By Paula Isabel G. Franco, MD

Ever since I started my oncology training in the Philippines, the dream was to become a recipient of the International Development and Education Award (IDEA) grant from ASCO and Conquer Cancer, the ASCO Foundation. Each year, IDEA enables early-career oncologists, surgeons, and palliative care specialists to attend the ASCO Annual Meeting and also pairs them with a mentor who will receive them during a brief observership in their home institute after the Annual Meeting.

I did my best to follow the footsteps of previous IDEA recipients in my country and tried to build my CV and skillset. I prayed fervently and even did borderline superstitious practices. For instance, in November 2022, instead of putting a clichéd “Paula was here,” I signed “Get ASCO IDEA 2023” at the finish line banner of the Singapore marathon to manifest my dream into existence. I remember checking my email inbox and spam folder multiple times a day, starting that second week of January, hoping for good news.

I can still remember that feeling of reading that life-changing email. It is not an exaggeration. I hope that by sharing this experience, more aspiring applicants will pursue this opportunity.

When “One Day” Becomes Day One

After travelling halfway around the globe, day one of my IDEA experience had finally arrived. The first two days were dedicated to a “Train the Trainers” workshop for our cohort. Here, we practiced honing our leadership and communication skills. It might sound absurd but the majority of us had never received any formal training in communication. We know that a big part of practicing oncology, and of being a clinician in general, is about building strong relationships with people—with your patient, your multidisciplinary team, your research team, and even pharmaceutical companies. We learned how to listen intently and provide effective feedback. The most memorable activity for me was an exercise called the elevator pitch. We had to role-play a scenario wherein we had a small window of opportunity (like during an elevator ride) to talk with a CEO or a big boss of an institution. We had less than a minute to pitch our proposal. The goal of the exercise was to catch their attention and get their approval to schedule a formal meeting. This skill is especially useful since people in important positions are very busy and chances to talk with them to possibly effect change come very seldomly.

Above: Dr. Franco (front row, far left) and other 2023 IDEA participants and mentors at the ASCO Annual Meeting.

In the Presence of Great Leaders

For most of my cohort, it was our first ASCO Annual Meeting experience. It was surreal and overwhelming—McCormick Place was its own city and we were surrounded by 40,000 experts in oncology. The excitement was palpable. Attending a special session for young oncologists on tips for navigating the ASCO Annual Meeting helped me create a realistic itinerary for the next five days.

As part of our meeting experience, we had multiple chances to directly interact with world leaders and rising oncologists in the Trainee and Early Career Oncologist Member Lounge and the Women’s Networking Center. We were also able to attend Ticketed Sessions that were only accessible onsite.

We then attended several ceremonies and receptions where we literally brushed elbows with the best and brightest leaders of the oncology world. We met with the inspiring recipients of 2023 funding opportunities at the Conquer Cancer Grants and Awards Ceremony. We were fortunate to spend time with the who’s who of oncology such as ASCO president Dr. Lynn Schuchter, ESMO president Dr. Andrés Cervantes, JSMO president Dr. Eishi Baba, and Dr. Roselle De Guzman, who serves as chair of the ASCO Asia Pacific Regional Council and is a renowned medical oncologist from the Philippines. The IDEA program really served as a global platform that catapulted us into building networks with distinguished people that could have otherwise taken years or even decades to create.

I was also extremely fortunate that my fellow IDEA grantees were all warm and nurturing individuals. We had created lifelong friendships. After spending six days in Chicago, we went our separate ways to our mentors’ host institutes. I was lucky to spend more time with four other IDEA grantees as we made our way to Memorial Sloan Kettering Cancer Center (MSKCC) in New York City.

Aspiring to End Cancer for Life

The days I spent with the sarcoma team of MSKCC were some of the best days of my life. We received an orientation, even a welcome breakfast, and had a curated, jam-packed schedule for the three days that we were there. The main goals during our observership were to be inspired and to create connections with people who could support our career and personal growth. I had the privilege of spending time with four of the most distinguished sarcoma specialists in the world—authors of trials that the current guidelines we read and memorize are based on.

My first day was spent doing inpatient rounds with Dr. Vishu Avutu and his team of nurse practitioners at MSKCC’s main hospital. I met patients across the cancer care continuum. One young patient had infectious and circulatory complications on top of her metastatic rhabdomyosarcoma; another young patient was about to receive news of the results of his incision biopsy, a small round blue cell tumor that was likely a Ewing sarcoma. Dr. Avutu’s warm bedside manner and method of breaking the bad news were commendable and something I aspire to follow. He would often tell his new patients to remember only one thing from their initial interaction: “Getting this cancer is not your fault.” He also provided me a bird’s eye view of the available services dedicated for adolescent and young adult (AYA) patients with cancer.

My second and third days were spent at the outpatient clinics at the Rockefeller Outpatient Pavilion. Dr. Sujana Movva graciously dedicated time for teaching despite her busy outpatient clinic. She shared with me the molecular intricacies of even rarer forms of sarcoma such as extraskeletal myxoid chondrosarcoma, sclerosing epithelioid fibrosarcoma, and epithelioid hemangioendotheliomas. Dr. Ping Chi gave me an overview of how she divides her time between her clinics, pre-clinical research work, and her clinical trials.

On my last day, I met with my mentor, Dr. Mrinal Gounder, who is also currently a physician ambassador to India and Asia. He is the primary author of the trial that established sorafenib as the category 1 preferred treatment for desmoid fibromatosis.¹ This was really a full-circle moment for me since one of my first publications was a case report about a Filipino with asymptomatic mesenteric desmoid fibromatosis.²

During my interaction with Dr. Gounder, I understood how drastically important MSKCC’s experience and research were in shaping the standards of cancer care globally. Pooling patient data and spending time and resources for well-designed research can really improve patients’ lives. Although we have several ongoing clinical trials in the Philippines, these are led by international pharmaceutical companies. It is my hope that one day, our county will also have an infrastructure for fellows and oncologists to design and successfully complete investigator-led clinical trials.

“We know the current standards of care, and we know the statistics driving in the guidelines. We have those at our back pocket. Our statistics here (in MSKCC) are sometimes better—and for some patients, we can offer hope for even better outcomes than the current standard,” Dr. Gounder told me.

He also introduced me to key leaders involved in AYA cancer care. I am infinitely grateful for all his valuable career advice and guidance, as I also dream of establishing our own AYA clinic in the Philippines. It will be designed to support the unique concerns of this patient population such as issues in fertility, sexuality, and financial and social support.

Above: Dr. Franco and her mentor Dr. Gounder during her visit to MSKCC.

Finding My Community

Through the ASCO IDEA program, I found a group of people who were equally, if not more, passionate about elevating the quality of the practice of oncology globally—people who believe that pursuing excellence translates to better patient care. I am eternally thankful to ASCO and Conquer Cancer. The lessons learned and experiences during those two weeks are core memories that will continue to inspire me to do good work.

I had a glimpse of what oncology could be—of what it should be. Ideal cancer care has now become attainable even for low-to-middle-income countries. We are all uniquely qualified to help reduce the burden of cancer.

Dr. Franco is a third-year medical oncology fellow training in St. Luke’s Medical Center in the Philippines. She has a special interest in sarcoma, breast cancer, and AYA cancer, and hopes to pursue further training in AYA cancer. Disclosure.

References

1. Gounder MM, Mahoney MR, Van Tine BA, et al. Sorafenib for Advanced and Refractory Desmoid Tumors. N Engl J Med. 2018;379:2417-28. doi: 10.1056/NEJMoa1805052.
2. Franco PI, Gorospe A. Asymptomatic mesenteric desmoid fibromatosis: a diagnostic and therapeutic challenge. JMCRR. 2022;5(05).