In 1976, against the joyful backdrop of America gorging itself on celebrations of its national bicentennial, about 335,000 people in the U.S. died from all forms of cancer.
That year, more than 47 women out of 100,000 would develop breast cancer, the Surveillance, Epidemiology and End Result Program states. Additionally, between 60 and 70 individuals per 100,000, according to SEER Cancer Statistics Review, were diagnosed with lung cancer.
The numbers, while shocking, were merely a harbinger of what was to come, touching off a 20-year upward march that would peak in 1993 at 555,000 deaths from all forms of cancer before beginning a slow, undulating trend downward that continues to this day.
It was into that medical environment that Central Arkansas Radiation Therapy Institute opened its doors in April 1976 and began treating patients in Little Rock. Five decades later, the war on cancer remains just as intense, and the combatants that wage it look very different, including CARTI, as it is now known. However, the group’s mission — to make trusted, cutting-edge cancer care accessible — has remained unchanged throughout, even as the organization maintains a decidedly unique structure and enhanced services.
“I have been able to work in leadership in various aspects of healthcare, and CARTI, as an organization, is unlike any of the others that I’ve ever had a chance to be a part of,” said Adam Head, who came aboard as president and CEO in 2017. “We’re unique in the healthcare space in general in the way that we’re organized as an independent, nonprofit, nonphysician-owned, nonoutside-managed entity. We’re governed by a community-based board that is solely driven by our mission.
Adam Head, CARTI president and CEO
“At the same time, I would say we’re trying to set the tone for the future of cancer-focused and cancer-adjacent care, which are those other services surrounding cancer care, provided in a completely different way than has been provided previously. It’s difficult to put the way that we operate and the way that we’re organized in a traditional box.”
The organization has always carried the tag of groundbreaker proudly. The idea that became CARTI was hatched in the 1960s, when local hospitals were looking for a way to provide cancer patients with state-of-the-art radiation therapy, the Encyclopedia of Arkansas states, technology that hospitals in the state found too costly to provide individually.
In 1968, CHI St. Vincent Infirmary, the University of Arkansas for Medical Sciences, Baptist Health and the John L. McClellan Memorial Veterans’ Hospital chipped in to establish a centralized provider of radiation therapy. In 1973, tax-exempt bonds were sold to build the organization a facility designed especially for such treatments at St. Vincent Infirmary’s school of nursing building. Design specs for the original space included treatment vaults with concrete walls and a roof up to 6 inches thick in places to house radiation therapy equipment.
Meanwhile, leadership and medical expertise were assembled, to include board-certified radiation oncologists, certified radiation therapists, dosimetrists, medical physicists, nurses, patient liaisons, transportation assistants and other support staff.
CARTI’s 50-year anniversary provides a chance to reflect on where the organization has been — and where it will go in the future.
(Photos provided by CARTI)
A decade later, CARTI became the first freestanding radiation therapy center in the nation to be accredited by what was then the Joint Commission on Accreditation of Healthcare Organizations. It also built its first satellite campus in Searcy in 1988. Today, CARTI offers various medical and diagnostic services in Clarksville, Clinton, Crossett, Conway, El Dorado, Heber Springs, Little Rock, Magnolia, North Little Rock, Pine Bluff, Fordyce, Saline County, Searcy, Stuttgart and Russellville. About 1,200 people are employed by the nonprofit systemwide.
Expansion has been a recent watchword for the Little Rock headquarters, as well. In 2015, CARTI opened its current facility in midtown, a $90 million, 175,000-square-foot comprehensive cancer center that increased the group’s annual patient capacity from 3,000 to 20,000. Three years ago, the organization christened a 57,000-square-foot surgery center and followed that with The Bridge, which houses various companion services for cancer patients and their families, both of which are part of the cancer center campus.
The new brick and mortar also houses continuing innovation in diagnostic and treatment services, such as CARTI recently branching into general urology, and is leading the organization to additional medical areas, as well.
“We’ve got some pretty big ideas about the field of research in general,” Head said. “So much is evolving, and we’re very encouraged, based on seeing how patients have responded to the CARTI model throughout the state, that we can do so much more than has ever been done. We think that means a lot in the world of research, which opens up opportunities for patients in new therapies and technologies, creating more access than has ever been seen or expected in the state. That’s what we think is going to make the most impact.”
Head said one challenging side effect of the growth of the organization, from number of locations and breadth of services to the size of facilities, is maintaining unrelenting focus on its culture. He described CARTI’s ethos as a balance of one-on-one attention to patients and working with a sense of medical urgency upon which the organization was founded. Those chapter-and-verse core values are what the CEO and former Army medical service officer preaches wherever he goes.
“Cancer care is relationship based, and we believe in forming relationships with all of our patients, whether they’re coming in for a simple screening or for treatment,” he said. “We’re also taking care of a lot of patients that don’t have a cancer diagnosis, and those are patients who we have the opportunity, the privilege, to serve for a long period of time. That is something unique and something very special.
“At the same time, our culture has been established over time, and as CEO I have been privileged to help set that culture where we like to get things done. We probably ask more of all of our leaders, our physicians, of all of our team members, perhaps, than other organizations do. That’s a generalized statement; I’m not saying that other organizations don’t have high expectations for their teams, but the stakes here are so high and the mission is so important that I think we approach things differently. Healthcare can traditionally work pretty slowly at times. We don’t like to do that here. We like to make things happen.”
Decades of research and billions of dollars have been spent on the war on cancer in the U.S. since CARTI opened its doors, and it has not been without its progress. Lung cancer mortality, resulting in 34 deaths for every 100,000 Americans in 1976, was reduced to 20 per 100,000 in 2022, the World Health Organization reported. Colon cancer deaths also dropped from 19 to 9 per 100,000, and breast cancer deaths plummeted from 14 to 7 per 100,000 over that same time period.
In Arkansas, the news is mixed. According to statistics of the National Cancer Institute of the Centers for Disease Control and Prevention, Arkansas posted an average incidence rate for all cancers in all stages of 476 per 100,000 people from 2018 to 2022, nearly 29 people more than the national average.
Over 22 cancer categories, Arkansas outpaced the nation in 11, showing the widest margin in colon, renal and lung cancers. However, the state did better than the national average in nine categories, notably breast, thyroid and childhood cancers, and was on the number in two cancer categories.
While not taking anything away from the advancements, Head bristled at the number of areas in which Arkansas still trails the country, taking the statistics as marching orders to continue to expand CARTI’s reach and execute its mission.
“I would say we’re probably in the midst of more change right now than we’ve probably been in 20 years, seeing more of an evolution in the world of cancer care,” he said. “In the state of Arkansas, [CARTI has] gone from one cancer center and a number of different clinics to now seven cancer centers that are hubs where multiple services are available at single locations. We now have the surgery center, so if a patient needs a one-time surgery, they could potentially have that and then get all their follow-up treatment close to home.
“We believe that the future, especially for a state like Arkansas, where over 40 percent of the population is living in rural communities, is in providing care that is more accessible than ever before. It’s got to be easy for the patient. Otherwise, we’re not really going to change things.”
The CARTI Cancer Center in El Dorado is one example of how the organization has expanded to better serve rural communities.
Visiting any one of the organization’s sites, it does not take much effort or time to be reminded why the group exists, as Head well knows. Not long ago, he was making the rounds at the CARTI facility in El Dorado when he noticed a volunteer working nearby. Head stopped to thank the man for giving of his time, only to receive a reply that has reverberated in his mind ever since.
“It turned out he had been on the receiving end of our services, and because of what he had been through and how he was treated, his answer to me was, essentially, ‘How could I not?’” Head said. “You know, we’re encouraged by having had an impact because we see it in our model and in how the mortality rate from cancer in Arkansas is staying relatively stable, but we also have to remember to always do what we do with understanding and respect.
“It’s projected that over 20,000 Arkansans are going to receive a new cancer diagnosis this year. Everybody knows someone affected by cancer. That’s a sobering statistic, but it fuels us in our efforts of walking patients and their loved ones through a really tough journey.”
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