cancer Risk Prevention and Early Detection C A D Program that brings together these three initiatives that are focused on patients at elevated risk for cancer because of hereditary predisposition or those with a suspected new diagnosis. The hereditary cancer clinic provides navigation services for patients with a hereditary predisposition who may need specialized cancer screening for the cancers that evolve in that particular syndrome, and of course cancer genetics does the initial evaluation to understand a patient's hereditary risk and to do the testing to determine whether they actually have a germline mutation of concern. This is how you refer a patient you can call us or you can fax us. You can use the online referral form. You can use a secure MD link portal and there's the website in case you just need to learn more. Thank you.
