Nov 07, 2019
By Maria Teresa Bourlon, MD, MS
In 2013, I received the International Development and Education Award (IDEA) from ASCO and Conquer Cancer, the ASCO Foundation! It was a landmark moment in my career and got me involved in global oncology. The award provided me with the opportunity to attend the ASCO Annual Meeting for the first time and connect with other awardees from other low- to middle-income countries (LMICs).
As a Mexican trainee, experiencing the ASCO Annual Meeting was a fascinating and overwhelming experience. It is such a huge and perfectly organized congress, with thousands of oncologists attending from all over the world, and multiple high-quality, practice-changing studies being presented at the same time. It was comforting to attend the meeting with co-awardees experiencing the same feelings. They also came from resource-constrained settings, and they were as surprised as I was to see oncology practice in a high-income country—and we were all perplexed, thinking about how we could implement those practices in our own unique limited-resource environments.
My mentor for the IDEA program was Dr. L. Michael Glodé, an enthusiastic professor at the University of Colorado, selflessly willing to share his knowledge. I was immersed in a comprehensive cancer center in the United States for the first time as part of a well-organized urologic oncology clinic. Dr. Glodé quickly realized how impressed I was by the institution’s tumor boards, facilities, and research area, which of course are lacking in my hometown. He quickly understood that I did not have a place to train in urologic oncology back home, and it was the field in which I wanted to focus my career. He motivated me to apply for a fellowship in the University of Colorado’s Genitourinary Cancer Program.
During the year we spent together during my fellowship, Dr. Glodé always encouraged me to think about how I was going to organize the clinic when I went back home. He emphasized the importance of networking and made sure I was able to interact with other faculty members. Three of them became my co-mentors: Dr. Thomas W. Flaig, Dr. Elaine Lam, and Dr. Elizabeth Kessler.
Using My Voice Within ASCO
During this time, I volunteered for an ASCO committee, and to my surprise I was called to serve on the Professional Developmental Committee.
I was very happy but also very nervous to join and interact with other senior oncologists. I clearly remember arriving at the beautiful ASCO headquarters, where everyone seemed to know which direction to go, and entering a conference room, where I found my name on the table next to well-known oncology leaders. It was a little frightening: I was the youngest in the room, still in training, a woman, Hispanic, not a U.S. citizen, and the discussion was not in my native language.
My co-mentor Dr. Flaig happened to be in the meeting, and he realized that I felt intimidated. He approached me and said, “You need to realize how important it is that you are here. You represent the minority in every sense and ASCO wants your opinion.” His support made me feel more confident. I could talk at the microphone. I could feel the committee members’ empathy and willingness to hear my perspective and include it in ASCO recommendations. “Diversity and inclusion” was not just a slogan, but a real phenomenon occurring at ASCO.
Ongoing Collaboration and Mentoring
International collaboration really fuels oncology training for fellows in LMICs. The faculty from the Genitourinary Cancer Program at the University of Colorado have supported us in a long-standing mentorship program. As visiting professors to our program in Mexico, they have provided our fellows an opportunity to interact with GU oncology experts, present cases, and discuss research results. Their visits have opened their eyes to the reality I face every day in my practice, and with this understanding they have become even better in advising me. In addition, this mentorship supports those fellows who cannot afford to travel to get exposure to world-class experts. In fact, these faculty members have become mentors for two of my fellows who are also IDEA awardees.
Becoming clinically and academically successful while working in an LMIC might be perceived as difficult. My ASCO mentors have helped me understand that in life you must see these difficulties as a challenge, never as an obstacle.
In 2018 the Genitourinary Cancers Symposium abstract notifications arrived! I had to read the email several times before I could believe what it said: my abstract had been accepted and I would be presenting my research in an Oral Abstract Session. It was a Mexican study, conducted with a Mexican foundation grant, and developed by a Mexican team. I had gotten local support to draft my study results, but my Colorado mentors were key in coaching me for the presentation. Seeing them in the front row at my talk was the most reassuring sight.
Advocating for Women in Oncology
I continued to be involved in ASCO activities, and I received an invitation to participate in an advisory group on the Women in Oncology Strategic Plan.
The goal was to develop a comprehensive understanding of the current professional state of women in oncology, advocate for the inclusion of women in all professional activities and in medical leadership, and to enhance programs that support women’s professional development. To my surprise, I was sharing the room with three exceptional women leaders: ASCO past presidents Dr. Sandra M. Swain, Dr. Julie Vose, and Dr. Monica M. Bertagnolli (at the time, Dr. Bertagnolli was ASCO president-elect).
Twelve states and two countries were represented in the advisory group. Hearing the challenges that these women leaders have faced, and learning firsthand how they overcame them, was an invaluable opportunity for me.
During the discussion, I happened to share a table with Dr. Swain, who had served as ASCO president during the same year I received the IDEA. Her inspiring presidential theme was “Building Bridges to Conquer Cancer.” Dr. Swain took the time to ask me how I was doing, and kindly offered me her contact information in case I needed further support. When she learned that I had presented at the Genitourinary Cancers Symposium, Dr. Swain “built a bridge” across countries and, along with chair Dr. Jaime G. de la Garza-Salazar, supported me in presenting my research at the Best of ASCO meeting in Mexico.
ASCO is a great platform for international mentorship! I was asked to serve in the Women’s Networking Center as a mentor. At first it sounded weird—that I could mentor anybody when I was still at an early career stage myself. But ASCO matched me as a mentor to fellows in training in other LMICs, and I could use my experience of applying for ASCO grants and opportunities to help other trainees to start an academic career in oncology. This has turned out to be a very rewarding experience.
From Mexico to the World
Getting involved with oncologists from other settings fueled my interest in global oncology. I had the pleasure to be invited to join ASCO’s Global Oncology Task Force. The task force was composed of a chair and nine members appointed by the ASCO International Affairs Committee and Professional Development Committee, with guidance from the ASCO president. The task force developed recommendations for ASCO to significantly advance the status of global oncology as an academic discipline focused on improving cancer care and health disparities in resource-limited populations and settings, wherever they may occur. These recommendations reflect the inclusion and diversity of ASCO and will be published in full in the Journal of Global Oncology (JGO).
In 2019, I received an ASCO Editorial Fellowship. As an oncologist practicing in an LMIC, I wanted this opportunity so much! The educational experience for an oncology fellow can vary significantly according to the country and institution where they train. A young oncologist in an LMIC is often struggling to deliver adequate clinical care in overtaxed facilities, starved of all kinds of resources, including mentorship for reviewing, writing, and submitting articles. JGO managing editor Emilie Gunn was a great guide and support, and the editorial fellowship with JGO allowed me to be more involved in ASCO’s international relationships. Dr. Eva Segelov, of the Monash Cancer Center in Australia, became my mentor, and her enthusiasm is striking. She has shown me the passion of being an editor, fueled my ideas, and helped me connect with other key members who are involved in JGO.
I am sure I will never forget Dr. Segelov’s passion for mentoring. She has been so generous with her time and I hope she will not get tired, because we have had a very productive journey, including writing editorials, reviewing my papers before submission, and engaging in global oncology research projects.
JGO editor in chief Dr. Gilberto de Lima Lopes received my co-fellow and me with profound enthusiasm and support, and welcomed us to the JGO working team. He has helped me reach the objectives I set for this fellowship in my application.
The ASCO community has been paramount in my career development as an oncologist and has served as an everlasting motivation. At the 2019 ASCO Annual Meeting, I had the pleasure to present at an Education Session on “Preparing Fellows for Real-World Practice: A Cultural Perspective.” My talk included a detailed analysis and feedback from my colleagues on the current situation for trainees in my country and other LMICs in Latin America—and since international collaboration and interaction is key, it included feedback from my mentors in the United States. (Here, too, Dr. Segelov kindly and carefully supported me in the rehearsal room before the presentation, on this very important day for me.) The session was enriched by the perspectives of my co-speakers from Lebanon and Australia.
The talk was truly a result of international ASCO collaboration. Years ago, I never imagined being invited as faculty for the ASCO Annual Meeting. ASCO made me dream, and ASCO mentors gave me the courage to make my dreams come true.
My Story Comes Full Circle
Today, I am happy to know that I will continue this international journey within ASCO. This year, I received an invitation from Vanessa Sarchet in ASCO’s International Affairs Department—the very first person I met on the ASCO staff—to become a member of the IDEA Working Group. A fascinating event, since the IDEA is where my story at ASCO started. Since that time, I have had the joy of seeing other co-fellows, my sister, and two of my trainees obtain this Conquer Cancer distinction. You can see from my own story that it is a life-changing award, one that opens the door for international networking, fuels an academic career, and offers opportunities to shape our profession and our world through the work of ASCO.
Dr. Bourlon is a medical oncologist in the Urologic Oncology Clinic at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico. She is a member of the International Development and Education Award (IDEA) Working Group, and was a 2013 IDEA recipient. Follow her on Twitter @BourlonMaite.