Interview

A New Standard of Cancer Care

Paul Thurmes, MD, is the president of Minnesota Oncology

This year Minnesota Oncology celebrates its 30th anniversary. What can you tell us about this milestone – from how the practice began to the point where it is today?

Celebrating 30 years of dedicated patient care is a monumental achievement for Minnesota Oncology. We are proud to be Minnesota’s sole independent, physician-led oncology practice, allowing us the flexibility to tailor decisions that prioritize our patients’ unique needs, while simultaneously reducing costs and maintaining the highest standards of care.

Our journey began in 1995 when three oncology groups across the Twin Cities united to form Minnesota Oncology Hematology, P.A. (MOHPA), later rebranded as Minnesota Oncology. The founders shared a bold vision to transform cancer care in the region.

Shortly thereafter, we partnered with Physician Reliance Network, now known as The US Oncology Network, which provides management support, enabling us to retain our independence and physician leadership. Since then, our practice has expanded significantly, adding more providers, locations, specialties, and services such as gynecologic, breast, thoracic, and melanoma surgical oncology, radiation, palliative care, two onsite pharmacies, laboratory, imaging, and many other services to best support our patients. We also care for benign diseases, offering hematology treatment for blood disorders such as anemia, bleeding disorders such as hemophilia, blood clots, and care for benign breast conditions.

What are some of the most dramatic advances in cancer treatment that you have seen over the past 30 years?

Over the past three decades, oncology has witnessed transformative changes, predominantly due to rapid breakthroughs in new treatments, including targeted therapies, immunotherapy and other biologicals, redefining patient care and outcomes. Some examples of this include the following:

Immunotherapy: This groundbreaking approach harnesses the body’s immune system to fight cancer cells. Treatments like checkpoint inhibitors and CAR T-cell therapy and BITE therapies have shown remarkable success, especially in cancers that were previously difficult to treat.

Targeted Therapy: Unlike traditional chemotherapy, which affects all rapidly dividing cells, targeted therapies specifically attack cancer cells by focusing on molecular and genetic markers unique to the cancer.

Personalized Medicine: Advances in genomics have paved the way for personalized cancer treatments. By sequencing a tumor’s DNA, doctors can tailor treatments that are most likely to work based on the genetic mutations present in the cancer.

Precision Surgery: Techniques such as robotic surgery and minimally invasive procedures have improved surgical outcomes, reduced recovery times, and preserved more healthy tissue compared to traditional methods.

Radiation Therapy Advances: Innovations such as intensity-modulated radiation therapy (IMRT) and proton therapy allow for more precise targeting of tumors, minimizing damage to surrounding healthy tissues.

Liquid Biopsies: This less invasive method of detecting cancer through blood tests allows for earlier diagnosis, monitoring of treatment efficacy and detection of recurrences without needing traditional biopsies.

Cancer Vaccines: Preventive vaccines, such as the HPV vaccine, have significantly reduced the risk of certain cancers. Therapeutic vaccines are also being developed to treat existing cancers by boosting the immune response.

All of these advances have revolutionized how we think about cancer treatment and prognosis; these therapies have allowed patients to live longer with improved quality of life.

Reducing funding for cancer research has widespread negative implications

What can you tell us about the Sarah Cannon Research Institute and your collaboration with it?

Minnesota Oncology offers clinical trials through the Sarah Cannon Research Institute (SCRI), one of the world’s leading oncology research organizations conducting community-based clinical trials. SCRI has contributed to research leading to most of today’s approved new cancer therapies.

Our research program provides patients with access to the latest clinical trials and is part of an expansive research network that works to advance therapies for patients and transform cancer care. We have an extensive range of clinical trials open across various disease types.

Additionally, our membership in the Mayo Care Network grants us access to their expertise and clinical trial program. We also offer clinical trials through the Metro-Minnesota Community Oncology Research Consortium (MMCORC), a nonprofit research program sponsored by the National Cancer Institute. We are fortunate to have an onsite research lead, Dr. Eric Lander, who manages our clinical trial program.

How has genetic risk evaluation grown as a tool in the work you do?

Some cancers have hereditary components. To help individuals potentially at risk, Minnesota Oncology offers genetic counseling to patients and family members. We believe such intervention can significantly increase the likelihood of successful treatment and inform the type of treatments. 

We also offer a high-risk breast cancer clinic. This team works with patients and their families to educate them about their breast cancer risk and collaborates closely with our genetic counselors, breast surgeons and medical and gynecologic oncologists to develop an effective plan to reduce risk and increase the chances of early detection.

In addition to understanding the inherited risks of cancer, understanding and mapping the genetics of the cancer cells (as opposed to the genetics of the patient) has allowed for new therapies to emerge in both the targeted therapy space and the immunotherapy space.

Federal funding for medical research is facing serious challenges. What are some consequences this could present and some reasons that cutting research costs could end up costing more money in the long run?

Reducing funding for cancer research has widespread negative implications. Ongoing cancer research projects may come to a halt, delaying potential breakthroughs in treatment and prevention. This could slow the development of new therapies, drugs and diagnostic tools that are crucial for improving patient outcomes. Halting cancer research projects not only delays or halts progression but will have the potential to set us back substantially. If funding does return, it will be impossible for scientists to pick up from where they left off; they will have to start from square one. The result? Many important projects will simply vanish, wasting all the time, money and energy that has already gone into this.

The United States has a proud tradition of being a world leader in cancer research. We have attracted the best and brightest scientists from around the world. Reduction in funding and the uncertainty that follows will certainly lead to an exodus of our most valuable resource: scientist who have paved the way for a brighter future for victims of cancer.

Reducing funding for cancer research could lead to a surge in cancer incidence and mortality rates. This scenario not only would inflate health care costs but, more important, would also result in the tragic loss of lives to cancers that might have been preventable. Maintaining or increasing funding is crucial to continue the fight against this complex disease.

What are some of the most dramatic advances that are in the pipeline that may be available soon?

As much as cancer care has changed in the last 30 years, the rate of change continues to accelerate. Drugs that used to take over a decade to develop are now being developed in a matter of months. The whole world of immunotherapy continues to evolve rapidly, as we understand the complexity of the immune system and harness its therapeutic potential while minimizing side effects. Nanoparticle-based drug delivery systems are being refined to improve the precision and efficacy of cancer treatments. These systems can deliver drugs directly to tumor sites, minimizing side effects and enhancing therapeutic outcomes. As a result, patients with cancers that are notoriously resistant to treatment (and therefore very difficult to treat) will have new treatment options. 

Perhaps more than in any other specialty, the size, expertise and specialization of the care team that supports cancer care has grown. What can you share about the non-MD health care professionals you work with to help support your patients?

At Minnesota Oncology, we treat the whole patient through integrated care. In addition to medical, surgical and radiation oncology, our dedicated care and support teams include: expert advanced practice providers, nurse navigators, care coordinators, oncology nurses, pharmacists, radiation techs, lab techs, social workers, dietitians, genetic counselors, clinical trial and research teams, scheduling, and patient financial support teams.

Our connections with external services, such as our long-standing relationship with the Angel Foundation, further enrich our support network. The Angel Foundation offers relief to cancer patients and their loved ones through financial assistance, education and emotional support.

Another option we provide our patients with is access to spiritual care from our fulltime chaplain. We also provide complementary services such as Reiki and are exploring other similar services.

Another important development for cancer patients is a robust and growing cancer survivorship program. What can you share about this?

Our ultimate goal is for cancer patients to become survivors who lead active, full, healthy lives. Cancer changes everything and being a cancer survivor encompasses more than completing treatment. Patients conquer physical, mental, emotional and spiritual challenges during cancer treatment, and our support extends beyond treatment completion. Minnesota Oncology’s survivorship program offers comprehensive support, guidance and resources, ensuring continued care and encouragement.

It is important for patients to have a summary of the treatment they received since their diagnosis and a survivorship care plan to help them be informed about the long-term and late effects of the therapies they received. This helps patients recognize any problems early on and offers suggestions for healthy behaviors after cancer treatment.

We know that anxiety and stress can sometimes be worse after treatment ends. With less focus on physical health, patients have more time to focus on a new normal, and oftentimes, this leads to another wave of emotions including worry, sadness and fear. That is why our survivorship program offers ongoing support for patients who may struggle with increased anxiety after treatment. We also provide recommendations for post-treatment physical activity, nutrition and a follow-up care plan.

While everyone knows early detection is crucial, what are some areas where primary care most often misses the signs or perhaps does not ask the right questions?

Primary care providers have an enormously difficult job. While there are so many advances in detecting and treating cancer, the reality is that many cancers present with nonspecific symptoms or no symptoms at all. Symptoms of cancer can masquerade as so many different diseases or disorders. It is vital that patients establish an ongoing relationship with a primary care provider. This allows for an ongoing dialogue between patient and provider, who can notice subtle changes in a patient over time. It also allows for a broader and more in-depth discussion of family and environmental cancer risks, and testing that can lead to early detection. 

Is there anything else about what you are doing at Minnesota Oncology that you would like to share?

Minnesota Oncology was founded with the mission to deliver a new standard of cancer care, and we remain steadfast in this mission. Our independence allows us to evolve with our patients’ needs and the communities we serve. We anticipate a future filled with innovation, growth and compassionate care.

Paul Thurmes, MD, is the president of Minnesota Oncology.