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What are Centers of Excellence?

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Posted 1/30/2020 5:22 PM (GMT 0)
Here and across the web and in books, I see references to the wisdom of seeking treatment at PCa centers of excellence? I initially thought that there would a be a list of them and that it would be a designation from some authoritative entity like NCCN; but NCCN seems to use different terms.

I can randomly think of some institutions that I assume would be considered centers of excellence -- Johns Hopkins, Mayo, MSKK, Cleveland Clinic, MD Anderson -- but is that right, and are there others? Is it a loose category or what?

By contrast, what's considered a tertiary care center?

I apologize if I'm asking obvious or recurring questions but site searches and google have still left me wondering. Thanks
Posted 1/30/2020 5:35 PM (GMT 0)
Ask away, there are no stupid questions as they say....

https://www.cancer.gov/research/nci-role/cancer-centers/find

This is not an exhaustive list, there other good places that are not on the list. There are also specialty groups or doctors that are very good at what they do (surgery or radiation) but would not fall under the heading of cancer center of excellence. The concept is you can see a group of doctors so that you get a more balanced opinion.
Posted 1/30/2020 5:36 PM (GMT 0)
I don't know about 'Centers of Excellence', but here's a link to a similar list (NCI Designated Cancer Centers)
https://www.cancer.gov/research/nci-role/cancer-centers

PS: Tertiary means that the place does (almost) everything. It doesn't mean that they do everything well...
Posted 1/30/2020 5:38 PM (GMT 0)
A link that is a decent explanation:

https://www.verywellhealth.com/primary-secondary-tertiary-and-quaternary-care-2615354

Just depends on how sick you are I guess.
Posted 1/30/2020 6:05 PM (GMT 0)
At the end of the day, if you go to one of the NCCN member institutions, or one of the NCI cancer centers, you will get excellent care. The best part is, even if you have a really unusual case--these lead doctors all know each other--and if the one you're seeing gets puzzled, there is someone in the network who can add insight.

I think some of the designations have changed lately. You used to be able to google "NCCN centers of excellence"--I think they are all now just listed as "member institutions"--which means they follow the published NCCN guidelines.
Posted 1/30/2020 6:19 PM (GMT 0)
Thanks guys. I'd visited that NIH list of cancer centers and was wondering if their "Comprehensive Cancer Center" designation was equivalent to what people mean when they say/type center of excellence, but that would cast a pretty wide net.

Anyway, appreciate your help.
Posted 1/30/2020 6:45 PM (GMT 0)
FreeWill88, where are you located?
Posted 1/30/2020 7:06 PM (GMT 0)

halbert said...
FreeWill88, where are you located?

I'm in the Hub of the Universe -- i.e., Boston. smile

Expressing it that way because it's background to my question. We in Boston are accustomed to thinking of our hospitals as top-tier (I'm trying to say that with a tone of some self-mockery, but there's little doubt that most of us around here think we are blessed to have the best hospitals (and the worst drivers) anywhere), and in this regard I would have assumed that Dana Farber is a cancer center of excellence. So I'm not surprised to see it listed by the NIH as a Comprehensive Cancer Center. (though I am surprised not to see Mass General on the NIH list)
Posted 1/30/2020 7:17 PM (GMT 0)
Ahhh Boston, land of the bean and the cod,
where the Cabots speak only to the Lowells,
And the Lowells speak only to God.

Seriously, there are several guys here who had PCa treatment at Dana Farber, and gave good reports.
Posted 1/30/2020 8:29 PM (GMT 0)
I’d like to provide some clarity.

NCI = National Cancer Institutes. NCI has designated 71 institutes in 36 states as NCI Institutes. Dana Farmer is one of them. 13 are Cancer Centers, 51 are Comprehensive Cancer Centers and 7 are Basic lab centers (primarily pre-clinical research. The NCI is an agency of the NIH.

NCCN = National Comprehensive Cancer Network. There are 28 affiliated centers that are members of this network. In Boston Dana Farmer, Brigham and Woman’s and Mass General are listed. These are comprehensive centers that offer clinical, research and preventative services and are generally affiliated with a University Medical Center/Medical School.

NIH = National Institutes of Health. An arm of the US Government. The NIH has 27 Institutes and Centers through the US and covers everything imaginable with health. It dates back to the 1870’s and has covered everything from tooth decay to bi-polar disorder. It is mainly research and treatment is often through NIH clinical trials. It also is one of the primary dispensers of research money that goes to institutes and universities for health related research.

The term Center of Excellence is not official, that I can find. Also, that a Center is neither NCI nor NCCN in no way means it is inferior It just means it is not in one of the networks. As an example in Atlanta we have two dominate hospitals that are major and well regarded comprehensive cancer centers, Emory/Winship and Northside Hospital. Emory is part of NCCN as it is part of the Emory University system. Northside is neither NCI nor NCCN. However it is highly regarded especially with breast, prostate and pediatric cancers.
Posted 1/30/2020 10:22 PM (GMT 0)
JNF - Great summary. It reminds of "accredited by" and"certified by" that you run into all the time in business. It can be helpful but does not guarantee anything. At least they all provide a "lifetime warranty" I suppose smile
Posted 1/31/2020 6:30 PM (GMT 0)
Thank you, JNF! I'll take all the clarity I can get these days!
Posted 2/1/2020 12:12 AM (GMT 0)
Reading more about the NCI and NCCN network affiliations, it appears they are significantly about the research the institutes do and the breadth of cancers they treat. NCI includes filters referring to treating complex, advanced and rare cancers. Affiliation is not about only patient outcomes. So these affiliations do not imply that you will do better with one of these centers than at a center not in the network.

Neither network would include institutes that may be truly excellent with certain cancers, yet not having the size or scope of the broad treatment or research. An example is Beaumont ion Detroit that has an excellent Prostate cancer center with one of the top radiation oncologists, Dr. Alvarez Martinez. Also Tulane University Cancer Center has Dr. Oliver Sartor, a leading PCa medical oncologist, but is in neither network. UCLA Medical Center is another example of a renowned center that is in neither network.

And the networks exclude the specialty clinics like Datillo in Florida, Moran in Chicago, Georgia Urology, Swedish in Seattle, and many others that have proven to be excellent treating PCa. If one limited their choice to the network centers, they would miss out on some great specialists.
Posted 2/1/2020 1:19 AM (GMT 0)
Seatlle has a great place... Seattle Cancer Care Alliance... Hooked up with the University of Washington

pasayten
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