Chapter 16: Global Academic Programs: the Advantages of Collaboration Part I
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Description
Dr. Dmitrovsky explains the benefits of international collaborations for MD Anderson and for the institutions overseas. He notes that Global Academic Programs is a unique model of relationships with over thirty institutions. He explains how these connections further MD Anderson's mission and also provides opportunities for clinical trials, research collaborations, and new knowledge. He gives the example of a recent trip to visit Hunan Cancer Hospital in Changsa Province, China. He explains that MD Anderson will provide support with smoking cessation and prevention. He also talks about making rounds of a clinic where traditional Chinese medicine is practiced in concert with Western medicine.
Identifier
DmitrovskyE_03_20150706_C16
Publication Date
7-6-2015
City
Houston, Texas
Interview Session
Topics Covered
The University of Texas MD Anderson Cancer Center - Beyond the Institution; Beyond the Institution; Multi-disciplinary Approaches; MD Anderson Culture; Institutional Mission and Values; MD Anderson Impact; Human Stories; Offering Care, Compassion, Help; Patients; Cancer and Disease; This is MD Anderson; Patients, Treatment, Survivors; The Professional at Work; Global Issues "“Cancer, Health, Medicine; Healing, Hope, and the Promise of Research
Transcript
Ethan Dmitrovsky, MD:
And what is distinct, if not unique, is this network, global academic program network, that has well over 30 sister institutions now, where we have a real desire to disseminate our best practices, to our sister institutions, and to learn from them about their best practices. And though this collaborative, bidirectional approach to raise the excellence of cancer care and cancer research, far beyond our campus.
Tacey A. Rosolowski, PhD:
What kinds of knowledge comes back to MD Anderson, through the sister institution, the links created through global academic programs?
Ethan Dmitrovsky, MD:
So I was I'll give you an example of that. I was in China just a few weeks ago, launching our latest sister institution at Hunan Cancer Center. And it was a very, very exciting moment, and I learned a great deal from that visit, and that event. I was most fortunate that the president of the cancer center gave me a personal tour through the clinics. And there is an example of how we could contribute to the health of the citizens of Hunan Province in China is that there's a heavy burden of tobacco use. And we have best practices that have been developed over many decades here at MD Anderson that allow us to develop apps on iPhones that could be culturally sensitive. Perhaps we could develop a culturally sensitive app which could be used on iPhones, which are nearly universal in China now. So that we could, in a culturally sensitive way, provide best practices that could be used for the prevention of tobacco use in the first place, and the cessation of tobacco use in those who are smokers.
Tacey A. Rosolowski, PhD:
And these were created by people in behavioral science. Yeah. I interviewed Ellen Gritz.
Ethan Dmitrovsky, MD:
Yeah, Alex Protopopov. Yeah, Ellen Gritz, Alex Protopopov, and Paul Cinciripini. But mainly, Alex has developed these platforms. And I had the occasion to meet with the minister of health for Hunan Province, and I spoke specifically about this educational tool, because we could help them place that into their school system. So that would be an example where MD Anderson could help the citizens of Hunan, but at the same time, there are ways that we can learn from best practices in China. So there is many thousand year history of traditional Chinese medicine. And there are practitioners here in the United States. So what I've learned was that at Hunan Cancer Center, they have a distinctive, not unique, traditional medicine center that combines Western medicine with Eastern medicine. So it's a shared service, where you have traditional Chinese medicine practitioners practicing side by side with Western trained. And so I spoke to the oncologist, and I asked did they use the traditional Chinese medicine? And they absolutely did, for symptom control. And so here is an example of a different model of healthcare delivery, where we might learn and perhaps even be able to control symptoms of our patients using traditional Chinese medicine.
Tacey A. Rosolowski, PhD:
Was that the center I know that there are some folks in Integrative Medicine who are doing research on and use of meditation for symptom control. Is that
Ethan Dmitrovsky, MD:
Yes. So this isn't meditation, this is actually herbal medicine. Plus acupuncture. And so the idea here is that we might be able to control the symptoms of our patients by adopting best practice from thousands of years of clinical experience. But what I'm saying is there's something we can learn from this partnership between Western and Eastern medicine. That's what was so interesting for me to learn, that they brought together both disciplines in a single clinic, and a single inpatient ward. And so I visited a patient. I did rounds, I visited a patient with pancreatic cancer who was suffering from intense pain, and was being administered an infusion of traditional Chinese medicine that actually was able to control his pain far better than narcotics. So that would be an example that perhaps there's a new pharmacology that we could learn from. That would be an example, I think a germane example. Yeah.
Tacey A. Rosolowski, PhD:
Sure. And, I mean, part of it would als
Ethan Dmitrovsky, MD:
And the patient was helped. And so I spoke to the patient, talked to his patient at his bedside to ask how his pain was before he came into the hospital, and how he was faring now, and he clearly derived benefit.
Tacey A. Rosolowski, PhD:
And probably without side effects too, that
Ethan Dmitrovsky, MD:
Well, my Chinese wasn't wasn't so well advanced that I could get into that level, but and we were on rounds, so we weren't able to calibrate them. But clearly, a patient was suffering before being admitted to this shared ward. And so that would be an example that perhaps we have something to learn, in a bidirectional way. So that's the point I wanted to say, is that this is just not best practices being disseminated to sister institutions, but in a bidirectional way.
Tacey A. Rosolowski, PhD:
And probably could eventually leave to clinical trials, investigating
Ethan Dmitrovsky, MD:
Absolutely. And that would be the next point, is that wouldn't it be remarkable if MD Anderson could set up international trials? And perhaps we could compare a Western medicine approach to tobacco control to the pharmacology that we have available to an Eastern medicine approach. So I actually visited their tobacco control clinic, and saw a patient who was being seen. And they were mainly using Western approaches, perhaps a shared approach would be of using Eastern and Western medicine could be a way to get even better benefits. And that could lead to a clinical trial. So that would be one example. Another example is that cervical cancer is a heavy burden in China, far more of a burden than it is in the United States, because there is not dissemination of a pap smear. And surprisingly, there is not dissemination of the HPV vaccine. So I know that there are trials underway internationally to ask one of the barriers would be HPV HPV vaccine takes three shots, which is a very expensive approach. And recently, a new HPV vaccine was approved by the FDA that's more effective. Perhaps in having three vaccinations is a barrier to disseminating this into a country of 1.4 billion people. Well, perhaps we can consider trials for you to compare one vaccination to two to three, to ask if you could reduce the cost. And that would be another example. And so China has not made the public health decision to make HPV vaccination available to all its citizens because of expense. That would be another example where we could be helpful.
Tacey A. Rosolowski, PhD:
Oh, I had it on my list of questions to ask you more about global academic programs. And so what is your vision of how those international collaborations can evolve in the next 10 years? You're talking about your ten year strategic plan. What's the international piece?
Ethan Dmitrovsky, MD:
Yeah. The international piece is a really powerful tool for us to use to wage against the cancer problem worldwide. And it is remarkable that MD Anderson has this reach. So again, returning to what I said before, it's our social responsibility to make the most of this remarkable community of international investigators who just visited MD Anderson, as you know, a few months ago. And the gap program, the global economic program, has developed tremendous good will, tremendous sense of partnership. And we have a joint grant program with the gap program affiliated institutions, where we will co-fund projects that are collaborative with MD Anderson on faculty, and with faculty of the gap program. So that's a very distinct, if not unique, program. And this goodwill is poised to allow us, permit us to actually open up clinical trials that might be disseminated throughout the GAP [Global Academic Programs] program. More through selective members of the GAP program. So one of the opportunities that I think we should take full advantage of is the goodwill that's already been created, and that we could conduct clinical trials that would benefit citizens from other countries, as well as potentially citizens here. A good example would be the new HPV vaccine. How many vaccinations are needed? What would be the right number? What's the most cost effective way to deliver? And I see this as a great opportunity for us to disseminate our trials in this network of goodwill network of collaborating institutions.
Recommended Citation
Dmitrovsky, Ethan MD and Rosolowski, Tacey A. PhD, "Chapter 16: Global Academic Programs: the Advantages of Collaboration Part I" (2015). Interview Chapters. 651.
https://openworks.mdanderson.org/mchv_interviewchapters/651
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