The landscape of cancer care in America faces critical challenges: geographic disparities in access, socioeconomic barriers to advanced treatments and the increasing complexity of precision medicine that outpaces individual providers’ ability to stay current. At City of Hope, we are addressing these systemic issues through a bold expansion that brings world-class cancer care and research closer to where patients live.
Cancer care has evolved into a systems issue requiring extensive infrastructure support. The rapid pace of scientific advancement creates an impossible burden for individual practitioners to maintain expertise across all domains. Americans living in rural communities particularly face poor access to specialized care, while even urban providers struggle with the increasing complexity of and access to modern cancer treatment.
There are also stark disparities in clinical trial participation. In prostate cancer, for example, 10% to 15% of patients are Black, yet less than 2% participate in major clinical studies. This underrepresentation occurs despite known genetic differences that may affect treatment response, highlighting how current research infrastructure fails to serve diverse populations.
A national approach to precision medicine
City of Hope’s national expansion addresses these challenges through strategic positioning in major metropolitan areas, including Los Angeles, Orange County, Chicago, Phoenix and Atlanta, alongside community oncology practices nationwide. This geographic distribution allows us to serve underserved populations while maintaining the critical mass necessary for subspecialty expertise.
The power of this model lies in scalable infrastructure enabled by our unified medical record and financial systems. Through digital pathology and virtual collaboration, we will be able to deploy disease-specific expert pathologists across our entire network without requiring physical presence at each location. A breast pathologist in Chicago could serve patients throughout our system, while a genitourinary pathologist in Atlanta could provide expertise nationally. This approach can extend to radiology, genomic testing and virtual patient monitoring.
Our City of Hope Phoenix network has piloted this integration through partnership with the Translational Genomics Research Institute (a fully integrated component of the City of Hope system), which has developed rapid-turnaround genomic assays. Tests that traditionally require 10 to 14 days now return results in 36 to 72 hours, allowing immediate precision treatment decisions rather than empirical therapy while awaiting molecular characterization.
The national network fundamentally changes our research capabilities as well. Previously, rare disease studies were limited by patient volume at individual sites. As a large system, we can now conduct meaningful trials for increasingly narrow molecular disease subsets. This scale attracts pharmaceutical partners and federal funding agencies, recognizing our ability to deliver diverse patient populations for clinical trials.
The network also enables investigator-initiated studies that would be impossible at a single institution. Rather than limiting ourselves to small pilot studies, our faculty can design and implement definitive trials with adequate statistical power across our national patient base.
Supporting community providers
Our national model recognizes that most cancer patients receive care in community settings. We have developed virtual tumor board systems and asynchronous collaboration platforms that connect our City of Hope providers and subspecialty experts in real time. When a community oncologist encounters a complex renal cell carcinoma case, they can immediately access kidney cancer expertise rather than waiting for scheduled tumor board meetings.
This support system elevates care quality across our network while providing continuous medical education. Each consultation strengthens the knowledge base of community providers, creating a multiplier effect that benefits patients beyond individual encounters.
Looking forward
The future of cancer care demands this system approach. As we develop increasingly precise therapies targeting smaller molecular subsets, the infrastructure required to deliver complex treatments and monitor outcomes grows exponentially. No individual provider or small practice can manage this complexity alone.
Our national network model at City of Hope demonstrates that large-scale, coordinated cancer care can simultaneously improve access, enhance quality and advance research. By bringing expertise closer to patients while maintaining the infrastructure necessary for leading-edge care, we are creating a new paradigm for comprehensive cancer treatment in America.
The goal is clear: ensure that a patient’s ZIP code does not determine their access to world-class cancer care and breakthrough therapies. Through strategic expansion and innovative care delivery models, we are making this vision a reality.
Listen to Dr. Bryce and Dr. Stadler on City of Hope’s new podcast, “On the Edge of Breakthrough: Voices of Cancer Research.” Available on Spotify, Apple Podcasts and at cityofhope.org/edge-of-breakthrough.
City of Hope® is one of the largest and most advanced cancer research and treatment organizations in the U.S., with its National Medical Center named top 5 in the nation for cancer by U.S. News & World Report. To learn more about City of Hope, visit: www.cityofhope.org.
