Leveraging International Expertise for Cancer Care in LMICs

Author Info

Aaron Saunders Carmelo Gaudioso Chukwumere Nwogu Jimoh Mutiu Saby George Tracey O’Connor Ugonna Ajoku

Corresponding Author

Aaron Saunders
Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

A B S T R A C T

Purpose: Cancer care in high-income countries (HICs) is often coordinated at multidisciplinary conferences (MDCs). However, among disparities encountered by cancer care providers in low- and middle-income countries (LMICs) is lack of access to specialized expertise. Modern communication technologies offer opportunity for remote MDCs; reports of this are limited and have described logistical barriers. We explored this concept further. Methods: We reviewed the experience of a cancer center in Lagos, Nigeria, connecting with multidisciplinary expertise in the United States (US). Multidisciplinary consultations were reviewed, and descriptive data were generated. Participating providers were surveyed. Results: Over a two-year period, 27 cases were referred for multidisciplinary consultation. Of these, 21 (78%) were referred to Roswell Park Comprehensive Cancer Center in Buffalo, NY, and 6 (22%) were referred to other US institutions. All but one (26, 97%) were referred using email, while one case was discussed via videoconference. Reasons for consultation were uncertainty about management in 10 patients (37%), need for validation of treatment plans in 14 patients (52%) and unusual clinical scenarios in 3 patients (11%). Limitations included incomplete documentation of treatment recommendations (5, 18.5%) and unavailable diagnostics (7, 26%) or therapies (3, 11%). Time to receive final recommendations ranged from 1 to 14 days, with a median of 3 days. Survey respondents (8, 100%) agreed or strongly agreed that remote MDCs added value, and that email was an effective, low-barrier method for their organization, with some drawbacks noted. Conclusion: This early experience demonstrates feasibility of remote MDCs to benefit providers and patients in LMICs. Future directions include using more sophisticated software and organization to maximize the scalability and sustainability of this concept.

Article Info

Article Type

Research Article

Publication history

Received: Sun 30, Sep 2018
Accepted: Tue 16, Oct 2018
Published: Thu 15, Nov 2018

Copyright

© 2023 Aaron Saunders. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.RCO.2018.01.004