Oncologist balances community care with academic investigation through NCORP

When Sara “Betsy” Adams, M.D., finished her fellowship in oncology 13 years ago, she wanted to work in a small community where she could make a real difference. Georgetown County, South Carolina, fit the bill.

“I felt very needed,” she said. “I had a lot of purpose providing cancer care in this community because some of it is underserved, and it is a smaller community.”

Adams also believes strongly that clinical trials can provide an extra level of care to cancer patients. But patients can’t often enroll in clinical trials at community practices. For access to the types of treatments that aren’t yet widely available, patients generally have to travel to large academic health centers – and that isn’t something that everyone can do.

“Coming from fellowship into the ‘real world,’ so to speak, in a smaller community, I did not realize the burden on patients to travel even a short distance,” she said. “They don't feel safe driving even an hour sometimes. These patients sometimes are very elderly, and their children live across the country, so they are relying on friends in their neighborhood who are also elderly to take them seven minutes down the road to my practice. So to drive to an academic center, whether it's MUSC or Duke – it's just not feasible.”

"Clinical trials are a cornerstone of cancer care. I think that they are central to providing excellent care to cancer patients, whether it's so you can provide them a treatment trial where they may be getting something that is not currently the standard of care, but may well be in the near future, or if it is something that is on the forefront of symptom management."

Sara "Betsy" Adams, M.D.

Adams’ patients, however, can access clinical trials right there at Tidelands Health, thanks to the health system’s participation in MUSC Hollings Cancer Center’s NCORP-MU.

NCORP, or National Community Oncology Research Program, is an initiative of the National Cancer Institute to build networks of clinical trial providers in smaller communities. Across the country, there are 46 NCORP sites, each of which works with multiple affiliated locations. Hollings, for example, works with cancer care providers in Greenwood, Beaufort, Lexington, Florence and, of course, Georgetown County.

Hollings’ NCORP is designated as minority/underserved, or MU, because at least 30% of the population it serves are considered racial or ethnic minorities or rural residents. Only 14 of the 46 NCORP sites have the minority/underserved designation.

Adams said that offering clinical trials is important to her so that she knows her patients are getting the best possible care.

“Clinical trials are a cornerstone of cancer care. I think that they are central to providing excellent care to cancer patients, whether it's so you can provide them a treatment trial where they may be getting something that is not currently the standard of care, but may well be in the near future, or if it is something that is on the forefront of symptom management,” she said.

“So for me, first, clinical trials are important to provide that excellent level of care. And the second thing is that clinical trials answer questions. The reason we have made so many advances in taking care of our cancer patients currently is because of questions that were asked and answered years ago. So I think it's important to benefit your future patients as well as your current ones,” she continued.

Participating in the Hollings NCORP-MU also gives her control in selecting studies.

“I think NCORP is extremely valuable to the community oncologist because you can choose specific trials that apply to your patient population,” she said.

NCORP means that smaller centers that don’t have all of the necessary resources to run clinical trials can still participate. For example, Tidelands doesn’t have its own Institutional Review Board, or IRB, which is necessary to oversee research involving human subjects and safeguard those participants’ rights. But through NCORP, it can rely on the centralized IRB at the National Cancer Institute as well as MUSC’s IRB.

In addition to trials that study new drugs, Tidelands has activated a trial that offered an intervention for possible cognitive side effects of chemotherapy, a study tracking financial toxicity and a study providing pain management strategies through a virtual platform.

"I get to take good care of patients close to home, and I can collaborate and learn from subspecialists at academic centers, whether at MUSC or around the country, and bring that care to my patients. That's been very rewarding."

Sara "Betsy" Adams, M.D.

Without NCORP, her only option for clinical trials would be industry-run studies, and industry typically doesn’t look at studies measuring those types of quality-of-life indicators, she said.

“NCORP answers a lot of questions that I think are really important. Pharmaceutical companies or industry trials aren't going to ask these questions because they may not be financially beneficial,” she said.

The “chemobrain” study, for example, was looking at a new use for a drug that already has FDA approval.

“NCORP provides resources to help us answer questions that apply to our minority patients and our underrepresented patients. It provides support and offers opportunities to attend meetings regarding clinical research in the community, and it provides the framework for my clinical trials coordinator to make it all happen,” she said.

For Adams, NCORP gives her the best of both worlds.

“I get to take good care of patients close to home, and I can collaborate and learn from subspecialists at academic centers, whether at MUSC or around the country, and bring that care to my patients. That's been very rewarding.”

Related Links

More MUSC Hollings Cancer Center news

Subscribe to our newsletter

Hollings Horizons magazine