North Carolina’s First Prostate Cancer Center Caught in Certificate of Need Litigation

Wednesday, April 28th, 2010 at 8:05 pm

Raleigh, NC: A prostate cancer center in Raleigh deemed necessary by the North Carolina State Health Coordinating Council in 2009 is now on hold because of pending lawsuits by three local medical facilities. Cary Urologists Dr. Kevin Khoudary and Dr. John Leung filed an application with the state for permission to open The Prostate Health Center, or TPHC. Since the physicians want to purchase a costly radiation therapy machine for the proposed center, state regulators must rule whether it fits cost-control guidelines.

The project is now delayed until at least June 3rd because of legal appeals brought on by Rex Hospital, UNC Hospitals and Wake Radiology. Neither Rex nor UNC Hospitals applied for a CON, however, Dr. Khoudary feels the objections are based on pure economics. “These objections are difficult to understand given the expected increase in cancer in the next decade, “ notes Khoudary. “I am hopeful that wisdom and concern about the patients will prevail and we will soon be permitted to proceed with this important project. I believe that others will copy the program, once they see its effectiveness.”

Prostate cancer affects one of every six men. African American men in North Carolina are disproportionately affected, but all men struggle to make sense of the multiple treatment options and to tailor solutions that best fit their own situation.

A movement lead by NC Minority Prostate Cancer Awareness Action Team to call attention to the problem among those who it affects has succeeded in increasing prostate cancer screenings and is making some inroads on earlier referrals. This 15 year old volunteer group meets with men on their own turf. They are raising awareness. The next step is treatment and prevention. Seeing the numbers and the incidence of late stage prostate cancer among African Americans in his Cary Urology practice, urologist, Kevin Khoudary, MD, resolved to do something about the problem and began to call the attention of state regulators to the issue in 2007. He was joined in the effort by with several advocacy groups including NC Minority Prostate Cancer Awareness Action Team and The Institute for Health, Social, and Community Research at Shaw University. He found urologists throughout Wake County had the same experience.

Dr. Khoudary sees two issues to be addressed, one epidemiologic. We need to know why prostate cancer mortality is so much higher among African Americans in North Carolina, even when compared to African Americans in places like Louisiana. The second is programmatic. The prostate gland is anatomically complex, located in a tight space where nerves and vessels associated with urinary and sexual functions cross paths with one another. Addressing prostate cancer requires specialized knowledge of anatomy and radiation. This combination of skills is rare in the organization of cancer centers. Most are directed by people who specialize in radiation medicine or in chemotherapy.

Dr. Khoudary’s vision is to have North Carolina catch up with medical centers like Johns Hopkins, M.D. Anderson and the University of Rochester. The Southeastern Cancer Control Consortium and Edward Messing, MD, FACS, of the University of Rochester have agreed to evaluate clinical aspects of the project. The Southeastern Cancer Control Consortium is a national leader in clinical trials associated with prostate cancer