Francianne Andrade, PhD is a SIOP Young Investigator and an active member of the Blog committee. She was able to have a very interesting conversation with Dr. Suzuki who works as a pediatric oncologist in Rio de Janeiro. See below for their Q&A!
Can you tell us a bit more about you Arissa? Where do you work?
My name is Arissa Ikeda Suzuki. I completed my training in Pediatric Oncology
at the Brazilian National Cancer Institute in Rio de Janeiro (INCA) in 2004. I got Master’s
degree in 2007 in which I studied Neuroblastoma biology. Now, I'm studying for
doctorate degree and my research is in rhabdomyosarcoma biology and prognostic
factors. Since 2007, I am medical assistant of the Pediatric Oncology Department at
INCA. My main interest in on pediatric solid tumors.
INCA is a branch of the Ministry of Health for the development and coordination
of integrated actions for cancer prevention and control in Brazil.
What is your clinical practice like?
INCA is a referral center for Pediatric Oncology and annually 180 new pediatric
patients with solid tumors are admitted. The practice in pediatric oncology is
multidisciplinary and focused on patient care. The main objective of treatment is to cure
patients with less sequelae. Over the years, we have seen refinement of treatments with
incorporation of biology in risk stratification of the patients. Since our country is an upper
middle income country, we still have to deal with socioeconomic difficulties of the patients
besides treatment and supportive care. Unfortunately we still receive patients with
advanced disease, although we participate in many educational projects on early
detection of childhood cancer for the primary care professionals. Abandonment of
treatment is low in our institution due to an organized program to prevent it. All over the
years there have been great breakthroughs in radiotherapy, interventional radiology and
molecular biology, for example, besides the appearance of new subspecialities like
palliative care and late effects which have shown improvements in Pediatric Oncology
treatments and have offered better quality of life to patients.
How long does it take for a patient to get a diagnosis and initiate the treatment?
Please summarize your experience.
We receive patients diagnosed with cancer or with a strong suspicion of cancer.
When the patient arrives at our institution, every effort is made to make a correct
diagnosis, staging and start treatment as soon as possible. In our center, it takes patients
2-3 weeks to initiate the treatment. We have some difficulties to scheduling imaging
studies, biopsy with anesthesia and surgeries, and also there is a time requirement for
laboratory diagnosis.
How much does the treatment cost for the patient’s family?
At INCA medical and hospital care is provided directly and completely free of
charge to cancer patients, within the country's Unified Health System, known as SUS.
Also patients have support from ONG with transport, food basket and shelter.
Do you have data on the survival/prognosis of the patients? If not, according to
your personal opinion, does it sound like the overall rate is good?
The overall survival rate is around 65%. There is a survival gap between high
income countries and low and middle income countries. We have been working hard to
improve the results.
Are there Brazilian institutions in pediatric hematology/oncology that promote
clinical trials, organize annual conferences and certify specialists?
The Brazilian Society of Pediatric Oncology (SOBOPE) promotes Brazilian
cooperative groups in pediatric oncology on many types of childhood cancer, some of
which work in partnership with international groups. Many pediatric institutions in the
country participate in these clinical studies. At INCA, we have an infrastructure for
clinical research in pediatric oncology and we participate in clinical trials national and
internationally.
SOBOPE organizes and promotes biannual conferences and organize meetings
to discuss how to approach new studies. The Brazilian Society of Pediatrics confers the
certification in pediatric oncology.
What are your perspectives for the pediatric hematology/oncology field in
Brazil?
Increase the quality of treatments and the possibility of cure with fewer side
effects.
Brazil is a country of continental dimensions, there is a need for homogeneous treatment
in the various regions of Brazil. Encourage early diagnosis. More access to cancer
treatment. Greater participation in cooperative studies, associated with molecular
studies and translational research.
It is needed more investment, be that public or private, to develop and improve treatment
and our knowledge of pediatric tumors.
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