ASCO’s International Cancer Corps Program Expands to Bhutan, Costa Rica, and Paraguay

Aug 27, 2013

Oncology professionals interested in volunteering through the International Cancer Corps (ICC; now have the opportunity to visit sites in Bhutan, Costa Rica, and Paraguay, in addition to the program’s established sites in Tegucigalpa, Honduras; Addis Ababa, Ethiopia; and Hue, Vietnam.



Currently in its third year, the ICC program is a partnership between ASCO and Health Volunteers Overseas (HVO)—an international medical education organization with 25 years of experience working with professional medical societies to develop education and training programs. With the help of program directors based in North America, HVO pairs volunteers with a medical center where the training needs of the facility match the expertise of the volunteer. The aim of the ICC program is to exchange medical expertise, develop training programs, and build long-term, supportive relationships between ASCO and the clinicians who provide cancer care in countries that have an HVO/ICC presence.

In the interviews that follow, directors of the volunteer sites in Bhutan, Costa Rica, and Paraguay share their perspectives and hopes for each of the programs.

ICC volunteer Dr. Simon and Dr. Tashi Wangdi,
Local Director at the Bhutan ICC site, consult
with a patient in the Medical Ward of Bhutan’s
National Referral Hospital.


HVO/ICC Bhutan: An Interview with Program Director Miklos Simon, MD

AC: What makes the cancer care situation in Bhutan unique?
Dr. Simon: Although government-sponsored basic health services are provided throughout Bhutan, there are significant delays in cancer diagnosis and treatment. Patients still prefer to visit their local healers, where they undergo healing rituals before seeking help from Western-trained medical professionals. The majority of cancers are diagnosed at advanced stages, which makes cancer diagnosis a death sentence and the word “cancer” taboo.

AC: You visited the Royal Institute of Health and Sciences in Thimphu last October—what did your visit reveal?
Dr. Simon: All patients with cancer in the country are sent to the National Referral Hospital. Here, a dedicated team of a surgical oncologist, a gynecologic oncologist, and six oncologic nurses are taking care of the constant flow of patients. There is no radiation therapy and no medical oncologist service. Currently, several hundred patients are sent to India on a yearly basis at the government’s expense to get oncologic care because of a lack of trained professionals in Bhutan. General internists and pediatricians are in charge of continuing chemotherapy locally, but the basic supportive services are lacking, and while chemotherapy agents are available, it takes time to get them.

AC: What are your hopes for this program and what do you see as ASCO’s role?
Dr. Simon: I see a tremendous opportunity for us in supporting the development of a well-functioning and successful comprehensive cancer care program in the country. HVO has been assisting other programs there for over 20 years with great success. With the collaboration of ASCO, I foresee a new generation of Bhutanese people who are well educated about cancer, take an active part in cancer prevention, and enjoy an array of new treatment modalities in their home environment.


  Dr. Denis Landaverde, an oncologist at the
Hospital de Mexico (right), and other oncology
staff show Dr. William Creasman, an ICC
volunteer (second right), and Dr. Pippen
(back) the Hospital de Mexico construction
in San Jose, Costa Rica.

HVO/ICC Costa Rica: An Interview with Program Director John E. Pippen Jr., MD, FACP

AC: What factors led to the development of the objectives created for the San Jose site?
Dr. Pippen: Several of the Costa Rican physicians told me that they feel somewhat isolated in their practice despite being a short flight from the United States. I had the feeling that if the volunteers go to Costa Rica prepared with case presentations from their own practice in the United States, the Costa Rican physicians will be able to compare what they do in their day-to-day practice with the standard of care in the United States. This will help them take care of their own patients and identify areas for which additional study will be helpful.

AC: What do you see as ASCO’s role in helping to improve cancer care in Costa Rica?
Dr. Pippen: My hope is that ASCO will emphasize the rewards of volunteerism and make sure that all ASCO members know about this program. This program is a fantastic way to start out as a volunteer because of the ease of travel, lack of language barrier, safety of the city, and friendliness of the Costa Rican physicians.

AC: What is an HVO/ICC Costa Rica volunteer likely to experience?
Dr. Pippen: In Costa Rica, expect to find physician colleagues who are well informed, friendly, and appreciative of the efforts that you are providing. It is not a bad bonus that it is easy to add ecotourism, reasonably priced accommodations, and great food as part of your stay.




Operating room of the National Hospital del
Cancer in Capiata, near Asuncion, Paraguay.

HVO/ICC Paraguay: An Interview with Program Director Thomas H. Openshaw, MD

AC: What makes the cancer care situation in Paraguay unique?
Dr. Openshaw: As in many other countries, breast cancer and cervical cancer are major public health problems. Limited access to mammography and lack of means of early detection of cervical cancer result in detection and treatment of these diseases at a relatively late stage. Available resources for diagnosis and treatment do not meet the current needs of the population.

AC: What factors led to the development of objectives for the Caipita site?
Dr. Openshaw: Physicians at the Hospital del Cancer identified breast and cervical cancer as the most important oncologic problems for the country. They felt (and we agreed) that a program to improve the diagnosis and treatment of these disease would have the greatest impact on their population. During our first visit, they developed guidelines for the diagnosis and treatment of cervical cancer that reflect the needs of their population and the resources available. They also started a multidisciplinary clinic for cervical cancer, which is reducing the time from diagnosis to treatment of this disease.

AC: What are your hopes for this program?
Dr. Openshaw: We hope that the ICC program will greatly improve the diagnosis and treatment of cervical and breast cancer. We hope that the availability of improved treatment will be an impetus to improve public health measures for earlier diagnosis and treatment.







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