Temidayo Fadelu, MD, MPH
Physician, Medical Oncology, Dana-Farber Cancer Institute
Instructor, Medicine, Harvard Medical School
Dana-Farber Cancer Institute
Conquer Cancer, The ASCO Foundation
Improving outcomes for breast cancer patients in Rwanda by ensuring they complete their treatments.
In Rwanda, patients with breast cancer are much more likely to die from their disease, with a death rate of over 50 percent, compared to less than 16 percent in the United States. This is not due to a lack of available medications, as free curative breast cancer therapy is available in Rwanda, but they are only effective when patients complete the full course of the therapeutic regimen. Two-thirds of patients with breast cancer in Rwanda have tumors that express estrogen receptor (ER), for which endocrine therapy after surgery—also known as adjuvant endocrine therapy (AET)—is an effective intervention. AET are oral daily medications that must be continued for five to ten years, but low adherence to AET by missing doses or prematurely stopping therapy is a major driver of poor outcomes and remains a challenge around the world. For his Conquer Cancer, The ASCO Foundation award, funded by BCRF, Dr. Fadelu and his team are working to identify what barriers prevent patients from completing their therapy at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda, and test an intervention to help address these barriers and improve survival.
With the assistance of the Dana-Farber Survey Core, the team created data collection tools including qualitative interview guides to assess patient perspectives on AET and preliminary drafts of survey instruments to assess adherence and patient quality of life. In addition, they analyzed all of the education materials available to oncology patients in low- and middle-income countries. The review of the education materials landscape helped them develop a theory-based behavior-change framework to guide the development and evaluation of AET education material and other future interventions.
Qualitative interviews are currently ongoing in Rwanda and the team aims to complete recruitment of 30 patients by August of 2022. The results of the interviews will be used to adapt the survey instruments to make them more contextually relevant. Eventually, the team will perform a randomized trial of interventions informed by the survey results with the aim of increasing patient survival and quality of life.
Temidayo Fadelu, MD, MPH has a clinical and research focus in global breast cancer and implementation science research. Originally from Nigeria, Dr. Fadelu moved to the U.S. for his undergraduate education at Baylor University. He earned his medical degree from Yale University School of Medicine and completed his training in internal medicine at the Hospital of the University of Pennsylvania. He then moved to Rwanda to serve as clinical and programmatic implementation lead for an oncology program based at Butaro Cancer Center of Excellence in rural northern Rwanda, where he coordinated several major initiatives including the implementation of pathology and palliative care services. He subsequently completed his fellowship training in medical oncology at Dana-Farber Cancer Institute, during which he also earned a master’s in public health at the Harvard T.H. Chan School of Public Health. He remains at Dana-Farber as a member of their Center for Global Cancer Medicine, where engages in implementation research projects in Rwanda and Haiti to address global inequities in breast cancer care.
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