Spreading the word near and far
It's Monday morning, and surgeon Michael Muto, MD, is offering his expertise to women facing cervical cancer. He usually does so at Dana-Farber or Brigham and Women's Hospital in Boston, but he also begins many weeks some 30 miles away at Lowell (Mass.) General Hospital Cancer Center.
In Lowell, Mass., Michael Muto, MD, works with women facing cervical cancer.
While research has determined that four of five women who die from cervical cancer have not had Pap smears in at least five years, many still don't seek out this simple procedure.
"Studies have shown that when women are screened, the rates of cervical cancer deaths are significantly reduced," observes Susana Campos, MD, MPH, a medical oncologist in the Gillette Center for Women's Cancers of Dana-Farber/Brigham and Women's Cancer Center. "But many women, especially those who have moved here from other countries, may have cultural barriers preventing them from seeking out this type of care. The key is to help mobilize and educate patients about the importance of screenings and what they can prevent in the future."
To this end, Muto and other members of the Gillette Center staff are venturing into the Greater Boston community to teach women the value of Pap smears and cervical exams — and help those patients who have already developed disease.
"I work on-site with Chief Radiation Oncologist Dr. Jeffrey Goldstein and a team of medical oncologists led by Dr. Ronald McCaffrey, and we always have an interpreter available," explains Muto of his work at Lowell General, an affiliate of Dana-Farber/Partners CancerCare. "Many of the patients we see are Cambodian, Laotian, or other immigrants who have not had Pap smears for five or 10 years, and they come in with advanced cervical cancer. We treat them there with external beam radiation and chemotherapy, then [Gillette Center radiation oncologist] Akila Viswanathan gives them brachytherapy — internal radiation treatment — in Boston."
Other members of the center's team, including Director Ross Berkowitz, MD, also make visits to area hospitals, and additional outreach efforts are under way. The Breast and Cervical Screening Collaborative includes 17 area community-health centers that work with Dana-Farber and the Partners HealthCare System to promote early detection of breast and cervical cancer. Since 1998, the consortium has provided free screening services for more than 3,000 low-income, uninsured women.
The key is to help mobilize and educate patients about the importance of screenings."
— Susana Campos, MD, MPH
Another initiative, the "Woman to Woman" study by the Center for Community-Based Research at Dana-Farber, evaluated the impact of a breast and cervical cancer education program in 26 Massachusetts worksites. "We trained female employees to educate their peers about the importance of screening and found their efforts to increase awareness and assist women in overcoming barriers helped raise screening rates," reports the center's Jennifer Allen, RN, MPH, DSc. "Now we're looking at using this educational strategy in churches and other settings."
Outreach extends back to the Longwood Medical Area as well. Roughly 40 to 60 women are seen weekly in the Brigham and Women's Pap Smear Evaluation Center, which has served a diverse group of women for more than 20 years. In addition, gynecologic oncologist Sarah Feldman, MD, has started a Dana-Farber clinic designed for patients who have received abnormal Pap smear results from their primary-care physicians or those referred by their gynecologists for more in-depth evaluation and management.
"We're giving women with abnormal Paps a place to go for specialized evaluations," says Feldman. "By offering focused treatment and patient education, we hope to prevent cancers before they occur."
