Iam a medical oncologist practicing in Western New York for more than 30 years, and want to express my views regarding the direction and changing patterns of care delivered to cancer patients in this community.

Roswell Park Cancer Institute is one of the pre-eminent cancer establishments in upstate New York. There are many well-trained cancer specialists with excellent credentials who treat patients in various private and hospital locations in our area. Many practicing oncologists in this region have been trained in some of the finest cancer institutions in the United States. Most community-based cancer care is rendered in accordance with National Comprehensive Cancer Guidelines.

A number of attempts have been made in the past to network and collaborate among physicians at Roswell Park and community oncologists to help improve the quality of care for cancer patients. Unfortunately, these efforts have met with very limited success.

The Western New York community looks up to Roswell Park with a great sense of pride. I have the highest regard for my colleagues who work at the institute, but most of them have been generally silent about the vital role of community- based cancer care. Roswell Park has launched a sustained and powerful marketing campaign that has blanketed the airways for several years. The subliminal message of this campaign is that state-of-the-art cancer care is neither possible nor available outside of Roswell Park.

Statistics indicate that the medical oncology physician work force will be declining by 30 percent over the next decade. At the same time, there will be a rapid rise in the number of cancer patients seeking care. It is also a well-known fact that it has been difficult to attract new physicians to this region.

Roswell Park has produced great scientists and trained excellent physicians who have contributed significantly to the field of oncology. Unfortunately, the institute’s reputational score has been declining for some time. Those familiar with U. S. News and World Report ratings know Roswell Park was not mentioned among the top 50 cancer institutions in this country. At the recent annual meeting of the American Society of Clinical Oncology, among approximately 350 faculty and cancer leaders recognized as educational resources, there was mention of only a single physician from Roswell Park.

In a rapidly changing environment of rising cancer incidence, declining physician work force and new economic pressures, there must be fresh dialogue to improve the overall care of cancer patients. Roswell Park will remain an essential and important resource for cancer patients in upstate New York. The institution needs strong support for research and clinical trials. But many patients can continue to receive excellent care under the direct supervision of their community oncologists with no compromise in quality.

Kandala K. Chary, M. D., is past president of the Roswell Park Community Cancer Network.