The Delmarva peninsula is geographically small but demographically complex. Jutting out from the mid-Atlantic East Coast, the peninsula is made up of Delaware in the northeast, Maryland in the east, and Virginia in the southeast. The combined population of just over 800,000 is spread across beach towns with large tourism industries, retiree communities, and some of the lowest-income counties in the region. Residents make up a patchwork of diverse identities, races, ethnicities, socioeconomic statuses, and life experiences, all served by the TidalHealth system of hospitals.
TidalHealth is a growing network with locations across the region, including 4 centers that provide cancer care in Salisbury, Maryland; Berlin, Maryland; Ocean Pines, Maryland; and Seaford, Delaware. Although each location has its own staff and operational system, the goal is to provide a consistent patient experience across the centers. Paul Sonder, MBA, was hired as senior director of Cancer Services at TidalHealth in September 2025 and is leading efforts to integrate the health system s cancer care into 1 service line. We re laser focused on streamlining the workflows, clinical care, and best practices among all those sites, said Sonder. No matter where you go, you ll have the same experience.
Expansive Oncology Options in the Community
TidalHealth holds accreditations through the National Accreditation Program for Breast Centers and the American College of Surgeons Commission on Cancer. But what the oncology team is most proud of is the work they have done to earn these recognitions. Accreditations are nice, but what they represent is what your program is actually doing [to enhance the quality of patient care], Sonder explained.
TidalHealth s medical and radiation oncology teams strive to offer cutting-edge therapies, introducing new treatment options to their patients as they become available. For example, the medical oncology team started administering bispecific T-cell engager therapy in the past year and is investigating opportunities to expand its immunotherapy repertoire further.
David McDermott, MD, radiation oncologist at TidalHealth, is proud to provide care using state-of-the-art technologies, such as the linear accelerator, surface-guided radiation therapy, and brachytherapy, to give patients precise and accurate treatment delivery. Many of these treatment options are rare at other community cancer centers in the region, but the robust radiation oncology department is an important part of making care accessible to local patients. From a radiation standpoint, patients often get treatment on a daily basis, so driving back and forth long distances can be very difficult, said Dr. McDermott. For these individuals, the option to receive treatment near their home on the peninsula makes a significant impact on their quality of life.
For the few treatments unavailable in its network, like bone marrow transplants and chimeric antigen receptor (CAR) T-cell therapy, TidalHealth works closely with Johns Hopkins and the University of Maryland across the bridge in mainland Maryland, and ChristianaCare in Delaware. TidalHealth providers are sensitive to location, insurance coverage, and the treatment needs of their patients, helping them choose the best option outside the region to meet their needs.
The opportunity to participate in clinical trials, however, does not require leaving TidalHealth. All patients receiving cancer care are screened for clinical trials, some of which are offered through the health system s dedicated research institute, which supports its entire network and all medical specialties. Some trials are run through the Johns Hopkins Clinical Research Network, which partners with community health systems to open multi-site clinical trials in rural areas.
TidalHealth has a total of 6 infusion centers, 4 of which offer cancer treatments. Many of these suites are connected to the cancer care centers to minimize patient travel and have dedicated pharmacies that mix chemotherapy and other drugs. These units are run almost entirely by nurses, whereas the rest of the medical oncology staff members work in a pod structure. These pods each comprise a physician, a nurse, a medical assistant, a medical secretary, and an advanced practice provider. This model fosters multidisciplinary collaboration and improves continuity of care for patients, who know that providers are working and communicating about their case as a team.
Support Within and Beyond the Hospital
The diverse population of the Delmarva peninsula also faces a unique set of barriers to care. TidalHealth uses a combination of in-house resources and outreach to ensure the community receives timely screening, care, and support throughout their cancer journey. A licensed clinical social worker is on staff to address individual issues of financial toxicity, food insecurity, and transportation. There is also a team within the oncology service line dedicated to outreach, which facilitates support groups in the community. All these services are free and available to patients at all locations to self-refer.
The TidalHealth Foundation plays an important role in supporting care and screening for the community. This 501(c)(3) raises money to support patients and expand the development of the health system. One of its biggest fundraising projects in recent years has supported a mobile mammography unit. This 38-ft pink vehicle brings mammograms and a multidisciplinary team including a certified mammographer, a nurse navigator, a nurse practitioner, a social worker, and community health workers across the peninsula. The ribbon cutting for the vehicle occurred in October 2025, and the unit will be fully operational in communities by spring 2026.
Training the Next Generation of Community Oncologists
Cancer centers around the country are currently grappling with a nationwide shortage of oncology professionals, particularly outside big cities. This workforce need drove TidalHealth to create the Hematology & Medical Oncology Fellowship, focused on training physicians for a career in the community setting. The fellowship received accreditation from the Accreditation Council for Graduate Medical Education in 2024 and welcomed its first class of fellows in 2025. Two fellows are accepted each year for a 3-year position that prepares them for the specific challenges of rural oncology, aiming to develop oncologists who will stay in the Delmarva region or in a similar part of the country where there is a shortage of oncologists.
One of the greatest challenges in recruiting providers to a rural area is persuading them to leave a big city. The fellowship program brings trainee physicians to TidalHealth to show them the value of living, training, and staying in the community setting. Trying to get somebody from Baltimore to move to Salisbury is going to be a tough sell unless they come and live here for a few years in training and see the difference, said Salahuddin Siddiqui, MD, FACP, program director and hematologist/oncologist for the TidalHealth Hematology & Medical Oncology Fellowship.
Dr. Siddiqui is proud to be part of the evolution of TidalHealth as an education hub. As he helps to develop the skills of these budding physicians, he also sees direct benefits for his patients. Having trainees here is good not only for their education but also for patient care, he said. You re always staying up to date and delivering cutting-edge treatments.
TidalHealth is in a period of growth and development. Whether it s a new treatment option, a new fellowship program, or a new way to connect with the community, the health system is pursuing opportunities to expand cancer care in its region. Its commitment to the people of Delmarva is evident, fueling innovative solutions to the challenges of rural oncology.
Understanding both the benefits to be had from offering BsAb therapy to its community and the scope of this undertaking, Vanderbilt-Ingram Cancer Center took a novel approach with its APP-led BsAb step-up dosing clinic, which won the program a 2026 ACCC Innovator Award.
