Some worry that the changing of the guard at the University of Hawaii Cancer Center will distract from the center’s core function in the fight against cancer. In truth, this transition should begin settlement of the upheaval that peaked when its controversial director, Dr. Michele Carbone, took center stage in UH leadership disputes.

If anything, Carbone’s departure from the helm ought to signal a time for refocusing attention on the mission, which is to serve the advance of cancer treatments, including the clinical trials that will help so many Hawaii patients.

The unanswered question is: Does the director’s abrupt resignation announced a week ago signal any urgent problems to be resolved? Official statements issued at the end-of-the-week assembly mentioned only Carbone’s desire to return full-time to faculty work as a cancer researcher, but the suddenness took some staff members by surprise.

Whatever’s gone on behind the scenes, the primary objective should be to conduct a thorough search for his replacement as soon as possible.

Carbone has more than his share of defenders and detractors, the former group essentially prevailing when former UH-Manoa Chancellor Tom Apple unsuccessfully sought to terminate him. The clash was apparently so contentious, however, that a complex and expensive reorganization was deemed necessary to keep the peace.

The director was able to keep his job but was placed under Brian Taylor, the interim vice chancellor for research. Virginia Hinshaw, the former chancellor who hired Carbone, was named senior adviser to Carbone and Taylor, a voluntary role. Finally, a new hire, Patricia Blanchette, was named the center’s chief operating officer, also reporting to Taylor.

Since then, Robert Bley-Vroman has been named interim chancellor, and cancer center oversight ranks high on his priority list.

In August, he and UH President David Lassner called for "an objective, forward-looking review" of how the operations can be improved. The results, due in a few weeks, should illuminate the path forward.

For now the title of acting director is held by Jerris Hedges, dean of the John A. Burns School of Medicine, adjacent to the center on the Kakaako campus. That will at least provide some continuity, but the dean has enough on his plate now and can’t give the cancer center the attention it deserves for too long.

Ultimately what the center needs is a pared-down chain of command. Not only would it be more reasonable in budgetary terms at a time of spending constraint at UH, but the lines of authority would be clearer.

Such clarity is essential to efficient administration of available grants and limited resources, which is surely necessary if the institution is to retain its hard-won designation as a National Cancer Institute Cancer Center.

More than two years ago, after a competitive renewal process, the institute award-ed the center another five years of funding and designation as the only NCI-designated research facility in the Pacific. The NCI designation was first awarded in 1996.

That designation gives patients increased access to clinical trials of treatments and new therapies, according to the announcement in June 2012. The center collaborates in this with its clinical partners, including the medical school, The Queen’s Medical Center, Hawaii Pacific Health and Kuakini Medical Center, which form the Hawaii Cancer Consortium.

Leaders of UH and its institutions can’t lose sight of the fact that Hawaii, separated by 2,500 miles from the next NCI cancer center, needs this increased access and benefits from the community’s public-private collaboration. And beyond these shores, the center is positioned to serve patients throughout the Pacific Basin.

The center represents a critical asset in the state’s health care system.

What’s needed to sustain it is less intramural drama and more collective focus on the development and delivery of the best treatments to cancer patients. Let’s hope that is how the next phase in the center’s history unfolds.