Conducting Global Oncology Research, Mentoring a New Generation of Investigators
The Center for Global Cancer Medicine (CGCM) collaborates with partner sites in Haiti and Rwanda to promote innovative and relevant global oncology research projects. Faculty and trainees from Dana-Farber Cancer Institute, as well as from across collaborating
institutions — including Brigham and Women's Hospital, T.H. Chan School of Public Health, and external foundation partners — engage in research activities that promote local research capacity. CGCM's U.S.-based and in-country clinicians are sharing
their research through papers and abstracts published in high-impact, peer-reviewed journals and through participation in cancer conferences around the world.
Breast Cancer Early Detection in Rwanda
CGCM works with the Butaro Cancer Center of Excellence and the Rwanda Ministry of Health to examine ways to promote earlier detection of breast cancer. Our previous work examined patient and health system factors associated with diagnostic delays.
With the financial support of the Breast Cancer Research Foundation (BCRF), an intervention was subsequently piloted that teaches community health workers to build breast awareness; trains health center nurses to recognize high-risk breast lumps;
establishes a referral pathway; and trains district hospital-based nurses and doctors to perform ultrasound evaluations. This intervention is now being scaled to other districts in Rwanda.
Breast Cancer Outcomes in Haiti
CGCM supported the local oncology team at the University Hospital of Mirebalais on a project to comprehensively assess breast cancer outcomes. Initial analysis in a retrospective cohort of nearly 350 patients revealed the preponderance of younger patients
with more advanced disease and other poor risk features, such as higher-grade disease. This analysis also highlighted significant delays that occur prior to treatment initiation, as well as along the treatment care continuum. We are currently working
on an analysis evaluating geospatial accessibility of cancer care and quantifying the impact of travel distance on cancer stage at presentation and on treatment outcomes. We are also evaluating patient communication preferences, and plan to explore
the utility of mobile health interventions to improve communication between patient and providers, as well as other future interventions that may improve outcomes.
Accurate and timely pathologic evaluation is paramount for quality cancer care. In collaboration with researchers at Brigham and Women's Hospital and the American Society of Clinical Pathology (ASCP), we have evaluated novel resource-appropriate ways
of providing pathology services in Rwanda, including sophisticated tissue-processing systems, whole-slide imaging and telepathology.
Other Disease Initiatives
Adult and pediatric research programs in Rwanda have empowered local clinicians to engage in disease-specific outcome projects. So far, they have evaluated clinical outcomes and determinants in chronic myelogenous leukemia (CML), acute lymphoblastic leukemia, gestational trophoblastic disease, and Hodgkin's lymphoma and Wilms tumor (WT).
In addition, CGCM received support from the Sanofi Espoir Foundation to establish a pediatric patient navigation program in Rwanda for WT to address barriers to pediatric cancer care completion, increase timeliness of diagnosis and treatment, and
reduce non-compliance with treatment recommendations.
Quality Improvement Initiatives
Quality improvement (QI) initiatives are an important component of building capacity and competency in low-resource settings. With a grant from Celgene, CGCM is engaged in research to evaluate a new, tailored curriculum and coaching program in cancer
care quality improvement at the Butaro Cancer Center of Excellence in Rwanda. The goal of this project is to understand barriers and facilitators of QI initiatives and, ultimately, to foster QI culture and mentor leaders that will sustain ongoing
QI efforts into the future.
With many possible arenas of research engagement opportunities in global oncology, CGCM will utilize a multi-pronged approach to expand our research activities. The Center seeks to:
- Foster deeper engagement within Dana-Farber itself to draw upon the considerable intellectual resources of the Institute.
- Establish health services and population science research initiatives to systematically evaluate elements of the current care delivery models, with the goal of maximizing efficiency and improving outcomes.
- Evaluate molecular diagnostic technologies that would potentially leapfrog current existing pathologic techniques and provide affordable timely diagnosis.
- Work toward building and supporting local research capacity by establishing research training programs at our sites.
Publications and Abstracts
Chiorean EG, Nandakumar G, Fadelu T, et al. Treatment of patients with late-stage colorectal cancer: ASCO resource-stratified guideline. JCO GO 2020;6(6):414-438. doi:10.1200/jgo.19.00367.
LeJeune A, Brock, JE, Morgan E, Kasten J, Martei Y, Fadelu T, Rinder H, Goulart R, Shulman L, Milner D. Harmonization of the essentials: matching diagnostics to treatments for global oncology. JCO GO 2020;(6):1352-1356. doi:10.1200/go.20.00338.
DeBoer RJ, Fadelu TA, Shulman LN, Van Loon K. Applying lessons learned from Low-resource settings to prioritize cancer care in a pandemic. JAMA Oncol 2020;6(9):1429-1433. doi:10.1001/jamaoncol.2020.2976.
Pace, LE, Schleimer LE, Shyirambere C, Ilbawi A, Dusengimana JMV, Bigirimana JB, Keating NL. Identifying breast cancer care quality measures for a cancer facility in rural Sub-Saharan Africa: results of a systematic literature review and modified Delphi Process. JCO GO 2020;(6):1446-1454. doi: 10.1200/GO.20.00186.
Raza S, Frost E, Kwait D, Bowerson M, Rugema V, Hategekimana V, Umwizerwa A, Shabani K, Shulman L, Lee YS, Huang CC, Mpunga T, Shyirambere C, Dusengimana JV, Pace LE. Training nonradiologist clinicians in diagnostic breast ultrasound in rural Rwanda: impact on knowledge and skills. J Am Coll Radiol. 2020 Sep 8:S1546-1440(20)30871-1. doi: 10.1016/j.jacr.2020.08.013. Epub ahead of print. PMID: 32916158.
Habinshuti P, Hagenimana M, Nguyen C, Park PH, Mpunga T, Shulman LN, Fehr A, Rukundo G, Bigirimana JB, Teeple S, Kigonya C, Ndayisaba GF, Uwinkindi F, Randall T, Miller AC. Factors associated with loss to follow-up among cervical cancer patients in Rwanda. Ann Glob Health. 2020 Sep 14;86(1):117. doi: 10.5334/aogh.2722.
Rubagumya F, Costas-Chavarri A, Manirakiza A, Murenzi G, Uwinkindi F, Ntizimira C, Rukundo I, Mugenzi P, Rugwizangoga B, Shyirambere C, Urusaro S, Pace L, Buswell L, Ntirenganya F, Rudakemwa E, Fadelu T, Mpunga T, Shulman LN, Booth C. State of cancer control in Rwanda: past, present, and future opportunities. JCO GO 2020;6:1171-1177. doi: 10.1200/GO.20.00281.
DeBoer RJ, Shyirambere C, Driscoll CD, Butera Y, Paciorek A, Ruhangaza D, Fadelu TA, Umwizerwa A, Bigirimana JB, Muhayimana C, Nguyen C, Park PH, Mpunga T, Lehmann L, Shulman LN. Treatment of Hodgkin lymphoma with ABVD chemotherapy in rural Rwanda: a model for cancer care delivery implementation. JCO GO 2020 Jul;6:1093-1102. doi: 10.1200/GO.20.00088.
Fadelu T, Damuse R, Lormil J, Pecan E, Dubuisson C, Pierre V, Rebbeck T, Shulman LN. Patient characteristics and outcomes of nonmetastatic breast cancer in Haiti: results from a retrospective cohort. Oncologist. 2020 Jun 25;25(9):e1372–81.
doi:10.1634/theoncologist.2019-0951. Epub ahead of print.
Schleimer LE, Vianney Dusengimana JM, Butonzi J, Kigonya C, Natarajan A, Umwizerwa A, O'Neil DS, Costas-Chavarri A, Majyambere JP, Shulman LN, Keating NL, Shyirambere C, Mpunga T, Pace LE. Barriers to timely surgery for breast cancer in Rwanda. Surgery. 2019 Dec;166(6):1188-1195. doi: 10.1016/j.surg.2019.06.021. Epub 2019 Aug 27.
Habimana O, Mukeshimana V, Ahishakiye A, Makuza P, Hategekimana V, Muhayimana C, Dushimana E, Shyirambere C, Haley J, Urusaro S, Kennell-Heiling S, Buswell L. Standardization of education of patients with cancer in a low- and middle-income country: a quality improvement project using the Cancer and You booklet. J Glob Oncol 2019;Jul;5:1-6. doi:10.1200/JGO.19.00118.
Park PH, Davey S, Fehr AE, Butonzi J, Shyirambere C, Hategekimana V, Bigirimana JB, Borg R, Uwizeye R, Tapela N, Shulman LN, Randall T, Mpanumusingo E, Mpunga T. Patient characteristics, early outcomes, and implementation lessons of cervical cancer treatment services in rural Rwanda. J Glob Oncol. 2018;4:1-11. doi:10.1200/JGO.18.00120.
Neal C, Rusangwa C, Borg R, Mugunga J, Kennell-Heiling S, Shyirambere C, Pritchett N, Clemence Muhayimana, Elisephan Ntakirutimana, Tapela N, Park PH, Shulman LN, Mpunga T. Cost of treating pediatric cancer at the Butaro Cancer Center of Excellence in Rwanda. J Glob Oncol 2018;4:1-7. doi: 10.1200/JGO.17.00155.
Martin A, Silverstein A, Ssebuufu R, Lule J, Mugenzi P, Fehr A, Mpunga T, Shulman L, Park PH, Costas-Chavarri A. Impact of delayed care on surgical management of patients with gastric cancer in a low-resource setting. J Surg Oncol 2018;
118: 1237-1242. doi: 10.1002/jso.25286.
Manirakiza A, Dugan G, Hanna C, Nguyen C, Fadelu T, Iradukunda E, Fehr AE, Ruhangaza D, Albert E, Mpunga T, Shyirambere C, Lehmann L. Implementation of a graduated-intensity approach for acute lymphoblastic leukemia in a Rwandan district hospital. Blood Adv 2018;2(Suppl 1):19–20. doi:10.1182/bloodadvances.2018GS112622.
Hanappe M, Nicholson LT, Elmore SNC, Fehr AE, Bigirimana JB, Borg RC, Butonzi J, Shyirambere C, Mpanumusingo E, Benewe MO, Kanyike DM, Triedman S, Shulman LN, Rusangwa C, Park PH. International radiotherapy referrals from rural Rwanda: implementation processes and early clinical outcomes. J Glob Oncol 2018;4:1-12. doi: 10.1200/JGO.18.00089.
Garcia-Gonzalez P, Lopes G, Schwartz E, Shulman LN. The role of humanitarian donations in decreasing preventable mortality from cancer in low-income countries: models to improve access to life-saving medicines. J Glob Oncol 2018;4:1-3.
Dusengimana JV, Hategekimana V, Borg R, Hedt-Gauthier B, Gupta N, Troyan S, Shulman LN, Nzayisenga I, Fadelu T, Mpunga T, Pace LE. Pregnancy-associated breast cancer in rural Rwanda: the experience of the Butaro Cancer Center of Excellence. BMC Cancer 2018;18:634. doi:10.1186/s12885-018-4535-y.
Muvugabigwi G, Nshimiyimana I, Greenberg L, Hakizimana E, Ruhangaza D, Benewe O, Bhai K, Pepoon JR, Fehr AE, Park PH, Butonzi J, Shyirambere C, Manirakiza A, Rusangwa C, Milner D, Mpunga T, Shulman LN. Decreasing histology turnaround time through stepwise innovation and capacity building in Rwanda. J Global Oncol 2018;4:1-6. doi:10.1200/JGO.17.00081.
Rubagumya F, Xu MJ, May L, Driscoll C, Uwizeye FR, Shyirambere C, Larrabee K, Gilbert UD, Muhayimana C, Hategekimana V, Elmore S, Mpunga T, Moore M, Shulman LN, Lehmann L. Outcomes of a low intensity treatment for acute lymphoblastic leukemia (ALL) at the Butaro Cancer Center of Excellence in Rwanda. J Global Oncol 2018;4:1-11. doi:10.1200/JGO.2017.009290.
O’Neil DS, Keating NL, Dusengimana JM, Hategekimana V, Umwizera A, Mpunga T, Shulman LN, Pace LE. Quality of breast cancer treatment at a rural cancer center in Rwanda. J Global Oncol 2018;4:1-11. doi:10.1200/JGO.2016.008672.
Pace LE, Dusengimana JV, Keating NL, Hategekimana V, Rugema V, Bigirimana JB, Costas-Chavarri A, Umwizera A, Park PH, Shulman LN, Mpunga T. Impact of breast cancer early detection training on Rwandan health workers’ knowledge and skills. J Glob Oncol 2018. doi:10.1200/JGO.17.00098.
Mpunga T, Znaor, A, Uwizeye FR, Uwase A, Munyanshongore C , Franceschi S, Clifford GM. A case-control study of HIV infection and cancer in the era of antiretroviral therapy in Rwanda. Int J Cancer 2018;143:1348-1355. doi:10.1002/ijc.31537.
Davey S, Mpanumusingo E, Fehr A, Butonzi J, Shyirambere C, Hategekimana V, Bigirimana JB, Borg R, Uwizeye R, Tapela N, Randall T, Shulman L, Park P, Mpunga T. Characteristics and early outcomes of cervical cancer patients at Butaro District Hospital, Rwanda: a retrospective review. The Lancet Global Health. 2017;5. doi:10.1016/s2214-109x(17)30135-3.
Neal C, Rusangwa C, Borg R, Tapela N, Mugunga JC, Shyirambere C, Ntakirutimana E, Park PH, Shulman LN, Mpunga T. Cost of providing quality cancer care at the Butaro Cancer Center of Excellence in Rwanda. J Global Oncol 2017. doi:10.1200/JGO.17.00003.
Rubagumya F, Greenberg L, Manirakiza A, DeBoer R, Park PH, Mpunga T, Shulman LN. Increasing global access to cancer care: models of care with non-oncologists as primary providers. Lancet Oncol 2017;18(8):1000-2. doi:10.1016/S1470-2045(17)30519-3.
Pace LE, Shulman LN. Breast cancer in Sub-Saharan Africa: Challenges and opportunities to reduce mortality. The Oncologist 2016;21(6):739-44. doi:10.1634/theoncologist.2015-0429.
Pace LE, Dusengimana JMV, Hategekimana V, Habineza H, Bigirimana JB, Tapela N, Mutumbira C, Mpanumusingo E, Brock J, Meserve E, Uwumugambi A, Dillon D, Keating NL, Shulman LN, Mpunga T. Benign and malignant breast disease at Rwanda’s first public cancer referral center. The Oncologist 2016;21:1-5. doi:10.1634/theoncologist.2015-0388.
Tapela NM, Mpunga T, Hedt-Gauthier B, Moore M, Mpanumusingo E, Xu MJ, Nzayisenga I, Hategekimana V, Umuhizi DG, Pace LE, Bigirimana JB, Wang J, Driscoll C, Uwizeye FR, Drobac PC, Ngoga G, Shyirambere C, Muhayimana C, Lehmann L, Shulman LN. Pursuing equity in cancer care: implementation, challenges and preliminary findings of a public cancer referral center in rural Rwanda. BMC Cancer 2016;16:237. doi:10.1186/s12885-016-2256-7.
Tapela N, Nzayisenga I, Sethi R, Bigirimana JB, Habineza H, Hategekimana V, Mantini N, Mpunga T, Shulman LN, Lehmann L. Treatment of chronic myeloid leukemia in rural Rwanda: promising early outcomes. J Global Oncol 2016;2(3):129-137.
Shyirambere C, Xu MJ, Elmore SN, Fadelu T, May L, Umuhizi DG, Uwizeye FR, Driscoll C, Muhayimana V, Hategekimana V, Rubagumya F, Nzayisenga I, Shulman LN, Mpunga T, Lehmann LE. Treating nephroblastoma in Rwanda: using International Society of Pediatric Oncology guidelines in a novel oncologic care model. J Global Oncol 2016;2(3)105-113. doi:10.1200/JGO.2015.000067.
Stulac S, Munyaneza RB, Chai J, Bigirimana JB, Nyishime M, Tapela N, Chaffee S, Lehmann L, Shulman LN. Initiating childhood cancer treatment in rural Rwanda: a partnership-based approach. Pediatr Blood Cancer 2016;63(5):813-7. doi:10.1002/pbc.25903.
Nzayisenga I, Segal R, Pritchett N, Xu MJ, Park PH, Mpanumusingo EV, Umuhizi DG, Goldstein DP, Berkowitz RS, Hategekimana V, Muhayimana C, Rubagumya F, Fadelu T, Tapela N, Mpunga T, Ghebre RG. Gestational trophoblastic neoplasia treatment at the Butaro Cancer Center of Excellence in Rwanda. J Glob Oncol 2016;2(6):365-374. doi:10.1200/JGO.2015.002568.
Mpunga T, Hedt B, Tapela N, Nshimiyimana I, Muvugabigwi G, Pritchett N, Greenberg L, Benewe O, Shulman D, Pepoon J, Shulman L, Milner D. Implementation and validation of telepathology triage at cancer referral center in rural Rwanda. J Global Oncol 2016;2(2):76-82. doi:10.1200/JGO.2015.002162.
Tapela N, Mpunga T, Karema N, Nzayisenga I, Fadelu T, Uwizeye F, Hirschhorn L, Muhimpundu M, Balinda J, Amoroso C, Wagner C, Binagwaho A, Shulman LN. Implementation science for global oncology: the imperative to evaluate safety and efficacy of cancer care delivery. J Clin Oncol 2016;34(1):43-52. doi:10.1200/JCO.2015.61.7738.
Buswell L, Umuhizi D, Hategekimana V, Muhayimana C, Kennell-Heiling S. Voices of hope from rural Rwanda: three oncology nurse leaders emerge. Oncol Nurs Forum. 2016;43(5):661-4. doi:10.1188/16.ONF.661-664.
Shulman LN, Wagner CM, Barr R, Lopes G, Longo G, Robertson J, Forte G, Torode J, Magrini N. Proposing essential medicines to treat cancer: methodologies, processes, and outcomes. J Clin Oncol 2016;34(1):69-75. doi:10.1200/JCO.2015.61.8736.
Stulac S, Binagwaho A, Tapela N, Wagner C, Muhimpundu M, Ngabo F, Nsanzimana S, Kayonde L, Bigirimana J, Lessard A, Lehmann L, Shulman LN, Nutt C, Drobac P, Mpunga T, Farmer P. Capacity building for oncology programs in sub-Saharan Africa: the Rwanda experience. Lancet Oncol 2015;16:e405-13. doi:10.1016/S1470-2045(15)00161-8.
Challinor JM, Galassi AL, Al-Ruzzieh MA, Bigirimana JB, Buswell L, So KW, Steinberg AB, Williams M. Nursing’s potential to address the growing cancer burden in low- and middle-income countries. J Global Oncol 2016;3:154-163. doi:10.1200/JGO.2015.001974.
Pace LE, Mpunga T, Hategekimana V, Dusengimana JMV, Habineza H, Bigirimana JB, Mutumbira C, Mpanumusingo E, Ngiruwera JP, Tapela N, Amoroso C, Shulman LN, Keating NL. Delays in breast cancer presentation and diagnosis at two rural referral centers in Rwanda. The Oncologist 2015;20:1-9. doi:10.1634/theoncologist.2014-0493.
Shulman LN, Mpunga T, Tapela N, Wagner C, Fadelu T, Binagwaho A. Bringing cancer care to the poor: experiences from Rwanda. Nature Rev Cancer 2014;14:815-21. doi:10.1038/nrc3848.
Mpunga T, Tapela N, Hedt-Gauthier BL, Milner D, Nshimiyimana I, Muvugabigwi G, Moore M, Shulman DS, Pepoon JR, Shulman LN. Diagnosis of cancer in rural Rwanda: early outcomes of a phased approach to implement anatomical pathology services in resource-limited settings. Am J Clin Pathol 2014;142(4):541-5. doi:10.1309/AJCPYPDES6Z8ELEY.
Mubiligi JM, Hedt-Gauthier B, Mpunga T, Tapela N, Okao P, Harries AD, Edginton ME, Driscoll C, Mugabo L, Riviello R, Shulman LN. Caring for patients with surgically resectable cancers: experience from a specialized center in rural Rwanda. Public Health Action 2014;4(2):128-32. doi:10.5588/pha.14.0002.
Sharma K, Costas A, Damuse R, Pierre JH, Pyda J, Ong C, Shulman LN, Meara J. The Haiti Breast Cancer Initiative (HBCI): initial findings and analysis of barriers-to-care delaying patient presentation. J Oncol 2013;2013:1-6. doi:10.1155/2013/206367.
Natarajan A, Rudolfson N, O’Neil D Schleimer L, Dusengimana JM, Keating NK, Shulman LN, MpungaT, Sebahungu F, Nguyen C, Umwizerwa A, Fadelu T, Shyirambere C, Kigonya CN, Butonzi J, Pace LE. Sociodemographic factors associated with cancer treatment completion among women with breast cancer at Butaro Cancer Center of Excellence (BCCOE) in Rwanda. J Clin Oncol 2020;38(15_suppl):e19220-e19220. doi: 10.1200/jco.2020.38.15_suppl.e19220.
Fadelu T, Sebahungu F, Diasti K, Nguyen C, Yeh T, Shyirambere C, Nkusi E, Nsabimana N, Ruhangaza D, DeBoer RJ, Chamberlin MD, Mpunga T, Shulman LN. Patient characteristics and outcomes of colorectal cancer (CRC) at Butaro Cancer Center of Excellence (BCCOE): Results from a retrospective cohort. J Clin Oncol 2020;38(15_suppl):e16081-e16081. doi:10.1200/jco.2020.38.15_suppl.e16081.
DeBoer RJ, Fadelu TA, Shulman LN, Van Loon K. Applying lessons learned from low-resource settings to prioritize cancer care in a pandemic. JAMA Oncol 2020 Sep 1;6(9):1429-1433. doi: 10.1001/jamaoncol.2020.2976. PMID: 32761149.
Pace LE, Dusengimana JMV, Shulman LN, Schleimer LE, Shyirambere C, Rusangwa C, Muvugabigwi G, Park PH, Huang C, Bigirimana JB, Hategekimana V, Rugema V, Umwizerwa A, Keating NL, Mpunga T. Cluster randomized trial to facilitate breast cancer early diagnosis in a rural district of Rwanda. J Glob Oncol. 2019 Nov;5:1-13. doi: 10.1200/JGO.19.00209.
Shyirambere C, Deboer R, Butera Y, Driscoll C, Bigirimana JB, Uwizeye FR, Fadelu T, Park P, Paciorek A, Lehmann LE, Shulman LN. Report on the treatment of Hodgkin lymphoma with ABVD chemotherapy at two rural district hospitals in Rwanda. Blood 2019;134 (Supplement_1):4053. doi:10.1182/blood-2019-130780.
Lormil J, Bhangdia K, Svoboda L, Pierre V, Buswell, L, Greenberg L, Damuse R., Triedman S, Fadelu T. Implementation and evaluation of video-based tumor board conferencing in Haiti. J Clin Oncol 2019;37(15_suppl):e18333-e18333. doi: 10.1200/jco.2019.37.15_suppl.e18333.
Fadelu T, Damuse R, Pecan L, Greenberg L, Danjoue S, Lormil J, Shulman L. Patterns of Treatment Noninitiation and early loss to follow-up in breast cancer care in Haiti. J Glob Oncol 2018;4_suppl: 75s-75s. doi: 10.1200/jgo.18.45500.
Fadelu T, Damuse R, Pecan L, Greenberg L, Danjoue S, Lormil J, Rebbeck T, Shulman L. Association between living in urban areas and obesity in Haitian breast cancer patients. J Glob Oncol 2018;4_suppl:79s-79s. doi: 10.1200/jgo.18.25600.
Anglade F, Mompremier M, Bhangdia K, Greenberg L, Orozco JD, Brock J, Pepoon J, Milner D. Implementation of anatomic pathology services in Mirebalais, Haiti. J Glob Oncol 2018;4_suppl:31s-31s.
Davey S. Characteristics and early outcomes of cervical cancer patients at Butaro District Hospital, Rwanda. Lancet Glob Health 2017;5:S28-S28. doi: 10.1016/S2214-109X(17)30135-3.
Lansigan F, Costa C, Mpanumusingo E, Kigonya C, Butonzi J, Sebahungu F, Shyirambere C, Mpunga T, Haley J, Figueroa K, Park P, Davis T, Chamberlin M. A novel global health fellowship elective in oncology in Rwanda: a multi-faceted model in education. J Global Oncol 2017;35:15 suppl:e18086-e18086.
DeBoer RJ, Driscoll CD, Butera Y, Bigirimana JB, Muhayimana C, Fadelu T, Park PH, Shyirambere C, Uwizeye FR, Mpunga T, Lehmann LE, Shulman LN. Report on the treatment of Hodgkin lymphoma with ABVD chemotherapy at two rural district hospitals in Rwanda. J Global Oncol 2016;2(3_suppl):67s-67s. doi:10.1200/JGO.2016.003764.
Buswell L, Elperin A, Houlahan K, St. Croix M, Virchick B, Bigirimana JB, Hategekimana, V, Umuhizi D. Answering the call: US oncology nurses train and mentor nurses in Rwanda. Proc of 18th International Conference on Cancer Nursing, September 2014, Panama City, Panama, 44.