A Global Perspective: Caring for Patients in Low- and Middle-Income Countries

In honor of the inaugural international panel at the Association of Cancer Care Centers’ (ACCC) 41st National Oncology Conference, ACCCBuzz spoke with Enrique Soto Pérez de Celis, MD, PhD, associate director for global oncology, University of Colorado Cancer Center, to gain further insight into his experience caring for patients with cancer in Mexico and the US.

ACCCBuzz: Please tell us a little about your background, why you chose to practice in oncology, and what inspires you about caring for patients with cancer?

Dr. Soto: In my second year in internal medicine training, I was assigned to the geriatrics ward at my institution. There, I took care of many older patients with cancer. I noticed that there was an enormous need for the creation of specialized interdisciplinary services that integrated geriatric expertise and supportive care into oncology to provide care for those patients, as well as for research to generate evidence on how to treat them. I decided that I would specialize in oncology and then in geriatric oncology in order to develop a clinic at my institution, and that is what I ended up doing!

My biggest inspiration is being able to help patients go through such a difficult time as dealing with a cancer diagnosis, and providing them with the information and tools to make decisions that align with their preferences and values.

ACCCBuzz: What are some of your suggestions when caring for patients, particularly in low- and middle-income countries?

Dr. Soto: As someone who has cared for patients both in a high-income and in a middle-income country, I can honestly say that the needs of patients, such as minimizing the risk of toxicity, taking care of their families, or making sure that they will be financially protected, are almost the same regardless of where they live.

I think that the most valuable suggestion I can give is to approach shared decision making with humility, to make a real effort to get to know patients and what they value the most, and to then use our knowledge to provide them with care that aligns with those values.

ACCCBuzz: How do you foster international collaboration to improve cancer care globally?

Dr. Soto: Global collaborations offer a valuable opportunity for mutual learning and innovation. While researchers in the U.S. and other high-income countries can partner with colleagues in low- and middle-income nations to enhance care in those regions, there's also significant potential to bring back lessons from their approaches and apply them in high-income settings. These collaborations can lead to the recruitment of more diverse populations into trials, to a better understanding of societal influences on cancer care, and to the development of more cost-effective techniques.

Whether in basic, clinical, or implementation science, adopting a global perspective is crucial for advancing research and fostering innovative solutions. For example, during my time training in the US under my mentor, Dr. Arti Hurria, I was exposed to the concept of mobile monitoring. After going back to Mexico, and with help from Dr. Hurria and her team, I was able to design a model to implement a remote monitoring intervention among older patients with cancer getting chemotherapy.

Read more content from the inaugural international panel in the Day 3 NOC ACCCBuzz Blog.

Rachel Radwan is the Editorial Manager for the Association of Cancer Care Centers.