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For World Cancer Day, Let’s Set Our Sights Beyond U.S. Borders

February 4th is World Cancer Day, a UICC-led initiative promoting awareness about how everyone and anyone can do their part to reduce the global burden of cancer. I want to emphasize the word “global” in that sentence, because in my experience, nearly everyone in the U.S. – including many of my colleagues in the medical profession – is focused primarily on cancer-related challenges that directly affect patients here.

 

Even the Cancer Moonshot initiative, a worthy endeavor that is technically global in scope, will truly only impact the U.S.  That’s because there is an enormous gap between U.S. patients and those in the rest of the world, another gap between developed and developing countries, and then a third gap between rich and poor inside developing countries.  Even if a cure for cancer were found tomorrow as a result of this Moonshot, it wouldn’t affect the vast majority of the world’s cancer patients.

 

The burden of cancer is greatest in low- and middle-income countries (LMICs). In 2012, 57% of new cancer cases and 65% of cancer deaths occurred there, and the average patient in a developing country is roughly twice as likely to die from their cancer than a patient in the U.S. That increased risk is primarily from lack of screening, lack of access to treatment, and treatment methods that are decades behind those used in the U.S. One jarring statistic to illustrate the delta: 58% of breast cancer patients in Mexico present with advanced-stage cancer, versus just 12% of breast cancer patients in the U.S.

 

The U.S. already provides the most advanced cancer care in the world. We have a responsibility to now help the rest of the world catch up.

 

There are some simple steps we can take to help measurably improve survival rates for underserved cancer patients worldwide. Here at GCI, we work directly with cancer doctors in LMICs to propagate simple interventions that are common in the U.S. and have been proven to accelerate diagnosis, access, and treatment. Some examples are:

 

  • Global Tumor Boards, which help physicians and oncologists in developing countries connect directly to U.S. physicians by videoconference to discuss challenging cancer cases and ask advice.
  • Patient Navigation Programs, intended to help ensure cancer patients have rapid access to treatment. Patient Navigators help patients find physicians, deal with insurance companies, book treatment appointments, and follow up to make sure patients get to appointments. This low-cost intervention is making a big impact: In a Mexico City pilot, the program reduced the median time from diagnosis to referral to a cancer center from two months to 11 days, boosting patient outcomes and survival rates.
  • Cancer Databases, to track and understand socio-demographics, treatment choices, and outcomes in patients in developing countries, to bring attention to long-standing cancer control problems (such as the larger proportions of young women with breast cancer in LMICs, like Mexico).

 

Do we need to find a cure for cancer? Yes, of course. But in the meantime, the U.S. has a wealth of medical knowledge that can and should be shared with the rest of the world to make an impact today. On World Cancer Day, let’s think not just about how to reduce cancers in the U.S., but globally. The rest of the world needs a Cancer Moonshot too.

 

Mapping Our Global Tumor Boards

Global Tumor Boards Connect Doctors to Improve Patient Care

Jessica St. Louis is the senior program coordinator for GCI and has been with GCI since its inception. Among her many duties, she coordinates Global Tumor Boards: live, online videoconferences that connect doctors from around the world to discuss complex patient cases. Here, Jessica answers some of the most frequently asked questions about these tumor boards and how she works with GCI’s global network to make them happen.

 

What are tumor boards?

Global Tumor Boards are meetings where a multidisciplinary team of doctors get together to discuss complex patient cases. They are not only valuable for patients, who of course benefit from having multiple doctors reach a consensus on best treatment and care, but they are also an important educational tool. They offer an opportunity for doctors to collaborate and learn from each other – even from different continents.

How exactly do Global Tumor Boards work?

Our tumor boards are online videoconference meetings with the ability to host 15 cameras and unlimited numbers of viewers who can watch the meeting. This is unique in that we can connect and communicate with hundreds of doctors at once in real time from our office in Boston! Doctors can also go on YouTube and watch recordings of our previous tumor boards at any time.

Who are the doctors that join tumor boards? Where do they come from?

Doctors who join our tumor boards are from over 18 countries in Latin America, Eastern Europe, Africa, and Asia. In total, our tumor boards have reached over 350 doctors worldwide. The patient impact of Global Tumor Boards is huge, considering that one doctor typically treats hundreds of patients per day.

What exactly do these doctors talk about during the one-hour meeting?

GCI holds monthly tumor boards on breast and gynecologic cancers. In each meeting, we invite hospitals from low- and middle-income countries (LMICs) to present challenging patient cases to a panel of multidisciplinary experts from prestigious cancer centers in the United States, including Johns Hopkins, Stanford University, MD Anderson, and others. Our panel of experts help the doctors reach a consensus on each patient’s treatment. We find that many doctors have similar challenges when providing cancer care in LMICs with limited resources. We discuss these resource challenges as well as GCI’s research initiatives and interventions to improve access to clinical care.

Why does GCI do tumor boards?

Global Tumor Boards are an effective way to improve patient care through doctors. The doctors in these countries often work in multiple hospitals and see hundreds of patients a day without the guidance of their peers. This burden prevents doctors from keeping up to date on clinical practice guidelines.

They are a great way to engage doctors in patient care discussions with their peers – doctors really enjoy talking about medicine with one another! It creates a “beehive effect” where doctors can learn together and build similar levels of clinical knowledge and styles of practice. We also engage the doctors in discussions about how their patient cases relate to “bigger picture” cancer control issues and public health interventions.

Besides that, it is very comforting for patients to know that their cancer is being watched by a team of doctors who came to a consensus about the best step forward.

What kind of technical capabilities are required to be part of a tumor board?

All that’s needed is a computer with a camera, microphone and an internet connection.

How can I join?

If you are a doctor in a LMIC and would like to join Global Tumor Boards, please contact us at info@globalcancerinstitute.org !