International Breast Cancer Advocate Receives Partners in Progress Award

Benjamin O. Anderson, MD, FACS

At today’s Highlights of the Day Session II, Benjamin O. Anderson, MD, FACS, will be awarded the Partners in Progress Award for his international work advocating for the development of optimal clinical practices for breast cancer management in low- and middle-income countries.

The award recognizes a person involved in activities that affect public awareness about cancer, its causes, cures or treatment, or activities that result in additional support either legislatively or fiscally for cancer research, treatment, prevention, or care.

A native of California, Dr. Anderson received his medical degree from the Albert Einstein College of Medicine in New York City. As a general surgery resident at the University of Colorado, Dr. Anderson was drawn to working with patients with cancer. He trained in surgical oncology at the Memorial Sloan- Kettering Cancer Center through an American Cancer Society clinical oncology fellowship award, and then decided to dedicate his clinical practice and research career to breast cancer.

He joined the surgical faculty at University of Washington in Seattle in 1994 and served as Clinical Medical Director of the breast program from 1998 to 2003. Dr. Anderson continues to serve as Director of the Breast Health Clinic at the University of Washington and the Seattle Cancer Care Alliance, where he has devoted his clinical practice to the care of patients with breast cancer and breast health issues.

Now holding joint faculty positions in the Fred Hutchinson Cancer Research Center Division of Public Health Sciences and the University of Washington Department of Global Health, Dr. Anderson is deeply committed to understanding and cultivating the vital interface between survivors and other advocates with the medical and public health science communities, nationally, and internationally.

Dr. Anderson’s first advocacy experience was as a founding faculty member for the National Breast Cancer Coalition’s “Project LEAD.” This course provides advocate graduates with critical thinking skills necessary to engage in local and national forums, such as research grant reviews, institutional review boards, and other activities directed at addressing breast cancer research.

“The key concept in Project LEAD was that women who have cancer are very much active participants in the process,” he said in an interview with ASCO Daily News. “I learned that advocates often ask questions of great importance that scientists sometimes miss. Scientists can become interested in what makes a project scientifically interesting, but advocates ask how it will help people with the disease. Advocates ground us and connect us to what got us going in the first place.”

Dr. Anderson’s first international experience was the U.S. Agency for International Development-funded “Ukraine Breast Cancer Assistance Program,” operated by Seattle’s Program for Appropriate Technology in Health, where he realized that U.S. guidelines often didn’t apply in low-resource settings.

“Oncology works by guidelines, but in the United States, we begin with the assumption that we have all the tools,” he said. “In low- and middle-resource countries, our guidelines fundamentally do not apply.”

International Effort toward Systematic Change In an effort to address the lack of appropriate guidelines, Dr. Anderson founded the internationally collaborative Breast Health Global Initiative (BHGI) in 2002, an outcomes-oriented alliance that has become internationally recognized for its pioneering work in developing evidenced-based “best practices with limited resources” for breast cancer. Co-sponsored by Susan G. Komen for the Cure® and the Fred Hutchinson Cancer Research Center, the initiative’s mission is to develop, study, and implement resource-sensitive, culturally appropriate “Guidelines for International Breast Health and Cancer Control” for breast cancer early detection, diagnosis, and treatment in low- and middle-resource countries.¹

BHGI’s work involves the evaluation of existing resources, as well as engagement of advocates and clinicians, to implement changes in beliefs and practices. Over nearly a decade and through its global alliance of organizations, BHGI held four global summits to create and publish resource-adapted guidelines and to investigate how these guidelines might be applied in practice.

In the process the BHGI created an international, interactive hub for linkages and alliances, providing a common network for clinicians, government health care agencies, advocacy, and nongovernmental organizations, both non-profit and for-profit organizations, and public health researchers, all key groups to advance systematic change.

“We based our analysis model on the National Comprehensive Cancer Network (NCCN), in which you create panels of experts to look at existing information and make recommendations on a combination of that evidence and opinion,” he told ASCO Daily News. “A lot of places don’t have the data, but they have experienced clinicians who can bridge those gaps.”

Dr. Anderson stressed that advocates are critical to improving cancer outcomes and that there is a necessary relationship between the medical and advocacy communities. Those in the medical community are focused on diagnosis and treatment as early into disease progression as possible, using the available resources and stage-appropriate multidisciplinary treatment.

However, he noted, this only works with participation from the patients. Once you begin having survivors, those survivors are able to communicate with other women about why they should participate in ways that the medical community cannot. Ultimately, it’s the advocates that create awareness and awareness makes this go forward,” he said.

The fourth BHGI Global Summit held in 2010 addressed how the BHGI resource-stratified guidelines can be applied in the real-world setting of low- and middle-resource countries. At the same time, BHGI began working with the International Atomic Energy Associations’ Programme of Action for Cancer Therapy (IAEA-PACT), which is focused on improving cancer outcomes in low- and middle-resource countries.

Dr. Anderson said that IAEA-PACT recognized the importance of education and training in these settings and wants to create an online “virtual” university. The BHGI, using educational modules, has organized a series of Ghana Breast Cancer Specialty Training Courses in Kumasi and Accra, Ghana. Working together with IAEA-PACT, the BHGI plans to deliver breast cancer care training in Sri Lanka, as well as advanced Breast Cancer Specialty Training Courses in Ghana.

Dr. Anderson, deeply honored to receive this award dedicated to patient advocacy, views it as a statement of responsibility to ensure that his collaborative international work meets the needs of women at all economic levels.

“This award is the highest of compliments,” he said. “It is wonderful to have our organization acknowledged as a transformational vehicle to support and raise up the role of the advocacy community. It is a call to move forward and bring multidisciplinary systems-based solutions throughout the world.”

Reference

1. The Breast Health Global Initiative. Guidelines for International Breast Health and Cancer Control. http://www.paho.org/ English/AD/DPC/NC/pcc-breast-cancerguidelines.htm. Accessed March 21, 2011.