When Kara Kenan was diagnosed with breast cancer at 35 and told she would need radioactive chemotherapy, all she can remember is that she couldn’t get the song Radioactive by Imagine Dragons out of her head.

“Often, when patients are first diagnosed, you have to realize that their capacity is completely overwhelmed,” Kenan said. “Many times, the way that we address that is we hand them a bunch of brochures.”

In 2017, Kenan founded Wilmington-based nonprofit organization Going Beyond the Pink to offer essential support to breast cancer patients and survivors and to address the gaps in care she experienced herself.

Later, Kenan founded the Cancer Wellness Institute, a cancer coach network and training program in 2020, and she currently serves as the director of marketing and strategic partnerships at Cancer Nation – one of the oldest cancer survivor-led advocacy nonprofit organizations.

For Kenan, approaching cancer care goes beyond treatment. She lists health literacy, transportation, finances and time as other factors that determine how a patient navigates a life-changing cancer diagnosis and subsequent treatments. Kenan also points to the need for a local central resource map as a step in the right direction.

“Comprehensive survivorship care is absolutely the (region’s) biggest unmet need,” Kenan said. “Survivors’ needs are falling through the cracks … from the moment of diagnosis through the balance of life. … And the onus shouldn’t be on the patient to do more work.”

To date, the region’s only dedicated, comprehensive cancer center is the Novant Health Zimmer Cancer Institute, which originally opened in 2000 as part of New Hanover Regional Medical Center.

“Most cancer patients touch about nine different services on average,” said David Rizzieri, physician-in-chief for the Novant Health Cancer Institute, which is inclusive of all the Winston-Salem-based healthcare system’s regions. “You need genetics and genetic counseling, physical therapy, nutrition, clinical research, social work and counseling. All of these things we provide in our comprehensive approach through Zimmer for our patients.”

Since being named physician-in-chief in 2021, Rizzieri has focused on offering specialized oncology locally to ensure higher levels of care. He pointed out that “general oncology care doesn’t cut it anymore” and that addressing the region’s growing oncology needs requires doing more than simply placing a general oncologist in the community.

“There are two things that patients want,” said Michael Papagikos, radiation oncology medical director at Novant Health. “One is they want to be taken care of by a cancer doctor that’s an expert and has specialization and a passion for their disease site, and they simultaneously want to get that care in a convenient location to where they live.”

To address both needs in the local market, Papagikos said that Novant has prioritized multidisciplinary clinics so that patients can come to one central location for an initial consultation.

The cancer institute navigated national oncology provider shortages last year by adding four new oncologists and three more this year, with five more hires expected next year. Adding recruits has allowed Zimmer to cut access time, or the speed of getting care, from 30 to 10 days, Rizzieri said.

“I want to realistically offer a new patient an appointment within five days,” said Rizzieri. “That’s our goal as we grow.”

In June, UNC Health and Wilmington Health filed a certificate of need application with the state for permission to establish a positron emission tomography (PET) scanner – a type of nuclear medicine imaging used to detect cancer, heart disease and gastrointestinal, endocrine and neurological disorders. At the same time, Novant Health also filed an application to acquire a PET scanner, at the Novant Health Brunswick Medical Center.

If approved, Wilmington Health and UNC Health's PET scanner would be operated as a freestanding center as part of a new comprehensive oncology program known as Coastal Cancer Care & Imaging. The filing states that the ownership split would be 51% and 49%, with UNC Health owning just over half.

The application outlines “a significant gap in access to fixed PET services” in the region, with Wilmington Health identifying a growing number of patients diagnosed with cancer, cardiovascular diseases and neurological conditions. Currently, Novant Health operates two PET scanners in the region, one located at the Novant Health Imaging New Hanover Medical Plaza and another at the Novant Health Scotts Hill Medical Center.

“The partnership with UNC is really to have an academically based cancer center,” said David Schultz, chief medical officer at Wilmington Health.

“Zimmer provides a really good service. They have excellent cancer care there. This is just going to be another choice in the community,” he added.

According to Schultz, Coastal Cancer Care’s PET scanner, if approved, would be used for heart tests as well as cancer screening.

Wilmington Health shuttered its own cancer program last year, Schultz said.

“We just never had the scale to really do everything that we needed to do, and having a partner will allow that,” he said.

Kenan said improving care for cancer patients in the region will require a more intentional framework for all providers involved.

“Our system isn’t built for survivorship care,” she said, “and for me, it takes more than adding equipment and adding buildings to really make a change there.”