In 2004, the Dominican Republic was the site of ASCO's first Multidisciplinary Cancer Management Course (MCMC). ASCO teamed with the Dominican Society of Hematology and Oncology to present a 2-day program in Santo Domingo, designed specifically for local providers. Since then ASCO has worked with oncology societies to develop and present the course 18 times in countries of South and Central America, Asia, the Middle East, and Africa-countries where nonspecialists often treat cancer.

Multidisciplinary Approach

"The main message is that to take good care of patients with cancer you need a multidisciplinary approach-medicine, radiation, social services, nursing. It's not a one-man task," says surgical oncologist Hugo Villar, MD, Professor of Surgery and Radiation Oncology at Arizona Cancer Center of the University of Arizona Health Sciences Center. Dr. Villar is a member of the MCMC Working Group, a 12-member ASCO group that oversees the entire MCMC process. He has served on the working group since its inception, and in fact began working in 1983 with the MCMC precursor, a standardized course offered by the American College of Surgeons to all of its state chapters and then throughout Mexico. "The mission is the same-to provide education and improve patient care," Dr. Villar comments.

Members of the working group represent all cancer subspecialties and come from countries around the globe. Although the group has been all physicians, it will soon include nurses. "We have tried very hard to incorporate nursing as part of the course and give the message that nurses are vital, but we haven't always had a module aimed at nurses," Dr. Villar acknowledges. He says that breakout sessions for nurses will be part of every MCMC in the future.

Dr. Villar emphasizes the valuable contribution that ASCO makes in the global fight against cancer through MCMC and its other international programs. "ASCO's financial commitment is vital, and the staff of the International Affairs Department are superb. They are multilingual-a huge plus-and a lot of the successes are due to their efforts."

How the Process Works

Once the MCMC Working Group approves an MCMC application from an oncology-related professional organization, a host course director works with an ASCO-assigned course director to plan and implement the course. Each MCMC includes core modules covering cancer biology; radiation, medical, and surgical oncology; radiobiology; and multidisciplinary care. "After those, the local organizers decide what they want," Dr. Villar explains.

The course features lectures, case presentations, skills stations, and group discussions. ASCO sends two or three faculty members to work with local faculty identified by the host society. Dr. Villar points out that having local faculty as a basic part of the program is of great value. "We don't want the course to be a one-time deal. We aim to leave a long-lasting legacy. It could be a tumor board that they do twice a month, or a breast cancer screening program."

Train the Trainer Course Launched

Last year MCMC piloted a train-the-trainer course in Santiago, Chile, in collaboration with the Chilean Oncology Foundation. Twelve trainers from five different countries participated in the program, which teaches principles and strategies of adult education and presents information for regional leaders to organize their own courses.

While the MCMC program has reached more than 2,000 clinicians in its 6 years, the train-the-trainer approach has the potential to multiply the outreach significantly. "We are refining how we can deliver the message that treating cancer is a multidisciplinary task," Dr. Villar says. "If we want to leave a long-lasting legacy, we need to give leaders the tools to educate. I believe that education affects the quality of care and the outcome. It's been one of my life's passions." ■

© 2011. American Society of Clinical Oncology. All rights reserved.