Ed Briercheck, MD, PhD
I had amazing opportunities to do cancer research during my graduate and medical training Ohio State University. At the same time my interests in healthcare inequality led me to question whether the discoveries we were making in the lab was having an impact for patients in low-resource settings. The gap in this care was obvious during my first visit as a student at the INCAN cancer hospital in Guatemala City, Guatemala. While cancer had not been a “traditional”global health topic it was clear that cancer was having devastating impact on patients in low-resource countries. Upon moving to Boston for residency I was thrilled to find in GO a group of energized people working to solve this problem.
One of the barriers to care in Guatemala and other low-resource settings is obtaining a proper diagnosis. This is limited by cost and an adequate number of highly trained pathologists. Along with my former attending at INCAN Dr. Fabiola Gamboa-Valvert and my current research mentor Dr. David Weinstock at the Dana-Farber Cancer Institute (as well as the laboratory of Dr. Yaso Natakunam at Stanford) we developed a research project that aims to solve this problem through an inexpensive and simple gene based diagnostic tool for lymphoma. This would drastically cut the cost to patients and provide a higher level of precision in their diagnosis. The current immunohistochemistry based diagnostic tests for lymphoma cost patients $450 or around 11% of the median income in Guatemala. We believe that we could produce a more accurate test based upon gene expression for $10. Further, with enough resources we could easily scale such a system to other regions and cancer types.
Locally, at Boston Medical Center we have an awesome opportunity to see patients from all over the world, so my interest in “Global Oncology” presents itself frequently on the wards. Greater than 1/3 of our patients in hem/onc clinic have no or limited English proficiency. This can make communication around sensitive topics like end of life care, and very practical issues like diarrhea associated with chemotherapy difficult to discuss. The organization Global Oncology along with the local design firm The MEME created some fantastic education tools to assist at their international cancer sites. These are currently available in Spanish, Haitian-Creole, Kinyarwanda, Setswana and English. Led by Constance Fontanet a BU public health student and Dr. Naomi Ko we’re working on adapting these materials to assist our diverse patient population.
The foundation comes from knowing we can do better as a medical community. Far too many patients are suffering or dying from cancer simply because of where they live. While seeking solutions to this inequality is challenging, it leads to exciting opportunities to be both collaborative and creative. Then for me, the day to day energy comes from the inspiring work that our colleagues in low-resource countries are already doing. They know better than anyone what their patients are up against and share the injustice of their illnesses.
GO has provided me a fantastic resource of solution finders. When we have come to potential road blocks in our projects it is extremely helpful to have a group of individuals with whom I can reach out to for ideas or help. Without GO I imagine many more of us would be needlessly struggling on our own island.
Edward Briercheck, MD, PhD
Resident, Boston Medical Center