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Bridging the Gap in Cancer Care between Developed and Developing Countries

Jul 02, 2012

Dr. John E. Pippen shares his experience as an ASCO International Cancer Corps volunteer in Hue, Vietnam

  Left to right: Dr. Cynthia Osborne, Dr. John Pippen, Dr. Ti (oncology fellow at Hue College of Medicine and Pharmacy), Dr. Nathan Green, Dr. Claude Denham, and Dr. Nguyen Van Cau. Drs. Osborne, Dr. Pippen, and Dr. Denham are from the Baylor-Charles A. Sammons Cancer Center, Dallas Texas.
  Dr. James Ewing, a fellow at Sammons Cancer Center.
  Dr. Pippen with a young patient with breast cancer and her mother.
  Josephine Divers, RN, enjoys a moment with the students.
International travel often goes hand-in-hand with discovery, adventure, and personal growth. When presented with the opportunity to travel to Hue, Vietnam, earlier this year and volunteer for Health Volunteer Oversees (HVO) by means of ASCO’s International Cancer Corps (ICC), John E. Pippen, MD, FACP, of Texas Oncology-Baylor Charles A. Sammons Cancer Center, seized the opportunity.

Dr. Pippen’s decision to volunteer in Hue was influenced in part by the city’s lush history as both the former capital of the Nguyen dynasty and backdrop to the 1968 “Battle of Hue” during the Vietnam War. His appetite was also whetted from a previous visit to the country for a general Southeast Asian medical meeting. During that time he explored Ho Chi Minh City and found Vietnam to be an “interesting country with friendly people and a lot of development.” Ultimately, he was left wanting more.

“All of that attracted me to Hue,” said Dr. Pippen about his decision to return to Vietnam. “But the opportunity to help with medical oncology there is what sold me on the deal.”

A mutual exchange of knowledge
From February 22-March 6, Dr. Pippen, along with three other medical oncologists (Claude Denham, MD; Cynthia Osbourne, MD; and Nathan B. Green, DO [Southeast Nebraska Cancer Center]), one medical oncology fellow (James Ewing, MD), and one oncology nurse (Josephine Divers, RN), worked with Nguyen Van Cau, MD, the main medical oncologist at Hue College of Medicine and Pharmacy. There, the group went over cases with Dr. Van Cau and his staff—suggesting approaches that they would take in the United States and comparing them to approaches that Dr. Van Cau and his staff would take, based on available resources. The two groups would then work together to find optimal solutions for patients in the region.

What stood out the most for Dr. Pippen was the Hue team’s remarkable work ethic, empathy for patients, and treatment resourcefulness.

The team saw a variety of patients, including those with lung cancer, hepatoma, and breast cancer. “It was good to have a diverse group of oncology professionals there because our expertise overlapped in various aspects of medical oncology, and we were able to help Dr. Van Cau out with a lot of different cases.”

Beyond seeing patients, Dr. Pippen and colleagues also identified several “continued unmet needs” that could potentially be addressed by future volunteers in Hue, including:
  • the creation of an out-patient hospice program;
  • setting up breast cancer screening;
  • modernizing the institution’s pathology department; and
  • better utilization of pain management by teaching the World Health Organization’s pain ladder.
Dr. Pippen recalled how any and all ideas by volunteers were welcome—and that some were carried out with a more informal approach. “One of our medical oncology fellows would go over to the clinic in the evenings, round up some of the students and say, ‘Hey, do you guys want to go and have a cold drink and learn better English?’”

He also emphasized the mutual exchange of knowledge between the two medical teams. “This is not just us going over there and teaching them things. We learned from them how to take care of patients with limited resources and do a good job of it.”

A challenge to ASCO members
Despite reimbursement concerns in the United States, Dr. Pippen stressed how “we can still pretty much get anything we need for our patients. The same, however, cannot be said for developing countries. His first-hand experience in the matter is something that has affected his career and outlook as an oncologist.

“Trips like this are something every medical oncologist should consider….Everyone should go to a developing country just to see how you have to get by without necessarily having the most modern equipment, most modern chemotherapy, and targeted drugs. There, you have to get by with utilizing the materials at hand and being resourceful,” said Dr. Pippen.

Because of the trip’s success, Dr. Pippen said it is likely that the Baylor-Sammons Cancer Center will be represented again in Hue in the next one to two years.

He advises those considering the HVO/ICC program to not be intimidated going to a country on the other side of the world. “Don’t let the distance, don’t let the language barrier, and don’t let general fear of travel stop you from going and having a great and rewarding trip. I would challenge all ASCO members to consider doing something like this at some point during their career.”

For more information on the ICC, visit asco.org/cancercorps.

—By Elyse Blye, Senior Editorial Assistant
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