In a collaborative approach they hope to apply to a host of diseases, doctors at Stanford University and the Palo Alto Medical Foundation will follow hundreds of local breast-cancer patients to develop a deep database on treatment choices and outcomes.

The project is the brainchild of philanthropist Richard Levy, former Varian Medical Systems CEO, who said he hopes the effort will lead to improvements in cancer care and survival as well as ideas for reducing national health care costs.

The three-year collaboration, focusing on both the medical choices and psychosocial factors that contribute to cancer treatment and survival, will be funded with a $2.1 million gift from Levy and his wife, Susan, who live in Portola Valley.

"From the point of view of patients, what makes for good health is good technology and good environmental factors, such as the doctor-patient relationship, nutrition, exercise and lifestyle factors. Patients need both," Levy said.

"Here we have two world-class institutions in both areas. It's a natural partnership.

"If Palo Alto and Stanford can find a way to provide better care at lower cost, that will set an example for other communities," Levy said.

In the future, Levy said he would like to see the collaborative approach applied to heart disease, diabetes and other types of cancer.

Breast cancer was chosen this time because it is a common disease in which there are basic protocols, though many variations in how doctors and their patients choose to pursue them, according to Hal Luft, executive director of the Research Institute at the Palo Alto Medical Foundation (PAMF).

Women may choose full mastectomy or breast-conserving surgery, for example, or may opt for different chemotherapy plans with different toxicities and frequencies, Luft said.

"So there is a decision-making process for women -- how do they choose among these options," Luft said. "We will try to capture this information and analyze how women's preferences and best clinical practices can be combined with other factors to achieve optimal treatment."

Researchers also will use interviews and journals to capture the women's anxieties, concerns and satisfactions.

"There is a kind of road map that physicians and patients follow, but they may deviate from that road," Amar Das, principal investigator at Stanford and assistant professor of medicine and of psychiatry and behavioral sciences, said of the collaboration.

"The question is, by how much? And does it matter? Are patients more satisfied going down one path over another, and what impact does that have on survival?"

Both medical and non-medical treatment choices and support -- from tests, drugs, and surgeries and radiation to yoga and alternative therapies -- will be documented.

All information from the study will be collected in a new electronic database known as OncoShare, in which patients and their treating doctors will remain anonymous. OncoShare will be the first large-scale research database to incorporate comprehensive information on breast-cancer characteristics, practice variation and treatment effectiveness, according to a press release issued by Stanford and the medical foundation.

The database will be able to help answer questions on how biomarkers, cancer genetics and patient choices and care patterns relate to outcomes.

Patients will have to consent to be included in the database, which will be anonymous both for patients and the physicians who treat them..

Levy retired as Varian Medical CEO in 2006 after working there 40 years. He remains chairman of the board. He has served on the board of PAMF for the past 10 years and on the board of its parent, Sutter Health, for the last three.

A nuclear chemist, Levy and his Varian colleagues worked with Stanford scientists in the Department of Radiation Oncology to pioneer linear accelerators for cancer treatment. He is currently active in initiatives involving philanthropy and health-care reform.