Mei is a radiation oncologist in Sydney, Australia and has written Global RT’s inaugural blog post. Learn about how she has combined a career in radiation oncology and global health.
Who are you and where do you work?
My name is Mei Ling Yap and I am a radiation oncologist from Sydney, Australia. My clinical practice is at Liverpool and Macarthur Cancer Therapy Centres, in the South-western region of Sydney. It is a unique part of Australia, very culturally diverse – so I see an interesting case mix of patients. My clinical sub-sites are lung, breast and gynecological cancers. As well as my clinical role, I keep busy through research, undergraduate and post-graduate teaching and my role as the director of registrar (resident) training.
Why radiation oncology?
I decided to specialize in oncology as I feel that it’s a very ‘human’ specialty. My patients and their families are so inspiring. Working in oncology, one has the potential to help people through what is an important and challenging time in their lives, and that truly is a privilege.
I chose radiation oncology in particular as I felt it was a field where we can make a difference for patients. Radiotherapy is often the primary treatment used to cure patients, in sub-sites such as head and neck, prostate and cervix cancer, to name a few. Achieving cure for cancer patients is a wonderful outcome. Equally as important, I feel, is the ability to palliate incurable patients from potentially distressing symptoms such as pain and bleeding – with radiotherapy able to achieve that in usually more than 2/3 of cases.
How did you become involved in global health, and in particular global access to radiotherapy?
Global health has been an interest of mine since my medical student years at the University of New South Wales, where I was involved in an Australian medical student-run aid organization (MSAP), and did a posting in Chennai, India. It was alarming to witness upfront, the lack of access to medical treatment, which exists in many parts of the world.
In 2008-9 I did part of my radiation oncology training at the National University Cancer Institute in Singapore. I found it interesting to manage a different case-mix of patients (e.g. High incidence of nasopharyngeal cancer), and learn the different cultural perceptions of cancer, which exist there.
It was while I spent a 2-year fellowship at Princess Margaret Cancer Centre (PMCC) in Toronto that I realized that my passions for radiation oncology and global health could be united. Dr Mary Gospordarowicz, at that time the head of PMCC and now UICC, was harnessing members of the radiation oncology community who were interested in tackling the issue of global access to RT. After returning back to Australia, I was fortunate enough to be given the opportunity to work alongside my GTFRCC mentor, Professor Michael Barton, who is an extremely prolific researcher in global cancer health research, as part of his team at CCORE.
What is your role in GTFRCC?
My role in the GTFRCC is as part of the burden and outcomes working group, which is working to define the scope of the need for radiotherapy in low and middle income countries, as well as estimating the benefit in outcomes that radiotherapy would add to these countries. The work that we are performing will be a significant part in the GTFRCC ‘white paper’ to be launched at the UICC meeting in Melbourne in December. I am also part of the GTFRCC Young Leader’s program.
What research are you doing in global health?
At present, I conduct cancer health services research as part of CCORE, Ingham Medical research, Liverpool. The CCORE team, under the direction of Professor Michael Barton, developed an evidence-based model, which estimates the optimal utilization of radiotherapy in a developed country. We are currently adopting this model to low and middle-income countries to measure the optimal utilization of radiotherapy in those countries, with projections up to 2035. We are also estimating the differences between what should be, and what is currently available, in terms of radiotherapy resources – and comparing the present deficit to that of a decade ago.
Why do you think advocacy for improved access to radiation is important?
Advocacy for improved access to radiation oncology will play a central role in achieving the goal of closing the gap in terms of radiotherapy resource provision. We have made huge gains in term of cancer outcomes in high-income countries, but unfortunately cancer in low and middle-income countries has gone largely ignored. This cannot continue! The statistics are harrowing – 70% of cancer deaths occur in low and middle income countries, and cancer causes more deaths worldwide than malaria, TB and HIV put together – yet majority of people are unaware of this. This is where I think globalRT will make a huge difference. We need to communicate these facts, particularly harnessing social media – twitter, facebook etc etc. So readers, go ahead and spread the word!
Where is the most interesting place that your global RT work has taken you?
There have been many interesting visits, but my most recent was to Imam Khomeini Hospital in Tehran, Iran. The radiation oncology department, headed by Professor Peiman Haddad, is currently in the process of some exciting developments. It was especially nice to meet the radiation oncology residents, currently 10 of the 13 are female.