An Interview with ASCO Volunteer - Claude Denham, MD

From left to right: Dr. Carlos Zuniga, Dr. John Pippen and Dr. Claude Denham

What made you interested in
volunteering? Why did you choose to
go to Costa Rica?

This was my second trip with HVO (we
spent a little over a week in Hue,
Vietnam in 2012). I have always
wanted to go on medical volunteer trips
for many years now, but it seemed like
the main desire was for surgeons who
could come in and perform a one-time
procedure or primary care doctors who
diagnose and treat infectious diseases.
In a sense, I felt left out as a medical
sub-specialist. These HVO/ASCO trips
though provide a great opportunity to
collaborate with oncologists from other countries who may
feel a little isolated and perhaps a little less confident in their
management in comparison to what they read in journals. I
had been to Costa Rica several years earlier for vacation and  
generally found it a very easy trip for an American.

What surprised you about your visit to the hospital in
San Jose?

I was somewhat surprised and very impressed with quality
of the clinical care, multidisciplinary conferences, and
knowledge base of the oncologists at all three hospitals.
Our discussion of patient management was much more a
two-way collaborative discussion considering the differences
in our health care systems than a purely didactic teaching
exercise. The health care system in Costa Rica struggles
with escalating need for technology, including advanced
imaging and expensive drugs just like the US. There is a
difference in expectations on the part of the patients, but
the oncologists spend a great deal of time filling out forms
and jumping through hoops to get newer drugs for their
cancer patients. This was very notable and impressive.

What lasting impressions/effects do you think your
visit might have?

I hope our trip provided them with reassurances that, within
the constraints of their healthcare system, they were doing a
remarkable job taking care of cancer patients. They have
structures in place for very effective multi-disciplinary cancer
treatments already. At present, there is apparently no access
to clinical trials in the country, but my understanding is that
this needs to be addressed at the national governmental level.
By discussing our access to clinical trials, perhaps the
oncologists in Costa Rica may be enabled to convince their
government to establish a process for this in the future.