Daily Record Conversations
March 23-29, 2020
by Kimberly Dishongh
DR. RONDA HENRY TILLMAN: Surgical Influence - UAMS Oncology Chair leads by service
DR Conversations is a new monthly feature by the Daily Record, where we sit down with top business, government and nonprofit leaders in Central Arkansas. Our second conversation” is with Dr. Ronda Henry-Tillman, surgical oncologist specializing in breast oncology. Henry-Tillman is the chief of Breast Oncology in the at the University of Arkansas for Medical Sciences for the Winthrop P. Rockefeller Institute as well as a professor for the Department of Surgery at UAMS. She was appointed by Gov. Asa Hutchinson to the Arkansas Medical Marijuana Commission in 2016 and has served as chairman of that commission since 2017.
You are an endowed chair of the Muriel Balsam Kohn Chair in Breast Surgical Oncology at UAMS (2017) and it looks like your research efforts have focused largely on health initiatives that address access to healthcare, disparities in levels of care, and cancer prevention, and you helped with the development of UAMS’s mobile mammography program. What is your research telling you? Can you share a little about why these things are so important?
“When I started my fellowship in disease of the breast here at the University of Arkansas for Medical Sciences, one of the things that I noted was there was a lack of access for screening, and a research study or review had come out that mammography facilities were closing across the 75 counties in the state of Arkansas. I wanted to make sure that we could reach people, and that if people couldn’t get here, we could get them screened and get them navigated into programs to get them care. I wanted patients to be linked with their primary care provider, but also have access to screening, whether that was breast cancer with mammography, whether that was colorectal screening with colonoscopy, cervical cancer screening with their pap smear, hypertension, diabetes. We had gotten a large grant from the Komen Foundation to develop that unit, and we took the unit to primary care facilities to keep the patients linked with their primary care doctors, and that’s all over 75 counties in the state. People get confused that because you’re in an urban area that you have access. It may be as simple as you can’t get into a place because you don’t have the appropriate health care coverage. When the Affordable Care Act came, we were instrumental in working with people to get on the Affordable Care Act. When they changed to Arkansas Works, we were instrumental in letting people know the new rules and regulations so that they could make sure that they met those work requirements to get health insurance. If you don’t allow or help people get access, you can’t change outcomes, and we know with any disease entity – whether it’s cancer, whether it’s a chronic medical condition – that early detection in all of those disorders matters.”
You’ve been teaching doctors – mostly men – in Africa. How did that opportunity come about, and what has it been like?
One of my mentors, Dr. Groesbeck Parham, is a professor at UNC University in North Carolina and he went to Zambia to study cervical cancer and HIV and noted that there was a number of cases that came in with women who had breast cancer, and he offered me the opportunity to develop a breast cancer training program and to come to Zambia and train two surgeons there. We had already been to South Africa, where we were in the rural areas of South Africa where we were just educating on cancer and different medical conditions, so we trained them and at the time, the University of Zambia was building a cancer disease hospital. With Friends of Africa he has a program, he asked me to come to Kinshasa in the DRC where Dikembe Mutombo built a hospital there in honor of his mother, and to build a women’s breast cancer program because we do both breast and gynecologic malignancies as well as cervical cancer screening and early detection and teach them how to do diagnostics and to manage breast cancer disease.
“It’s mainly going to the hospitals, lecturing, training and working with the hospital not just on training them but developing infrastructure so that they can continue, and that’s important. We want things to progress and we want the same access the same ability and so we’re trying to build a large capacity to change outcomes.”
Gov. Asa Hutchinson appointed you to the Arkansas Medical Marijuana Commission, and you are currently the chair of that commission. There have been some apparent frustrations involved with the commission’s work thus far. Do you see the commission’s work moving forward more smoothly in the future?
“I think that the Arkansas Department of Health, the Department of Finance and Administration and the Medical Marijuana Commission have followed the rules of the legislation and been pretty fast about it. The frustration is that people just have to do what they say they’re going to do and law is out there. The cultivation centers are open and producing, and dispensaries are open, so I think that we’ve moved forward.
“I don’t look at it as frustration. I think that anytime people are in competition, it makes it kind of difficult and I think that the state did what they wanted to do, and we’ll see how it works out. As a commission, what our legislative leaders are senators and house representatives, the governor, what they put on paper we followed, and we’re bound by rules.
“The numbers are pretty good now. Some areas are better than others. I think that some people were prepared and followed it through, and it worked out and then some people, you would have to ask them why they didn’t. There are always barriers. You put in an application one year and two years later, it’s funded, and a lot may not be available anymore, so there’s things that are beyond people’s control.”
Do you think that many of the women you treat benefit from the legalization of medical marijuana?
“It depends on the condition. If you go on to the Arkansas Department Health website, they’ll list all of the conditions there and you can go through them. Cancer is listed as a benefit, and they may benefit but it depends on what they’re taking it for. Is it because you are dying of cancer and you have chronic pain? That may benefit you. Is it because your cancer is metastatic and you’re cachectic, meaning you’ve lost so much weight, and you need something to stimulate your appetite? That may benefit them. If you have an early cancer and you’re fine, I don’t know how much benefit, unless it’s from anxiety, you may get from it. You also have to look at the different combinations or strains of the medical marijuana and make sure they get the appropriate combination of the CBD to THC that goes along with the chronic condition. Then you have to look at their medications and make sure there’s no cross reaction or problems with taking the dose of CBD and THC, with the other medications they’re on because cancer patients are on lots of different medications. And first, you don’t want to cause any harms or any interactions that could be a problem.”
You were told early on in your medical career that women were not surgeons. How have things changed for women in medicine?
“I trained at the University of Arkansas for Medical Sciences and when I came here in 1992, I was the first African American female in their general surgery training program. Throughout my training, there were one or two other females. Over the years that number in our residency training program has increased – one year we had all females, usually 40 to 60 percent of them are females.
“It’s been very difficult, but it’s improving with women in leadership. Look at the ‘Me Too’ movement. I mean, what women go through to just be in leadership or to be at the top of the field, whether it’s the entertainment field, or whether it’s medicine, whether it’s business, we’re all at that same level struggling to prove that we are the ones, that we can do it, and it shouldn’t be that way. We should be valued equally, but we aren’t equal – no one’s equal. The first thing patients see is me as a woman, a black female, and they get to make an assessment before they even know who I am. People sometimes still say, ‘Are you the doctor?’”
You left Blytheville as a teenager, found yourself back in the state for medical school and have made a career here. What is your relationship with your hometown – and your home state?
“I was born there. That’s my home. I left at a young age to try to create a better opportunity for myself, but Blytheville is a beautiful city. I left at the end of high school, before I graduated, and went to California and things worked out for me there. My high school was great. My class of the 1980s still consider me a part of their class. I have so many friends there and the support from the community is great and my father’s still there. But for me to be where I am, I did have to leave. It wasn’t about escaping. But if I wouldn’t have left, I probably wouldn’t have been a leading cancer surgeon here.
“As for coming back to Arkansas, I said, ‘That’s where God wanted me to go,’ because that’s where I matched. In training for surgery, it’s a tough field. You deal with a lot in training to be a doctor and people don’t know the struggle. There are also great moments and to be able to do what I do is an honor and a blessing, that I could touch people’s lives and help make a difference. Coming back to Arkansas was a blessing for me. I met my husband here. Although God took me somewhere else, he took me on a journey somewhere else to get back here, maybe that was his plan.”