Foreground, at right: Gary Levine and Jane Brock meet with pathologists in Myanmar.

Although their work takes place behind the scenes, pathologists are on the front lines when it comes to diagnosing and, by extension, treating cancer. But in much of the world, experienced pathologists are in short supply. On a recent trip to Myanmar, one of many countries faced with the challenge of an increasing cancer burden and limited resources and infrastructure to tackle it, a Brigham team began bridging that gap through technology.

In April, Jane Brock, MB, BS, PhD, chief of Breast Pathology, and Carrie Robinson, MD, clinical fellow in Obstetric/Gynecologic Pathology, spent several days in Yangon, the country’s largest city, collaborating with pathologists from across the region to support and expand their capabilities. 

“Improving access to high-quality cancer treatments in low-resource settings is a global health challenge, and making a significant difference at the country level requires coordination of efforts by many organizations working together and pooling resources, knowledge and skills,” Brock said. 

Two of these groups are the American Society for Clinical Pathology (ASCP) and C/Can 2025: City Cancer Challenge, part of the Union for International Cancer Control. ASCP’s Center for Global Health aims to implement innovative methods of improving laboratory practice in a sustainable way across the globe, and C/Can 2025 is committed to reducing premature deaths from cancer by 25 percent by 2025, primarily by uniting governments, the donor community, nonprofits and the private sector to launch sustainable, comprehensive cancer solutions.

The Brigham’s Department of Pathology has supported global health initiatives for many years, with pathologists and laboratory staff donating their expertise to benefit patients in Rwanda and Haiti. 

Technology is making it simpler than ever to support these efforts. Biopsy tissue on slides can now be imaged digitally with a slide-scanning device. Providers in a low-resource setting can upload these images to a web-based system to be viewed by an expert pathologist at the Brigham — or anywhere in the world. 

“We no longer need to have glass slides shipped at high cost and with significant time delay around the world to be able to assist with diagnoses,” Brock said. “Our goal is to use telepathology to improve the quality of all cancer diagnoses made in a country that lacks subspecialty expertise and is struggling with providing high-quality education to its pathologists.” Through telepathology, it’s also possible for the Brigham to provide feedback that can help to improve laboratory procedures.

Following a private donation of a slide scanner to Myanmar, the country can now link into ASCP’s Motic telepathology platform, which currently serves countries in Africa. 

“We will shortly be able to offer a Brigham-based telepathology service to Myanmar — the first in Southeast Asia for ASCP,” Brock said. 

To ensure that Myanmar hospitals can take full advantage of this technology, Gary Levine, program manager for the Brigham’s Business Development and Strategic Initiatives group and an expert in the IT infrastructure needed for telepathology, also traveled with the team to Yangon. Levine, who has been instrumental in establishing telehealth connectivity between the Brigham and a partner institution in China, provided guidance through multidisciplinary lectures and meetings. 

By facilitating access to the deep expertise that lies within the Brigham and other academic medical centers, telepathology is positioned to improve cancer care in Myanmar and beyond.