May 22, 2013

Dr. Sait:

I am pleased to write a review of my meeting with you and your staff at the

Gynecology Oncology Unit of King Abdullaziz University Hospital on Sunday, May

12, 2013.

The Scientific Chair of Professor Abdullah Hussain Basalamah for Gynecologic

Cancer program presentation:

Present: Dr. Khalid Sait, Dr. Nisreen Anfinan, Dr. Daniel Smith, Ms. Madi

Florendo, Rowaida Al Mehy, Faten Anfanan, Reem Al Quibiadi.

Initially, we reviewed the presence of gynecologic oncologists in the Kingdom,

specifically in Jeddah. Since your coming in 1999 as the first GYN Oncologist,

the shift in care of patients with gynecologic malignancies has definitely swung

to specialty care delivered by specialists. With Dr. Nisreen Anfinan joining you

two years ago, you have been able to devote more time to programmatic issues

and research.

Establishing the Scientific Chair of Professor Abdullah Hussain Basalamah for

Gynecologic Cancer is the result of identifying important goals of service and

obtaining adequate support. In the two years of your program’s existence, I see

much to admire.

You presented a number of areas of interest. I would like to address each

separately:

1. Population research

Finding little information concerning incidence or survival of women in

the Kingdom with gynecologic cancers, you have begun a program to

obtain these data. Such information is important for two reasons: 1) it

will demonstrate disease prevalence and focus health resources to

these most pressing problems and 2) it will demonstrate the

effectiveness of current cancer care and allow for necessary

improvement.

2. Jeddah Cervical Screening Program

The program provides screening, diagnosis, and treatment in one

center. It is free and open to Saudi and non-Saudi women. The ability for

continuous follow-up and recall are a part of the program. The stated

objectives are to decrease the incidence of cervical cancer by providing

early detection and treatment of women with both pre-invasive and

invasive cervical disease.

Certainly, this is a worthy project. Again, we discussed the lack of data in

Saudia for women with cervical disease. Your program will certainly

gather important data from your area. In addition, you are addressing the

issue of high risk Human Papilloma Virus (HPV) presence and its

association with cervical changes. This is new and important work.

We did discuss the issue of obtaining specimens from the broadest range

of women. As discussed, there has been demonstrated success using

patient-performed testing in other countries. The tests are distributed and

collected by neighborhood health care workers and might afford a broader

sampling size for your statistical data and, more importantly, help you to

discover more women with cervical disease.

3. Gestational Trophoblastic Center

Recognizing the presence of the disease in the Kingdom and the

probability of cure in most cases if internationally standardized staging and

treatment are applied, you have established this center in the Jeddah

region. Using the WHO Staging System and recognized treatment plans,

stratified for patient risk, you should quickly develop a strong reputation

for excellence in diagnosing and treating this relatively rare disease, which

is often fatal if not properly handled.

As in other areas of the world, establishing a Center of Excellence in any

area will draw attention and leadership in the area. In the US and Great

Britain, there are few true Gestational Trophoblastic Centers; however,

those few have set standards for diagnosis and care and have major

importance in treatment and training of care in their respective countries.

My prediction is that your center is now unique and approaching a problem

which can be solved following internationally accepted standards. I

believe that the importance of you program will be recognized nationally

and should become the Saudi Center of Excellence [in Gestational

Trophoblastic Neoplasia].

4. We then discussed other programs

a. National Cancer Screening Program

b. Colposcopy clinics

c. Etc.

The Scientific Chair of Professor Abdullah Hussain Basalamah for Gynecologic

Cancer has entered into projects which will advance the cancer care of women

Saudia. Additionally, it adheres to internationally established standards of

diagnosis and care. Thus, this program may well lead Saudia into the

mainstream of medicine as practiced world-wide.

Looking forward, we have planned a Tumor Board Symposium for this October.

Physicians in Jeddah and New York will discuss contemporary and problematic

cases live – via instant audio and video connection. Radiology images and

pathology slides will be available for all to see and to review. From our first

symposium, I expect this to be a stellar experience for all.

As an observation, looking at the posters on the walls of the King Abdulaziz

University Hospital, I became aware of over ten programs sponsored the

Scientific Chair of Professor Abdullah Hussain Basalamah for Gynecologic Cancer

or the Gynecological Oncology Unit. The breadth of the programs, from issues of

public health to the detailed treatment of cancer, impressed me that Dr. Sait has

moved beyond the practice of medicine and has assumed a leadership role in

education of women and physicians.

Although my visit in Saudia was my first and was short, I strongly believe that

the efforts of the Scientific Chair of Professor Abdullah Hussain Basalamah for

Gynecologic Cancer under the direction of Dr. Sait and his team is a vitally

important program for the healthcare of women in Saudi Arabia.

I would welcome more opportunities of collaboration and/or opportunities to

participate in the teaching programs in the Kingdom.

The Surgical Skills Laboratory in the King Abdullaziz University Hospital is

marvelous. I have visited skill centers in Tel Aviv and New York which purport to

be the ‘top of the line.’ Trust me, under the direction of Dr. Haitham S.

Abdulmajeed and the site director Su, your unit is the best that I have seen. You

have the manikins, the clinical space, the trainers in surgical skills and surgical

procedures, and open access. Never, have I seen such a comprehensive

program.

Believing that the surgical instruction of the future should embrace surgical skills

labs, I wholeheartedly support the lab which you have. Looking at the plans for

the future lab, I encourage you to involve all health care professionals in the

various aspects of this sentinel program in medical education.

The future is in progress in training, educating, discovery, and collaboration.

Your center could be a model for any progressive medical education system

anywhere… especially the USA.

Dr Daniel Smith