UW Carbone Cancer Center is one of 27 institutional members of the National Comprehensive Cancer Network (NCCN). One of NCCN's roles is to assemble committees of physicians in order to pour over the medical literature and set guidelines for the evaluation and treatment of most types of cancer. 

In order to make practical recommendations on how guidelines-based care might be achieved in different areas of the world, NCCN sends physicians abroad to work with local physicians in Africa, the Middle East, and elsewhere to determine how the "gold standard" can be adapted to global health settings. 

In May, 2018, Natalie Callander, MD, professor (CHS), Hematology, Medical Oncology and Palliative Care, was asked to visit the Caribbean as a myeloma expert. Dr. Callander serves as vice chair of the NCCN Multiple Myeloma Committee. 

"We started by having in-person meetings with teams of physicians. And my role wasn’t to say, 'This is what you should do.' It was, 'Tell me what you do. Tell me about your clinics and your health system,'" said Dr. Callander. 

Together, the oncologists discussed challenges such as limited access to bone marrow transplant procedures and unavailability of some of the newer drugs used to treat multiple myeloma. 

At the end of the three-day visit, the NCCN team drafted a Caribbean version of the guidelines, which will be finalized and made available for any physician to use. 

Dr. Callander described the experience as “humbling,” and said she was impressed by the level of expertise of physicians practicing in Caribbean.

“Our current NCCN guidelines don’t add in the reality that some parts of the world face, and I think the emphasis of our visit was that these are all very well-trained, very knowledgeable oncologists,” Callander said. 

“It’s not that they don’t know or don’t want to implement the top treatments, it’s that they can’t. And they’d like to come up with the best way to treat their patients effectively with the resources that they have.”

Resources:

• "UW Carbone Myeloma Expert Looks to Improve Care in Caribbean Nations," UW Health, July 11, 2018

Photo (top): San Fernando General Hospital, located in the City of San Fernando, is considered as the main trauma unit for the southern region of the island of Trinidad in the Caribbean nation of Trinidad and Tobago. Photo CC-SA 4.0 courtesy of Grueslayer.