University Health Network
Fellow, Radiation Oncology
Conquer Cancer, The ASCO Foundation
Understanding severe radiation induced skin toxicity in Black patients with breast cancer in Zimbabwe.
Breast cancer is second only to cervical cancer among the most common cancers in Zimbabwe. Patients there can experience poor breast cancer outcomes, as many are not accessing all of the treatments available to them—only 34 percent of eligible patients received post-mastectomy radiation. As global efforts successfully expand access to radiotherapy services, treatment related side effects including radiation dermatitis have not been assessed as a patient reported outcome in low- and middle-income countries. Prior studies identifying the prevalence of severe radiation induced skin toxicity (RIST) were conducted in high income countries where the majority of patients are white. In Zimbabwe, patients predominantly identify as Black, and studies have noted that Black-identifying patients have worse severe radiation dermatitis. Moreover, the standard clinical grading system to evaluate the severity of this toxicity does not function well in patients with more pigmented skin, especially at early stages. For her Conquer Cancer Young Investigator Award, Dr. Mushonga will perform a study to define the true incidence of RIST in Zimbabwe, which can lead to the development of strategies to improve patient comfort, mitigate negative perceptions of radiotherapy, and increase access to treatment.
The study will take place at the Parirenyatwa Radiotherapy Centre, the major public referral center for oncology. Dr. Mushonga will identify the RIST incidence rates reported by physicians and perform a questionnaire with patients reporting their own symptoms—the latter potentially revealing a higher prevalence compared to physician-reported levels as patients may identify changes in their skin that would be missed by clinical grading techniques. Dr. Mushonga will also search for risk factors for RIST, such as skin care routine, scarring, and receipt of chemotherapy immediately prior to radiotherapy.
Melinda Mushonga, MD is an early career clinical oncologist who completed medical training including residency in radiation oncology at the University of Zimbabwe, attaining certification as a Clinical Oncologist in Zimbabwe in February 2020. She is currently enrolled in a Radiation Oncology Clinical Fellowship at University of Toronto, Princess Margaret Cancer Center, and Sunnybrook Odette Cancer Centre sites.
Her research interest is advancing the evidence base for personalized treatment strategies in radiation oncology guided by tumor biology, with the goal of improving the patient experience—particularly in breast cancer—through inclusive collaborative clinical research which promotes equity in quality cancer care to narrow disparities in outcomes. Her career goals include making quality clinical research accessible to Zimbabwean women with breast cancer, creating a local/regional evidence base for evidence-based quality cancer care, and capacity building through targeted clinical educational interventions to dissipate knowledge to colleagues—introducing and strengthening advanced radiation techniques under Global oncology framework. Her foundational research work, with accompanying publications completed in Zimbabwe, explored patterns of care in breast cancer management from a low resource setting to guide future work that closes the gap in cancer care.
Dr. Mushonga is currently undertaking teaching duties in the Department of Oncology, University of Zimbabwe, educating residents in training to complement on site efforts. She is a member of several professional society groups including the Association of Radiologist and Radiation Oncologist in Zimbabwe (ARRoZ), ASCO, ASTRO, AORTIC, ESMO, CARO, and others. She is actively involved in Cancerserve trust on a volunteer basis, a charity organization taking care of women affected with breast cancer, with projects aimed at improving outcomes in breast cancer patients in Zimbabwe.
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