As vice chair of the National Comprehensive Cancer Network ‘s (NCCN) committee on multiple myeloma, Dr. Natalie Callander helps to set guidelines for effective evaluation and treatment. The NCCN commonly sends its teams of professionals to medically challenging regions, such as those in Africa and the Middle East, to plan out how standardized practices can be implemented in those areas. Callander recently traveled to the Caribbean on just such a mission. Keep reading to learn more about her experience, or follow the original story here for more information.
What is Multiple Myeloma?
Multiple myeloma is a cancer of the white blood cells known as plasma cells. Normally plasma is an integral part of the body’s immune response. When affected by multiple myeloma, however, cells begin to accumulate in the bone marrow. This leaves no room for healthy blood cells.
Common symptoms of multiple myeloma include bone pain, kidney problems, fatigue, and frequent infections. The exact cause of multiple myeloma currently remains a mystery. Researchers have, however, discovered an interesting correlation between multiple myeloma cells and a missing portion (or completely absent) of chromosome 13.
The NCCN consists of a number of committees each specializing in a specific type of cancer. Together, these researchers examine and review medical data and sources to determine the best methods of evaluating and treating each cancer. These guidelines can be used by oncologists to inform their diagnoses and practices, as well as other professional groups in medicine, such as providers, and insurers, to ensure the best work is being done in any given case.
Across the globe, many respect NCCN recommendations as “the gold standard of care.” Not every region of the world, however, has access to the resources to follow these guidelines.
Adapting to Difficulties
NCCN doctors travel to various regions around the world to spread their expertise and help find ways to bring best practices to areas in need. It begins with meetings, held in person, to discuss what local doctors are currently practicing. Callander describes an important distinction: her work is not so much about ordering other doctors around, but rather listening to what they are currently able to do.
A major factor in this is the availability of technology. Bone marrow transplants, for example, are a common part of treatment for multiple myeloma patients in the US. In the entire chain of 24 Caribbean nations, there exists only one center equipped for this procedure. Another sticking point exists in the form of availability of medication. A lot of new drugs, says Callander, simply can’t be found in the Caribbean.
Callander’s mission then is to adapt NCCN guidelines to what is readily available. In the case of medications, Callander explains that they revise treatment plans to use drugs less commonly utilized in the US. The drugs may be older, but they are still effective. Perhaps they do not carry the potency of the latest therapies, but Callander expresses the importance of working with what is available in these situations.
One other aspect of her trip that Callander underlines is the expertise of Caribbean doctors. She describes her experience as a humbling one. The doctors, she continues, lack nothing in terms of training, knowledge, or determination. They merely lack the tools to care for their patients the way they wish they could. The NCCN guidelines being revised for them should help bridge the gap.