Health Care Official Works Daily to Help Locals Feel Better

By Hubble Smith

By HUBBLE SMITH

REVIEW-JOURNAL

Paul Cohen has been working to improve Nevada’s health care system for more than 30 years, first as chief of the Bureau of Alcohol and Drug Abuse rehabilitation division under Gov. Mike O’Callaghan and now as executive director of Comprehensive Cancer Centers of Nevada.

Cohen said he’s been blessed by a career that benefited Nevada’s children and working adults.

He moved to Reno from California in 1965 to work as a science teacher with the Washoe County School District. He worked in Carson City for Govs. O’Callaghan and Bob List before coming to Las Vegas in 1982 to revamp the Culinary union’s health and benefits package.

For the past 14 months, he’s been trying to make it as comfortable as possible for terminally ill patients who are living day to day.

“Cancer is a very nasty disease,” Cohen said. “Everyone of us has a one-way ticket on the train. Some of us have a bumpy ride. Some of us have a short ride.”

Cohen oversees six locations for Comprehensive Cancer Centers of Nevada, including the main 34,000-square-foot plant at 3730 S. Eastern Ave. He has 230 employees, including 22 doctors.

Question: What is your mission at Comprehensive Cancer Centers of Nevada?

Answer: Real simple: to provide comprehensive and quality care to our patients. It’s on all of our advertisements and logos. That’s our branding program. Not only providing that comprehensive care, but providing supportive care to the family. A lot of people forget about the family. Look at patients in the waiting room; the vast majority are not by themselves. That’s what comprehensive means – what are all the options available out there for (improving) their quality of life.

Question: How has cancer treatment in Las Vegas evolved over the years?

Answer: It has changed with technology. We have pumps implanted to release drugs for pain management. One of them allowed one woman to travel for six months before she died. When you have someone who’s terminally ill, you don’t want them to just crawl up in the fetal position and die.

With pediatrics, it’s even worse. Those kids react more violently to treatments; they’re more sensitive and will often end up in the emergency room. It tears you up.

Question: Any other advances in cancer treatment here?

Answer: Technology and drugs. And physicians are becoming more proficient … they are literally specializing in forms of cancer. Breast cancer is a good example. Before, we used invasive procedures. Years ago, you had a lump on your breast, (the treatment option would be) ‘Let’s go take it out.’ You add technology, new drugs and training of physicians, couple that with the availability of resources and you’re seeing a trend. It’s true that preventive medicine is the best alternative; that’s really the key. We’re seeing from the self-insured (companies) more pap smears and wellness programs.

Question: What kind of technology is driving the changes?

Answer: I’m talking about the drugs that are available for chemotherapy and the equipment, the nuclear camera, the PET (positron emission tomography) scan, all the diagnostic equipment, the linear accelerator where they do the treatment. We’re excited because our new building in the northwest (Las Vegas Tech Center) will have a combination PET-CAT scan. That’s $1.5 million.

Question: Why has Las Vegas been depicted as a city of shortcomings in medical technology?

Answer: When you look at the history of this city and how it was developed, you look at the hospitals here in the 1960s, Desert Springs and Valley and North Las Vegas, they weren’t built as hospitals. They were built as skilled nursing centers. Sunrise was really the first hospital. UMC was Southern Nevada Hospital. There wasn’t an awful lot here.

Question: Comprehensive Cancer Centers of Nevada has participated in a number of clinical research trials. With whom do you work?

Answer: We’ve had a 10-year relationship with the University of California, Los Angeles and we’re probably going on a similar time with U.S. Oncology in research. There’s four phases of research. Phase one is when you basically are the guinea pig, the cutting edge of research. Phase two and three is what we do, where we identify certain patients with certain cancers, what are the protocols, certain procedures you follow.

You see ads in the paper where people, usually a pharmaceutical company, want to do research.

The patient has to have a specific kind of cancer to where they will be put on a specific drug regiment and there are outside monitors to track these patients and that becomes your database. Phase four research is what you find in your academic institutions, where they bring in young doctors to do research.

Question: How would you change the state of health care?

Answer: To me, to truly solve the problem, you need to get the patients, the providers and the facility owners together and develop a system that will maintain the quality of care and the cost. The cost will never be controlled but you can control the rate of increase in costs.

Get the consumer to buy in. It’s consumer education. Doctors say, “Pee in the bottle,” you pee in the bottle. Those days are over. The informed consumer says, “Is this the best option for me?”

One of our philosophies here is the only thing constant is change. There are new drugs coming out every day.