Making a Difference: One Scholar’s Journey to Help Young Breast Cancer Patients in MexicoFebruary 4, 2016
Dr. Cynthia Villarreal-Garza was selected by the Avon Foundation Scientific Advisory Board and program mentors as one of 23 physicians to come to the U.S. to participate in the second class of Avon Global Breast Cancer Clinical Scholars. The program trains breast cancer specialists living outside the United States at 12 leading Avon Foundation-funded U.S. breast cancer centers. Cynthia traveled from Mexico City with her eight-month-old daughter, Natalia, and her mom to spend eight weeks in Boston. She was assigned to Massachusetts General Hospital under the mentorship of Dr. Paul Goss. Cynthia shares her experiences below.
When I was young, I saw the movie “The Fugitive” with Harrison Ford. He played a doctor who was able to heal himself and others. I remember thinking, “I might want to do this. I might want to be a doctor.”
Today, I am a breast medical oncologist in the Breast Cancer Center at the Tecnológico de Monterrey and a clinical researcher at the Instituto Nacional de Cancerología in Mexico City.
I learned about the Avon Foundation for Women’s Global Scholars program through the American Society of Clinical Oncology (ASCO) and knew this program would be a great opportunity. Specifically, I wanted to work with Dr. Paul Goss, Director of the Avon Foundation Breast Cancer Center of Excellence at Massachusetts General Hospital and Chairman of the Avon Foundation Scientific Advisory Board. Dr. Goss works extensively on global health issues, including breast cancer, in Mexico and other Latin American countries. He and his team run a program called Live Tumor Boards, where a multidisciplinary team of medical experts at Massachusetts General Hospital discuss difficult breast cancer cases with oncologists in Brazil and Mexico.
Since my early days as a physician, I’ve had a special interest in breast cancer among young women. In Mexico and many other Latin American countries, it is common to spend a year after finishing medical school providing medical care in areas with limited resources. Many doctors in these areas are not knowledgeable enough about breast cancer detection and screening, especially in younger women.
In Mexico, we see a high proportion of women under 40 diagnosed with breast cancer, up to 12%(compared with 3% in the U.S.), and this population faces special needs that are not currently well managed in our setting. One of the most concerning medical issues is that approximately 70% of young patients present with locally advanced disease at diagnosis. In Mexico, it has been reported that the time between symptom discovery and the beginning of cancer treatment is almost eight months (compared with approximately 50 days in the U.S.). Unfortunately, much of the delay is attributed to medical errors.
At the National Cancer Institute in Mexico, we adopted the model of a specialized clinic for the care of young women with breast cancer, the first in Latin America. The goals of our clinic include optimizing complex clinical care and supporting the needs of young women with breast cancer and their families; promoting medical and social research focused on this population; educating young women about the importance of early detection; and teaching health professionals to promote early cancer detection and better multidisciplinary management.
During my two months in Boston, I worked closely with Dr. Paul Goss, Dr. Ann Partridge of the Dana Farber Cancer Institute and their work groups. Physicians in these Institutions focus on specific areas of interest and research, and there is a unique and invaluable opportunity to learn from them. This experience helped me refine the objectives of our program in Mexico. Dr. Goss, Dr. Partridge and I continue to collaborate on research projects and are developing a study to collect information on young breast cancer patients. We want to look at diagnosis delays, risk factors, specific needs and outcomes. This information will enable us to implement supportive measures and interventions to improve outcomes and quality of life for this group of women.
Also, we will soon join the Live Tumor Boards run by Dr. Goss and his team. This will provide us with the opportunity to present our cases in a multidisciplinary fashion to top experts, which will ultimately improve the care of our patients.
We will continue working together and join efforts to reach our shared goal: to improve the care of young breast cancer patients, even in settings with more limited resources.
One thing is for sure – our friendship and collaborations will not end in Boston.