Institute’s CEO has big ideas
October 25, 2009 - 9:00 pm
Dr. John Ruckdeschel, the new director and CEO of the Nevada Cancer Institute, has lived in Las Vegas for less than six months, but he already is so tired of the joke it makes him grit his teeth.
"Where do you go for good medical care if you live in Las Vegas? -- The airport."
"You can bet that people won't be talking that way when the institute's hospital is up and running," Ruckdeschel said during a tour of the institute's new research labs in Summerlin.
In that brief pugnacious aside, there was more than just a venting of frustration by a proud physician-researcher whose academic medical pedigree includes stops at Johns Hopkins and Harvard universities.
There also was the promise of radical change in health care in Southern Nevada.
A new hospital. Dedicated to the treatment of cancer.
Big news for a state where, studies show, thousands of people go out of state for their cancer care, including former Govs. Kenny Guinn and Bob Miller, former Las Vegas Mayor Jan Jones, and Jim Rogers, former chancellor of higher education.
Big news in a state where the American Cancer Society estimates more than 12,000 new cases of cancer will be diagnosed this year.
Big news in a state where an estimated 4,600 people will die of cancer in 2009.
"The hospital won't be here," Ruckdeschel said as he stood on the institute's property near Town Center Drive and Twain Avenue. "But not far from here. We'll have some excellent surgeons."
Within the next few months, he plans to see work begin on the free-standing hospital.
Those comments veered from the script laid out by his public relations department as he gave a tour of the Ralph & Betty Engelstad Cancer Research Building that will be dedicated Tuesday.
That building, in its own right, is big news to staff at the institute.
It's "state of the art (with) laboratory space that will allow cutting-edge research," Ruckdeschel, 63, said of what is the third building on the institute's Summerlin campus. The 184,000-square-foot, $50 million structure is now the single largest dedicated research building in the state.
As he suggested how research can lead to new treatments, Ruckdeschel couldn't refrain from discussing how he believes the institute will enhance the quality of medical care in Las Vegas, regardless of whether city leaders are successful in their continuing efforts to persuade the renowned Cleveland Clinic to open a satellite operation here.
"I did this in Florida and I can do it here," Ruckdeschel said, referring to his taking over the fledgling Moffitt Cancer Center in Tampa in 1992.
Within 10 years, he took Moffitt from a place that received no federal funding to one bringing in more than $40 million a year, also earning the facility the National Cancer Institute's prestigious designation as a comprehensive cancer center.
So how is he going to fund a new building and staff a new hospital during these tough economic times? Although the institute has garnered an impressive $200 million in philanthropic donations in less than a decade, Ruckdeschel admits gifts have slowed down.
"Talk to me in a couple of months and I'll tell you how and where I'm going to do it," Ruckdeschel said.
If that sounds overly confident, consider where Ruckdeschel worked before coming to Las Vegas: Detroit.
Under Ruckdeschel's leadership, in the hardest hit state in the country, the Karmanos Cancer Institute was able to gain a four-fold increase in yearly funding from the National Cancer Institute and it became one of the only hospitals in southeast Michigan that was making a profit and ahead of budget.
Ruckdeschel was instrumental in helping Karmanos maintain its certification as a comprehensive cancer center, a designation Nevada Cancer Institute badly wants for itself since it carries with it renewable grants that add millions of dollars to research efforts.
"Where did I just come from?" he responded to a question about Nevada's own economic woes. "What was there was worse. Of course we can carry out the vision."
If the institute does build a hospital, it could be on land at Alta Drive and Hualapai Way, less than five miles from the institute's research facilities.
In March, the House approved a provision by Rep. Shelley Berkley, D-Nev., that would transfer ownership of 24 acres at the site from the Bureau of Land Management to the Nevada Cancer Institute for use as a new campus.
"We have yet to do the analysis to determine how to best use this land," said Jennifer McDonnell, a spokeswoman for the institute. "However, it will be in keeping with our mission to reduce the burden of cancer for Nevadans through groundbreaking research and patient care."
One way to help ensure an in-patient facility can be realized in the current economic climate, according to a source familiar with the institute's financial operations, would be through pork barrel politics.
If a proposed amendment by Senate Majority Leader Harry Reid, D-Nev., to the health care reform bill being crafted by the Senate is included in the final legislation, the Nevada Cancer Institute would be one of the few medical centers in the nation exempted from the Medicare "prospective payments" system, which compensates hospitals on the basis of diagnoses rather than treatments they actually provide.
"Essentially, the institute will be able to get from Medicare whatever it bills it, up to around 330 percent more," the source said. "It's inherently unfair to other hospitals, a very political process, but it brings in a lot of money."
Officials with cancer hospitals have long argued that the prospective payments system is inadequate to cover the skyrocketing costs of cancer treatment. Ten of the 41 comprehensive cancer centers around the country have the exemption.
The Nevada Cancer Institute spent $115,000 on federal lobbying fees this year, according to McDonnell.
"Senator Reid is still working with his colleagues and the White House on the bill," Reid spokesman Jon Summers said. "It's still too soon for us to comment on specifics, because they're still being worked out."
THE LONG WAR
Unfortunately, building new facilities in the war on cancer is no guarantee that it will be won.
Since President Richard Nixon announced the beginning of the war in 1971, hundreds of billions of dollars have been spent by government agencies, universities, drug companies and philanthropies to defeat cancer. Yet the American Cancer Society reported this year that nearly half of all men, and nearly one in three women, will be diagnosed with cancer at some point in their lifetimes.
In 2009 alone, nearly 1.5 million Americans will be diagnosed with a new cancer and 600,000 people will die of their cancers, about 1,500 deaths per day.
Still, there are encouraging signs on the battlefront.
The American Cancer Society reported a 19.2 percent drop in cancer death rates among men from 1990 to 2005, as well as an 11.4 percent drop in women's cancer death rates during the same time period.
And while the average five-year survival rate for all patients diagnosed with cancer was only about 50 percent in the mid-1970s, patients diagnosed with the same types of cancers between 1996 and 2003 experienced an average five-year survival rate of 66 percent.
It is against that backdrop of death and hope that two of the institute's top physician-researchers, Dr. Oscar B. Goodman and Dr. Wolfram Samlowski, now go to work in the Ralph & Betty Engelstad Cancer Research Building.
Both say the facility, made possible by the Engelstad Family Foundation's $20 million gift, affords researchers a remarkable environment for success, housing up to 40 laboratories and unique "cold rooms" for special experiments, where investigators need to bundle up in August to do their work. The facility also will house small animals for experiments.
"It's really pretty incredible that people would make this happen," Samlowski said.
In June 2002 the foundation was formed in the memory of Ralph Engelstad, former owner and operator of the Imperial Palace who died of lung cancer that year. In 2006, the foundation donated $15 million to the institute for the advancement of research, screening and treatment in the field of lung cancer.
Within 10 years, as many as 250 other staffers will join Goodman and Samlowski, including 40 primary investigators.
The brain power is not inexpensive, Ruckdeschel notes.
He doesn't shy away from the fact that he is being paid nearly $1 million a year to make things happen. Senior staffers earn more than $200,000 a year, though grants they win will often pay half their salaries.
Goodman, who in addition to his work as a researcher sees patients with prostate and bladder cancer at the institute two days a week, doesn't have the larger-than-life personality of his father, Las Vegas Mayor Oscar Goodman, who dreams of one day having "world class" medical facilities in Las Vegas.
Goodman the younger has an even bigger dream.
"I'd like to come up with the cure for prostate cancer," he said. "I still think it can be cured."
Samlowski specializes in the treatment of melanoma and kidney cancer with emphasis on treatments that activate the immune system to fight these cancers.
Institute researchers already have done some groundbreaking work, including a study that many scientists think will lead to a precise tool to detect epithelial ovarian cancer before physical symptoms are present.
Researchers have worked with more than 11,000 patients and conducted more than 125 clinical trials involving potentially life-saving drugs since the institute opened in 2005.
The more Samlowski works in cancer research, the more he worries that truly innovative studies can get pushed aside by government agencies in the fight for funding. Too often, Samlowski said, he has seen government fund small, incremental studies because those doing the peer review happen to agree with a study's direction.
When cancer researchers march in bureaucratic lockstep, he said, studies get funded that only tweak treatments instead of helping to fundamentally change the way investigators understand cancer and physicians treat it.
"What I like at the Nevada Cancer Institute is that we're encouraged to really try something new. If that attitude was around the country, we'd be a lot better off."
Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.