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Nov. 22, 2011

Forming a global cancer network for research, clinical care, education and prevention.

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Taking the Long View – Alma Rodriguez and the Future of Oncology Care

Speaking with leadership whose offices are on the top floors of institutions conjures images of political savvy, smooth talking and rushed conversations filled with sound bites as they fulfill their public relations duties. Within a few moments of speaking with Alma Rodriquez, M.D., however, it is apparent she does not fit that stereotype. In fact, she does not fit any of the stereotypes with which her history and profession would label her. Rodriguez, who is the vice president for Medical Affairs at MD Anderson, is calm and fluid - in her walk, her appearance, her speech. She does not seem unsettled, even when she is unsure why someone is in her office to talk to her about her work.

Rodriquez’ work of more than 30 years is as a physician who specializes in treating Lymphoma and Myeloma. Her contributions placed her along with 25 other women in the book, “Legends and Legacies: Personal Journeys of Women Physicians and Scientists at MD Anderson Cancer Center.” In that book, Rodriquez talks about her improbable progression from the daughter of migrant farm-workers to an integral member of the leadership at the largest cancer center in the country. Recounting her life story, Rodriquez repeatedly uses the word serendipitous to describe her education and career transitions. Her countenance continues to reflect that same belief that she is where she is supposed to be.

At this stage in Rodriquez’s career, she has turned much of her focus to creating a sustainable infrastructure of clinical professionals. As with many other medical disciplines, oncology is looking to a future with more patients and fewer specialists. By 2020 The American Society of Clinical Oncology estimates a shortfall of approximately 4,000 providers for the projected number of cancer patients. To bridge that gap, oncology as a profession is looking to mid level providers, and specifically physician assistants (PA), to provide care and support. Most PAs choose family practice as a career path and few have historically considered oncology.

Rodriguez and others have sought avenues to attract PAs to oncology and to MD Anderson. In 2008, MD Anderson started the only PA oncology fellowship in the country and created an e-learning course to introduce PAs and other health care providers to an overview of oncology. This original “Introduction to Clinical Oncology” course was in audio with power point and covered several broad topics, including cancer development, diagnosis, treatment and supportive care. Recently, as part of the Professional Oncology Education (POE) initiative at MD Anderson, the course was expanded and produced as part of an online series available at no cost to health care professionals and anyone with an interest in cancer.

In addition to enabling oncology services by increasing the number of participating PAs, Rodriguez is also concerned with engaging community general practitioners and internists, who are increasingly likely to have cancer survivors as patients. As cancer patient numbers grow, so too do the number of survivors. But surviving cancer brings its own medical challenges. Rodriquez and Lewis Foxhall, M.D., vice president of Health Policy, have focused on creating POE classes in survivorship. Although also of interest to health care professionals contemplating careers in oncology, these courses are geared towards informing physicians who may need to support and treat survivors after, or in concert with, their oncologist. Survivorship I is currently available and Survivorship II should be online soon.

While Rodriguez’ strives to enable the access to information that will allow PAs to contribute to work that has predominately been the domain of oncologists, she continues to maintain her own clinic. Caring for patients was how she started her career. It is why she was drawn to oncology in the first place. Rodriguez saw her first patient during a clinical rotation here at MD Anderson and ten years later returned to practice as faculty.

“I have never had an unkind cancer patient,” she recalls. “Even though they have cancer they have been optimistic and upbeat. I felt like I wanted to help them in what they were going through.”
So, Rodriquez is trying to help future cancer patients obtain the care they need whether it is at MD Anderson or elsewhere and whether it is from a physician or not.  Even with legendary status, Rodriguez has no plans to stop working, however, and will continue to see her patients and provide the care and kindness that exemplify her personally and professionally.

Calendar of Events

9th International Conference on Ovarian Cancer
MD Anderson
Dec. 2-3, 2011

Recent Developments in Cancer Prevention
Udaipur, India
Dec. 16-19, 20111

Excellence in Oncology
Istanbul, Turkey
Feb. 23-25, 2012


Next Global Oncology Lecture Set

Phil Castle, Ph.D., is the executive director of the American Society of Clinical Pathology Institute (ASCP).  Previously, Castle was a senior, tenured investigator at the National Cancer Institute and contributed to several seminal epidemiological studies involving HPV and Cervical Cancer Screening. In his current role, Castle leads the ASCP’s Center for Health Services Research and Global Outreach and has been tasked with delivering new laboratory technologies, including those for HPV testing and cervical cancer screening, in underserved populations. Castle’s lecture will be held on Jan. 19, 2012 from 12-1 p.m. in the Mays Clinic, conference room ACB 1.2325. Keep reading GAP Connect for a profile of Castle and additional details regarding his lecture.

Network News

December Travels to India

Next month, several members of Global Academic Programs, and faculty and administration from The University of Texas MD Anderson Cancer Center will be travelling to India to visit institutions and attend conferences at various locations. GAP will be visiting four sites.

Tata Memorial Hospital (TMH)

As one of GAP’s Sister Institution’s TMH is a valued research and education partner and the largest cancer hospital in Asia. During this trip, GAP staff will visit The Advanced Centre for Treatment, Research and Education in Cancer (ACTREC). This Centre is a state-of-the-art research and development facility divided into R&D for both basic science and clinical. The goal of ACTREC is to better understand the molecular mechanisms that cause cancer and contribute to drug development and therapies for treatment and prevention of cancer.

Delhi State Cancer Institute (DSCI)

DSCI was started in 2006 by the government of Delhi and began with the grand ambitions to become a leading cancer care center within five years. Currently, the Institute boasts a CT scanner with RT simulation, digital X-Ray with Fluoroscopy, digital mammography with computer aided detection (CAD), three linear accelerators and chemotherapy facilities.  In the near future DSCI expects to upgrade and expand their surgery facilities to four surgery theatres and introduce brachytherapy. In addition, DSCI is also planning to open several specialized research labs and launch community education and screening programs.  As part of their mission, DSCI is interested in partnering with other leading international cancer centers.

Institute of Liver and Biliary Sciences (ILBS)

Focused entirely on liver and biliary disease, ILBS differentiates itself not just by specializing in care, but through the varied research in which it engages. The Institute’s research focuses on six areas:

• Hepatitis induced by HCI and HCV-HIV co-infection
• Role of microRNAs in liver disease
• Chronic hepatitis in adults and neonates induced by HBV infection
• Non-alcoholic steatohepatitis
• Regenerative medicine
• PCR-based diagnostic assays

Several specialty areas coordinate patient care including hepatology, surgery, radiology, laboratory medicine and transfusion medicine. Also started by the government in Delhi, ILBS is a little over a year old and hopes to bridge the gap between the standard of care in a private hospitals and government run hospitals.

Rajiv Gandhi Cancer Institute & Research Centre (RGCI)

RGCI is a unit of Indraprastha Cancer Society & Research Center, which is a non-profit society concentrating on research involving patient care.  Opened in 1996, the Centre maintains specialty services in surgical oncology, radiation oncology, medical oncology and a disease specific division for urologic oncology. The Centre employs multidisciplinary care in its treatment of patients as well as its research. Current research programs incorporate epidemiological, behavioral, clinical, biochemical and biological studies to work towards understanding the basic molecular structure and evolution of cancer.