Oct 16, 2018
By Anees B. Chagpar, MD, MSc, MPH, MA, MBA, FRCS(C), FACS
ASCO is such a misnomer: the American Society of Clinical Oncology is far more than simply “American.” Over the past several years, I (a Canadian-born breast surgical oncologist, with an Indian-born mother and a Tanzanian-born father) have travelled to Zimbabwe, Bhutan, and the Philippines with this organization, and have networked with oncologists from all over the world as part of the International Affairs Committee and Multidisciplinary Cancer Management Course Working Group.
Alas, I suppose it’s too late to change ASCO’s name to ISCO (the International Society of Clinical Oncology), but perhaps the “A” could be better understood as “All-Inclusive” or “Awe-Inspiring” or simply “Amazing”—all of which would be appropriate adjectives to describe ASCO’s international work.
My interest in global affairs started at a young age. I can still remember the year I got tired of Barbies and playhouses and asked Santa for world peace instead. He looked at me kind of quizzically, as though the elves didn’t know how to make that happen... go figure—so much for the magic pixie dust! Over time, I’ve realized that so much of international development, including world peace, will depend on global collaboration to improve the state of affairs, particularly in low- to middle-income countries. This isn’t to say ASCO can wave a magic wand and eliminate poverty (darn it!), but it still can (and does) do its part to help foster access to quality cancer care worldwide through a three-part strategy:
- Cultivating and collaborating with oncology leaders around the world;
- Working with these leaders to adapt and deliver quality improvement, education, and clinical training programs in their countries; and
- Supporting and disseminating global oncology research that discovers new models to improve access to quality care in resource-limited settings.
When I was part of the inaugural ASCO Leadership Development Program class, Drs. Jyoti Patel, Matt Galsky, and I were given a small year-long action project. The task? To answer the question of “How can ASCO help improve global cancer care in a sustainable, scalable and cost-effective manner?” Yeesh… but with the help of mentors like Dr. Patrick Loehrer, who had already been successful in his own right in developing programs in Uganda, and Doug Pyle, ASCO’s vice president of International Affairs, we were quickly introduced to oncologists all over the world who were working with ASCO to enhance oncology programs in their own countries. We were able to better understand the diversity of needs and cultures that faced people in different corners of the world, but there were a few key underlying themes: the effect of poverty on the state of health of populations; the need for access to care, better education, and infrastructure for research; and the potential impact of relatively small interventions.
With the lack of a highly skilled medical workforce to meet the needs of the population, many countries rely on community health care workers and primary care physicians for cancer prevention and control. While these individuals are motivated and compassionate, they still require up-to-date education and benefit from the knowledge of experts from around the globe who can support them in their activities. ASCO fills this need in a myriad of ways, including the Cancer Control for Primary Care Course, one of which I chaired in Bhutan. We had expected only 50 people, including those from some of the more far-flung districts, to attend, but to our amazement over 80 people came from all over the country who were eager to learn about signs of cancer, genetic counseling, prevention, and more. ASCO faculty continue their work with colleagues in Bhutan, providing an ongoing source of mentorship and support.
For countries that have access to specialists, often there is a need to integrate and coordinate care, and extend best practices to multidisciplinary teams. ASCO has done incredible work with their Multidisciplinary Cancer Management Courses (MCMC) in this regard, often combining this with Train the Trainer (TTT) sessions to ensure that the education they provide, particularly in developing tumor boards, is scalable across the region. A few years ago, we went to Zimbabwe for an MCMC and TTT—what a phenomenal success! Since then, tumor boards have been set up, and we continue to communicate with our colleagues in Zimbabwe. Folks like Dr. David Raben have even helped with radiation planning there!
Train the Trainer programs don’t just happen in low- to middle-income countries. There has been a spectacular response to them at the ASCO Annual Meeting. We’ve had a number of International Development and Education Award (IDEA) recipients attend action-packed seminars where they’ve learned how to present their ideas and talk to the media. This is great training for them, especially as you consider how these junior faculty from all over the world who have the opportunity to partner with more senior faculty in the United States and Canada can go on to fulfill their research and clinical ambitions at home, using IDEA as a springboard! Over the years, I’ve had a number of IDEA recipients spend time with me at Yale, and it’s been a rewarding experience all around.
Indeed, the IDEA is just one award that ASCO and ASCO’s Conquer Cancer Foundation offer to help further global development. There’s also the Long-term International Fellowship (LIFe), the International Innovation Grant,
Suffice it to say that, in its own way, ASCO is making a real impact on the world—bringing the global community of oncologists and people dedicated to the mission of conquering cancer worldwide a little closer together. It may not be world peace (yet), but the folks working in International Affairs are doing remarkable work—Santa would be proud!
Dr. Chagpar is a professor in the Department of Surgery at Yale School of Medicine and assistant director for Global Oncology at Yale Comprehensive Cancer Center. She is chair of the ASCO Multidisciplinary Cancer Management Course Working Group and an ASCO Connection blogger.
ASCO International programs are supported in part by ASCO’s Conquer Cancer Foundation.