Randall Holcombe, MD
Treating Cancer by Community
What do 9/11 first responders, Native Hawai'ians, and Vermont’s rural populations have in common?When they get cancer, they suffer worse outcomes than the average American. Serving these kinds of communities by eliminating cancer disparities and building equity is what drives Dr. Randall Holcombe, the new Director of the University of Vermont Cancer Center.
In the aftermath of September 11, 2001, Dr. Holcombe—the then-newly appointed Deputy Director of New York City’s Tisch Cancer Institute at Mount Sinai—understood a troubling consequence: first responders and rescue workers would be at a higher risk of cancer, and it would be critical to think long-term about their care.
Holcombe knew Mount Sinai was the coordinating center for medical care for first responders. And yet, his proposal to the Tisch leadership team would be unconventional. Rather than focusing on geographic areas, Holcombe and researchers looked at the experiences of first responders and rescue workers, such as exposure to environmental toxins, to track the development of cancer and examine the epigenetic factors responsible. Not only was it the right thing to do from a treatment and research perspective, but it was a novel achievement. Redefining the causal area was a key factor in the cancer center’s recognition as a top center by the National Cancer Institute.
Holcombe applied similar thinking in 2016 at the University of Hawai’i, where he led a cancer center with extensive epidemiologic research focused on the local community, including Native Hawai'ians who suffer and succumb to cancer at markedly higher rates than others. During his five years as director in Hawai’i, his paramount mission for the institution was eliminating cancer disparities at their root causes and with culturally appropriate interventions. This emphasis on achieving cancer equity contributed the University of Hawai’i Cancer Center’s renewed status as a National Cancer Institute designated cancer center.
Now, having arrived at the helm of the University of Vermont Cancer Center in August, Holcombe once again sees this as a moment to anticipate and respond to the needs of a unique population.
“There are great opportunities at UVM to address those cancer issues that are most important for our population,” he says. “For instance, we already know that cancer patients from rural areas have worse outcomes, and I want to address that. I’m very concerned about the potential long-term effects of COVID-19 and, similar to the 9/11 responders, we need to track this and understand the underlying causes.”
Holcombe envisions a cancer center at UVM rooted in innovative research, best-in-class education for students and clinicians, cutting-edge patient care, and community outreach. He was drawn to potential to build upon Vermont’s strong foundation: engaged leadership; long-standing donor support that makes advancements, such as the J. Walter Juckett Cancer Research Foundation, possible; talented researchers and skilled clinicians. But even so, few seem to know what a cancer center is, let alone its value to Vermont.
Which is why catering to the unique cancer care needs of Vermonters and Northern New Yorkers is at the top of Holcombe’s to-do list. This winter, he will convene a newly formed advisory group of regional advocates, non-profits, and state health organizations to inform a research profile for the Cancer Center.
And Holcombe will be one of those researchers. In addition to seeing patients as a medical oncologist and Chief of the Division of Hematology and Oncology in the Department of Medicine, he will continue his work on cancer patient care, focusing on rural caregivers. Understanding that cancer science demands time, patience, rigor, and problem-solving—and that it takes years for discovery to become treatment—Holcombe plans to make clinical trials a prime focus of the UVM Cancer Center.
“Trials offer the highest quality of care for patients,” he explains. “Today’s standard treatments were clinical trials ten years ago, and today’s clinical trials will be the standard treatment ten years from now. We’ve made great advances in treatment of some cancers—breast cancer, for example— but more needs to be done for many others.”