Cecilia Monge, M.D., M.P.H., F.A.C.P., is an Assistant Research Physician in the Thoracic and GI Malignancies Branch. She was born and raised in Costa Rica, where she completed medical school, and then proceeded to residency training in internal medicine at the Washington Hospital Center/Georgetown University Hospital. She returned to Costa Rica, where she worked in academic medicine and research for a decade and led the development of the first government-based clinical research department in the country before coming to CCR to pursue a fellowship in medical oncology. For this Hispanic Heritage Month Q&A, she tells us about her interests in health disparities research, her experience working in a developing country and what makes a good mentor.
Can you give us a quick overview of your research interests?
I joined the Gastrointestinal Malignancies Group at CCR in 2019. Our group studies liver, biliary tract, colon and other gastrointestinal cancers. Many of our clinical protocols study immunotherapeutic approaches to develop better treatments for these diseases. I also have a research interest in health disparities in cancer treatment. Increasing enrollment of Hispanics and non-Hispanic Blacks throughout all phases of oncologic research is fundamental to proving the effectiveness of treatments in different populations.
Why did you come to CCR to pursue your research?
I was very happy to have the opportunity to do a medical oncology fellowship at CCR because it is the largest research-dedicated hospital in the world. Doing research in a developing country is challenging, as opportunities are scarce. My experience having worked and done research in Costa Rica made me appreciate all the opportunities, support and resources available at the CCR from a different perspective.
In my opinion, NCI is a unique environment to do research in cancer health disparities. Some current literature suggests that one of the reasons that Hispanics and non-Hispanic Blacks have relatively lower enrollment rates in clinical protocols is the lack of health insurance. This obstacle is already overcome at NCI where all patients receive medical care free of cost and it enables researchers to study and identify other factors that contribute to the underrepresentation of certain population groups in research studies.
How did your cultural background influence your decision in pursuing disparities research?
Gastrointestinal malignancies have always interested me because Costa Rica has a high incidence of these cancers. My familiarity with the differences between the treatment options in a developing country and at NCI made it clear to me that increasing Hispanic representation on our trials is important.
Improving equal representation of the U.S. population in our clinical trials is an important step in improving global oncology care.
Could you expand on this disparity? Why does it exist?
Approximately 19 percent of the U.S. population is Hispanic, yet this percentage is not reflected in protocol enrollment. This is an area that merits much more research and that is now steadily advancing. In general, it seems like Hispanics are more likely to be diagnosed with liver cancer at a later stage of the disease and may not receive care in a timely fashion; this could result in decreased survival rates. Apart from the insurance barrier mentioned earlier, there are likely cultural, communication and language barriers, all of which need to be dissected and understood in order to overcome them.
Congratulations on receiving the Robert A. Winn Award. Can you tell us more about it?
Thank you, I’m so honored to receive it! The award is dedicated to early-stage researchers focused on healthcare disparities in oncology. The recipients dedicate a percentage of their time to disparities research, and they receive specialized training in health disparities research through the AACR. They are also provided with support for a disparities-focused research project over two years. I look forward to continuing my research in studying equal representation of Hispanics and non-Hispanic Blacks on protocols during all phases of clinical research.
The award is also granted to the researcher’s mentor who oversees their research; my mentor is Dr. Tim Greten. I started working with him three years ago, and he has played a key part in my professional advancement. He dedicates a lot of time, effort and continuous support to the professional development of his mentees, carving their paths forward in research and bringing them many opportunities.
It sounds like your mentorship experience with Dr. Greten has been extremely rewarding. What kind of advice would you give to a trainee looking for a mentor?
I started working with Dr. Greten three years ago, and he has played a key part in my professional advancement. He dedicates a lot of time, effort and continuous support to the professional development of his mentees, carving their paths forward in research and bringing them many opportunities.
I think it is fundamental to find a mentor with professional expertise and institutional seniority who is also committed to paving the path to success for their mentees. An ideal mentor also has many collaborators and can continuously open doors for mentees by introducing them to other investigators. There also needs to be a right fit and a compromise from the mentor to invest time in their trainee.
What advice would you give to the next generation of Hispanic students that are considering a career in science or medicine?
In the year 2020, there were 62 million Hispanics in the United States, yet only four percent of the workforce at NIH is Hispanic. As a Hispanic student, if you decide to pursue a career in science or healthcare, you will contribute and add value to society by taking care of patients and advancing science. You can also play a fundamental role in increasing the diversity of scientists and physicians, as well as possibly contributing to decreasing health disparities.
Dr. Monge recently gave a TEDx Talk about her work, which you can view here. You can also follow her on Twitter @CeciliaMonge4