Caring for more people with cancer through virtual visits, home care and new technology

By Cheryl Willman, M.D., executive director, Mayo Clinic Cancer Programs, and director, Mayo Clinic Cancer Center

As I reflect on my first months as executive director of Mayo Clinic Cancer Programs and director of Mayo Clinic Cancer Center, I am thrilled to lead one of the world's finest cancer programs. We're changing cancer medicine and the way cancer care is delivered, and it's absolutely fantastic.

I came to Mayo Clinic from The University of New Mexico, but I'm not new to the organization. I attended medical school at what is now Mayo Clinic Alix School of Medicine. I completed my residency and postdoctoral training in pathology and cancer research at Mayo Clinic, The University of New Mexico, and University of Washington.

I've always felt a deep connection to the communities we serve ― and an obligation to give back. And that's how I lead.

At Mayo Clinic, I am determined to find ways to give all patients access to outstanding cancer care, as well as access to the knowledge we develop and the treatments we discover. And that starts by deeply engaging our communities.

Mayo Clinic Cancer Center is the only three-site National Cancer Institute-designated Comprehensive Cancer Center, with locations in Arizona, Florida and Minnesota. One of the expectations of Comprehensive Cancer Centers is that they serve the needs of populations living in the geographic regions they serve.

We need to connect with the diverse people and communities in these areas and understand their cancer priorities and needs ― in turn answering these questions:

• What are the most common cancers in these communities?
• Do people have access to cancer screening, and how do we help them?
• How can we reach underserved and minority populations in these areas?

I think virtual cancer care is the answer.

We've learned from the COVID-19 pandemic that virtual care can work. At first, it was stressful for patients, but over time, as we've all gotten used to Zoom calls, we have found that people like virtual care. They can stay in the comfort of their home and still have a personal interaction with their physician, advanced-practice provider, clinical trial specialist, psychologist or nutritionist.

So why not continue virtual care permanently and expand our new Cancer Care at Home Program, as it can transcend geographic boundaries? Why ask people to travel to Mayo Clinic when we can deliver care to them in their homes, where they are safer and not exposed to other patients who may be ill?

Just think about the expenses and difficulties that come with traveling: gas, vehicle maintenance, wheelchair accessibility. And then factor in the emotional toll, time needed for travel, and time away from family and friends who support and love them.

Think about a real-life example. Consider the case of a patient who has undergone a bone marrow transplant and is at home recovering, and that patient experiences complications. Why should that person drive to an emergency department when we can offer 24/7 remote care, where at the push of a button, they're in touch with a Mayo physician and a nurse. We also can provide support from patient navigators, who are trained to help people navigate a complex health system.

One of the projects I'm most excited about is a Mayo Clinic trial to deliver breast cancer infusion chemotherapy in the home setting for the first time. I think such projects will revolutionize how we care for people with cancer. Advancements in home care could allow us to deliver high-quality care across any geographic barrier to communities who don't have access to any cancer care.

American Indians have the highest rates of cancer and the poorest cancer survival of any group in the U.S., including Blacks and Hispanics. Rural populations of all races and classes have poorer cancer outcomes for even the most common cancers. Virtual cancer care could bring care to many people who don't have the ability to travel to a Mayo Clinic location. This is going to be one of the leading innovations of Mayo Clinic Cancer Center.

While virtual and home care will help us provide cancer care to more communities, new technologies will help us treat more cancers more safely.

I think new particle therapies — advancements in radiation therapy — will truly transform cancer care around the world. Traditional radiation therapy for cancer uses beams of photons. We've learned over the past decade that proton beam therapy targets cancer more precisely, sparing healthy tissue from radiation.

More people need proton beam therapy than we can accommodate, so we are expanding our treatment space. We're also building North America's first carbon ion therapy facility to research and develop even more precise therapies for cancer cells resistant to traditional radiation. This is incredibly important for people across the globe because carbon ion therapy is currently only available in Asia and Europe.

Researchers at Mayo Clinic Cancer Center also are studying the development of personalized messenger RNA vaccines for cancers — vaccines that are specific to each person's DNA. Cancer arises because our cells acquire mutations, or little mistakes, in the coding of our DNA. These mutations come about through aging and the process of living, and some environmental exposures. We now understand that we need to sequence the DNA of every person's cancer so we know exactly what the mutations are and what should be in the personalized messenger RNA cancer vaccines we're studying.

I wake up every day and discover new opportunities to deliver outstanding Mayo Clinic cancer care to everyone who needs it — anywhere in the world. And I am incredibly honored to lead the phenomenal Mayo Clinic team of physicians, scientists, allied health staff, and students who will make it happen.