FOR THOSE IN NEED

Lebanon 2015 | HEALTH & EDUCATION | VIP INTERVIEW

TBY talks to Dr. Hassan El Solh, Medical Director of
Children's Cancer Center of Lebanon (CCCL), on Lebanon's potential as a medical hub and the role of research in the fight against pediatric cancer.

How do you assess Lebanon's potential to become a medical hub for the region?

For years, Lebanon has focused on education and healthcare. Over time, the country has experienced a brain drain as a result of the regional political instabilities. Many of the Lebanese people who moved abroad to North America, Europe, Africa, and Australia excelled in their fields of healthcare, business, engineering, and politics. As such, the common origin of these people, Lebanon, is well placed to become a medical hub for the Middle East and beyond. An institution can have the most sophisticated equipment and cutting‐edge technology, but the key to its success will be a capable team of human resources. One of the main pillars of the American University of Beirut Medical Center (AUBMC) 20/20 vision and strategy set by Dr. Mohamed Sayegh, Vice‐President for Medical Affairs and Dean of the Faculty of Medicine at the American University of Beirut (AUB), was to reverse the brain drain that Lebanon has been experiencing. The strategic plan includes bringing the experts in the field of medicine back to Lebanon, expanding and developing new programs and services as Centers of Excellence, and establishing national, regional, and international collaboration in healthcare. A vital goal for any medical center is to focus on the patients themselves and to tailor its systems and services to their needs. Over the last few years, the AUBMC has recruited almost 90 new physicians and scientists with expertise in different specialized areas. Recently, QS Rankings ranked AUB's Faculty of Medicine as the top medical school in the region. This is a major achievement considering the multitude of political and security instabilities that AUB and Lebanon have faced over the years. The Children's Cancer Center of Lebanon (CCCL) at AUBMC in Beirut is a unique healthcare facility that was established as a Center of Excellence to treat children with cancer without remuneration from patients or their families. This is made possible through CCCL's partnerships with the St. Jude Children's Research Hospital in Memphis, Tennessee, US, and the AUBMC. Dr. Hassan El Solh, the Medical Director of CCCL, addressed the recent advances in the management of childhood cancer and the role of CCCL in Lebanon and the region.

What is the role of research in the drive to fight against pediatric cancer?

At CCCL, evidence‐based practice and research drives medical treatment. Research is based on data collection and analysis. We have a Data Management Unit with staff members who are experienced in entering patient data. We are investing heavily in translational research, which is the taking of laboratory research to the patient's bedside to use as novel treatment. We look at the biology of disease and at individual patient factors that influence treatment. There are special issues related to our patients as compared to patients in Europe or North America. Firstly, the genetics and cancer biology of the diseases that inflict patients in our region may not be the same as that elsewhere. Our research is based on genomic and chromosome studies that look at certain genetic indicators of the tumor itself. Some tumors are more aggressive than others, and laboratory research allows us learn more about the individual characteristics of the tumors we encounter and adjust our treatments accordingly to tailor the treatment to best match the disease. There are also call host implications that need to be accounted for. The way an individual patient's body metabolizes and reacts to different medications varies from one child to the other, so we need to perform studies to assess how an individual patient will respond to a specific treatment. This is called personalized medicine; we have to personalize the treatment based on the information we have about the cancer, the medications we use, and the patient. Our mission at AUBMC and CCCL is to support and advance services in Lebanon and in the region so that others can learn from our experience. We regularly meet and collaborate with pediatric oncologists working at hospitals and centers across the country. If physicians at these centers suspect cancer in patients at their own hospitals locally, we can help support the diagnosis through consultation and collaboration between physicians at our center and the referring physician, without taking over the care of the patient completely. This allows us to promote the transfer of knowledge and education, allowing others to benefit from our research and experience. When required, we perform specialized procedures, such as surgery or radiation therapy, that referring centers may not be equipped to perform. Two years ago we established the Pediatric Oncology East Mediterranean (POEM) group in order to support pediatric cancer centers in the region through transfer of knowledge, training, and data collection. POEM encompasses 70 centers in 22 countries across the region. We have another five centers that are now in the process of joining our growing group. We meet on a regular basis for scientific conferences and workshops. We regularly hold case presentations through teleconferences between oncologists in Lebanon, Saudi Arabia and the Gulf Countries, Iraq, Egypt, India, Turkey, Pakistan, and other countries. We hold scientific meetings once every year where we have a two‐ or three‐day conference presenting updates childhood cancer.

How do you envision CCCL advancing in the future?

There are two pathways: one is related to research, as we need to learn more about the nature of childhood cancer in our region; and the second is related to the promotion of comprehensive care for childhood cancer so it can be provided by other centers in Lebanon. Initiatives like the Lebanese Children's Oncology Group and the POEM Group are important in engaging the local community and fostering a sense of social responsibility amongst patients, their families, healthcare providers, and the public in general. This is what the CCCL is striving to accomplish. It is not only the family of the patient who should be responsible for the treatment of a child with cancer; the government and the local community have a social responsibility to care for those afflicted with devastating disease. Without the CCCL, many children with cancer will have no option for treatment, as accessibility to advanced care for childhood cancer is currently limited in the region, and many families cannot afford its prohibitive cost on their own. Our mission is to provide accessible and excellent care to every child with cancer who needs it in Lebanon—and the wider region.