World Cancer Day 2024: HCA Healthcare’s Dr. Dax Kurbegov offers hope for the future of cancer care

Every year on February 4, we recognize World Cancer Day, a global initiative led by the Union for International Cancer Control to face one of the world’s greatest challenges: cancer. The annual observance raises awareness about cancer and encourages prevention, detection and treatment – all with a goal of reimagining a world where millions of preventable cancer deaths are avoided and access to lifesaving cancer care is equitable for all.

The American Cancer Society (ACS) released its annual report on cancer facts and trends in January 2024, showing that the risk of dying from cancer has steadily declined over the past 30 years, sparing some 4 million lives in the United States. ACS credits the downward trend to big wins in smoking cessation, early cancer detection and treatment advancements.

On World Cancer Day 2024, Dr. Dax Kurbegov, vice president and physician-in-chief of clinical programs at HCA Healthcare’s Sarah Cannon Cancer Institute, offers hope for the future by sharing how we are giving patients healthier tomorrows through comprehensive and innovative cancer care.

HCA Healthcare’s Sarah Cannon Cancer Institute

Dr. Kurbegov: In the six years I’ve been with Sarah Cannon, the Cancer Institute of HCA Healthcare, I’ve had the privilege of leading clinical program development and, through it all, have seen a lot of pioneering change and growth. At its core, Sarah Cannon has long been a leader in offering integrated, cutting-edge cancer treatments to patients close to their homes. As a part of HCA Healthcare, one of the nation’s leading healthcare providers, the Sarah Cannon Cancer Institute (SCCI) is uniquely positioned to provide high-level cancer care throughout HCA Healthcare’s U.S. and U.K. markets, with a network of expertise and resources unmatched in the industry.

Regardless of how patients come into our network, they all deserve access to high-quality, consistent care. It’s my job, along with our incredible teams, to help engineer consistency and quality into all that SCCI does, while fostering collaboration across our global network of cancer programs.

In many ways, cancer care is the ultimate “team sport.” It requires a coordinated effort across physicians, nurses, navigators and so many others to understand individual needs and effectively address them. We believe you shouldn’t need to know someone in healthcare to get great cancer care, and our data shows that the vast majority of patients should be able to access that care close to home.

At SCCI, we’re proving that to be true, providing world-class cancer services to patients when and where they need them. We can tell that story through numbers.

In 2023:

• HCA Healthcare’s SCCI oncology nurse navigators guided over 30,000 patients along their cancer journeys. 
• SCCI and our affiliated providers treated over 130,000 newly diagnosed cancer patients.
• More than 1,000 radiation treatments were administered to patients every day across 63 radiation centers.
• Oncology surgeons performed over 285,000 cancer-related surgeries in our network. 
• The Sarah Cannon Transplant and Cellular Therapy Network was recognized for providing more allogeneic bone marrow transplants than any other institution in the world. 

Further, SCCI and the Sarah Cannon Research Institute(SCRI) comprise a research network of more than 1,300 physicians who provide access to cutting-edge research at more than 250 locations in 24 states. 

Related article: How the HCA Healthcare Research Institute is moving medicine forward through clinical trials and research

And while the scope of this work is significant, what has impacted me most in my years with HCA Healthcare are the individual stories of our patients, and how they fight to stand up to cancer. The perseverance of our clinicians as they work tirelessly to fight alongside them. The dedication of other colleagues in nursing, research, lab, pharmacy, IT and other roles who relentlessly support our clinicians and patients in so many unseen, but critically important ways.

Today, as we recognize World Cancer Day, I celebrate everyone involved in the fight against cancer. I celebrate the countless ways we are innovating cancer care across the continuum — from risk identification to early detection to diagnosis and treatment.

And more than ever before, today I see and celebrate hope for the future of cancer care. Here are some reasons why.

Risk identification

Dr. Kurbegov: If we think about a first step in fighting cancer, it starts with identifying individual risk. Everyone has different risks across their lifetime — personal and family history, age, environment and many other factors are at play. These days, we have technology and tools to help us better understand risk, which can help people make informed decisions about lifestyle and prevention.

While our goal is to screen all people for all kinds of risk, at SCCI we are starting with women’s programs to predict and prevent cancers like breast and ovarian. Now, with routine mammography, we have the infrastructure and technology to consistently ask the right questions, and engage women to better understand their own risk. Through our High-Risk Women’s Program, we are helping educate patients, many of whom — up to 90%! — have never been informed about or screened for familial or inheritable cancer risk.

Digital feedback obtained prior to the patient appointment is acted on right then and there. Risk is assessed, and we leverage SCCI’s infrastructure to educate, offer genetic testing when appropriate and, if risk is identified, direct patients to cancer care providers to proactively address it. We’ve piloted this program at 22 women’s centers, launching eight programs in 2023 alone, and the results are staggering.

From March 2022 to December 2023, we sent more than 100,000 digital assessments to patients, with an impressive 80% completion rate. We have found consistently across sites that 25% of women are eligible for genetic testing — with about 10% having family risk — and that one third of patients offered genetic testing take advantage of it before they ever leave the center.

Through this work, we have identified hundreds of women who are at risk for cancer. All of the elements we built into this program are dramatically increasing our ability to identify women who have more than average risk, get them tested and when needed, introduce them to a care team who can advise on early detection and prevention strategies before they ever have a cancer.

As you might imagine, we’re not stopping there. We will be working to expand this level of advanced risk identification to other areas of cancer care as well.

Early detection

Dr. Kurbegov: As we help people address risk, we are equally passionate about the importance of early detection. Across the healthcare landscape, we do a good job at detecting few cancers early — including breast, colon, cervical and prostate — for which regular screenings are recommended. But approximately 70% of cancer deaths are from those for which there are no recommended early detection screenings, as we haven’t had the ability to identify them until it’s often too late. That is, until now.

In 2023, we announced SCCI’s collaboration with GRAIL, a healthcare company with a mission of detecting cancer early. We are offering GRAIL’s Galleri® multi-cancer early detection (MCED) test to patients who meet screening criteria (due to personal risk) at select HCA Healthcare physician practices.

The Galleri test is the first MCED test that can detect a shared cancer signal across more than 50 types of cancers using a simple blood draw. It offers a fundamentally different, blood-based approach to cancer screening, to be used in addition to the aforementioned recommended single cancer screenings.

MCED and the Galleri test have ushered in a new paradigm in cancer screening. And at SCCI, we are leveraging our leading nurse navigation program to support patients and providers through the diagnostic journey following a positive Galleri test result.

Never before in my career have I seen progress this quickly in cancer care. From our first efforts in 2016, we have enrolled more than 30,000 patients on clinical trials in partnership with the world’s leading companies including Grail, Harbinger Health, Freenome, Roche, Exact Sciences and others to advance these promising technologies. To go from those early clinical trials to actually putting these tools in the hands of our primary care doctors to help find more cancers early has been incredibly exciting, and is a great example what we can accomplish as a team. And by the way, HCA Healthcare is now covering MCED testing as a benefit for health plan colleagues who have a history of cancer. Talk about caring like family.

Related article: HCA Healthcare and GRAIL collaborate to advance comprehensive cancer care with multi-cancer early detection screening

Diagnostic innovation

Dr. Kurbegov: As with risk identification and early detection, cancer diagnosis has become increasingly personalized. Determining the very best treatment for an individual requires that both patient and doctor have the information they need as quickly as possible and fully understand what they are battling. The Sarah Cannon Clinical Pathways Program leverages the insights of leading national physicians in our network to define every step of the journey between diagnosis and treatment to ensure that every patient, everywhere, every time is accurately diagnosed as quickly as possible so that timely, critical decisions about treatment can be made.

In partnership with Sarah Cannon Research Institute, all of that information informs personalized treatment plans and can be used to identify the most promising clinical trials for our patients. It’s a game changer, and coupled with the nation’s largest nurse navigation team, we are verifiably improving cancer care for patients — with far-reaching implications beyond our own health system.

Sarah Cannon’s Nurse Navigation Program provides the technological, operational and educational framework to support patients through their diagnosis and treatment journey. Our network comprises more than 150 hospitals across the country, with 200 nurse navigators who specialize in cancer care and support approximately 30,000 cancer patients annually. We have proprietary technology systems that help manage all details of a patient’s care, which include coordinating timeliness, eliminating barriers, fostering patient education and everything in between. By tracking progress, facilitating communication and documenting data, our navigation team and systems are vital to supporting excellent patient outcomes.

SCCI’s navigation and clinical pathways programs support cancer patients at every point along their journey, not only with diagnosis and treatment but with financial resources, emotional support and so  much more. We know that these programs increase physician and patient satisfaction, improve patient compliance and promote timely access to care — all of which help to improve care equity.

Groundbreaking treatment

Dr. Kurbegov: Importantly, and rounding out this conversation about holistic cancer care, Sarah Cannon offers integrated cancer treatments, with convenient access to cutting-edge therapies for cancer patients. We provide state-of-the-art cancer care close to home for hundreds of thousands of patients every year, a number unmatched by any single cancer center.

SCCI, alongside our affiliated providers, offers cancer care services to 130,000 new cancer patients every year, more than any other health system. And our surgical oncology programs offer minimally invasive and innovate treatments that have historically been located only at academic centers. SCCI is the largest provider of cellular therapy and stem cell transplants in the nation, with 8 centers across the country. And we are national pioneers in robotics, removing tumors in shorter periods of time and in ways that are less traumatic for patients. Further, our personalized medicine initiatives and Molecular Profiling are transforming cancer care, helping to identify genetic mutations specific to an individual’s cancer that can be matched with more effective therapies.

But today, I’ll dial in on the Sarah Cannon Transplant and Cellular Therapy Network (SCTCTN), which specializes in blood and marrow transplant and cellular therapy for adults with blood cancers. SCTCTN offers patients convenient, community-based access to complex blood cancer care, hematopoietic cell transplant (also called blood and marrow transplant), clinical trials and innovative therapies such as immune effector cell therapy. The network also provides care for those facing blood disorders and other immune-related disorders.

SCTCTN provides care for a large segment of the 1.6 million people currently living with or in remission from blood cancers in the United States. According to bone marrow donor registry, Be The Match, every 3-4 minutes someone in the United States is diagnosed with a blood cancer like leukemia, myeloma or lymphoma.

Chimeric antigen receptor T-cell therapy, also known as CAR T-cell therapy, is a novel immunotherapy that programs a patient’s immune system to recognize and fight cancer. The immune system is responsible for ridding the body of abnormal cells that are foreign (like cancer) or infected, and T-lymphocytes (T-cells) are a type of cell responsible for killing abnormal cells.

During the CAR T-cell treatment process, T-cells are drawn from a patient’s blood and genetically engineered to recognize the patient’s cancer cells when reinfused. T-cells are really good at killing cancer cells, but under normal circumstances need the help of other immune cells to work effectively. With the technology we have available now, these cells can be taken from the body and their DNA modified such that they can start identifying cancer proteins and antigens directly.

The FDA has approved CAR T-cell therapies for patients with advanced acute lymphoblastic leukemia, lymphoma and multiple myeloma. But importanly, since T-cells can be engineered to target any cancer antigen, there is a significant amount of research underway to evaluate treatment for other blood cancers and in patients with solid tumors (e.g. GI cancers, brain tumors, lung cancer, etc.).

In addition, we are now able to genetically modify other types of immune cells to treat cancers. Most importantly, we are able to offer these cutting-edge treatments through clinical trials to cancer patients at SCTCTN. In fact, our programs participated in many clinical trials that ultimately led to FDA approval for nearly all CAR T-cell treatments currently approved for routine clinical use. 

Related article: First U.S. patients undergo innovative brain cancer treatment in new clinical trial at HCA Healthcare’s Johnston-Willis Hospital

Future of cancer care

Dr. Kurbegov: Our goal at HCA Healthcare and Sarah Cannon is to meet people where they are along the cancer continuum to understand and reduce their individual risk and engage around their healthiest lifestyles. And when we can’t avoid cancer, to understand personalized needs and offer the best possible treatments that are tailored to meet them.

Prevent when we can. Find early when we can’t. And then remove and eradicate in the most patient-centric way possible. With our innovative programs and treatments, and convenient access to consistent, quality care, we know at SCCI that we are moving the needle on improving cancer care.

In my experience, it normally takes a decade for new medical innovations to be integrated into patient care. At Sarah Cannon and HCA Healthcare, we compress that timeline due to our network of providers who are involved in our cancer care research and ready to introduce new best practices immediately. There has never been a more exciting time for innovation around cancer care, and I am grateful to be part of the community of people who are leading this charge.

On this World Cancer Day, I am hopeful for the future of cancer care. And I am grateful that this future is not far away, and in many ways…here today.