New hopes to improve cancer diagnosis and treatment for children

Motivated clinicians and an Internet connection combined with computers and e-mail access have the power to transform pediatric cancer treatment in the most remote corners of earth, according to a St. Jude investigator writing in a recent issue of The Lancet Oncology.

"A successful teleoncology program does not require a lot of expensive equipment. The most important element is having committed people," said Ibrahim Qaddoumi, M.D., an assistant member in the St. Jude Oncology department and telemedicine director of the hospital's International Outreach Program (IOP). He co-authored a recent report on telemedicine as a tool for improving worldwide cancer treatment.

Like other telemedicine efforts, teleoncology initiatives range from e-mail exchanges, real-time videoconferencing or educational seminars available through Web sites like St. Jude's www.Cure4Kids.org, a program dedicated to supporting the care of children with catastrophic diseases by providing high-quality educational materials and online collaboration tools. Cure4Kids provides educational content to more than 17,000 doctors, nurses and other health care professionals in 169 countries.

Such activities unite providers worldwide to review pathology and radiology images and other important clinical data in hopes of improving cancer diagnosis and treatment. Qaddoumi said that regardless of the technology, successful teleoncology programs should reflect the priorities, needs and resources of health care providers working in developing nations or underserved regions of the U.S.

Those needs are expected to grow in the next 20 years when the global incidence of cancer is predicted to jump 50 percent, with most new patients living in developing nations, the researchers noted, citing the work of a 2007 Institute of Medicine committee and other researchers.

Meanwhile, the childhood cancer survival gap remains stubbornly wide. With the right diagnosis and treatment, cancer is curable in as many as 70 percent of young patients, yet the disease remains the second leading killer of children in many Latin American countries.

"Teleoncology is not a panacea for global oncology problems," the authors noted, but Qaddoumi said he hopes to create greater awareness of how teleoncology can be used to improve childhood cancer treatment worldwide and to prompt more institutions to get involved.

Teleoncology often works best as part of a broader institutional partnership, the authors noted. One approach matches hospitals in the developed and developing world in long-term partnerships known as twinning programs. St. Jude is involved in twinning programs in 20 countries worldwide. "Evidence suggests that twinning improves cancer survival in low-income and middle-income countries; and the integration of teleoncology into twinning programs maximizes clinical benefits and the effective use of resources," the authors noted.