The University of Hawaii Cancer Center and the John A. Burns School of Medicine today are launching a historic partnership called Ka ‘Umeke Lama, which aims to erase the disparities that affect cancer outcomes and ensure all people have access to high-quality cancer care, regardless of background or geography.
Ka ‘Umeke Lama, which translates into Bowl of Enlightenment, was created to address the challenges that Hawaii and the U.S. Affiliated Pacific Islands face in providing comprehensive care, including high cancer incidence and mortality rates among Native Hawaiians, Pacific Islanders and Filipinos; acute shortages of oncology professionals, especially on the neighbor islands and in the remote islands and rural areas of the USAPI; as well as the expectation that Hawaii’s aging population will expand demand for cancer care.
Dr. Naoto T. Ueno, director of the UH Cancer Center, an expert in inflammatory breast cancer and a two-time cancer survivor, said the three-pronged effort will focus on cutting-edge research, workforce development and culturally informed practices to raise the quality and consistency of cancer care in Hawaii and the Pacific.
The partnership is designed to synchronize the UH Cancer Center and JABSOM with other Hawaii Cancer Consortium member organizations — Hawai‘i Pacific Health, The Queen’s Health Systems, Hawaii Medical Service Association, Kuakini Medical Center and Adventist Health Castle — to produce a major collective impact.
Ueno said an initial $250,000 startup donation from Jay Shildler laid the foundation, and “additionally, we are exploring other funding avenues to ensure the program’s sustainability and growth, including Hawaii Cancer Consortium members Hawai‘i Pacific Health and The Queen’s Health Systems to support the fellowship,” he said.
Ueno said the ultimate goal is to reach $10 million to support a thriving, robust system with an implementation timeline that runs through 2028. He said anyone interested in supporting Ka ‘Umeke Lama can visit uhcancercenter.org/donate or contact Tawney Sablan at Tawney.Sablan@uhfoundation.org or 808-356-5757.
Ueno said implementation of Ka ‘Umeke Lama will stabilize cancer care in Hawaii by developing a strong and integrated oncology infrastructure where “cancer care is accessible, equitable, and rooted in both scientific innovation and cultural understanding.”
He said the program is expected to start with a statewide professional education program in January, followed by a digital network this summer and the opening of Ho‘ola, an early-phase clinical research center, in late 2025. Enrollment for UH’s first set of medical oncology fellows is expected by July 2027 or 2028.
Ueno said establishing Hawaii’s first medical oncology fellowship program is a critical part of the initiative and crucial to its focus on health disparities, geriatric oncology and drug development, which could create opportunities for more clinical trials in Hawaii and for greater retention and more successful recruitment of cancer specialists.
He estimates that Hawaii is about 80% behind in clinical trials and said the introduction of AI-based cancer clinical trial screening and monitoring tools could help close the gap.
“We do have good care here; it’s just kind of fragmented,” Ueno said. “We could do a much more cohesive approach that would make a difference for the community and for the patients.”
He said fine-tuning a collective approach to cancer care, including the creation of a centralized database, means patients across the state could soon to reach out to any cancer-related health care provider to address complex issues in Hawaii. New opportunities also mean that fewer cancer patients might have to travel outside of the state to find cancer specialists or to take part in trials, he said.
Ueno’s patient Susan Hirano, diagnosed with Stage 4 metastatic breast cancer more than three years ago, said she previously investigated going to the East Coast and to the Southwest to look into alternative treatments and was there again on the mainland last week exploring clinical trials.
“Unfortunately, all of the wonderful things that are happening here at the Cancer Center with research and clinical trials is probably nine months to a year too late for me. I’m going to end up being one of those people who has to go off- island to figure out what to do next,” said Hirano, who serves as the UH Cancer Center’s ambassador and patient advocate.
She said her husband has been close during her treatment in Hawaii, and it’s “daunting to think that I would have to face that alone when I’m thousands of miles away from him and my son.”
Hirano is hopeful that Ka ‘Umeke Lama will bring about a future where fewer Hawaii cancer patients have to face the financial as well as physical and emotional challenges of receiving treatment away from home.
Ueno said a major goal of the program is to provide everyone with “access to high-quality cancer care, regardless of their background or geography.”
But shortages of resources and inequities exist in Hawaii. The U.S. Department of Health and Human Services Office of Minority Health identified some concerning disparities in health outcomes in Hawaii from 2013 to 2015. During that time period the Office of Minority Health noted that Native Hawaiians had the highest mortality rate for all types of cancer, compared with whites in the state. American Samoan men also were eight times more likely to develop liver cancer, and Native Hawaiian men were 2.4 times more likely to be diagnosed with that disease compared with non-Hispanic whites.
The Hawaii Tumor Registry noted in 2022 that each year in Hawaii an average of more than 7,000 local residents are diagnosed with invasive cancer, leading to 2,000-plus deaths, and projected that Hawaii’s aging population will increase the need for cancer care. Projections show that by 2030, people age 65 and older are projected to make up 29.7% of Hawaii’s population — compared with 20% for the U.S. population as a whole.
Dr. Lee Buenconsejo-Lum, JABSOM’s associate dean for academic affairs, who co-leads Ka ‘Umeke Lama with Ueno, said standardizing cancer curriculum across the islands and access to care is an important part of Ka ‘Umeke Lama, as “cancer tends to be diagnosed at later stages certainly throughout the Pacific, meaning that cancer is much more advanced at the time of diagnosis.”
She said developing UH’s first oncology fellowship program with the goal of training two or three fellows each year also has a role to play in improving patient care delivery and growing the capacity to do more clinical trials through enhanced clinical research and by ensuring wider participation across diverse communities.
“There’s a lot of work that the Cancer Center and the hospital partners have been doing to increase our ability to offer clinical trails here in Hawaii, but when you have a fellowship, that becomes even more of a mandate,” Buenconsejo-Lum said.
