Empowering Cancer Advocacy v.1: Dr. Maira Caleffi on Personalized Medicine and Global Impact

Zainab Shinkafi-Bagudu: Welcome to today’s edition of our United Against Cancer interview series where we’re interacting and engaging lots of advocates, scientists, researchers, policy makers that are involved in the cancer control global landscape. Today we’re going to be talking with somebody who is very experienced and a good friend of mine. She’s from Brazil and she’s going to tell us much more about herself.

Today we’re going to be chatting with Dr. Maira Caleffi, who is the President and Chair of FEMAMA, which is a non-governmental organization that is focused on breast cancer. She’s a breast oncologist with very wide training from the UK, the US, and has also led a lot of initiatives in her home country of Brazil. Dr. Maira, bon dia, good to see you as always. So Dr. Myra, today tell us a little bit about the background of your, you have a lot of extensive background in breast oncology, trained in different high-end institutions.

I believe it’s at Guy’s Hospital in the UK and so on. So tell us about your background in breast surgery and how you see the future of, you know, personalized medicine emerging for cancer patients.

Maybe I should back off a bit and tell us a bit about yourself, the hats that you wear, FEMAMA, the IGCC, and your role in the CCAN initiative in your city of Porto Alegre.

When we embark in as being supportive to patients, we need to do something else than medicine in our patients’ clinics. We need to make sure that we are understanding, they understand what we need to do together. And I think this is what happened to me.

I am a dedicated breast surgeon with over 40 years of experience now and really dedicated to amplify the voices of female cancer patients with the purpose of promoting changes in access to early diagnosis and proper treatment.

When I was doing my studies at Guy’s Hospital, as you know, specialized in breast cancer, I realized that it was a big taboo and the word cancer was not even talked in Brazil yet, as it should. And I was really paying attention of the movements, what’s going on in the world, mainly in the United States and I was in UK, but watching what was happening in the United States when the first lady that was like Nancy Reagan was diagnosed with cancer.

And thanks to the mammography that she did as a screening, she was found with a very early cancer, a breast cancer, and she was cured. And she started the movement there that was really resonating what I was thinking that I needed to involve the community. And then I went to the United States, I did my postdoc in Nashville, Tennessee, and I stayed there for three years almost.

And I did in genetics, molecular biology at that time. So this is why I’m very, very close to the idea of personalized medicine. I’m talking about the late eighties, early nineties, when we started all this idea that cancer was systemic and also genetics.

So I think came back to Brazil for 1993. I started a state NGO together with psychologists, other breast specialists and patients. And then I started something that really, really, really is very dear to me, that was the Institute of Breast Disease, not only cancer, because I couldn’t use cancer at the first time.

And that was is just last week was 31 years old. And that was really, really nice. Yesterday, we did the dinner to collect money for the NGO.

And it was over a thousand people from the Porto Alegre Society clapping and engaging the movement. Then later on, I started FEMAMA because I thought that couldn’t be just one state. And there were other people, there were other people working on the same way.

And then we started a federation. FEMAMA stands for a federation of NGOs that are dedicated to women first, female cancer, but with a very strong relation to breast cancer. This is MAMA.

Congratulations for all the major milestones that you have achieved. It’s not easy to run one NGO for one institution for 40 years, but you have brought a federation of organizations together and raising funds for not just female cancers, breast cancer, but issues around women, which we know is quite a lot and we need to focus on a lot more. So now we can move to the next stage.

With your extensive background in breast surgical oncology, and I know you’re still practicing, you’re still an oncologist and you’re still operating because sometimes I call you and you have patients, theater days and so on. So well done. It’s important that I understand where you’re coming from when you say after working in the clinics and theater for so long, then you realize that there has to be more to this oncology thing.

You have to open it up and have more awareness. For us, we see a lot of late detection. And so that was one of the prompts for me, when you see a woman who you can’t really offer any more treatment solutions, even when if you had caught it early, there could have been.

So we focus more on going to the communities and doing a lot of education in the grassroots. So as somebody who has this surgical background for personalized medicine, how do you see it evolving for breast cancer patients?

It is a genetic inherited disease? What type of cancer we are really dealing with? And this is very specific to each patient because we need to talk to the patient about their family history.

And we also need to know, as I say, normally, we need to talk to the cells. We need to know more about the cells. The cells, the DNA of the cells, mostly it’s going to tell us, they are going to tell us, even to the surgeon, what to do.

So I think that we became more and more dependent in medicine of genetic testing. And not only the germ native, the germline DNA testing that they are the ones that we inherited from our parents, but also to know the mutations that the cells are going through on the process, on the journey of a patient, cancer patient.

And this means that sometimes we do one diagnosis and along the line, we have to test it again with another biopsy, another biopsy to know what that devil is doing to become resistant, to become so difficult because there are changes, mutations that are happening along the line.

So I think I’m very, very strong when I feel that countries like ours are so delayed on this process because we know, Zainab, you’re also an MD, we know what to do. We have the tools, the science already is there for us and we can’t use it. And that make me get up in the morning every morning and say, I have more to do.

My job is not done because I really feel strong about this inequity about what we can do, what we do in private practice and what we’re doing when we see patients in the universal healthcare coverage, for example, because I’m not talking about only Brazil, I’m not talking about Nigeria, I’m talking about even UK and Canada and other places still. In Europe, we have a lot of different access to our patients.

So it becomes a real problem and an economic and managerial problem for our governments. But very laudable and very interesting comments that you have made there. And I thank you for what you’re doing and your perseverance in continuing to serve your people, despite your vast networks globally and interactions.

And we still feel very strongly about the inequities that you faced in terms of what is available and the access that people, especially the women in Brazil, are able to get.