A Conversation With Patricia Goldsmith

Patricia Goldsmith

Patricia Goldsmith is the executive vice president and chief operating officer of the National Comprehensive Cancer Network (NCCN), a nonprofit alliance of 21 cancer centers in the United States. We spoke with Goldsmith following the NCCN 16th Annual Conference: Clinical Practice Guidelines & Quality Cancer Care, which was held March 9-13, 2011, at The Westin Diplomat in Hollywood, Florida. Goldsmith has been with NCCN since 2005; prior to that she was vice president for institutional development, public affairs, and marketing at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida.

OBTN: What was your primary goal for this year’s NCCN 16th Annual Conference: Clinical Practice Guidelines & Quality Cancer Care?

Goldsmith: This conference represents an opportunity to showcase the NCCN Clinical Practice Guidelines in Oncology and to speak with the oncology community about the changes in the Guidelines and the evidence that is present in the Guidelines. It’s one-stop shopping, so to speak, for oncology professionals to be able to come to a conference and learn a great deal that impacts their real-world clinical practice life immediately. It’s also an opportunity—and we hear this from many attendees—to network in a meeting that is manageable in size and gives them an opportunity to get to know their fellow clinicians in an easy environment.

How does this, the 16th Annual Conference, differ from the first conference? What has changed since then?

Oh, it has changed very much. It’s probably at least 5 times bigger in terms of attendees. By all measures, it is the largest organized meeting—that we know of—of oncology fellows anywhere. It also has a very large advanced practice nursing program, as well as a very large program for oncology pharmacists. Plus, there are now 2 roundtables that deal with topical policy issues or issues that are of extreme importance to the oncology community.

Can you briefly describe how roundtable host Sam Donaldson came to be involved with this event?

Sam Donaldson is my dear friend. I actually met him 8 or 9 years ago when I was a vice president at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida. Sam is also a close friend of US Senator Connie Mack, who was at the time the chairman of the Board of Directors at Moffitt Cancer Center. We invited Mr Donaldson to be the keynote speaker for the grand opening of a research building at Moffitt Cancer Centers, and we just became very close friends through the years. When I joined NCCN, I had this idea of trying to create a very high-profile opening roundtable at our annual conference, and Sam signed on to do that 6 years ago. He subsequently agreed to be the chairman of the Board of Directors of the NCCN Foundation. So he’s become very actively involved at NCCN.

Are there any NCCN Guidelines update sessions that you considered more surprising or important than others in terms of what’s changed since the last update?

Well, I thought about that a lot. I reached out to our scientists and I wanted to pick 1 thing that I thought might be not necessarily “surprising,” but something that has really changed the view of standard of care. And I think that really was the discussion that came in the talk given by Robert J. Morgan, Jr, MD, of City of Hope Comprehensive Cancer Center in Duarte, California. Dr Morgan presented the guidelines for ovarian cancer and discussed the fact that the data indicate that intensive follow-up with CA-125 screening after a complete response in ovarian cancer may not be helpful. According to the data, early treatment initiated after an increase in CA-125 versus treatment only when there was clinical evidence of the disease provided no benefit in survival, but a decreased quality of life. The panel felt that CA-125 testing should be discussed with the patient because these data need to be balanced with the patient’s natural anxiety about whether the cancer is coming back. So I think that was a very important discussion, and again challenges a belief in the oncology community regarding what to do with the results of CA-125 and—also important— balancing the patient’s quality of life.

"We felt that the NCCN Foundation had the opportunity to be able to generate funding for young investigators— both physicians and nurses within the NCCN member institutions—to help give them some money to fund research, particularly research that in some way or another could focus on the Guidelines and how they’re used in practice."

—Patricia Goldsmith

Can you discuss the NCCN Foundation and its philanthropic services? Also, Russell Budd, an attorney, was recently named the newest board member. Is he the only lawyer on the NCCN Foundation board?

Yes, Russell Budd is the only attorney on the NCCN Foundation’s Board of Directors. We are in the process of rounding out that board and looking for diversity from a number of perspectives, so having an attorney on board was something that we thought was important.

The NCCN Foundation was created and began operations around 11 months ago, and the objective was to continue to support the good work of NCCN and to broaden the work of NCCN in some specific areas. One of the major priorities of the NCCN Foundation is to fund the resurrection of the NCCN Guidelines for Patients. This was a very successful program that we had many years ago with the American Cancer Society, but unfortunately it came to an end about 3 years ago simply because the American Cancer Society was not able to keep up with all of the updates of the NCCN Guidelines for Patients. As you know, our Guidelines are continuously updated for professionals, and the Guidelines for Patients have to adhere to that same high standard. For example, we have one Guideline that is already on its fourth update in 2011. So, we really felt that the NCCN Foundation represented an opportunity to create a philanthropic arm of the organization that could resurrect those Guidelines for Patients. In fact, we had 6 NCCN Guidelines for Patients completed by the end of 2010 and have a plan for at least 9 more in 2011. That’s a major priority.

Additionally, we felt that the NCCN Foundation had the opportunity to be able to generate funding for young investigators— both physicians and nurses within the NCCN member institutions—to help give them some money to fund research, particularly research that in some way or another could focus on the Guidelines and how they’re used in practice. So, that is another priority of the NCCN Foundation, and ultimately, I think that the Foundation will be able to create survivorship programs for patients.

Are there plans to add any cancer centers to the existing 21 Member Institutions?

No. While I think that virtually every comprehensive cancer center in this country has at one time or another asked for membership into NCCN, there is currently a moratorium on membership, and that has been the case for the last 2.5 years. We receive requests from cancer centers all across the world. Ultimately, we may consider some sort of international membership. But right now, there are no plans to add any cancer centers into the existing membership structure. The reasons for this are several-fold. All of our 21 member institutions pay very significant membership dues and are required to volunteer hours on many different committees. For example, last year the NCCN Guidelines Panel Members from our 21 Member Institutions donated more than 16,800 hours of volunteer time—not including travel—just in the development and maintenance of the Guidelines. All of these institutions have donated an extraordinary amount of time and talent—the Guidelines being a major area of focus, but not the only one. Those cancer centers that have been with us since the beginning feel that NCCN has become very influential and prominent, and they don’t want to dilute the organization that they have worked very hard to build with their resources. Plus, the organization feels that, geographically speaking, most of the map is covered, so we would only consider additional members if we felt that they brought great value to NCCN as a whole.