"A Different Perspective"

Dr. Abdul Calvino is a long-standing member of the Partnership's Board of Directors. As a Surgical Oncologist, he brings to light the importance of variety among a Board, and how his experience as a healthcare professional provides a different perspective to the Partnership's goal to improve cancer care and reduce the burden of cancer in our Rhode Island community. His years of experience in cancer care and addressing health disparities, particularly among the Latinx population, makes Dr. Calvino a key person in our efforts to support all cancer survivors and caregivers.

00:00 Megan: Good afternoon and welcome back.

00:02 I'm Megan Daniel, Administrator for Community Partnerships and I am joined by Joe Dziobek, the Partnership Director. We are continuing our Board interviews today with Dr. Abdul Calvino. Thank you, Dr. Calvino for your time.

00:16 Dr. Calvino: Oh, you're welcome.

00:18 Megan: So, to start off could you please tell us

00:20 Dr. Calvino: Thank you for trying to learn a little bit more about the Board members.

00:24 Megan: Yes, yes. We are excited to have you. Could you, first, just tell us a little bit about yourself. Where you're from, where you work, what you do. Any special hobbies, things like that.

00:40 Dr. Calvino: Wow. Sure. So, I'm a Surgical Oncologist. So I do cancer surgery.

00:49 I'm originally from Panama, Central America. I know my name, Abdul Saied Calvino doesn't necessarily represent someone who comes from Panama but we're a mix in Panama. So I'm from Panama originally.

01:06 I did general surgery at the University of Illinois in Chicago. Spent five years over there. And then did pancreatic cancer research basic science research over there as well. And then did a fellowship. Surgical oncology fellowship here at Roger Williams Medical Center in Rhode Island.

01:24 And I spent two years training to gain the skills and the knowledge to do cancer surgery. And they hired me. I must have done something good because they hired me after I finished. And I have been here since then.

01:39 So, already six years working here in Rhode Island. At Roger Williams. And it has been great. So, I'm very happy.

01:50 In terms of my hobbies and what do I do when I'm not working. Well, the first thing is I love to enjoy my family. I have two kids, two boys, seven and six. So, every time I have I try to spend with them.

02:08 And I also like music a lot. I enjoy everything. But I like jazz music and Latin jazz. I do play the, the alto saxophone. So, when I have time I try to improve my saxophone skills which are not where they should be. But, at least I can, you know, spend some time trying to.

02:31 Joe: Have we knew that we wouldv'e had you lead in this, played a couple of riffs.

02:37 Dr. Calvino: Having a solo, yeah, no, I don't think so.

02:41 Megan: Well, learning an instrument, you know, a really, a tough thing. So, I commemorate you for doing that.

02:48 Dr. Calvino: Yeah. And then, so, you know, sometimes when, when I talk to people they ask me, what do I, what do I do? Surgical oncology is kind of a very broad topic. So just to give you an inside of what I do specifically. I specialize in cancer surgery of the gastrointestinal tract. Which is called rectal, also pancreas, liver, and small bowel.

03:21 And pretty much that's the area where I do most of my, my work. And has also been the area where I have, I have dedicated some time to do some work on prevention.

03:36 You know, what I do is to take care of one patient at a time. But, when you work on prevention then you are taking care of a lot of patients at a time. And I believe that a lot of the impact we can have in the population is towards prevention and education.

03:57 So, that's how I started working with the Partnership to Reduce Cancer in Rhode Island. And I started, actually, my first year. I was invited to one of the meetings and that was, pretty much five years ago, and I started working in a work group and then after that I became a member of the Board.

04:18 Megan: Great.

04:18 Joe: And we're glad you did.

04:20 Dr. Calvino: Oh, thank you.

04:22 Megan: We're very glad to have you, so. Well going into medicine is a very noble thing to do so, what led you to the decision to dedicate your life to helping and healing others and what do you find most rewarding about your work?

04:40 Dr. Calvino: Sure. Well, since I was a teenager I was exposed to, to cancer. Not myself, but my grandfather died from lung cancer. He was a smoker. So I started to understand that relationship between risk factors and cancer.

04:58 And I also had the exposure to surgical oncology because my, my, my grandfather needed cancer surgery. Chemotherapy, radiation therapy. And I got drawn to it. I really wanted to understand it better and I decided that that's what I was gonna, gonna do.

05:19 And I always felt I was gonna be better in the technical part. So, surgery was kind of the normal route to, to then surgical oncology. So that's how I started. And that's how I started to get interested in surgical oncology.

05:39 In terms of the, of what I enjoy, I enjoy to, to help people. To be able to, to have a patient that has cancer and you can help them through. And, you can do two things for them. You can cure them, hopefully, but in many cases you just improve the quality of life they have.

06:02 And take them to that process. Independently of what the end result is, which a lot of times is not what we want, if you can help them through that process and they feel they did their best and everybody around them did their best, I think I feel very happy and I feel joy when that happens.

06:24 Obviously, in my mind I want to try help every single patient I see and hopefully make them cancer-free but it's not something that is gonna happen in all the patients we see.

06:39 Joe: No, I, I, I think that's true. I know in my mom's case I had her seen. She had an appointment with an oncologist and, you know, at her age in the nineties he looked at me and he said, Joe, you know, you really don't wanna put your mom through what she would go through at, at that age with this.

07:00 Her quality of life is decent so, you, sort of, you know, at some point you have to accept that, you know, maybe it's the inevitable. But, she really didn't suffer that much you know, the quality of service she got.

07:16 You wanted to talk about palliative care, that that really came into play and helped tremendously. You know. So, I admire you, Dr. Calvino, you and your wife, for choosing those fields and day after day, I mean, you're not going in, stress is on the line every time you go into the OR. That's you know, it's

07:41 Dr. Calvino: Yeah, I think we, we learn how to deal with those emotions and how to try to remain

objective and, and try not to, you wanna be empathic with the patient but at the same time you need to, to be objective.

07:59 And try to, you know, make the best decision for, for the patient. But I think it's something that you learn and, you know, with, we have been trying to learn every time. So, hopefully we're getting better and better on that.

08:20 Megan: Yeah, I've noticed you know, from everything you've just said, that you are kind of involved in all of the areas that the Partnership is trying to address with cancer.

08:30 So you mentioned your interest in prevention, which is obviously pretty important before you even step into the world of cancer. That's definitely the best we can do. Prevent a diagnosis and then, obviously, as a surgical oncologist, you're involved in the treatment and then, you assist with helping the quality of life after if a patient isn't cured.

08:59 So, I think that's really amazing that you, kind of stay involved in all of those areas which are really important to the Partnership and, I think, just in general in the cancer world.

09:12 Dr. Calvino: Yup. Yup, definitely. And thank you. You know I, so we work with wonderful people at the Partnership and, you know, the Board is all full with very smart and wonderful people so, it's not difficult to enjoy and it's not difficult to be part of, of the Board.

09:31 However, I do think that is, that it is very important to have the point of view of, of people who actually deal with cancer with the patient. Because we have a different perspective, I feel. And I feel it's very important for me to communicate that perspective to, to the people and the stakeholders and, and the people who's interested on improving cancer care and reducing cancer in general.

10:04 So, I feel, you know, that perspective of a surgeon, someone who actually feels the cancer, who take it out, who have seen it. It's very important to then try to drive some, and design, some interventions and implement some interventions that maybe try to help to shape policies that might help the population in general.

10:35 But, but I think that that perspective is very, very important. And that's what I have tried to do at the Partnership. Tried to give that perspective, that clinical perspective

10:47 Joe: Yeah, yeah. That, that's, that's really important that you say that and unfortunately, oftentimes people in your position, you know, their time, their time, their personal time is hard to carve out.

11:02 And so they tend not to they may have the best of intentions to be part of something like the Partnership. But, their follow through isn't always the best because there's so many competing demands on their time. But, you've been you've been answering the bell. Every time. We really appreciate it, for sure.

11:24 Dr. Calvino: I think, I think the key is that you have to get them young. You need to get them when they're starting they have a little more time and then. But, yeah, no.

11:35 I, I think, I think it's very important to have clinical the clinical perspective. And, besides, I'm Hispanic, right? I'm originally from Panama so, one of the things I saw here in Rhode Island is that most of my patients that were Hispanic they were presented with more advanced cancer.

11:53 So, when I first started, I started working with the Department of Health, looking into what was the stage of those Hispanic patients that presented with cancer.

12:02 And when you look at the tumor registry here for the state, you can tell that Hispanic patients and some other underserved populations present with more advanced cancer. And that's something that I'm not going to be able to do anything about.

12:16 I can see them when they present with the problem. But, if we want to have an impact and maybe decrease that disparity between underserved populations and specific ethnicities and races and have a real impact, we need to collaborate.

12:35 We need to work with the state, state organizations and other stakeholders. We need to create policies, we need to collaborate. Otherwise, we won't be able to do something that really will have a positive impact.

12:50 And that's why, I've also been very vocal about trying to have programs with patient navigation, that are language and culture appropriate for patients. In our case, because we're more interested in Hispanic communities, we started, and I think I have discussed this with you before, we started a, a program designed for Hispanics.

13:18 Where we have a patient navigator that will navigate the patient, explain to the patient why a colonoscopy is important. And we'll help, we'll help them and navigate them through all that process to make sure they actually get them the test they need. Also, with breast cancer, we have a navigator for breast cancer.

13:38 For colorectal, we have navigated more than 700 patients, for breast more than 150. And now we're working on navigating Hispanic patients that have been diagnosed with cancer. So they can coordinate and understand what they need to do in, in relation to radiation therapy, in chemotherapy.

13:59 Where do they, they need to go? How can we improve the quality of the care they are receiving by trying to breach that gap in terms of language and, and culture. And I think that's, that's, that's key.

14:16 Joe: You know, it's interesting Dr. Calvino, when we did the skin checks last summer at the beaches, we did one also at Lincoln Woods and we had almost as many people at Lincoln Woods as we had, I think, at Narragansett.

14:33 And, what was interesting though, is whereas at the beaches we were, people that had already gone with the purpose of being on the beach and swimming and we had the tents up and so they would wander over and some people, you know, made a concerted effort to go there.

14:50 But, people who came to Lincoln Woods, came largely because we were advertising the skin checks that we were doing. And there were some housing employees, let's say in some of the housing complexes who utilized their vans to take people.

15:12 People would say, hey, we'd really like to go to this. And so, I was impressed by that, though. That somehow, word had gotten through the community these skin checks were gonna happen even though

it wasn't the best beach day. People didn't really show up to go on the water. They showed up to, to get their skin check.

15:30 And, as I said, I think you know, the messages people will be receptive to it if the information is out there. And that's part of the challenge. Is getting the information out there. Crossing those barriers.

15:45 Dr. Calvino: Definitely. Something that we have learned with community outreach is that to have outreach that is effective and efficient you have to get to the community.

16:02 You cannot expect, and this is something that, that we used to do initially, you cannot expect people to come to you, like for example, oh, we're going to have a conference or we're going to have a community outreach event you know, at Roger Williams Medical Center or at St. Joseph Health Center. Unfortunately, if we want to reach people we have to go to where they are.

16:29 Something, for example, we were doing with the Department of Health is that we said okay, where do, where can we reach people in their own communities while they're doing the things that they usually would do.

16:42 So, churches is one of the places and so we work with some churches going over there and just meeting with small groups 35, 55 group of, of, of church goers. And so we did that with a couple of communities. Also to where they work.

17:05 We worked with the, with the Department of Health we went to Job Lot, for example. They have 300 Hispanic employees just in one conference room that were on, on that, on that shift. So, that was very also, very efficient and effective for us to reach people.

17:26 So, so going to the communities, going to their beach, to their shores, to their work I think is key if we really want to outreach and educate them.

17:36 Joe: Yeah.

17:37 Megan: Yeah. So, the Partnership is trying to do more to address the health disparities that exist among cancer patients and you clearly are doing a great job addressing that in your work. And you are going to join the new health disparities work group that the Partnership is starting.

17:57 So, you've already given some great suggestions, is there anything else that you think the Partnership can do, especially with this work group, to specifically address the needs of cancer patients

and caregivers in our communities?

18:12 Dr. Calvino: Sure, yeah. I think, I think one of the, our main goals should be one, to bring more partners into the Partnership and to spread the, the word. So more people and organizations know about what we're doing.

18:30 So, if we can get more people involved and, and people know what we're doing I think we're going to be more successful on trying to reach. I think the Partnership have proven that when we all collaborate and, and we can do very good things.

18:49 And, and Joe was just talking about the SMART or skin cancer check program it has been very successful. So, so when we can collaborate and people know about what we're doing I think we can, we can have a, a very good impact. Positive impact in the community.

19:13 Megan: Are there any other, I guess, major issues in cancer care and survivorship that should be addressed besides health disparities? That you

19:25 Dr. Calvino: Well there are, there are. I think when, so the reason a lot of us look into disparities is cause when you're going to look into where you're going to get more, most of the benefit from an intervention, I think we have to look into those high risk groups.

19:47 We have to go to the underserved populations the populations that, unfortunately, don't have insurance, that have less access to care and have less access to prevention and preventive tests or screening tests.

20:05 So, I think that's why we focus a lot on disparities because we know those populations are higher risk and if we want to create, design and implement an intervention that's going to have a lot of benefit

and that is going to be more effective I think we have to look into those.

20:28 Once we have done that, I think the next step is education in general. For example, one of the main problems, obviously, probably the main problem is the financial aspect, the cost of a screening test and the lack of insurance, medical insurance or other insurance.

20:50 But, the next problem you have is education. And therefore, you have a lot of Hispanics, for example, that have medical insurance but they don't do their colonoscopies or their mammograms, in most of the cases because they didn't know. Because the primary care didn't have the time to teach them about it.

21:09 So, once you have taken care of the access in terms of having the insurance or a type of insurance that allows them to have the test, then the next step is education. And I think that is also important for all the other groups.

21:26 So, I think those are the two main things that we have to kind of, worry about and we have to plan ahead for those. 

21:34 Joe: That's a good, that's a good point Dr. Calvino. Cause I know, you know, when people hear about a colonoscopy for example, they may not really know what's involved and it sounds like, oh, you know, i'll push it off to next year or whatever. You know, there's something, it's, it can seem overwhelming to some people for sure.

21:56 And I think if there's a, a language barrier or just in terms of access to getting to you know, a physician's office or someone that have a primary care doc, I mean myself, when I moved around a bit

I didn't, someone say to me well who's your primary I didn't have a primary doc and I realized how important that, that would be.

22:24 But, so, those are those are excellent points. The education is key and and we need to, you know, really constantly focus on that cause sometimes you take it for granted. Figure, well the literature's out there but, you have to really bring it to people as you say.

22:46 Dr. Calvino: Yup, definitely.

22:53 Joe: Megan, do you have any other questions for doc

22:55 Dr. Calvino: Anything else, Megan?

22:58 Megan: We covered a lot. And definitely a lot of important things.

23:03 Joe: Let me, let me ask you this, Dr. Calvino, in terms of the Board, what, obviously we want to add a few more people to the Board.

23:15 And one of the reasons we're doing these Board interviews is to kind of, bring the Board into people's livingrooms, if you will, to get a sense of well, who, who are the kind of people who sit on the Partnership Board. And people will get a sense as we go through these interviews how diverse a group can be.

23:35 What do you feel, as a Board member, are the kinds of, of personal qualities, skill set, that would be important for us to add to the Board?

23:52 Dr. Calvino: Well,

23:53 Joe: In your perspective.

23:55 Dr. Calvino: Yeah, sure. I think, so bringing you, bringing you aboard, I think was very important, so. And Megan.

24:05 So we need, to be able to do outreach and to be able to reach people we need to, to know how to navigate the social media, and how to be on, you know, Twitter and Instagram and all those.

24:20 So, so I think obviously bringing people who can help in that part is very important. As well as, having someone who can help coordinate and then, and do the administrative part of the Partnership. It's going to be very difficult for any of the Board members to take on that.

24:38 Joe: Right.

24:39 Dr. Calvino: It's not going to, you know, it's not going to it's not gonna happen. So, I think that was very important and I think we should keep moving forward in that direction.

24:52 And then, the next step which, which I think has been very good is to try to involve some of the non-for-profit organizations on the State. I know we started conversation with the Latino Control Cancer Task Force and the Pawtucket Cancer Task Force.

25:10 I think a lot of times, and even when it's a small state, we have a lot of people doing great things in silos. So, we need to try to get them together. So we can have a more impact on what we're doing and we can help them, collaborate with them, and they can also help us and collaborate with us.

25:30 Joe: Good points, good points. Well, I wanna thank you, Dr. Calvino, for serving on the Board for the past 5 years. And, as I said you've been an active member and through your involvement, through the comments you made just today as we were sitting here.

25:49 We had submitted a grant which we're waiting to hear on to the Department of Public Health to put together, kind of, what we're calling personal care kits for people who are getting treatment at the infusion centers.

26:05 And, when you mentioned about you need to bring things into the community I’m thinking, well why couldn't we extend that type of idea into some of the places where, you know, the Latino community may frequent whether it's certain social centers, churches, etcetera.

26:28 I mean, we could broaden this narrow view. And that's where, I think, people like yourself are helpful because you stimulate conversation. You stimulate ideas about where can we go next.

26:45 And, so that's, that's one of the valuable things for me. And we appreciate your involvement and your active involvement and your ideas and look forward to, you know, an interesting and exciting year ahead. Despite COVID which, you know, has changed the way a lot of us approach what we do, you know.

27:09 Dr. Calvino: Yes, definitely. Well, thank you. Thank you very much for, for the interview and wanting to learn a little bit more about the members of the, of the Board. I think it's a great idea. And, and, you know, hopefully we're gonna bring more people in.

27:29 And, and, if I wouldn't think that the Partnership is doing a great job I wouldn't be here. I wouldn't be part of it, so. After 5 years I know there's a lot of other things that could be done.

27:45 And I, I know there's a lot of potential. And, and the things that have been done has been great. So, so the reason I am still part of the Partnership and part of the Board is because all the great things that has been done and all the potential that, that I see on it, so.

28:04 Joe: Well thank you for that.

28:05 Megan: Yeah, the Board members have been a big part of that, so, we thank you for your efforts in our success.

28:14 Dr. Calvino: You're welcome.

28:16 Megan: Thank you.

Partnership to Reduce Cancer in RI
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This program is supported in part by Cooperative Agreement Number NU58DP006291, funded by the Centers for Disease Control and Prevention and awarded to the Rhode Island Department of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention, the Department of Health and Human Services, or the Rhode Island Department of Health.

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