March Physician of the Month: Yvonne Efebera
Yvonne Efebera, MD, MPH, has a lot of big ideas.
They range from a new clinical trial that could make it easier for multiple myeloma (MM) patients who need donor stem cell transplants to find matches, to a new clinic for the rare disorder Amyloidosis, to opening a comprehensive medical facility in her African homeland of Sierra Leone.
The common denominator in all her big ideas is simple: patients.
“I want to give back and help people,” Efebera says.
For this and many other reasons, Efebera is the March Physician of the Month at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James). She is a leading expert in multiple myeloma, a cancer formed by malignant cancer cells. March is Multiple Myeloma Awareness Month.
War at Home Inspires Passion and Purpose in School and Career
Efebera’s journey began in Sierra Leone, where she was raised by her maternal grandparents.
“My grandmother saw something in me,” Efebera says. “And for as long as I can remember, she said, ‘You’re going to be the doctor in the family.’”
There was a problem: there were no medical schools in Sierra Leone at the time. The impoverished West African country doesn’t have much of a healthcare system, and many people do not receive the diagnosis and treatments they so desperately need.
Efebera went to the University of the District of Columbia in Washington, D.C., where she earned a degree in chemistry in 1994. She was them appointed to Minority Access to Research Careers (MARC), a National Institutes of Health program that encourages underrepresented populations to pursue careers in the sciences and provides funding for their education.
Then it was on to medical school at Pennsylvania State University.
“At first, my plan was to be a pediatrician,” she says.
While Efebera was in medical school, a terrible civil war broke out in Sierra Leone in which thousands of people were killed. Her mother and younger twin brothers fled to Gambia, and Efebera supported them financially, using whatever she could scrape together from her student loans.
“Making sure they were safe was the most important thing,” Efebera says.
Efebera did her residency in internal medicine, then a fellowship in hematology/oncology and a second fellowship in blood and marrow transplant. “I became very interested in stem cell transplants and multiple myeloma,” she says. The OSUCCC – James is a world leader in multiple myeloma research and treatment.
Family and Focus Find Roots in Columbus
Efebera came to the OSUCCC – James in 2009 with her husband, Percival Vera, who is in IT management in the healthcare industry. They have two sons: Justin, 16, and Pervonne, 11, and are in the process of bringing their adopted daughter Yeannor Vera to the United States. Efebera became an American citizen in 1997, and later her mother and two brothers were able to come to this country.
“I began my career in internal medicine, and I would diagnose patients and then turn them over to other doctors for treatment,” Efebera says. “I wanted to have a long-term relationship with patients, to be more of a part of their treatment.”
Efebera is an outgoing, people person. Or, in her case, “patient person” might be a better description. She’s a hugger and thinks of her patients as family members.
She is currently working on a new clinical trial that would allow every MM patient who needs an allogeneic stem cell transplant to have a donor. An autologous stem cell transplant is one in which a patient’s stem cells are used, while an allogeneic transplant utilizes donor stem cells. It can be hard to find a match for many patients.
“The chances of finding an unrelated donor for a Caucasian are about 75 percent,” Efebera says. “It’s less than 30 percent for African-American and Hispanic patients, because their genes are more heterogeneous and the diversity of different genes makes it harder to find matches.”
This trial would allow the use of what Efebera calls “half-matched” donors by using drugs that reduce the side effects from these types of “lesser” matches.
“Multiple myeloma affects twice as many African Americans as Caucasians,” Efebera says, adding that when African-Americans are diagnosed early and receive state-of-the-art healthcare, “their outcomes are the same. But for many reasons, for example they don’t have insurance, they don’t see their doctors or wait until it’s really bad and then go to the ER, and then don’t get involved in as many clinical trials. Because of this, their outcomes aren’t as good. I want to change that.”
Taking on Challenges Around the Globe
Efebera recently opened the Comprehensive Amyloidosis Clinic at The James. Amyloidosis is a very rare disorder in which a substance (amyloid fibrils) builds up in the organs. There are three types of amyloidosis, with one of them ( AL or light chain amyloidosis) having some things in common with multiple myeloma, but much more rare. The other two types of amyloidosis are even rarer, and there are not many treatment options.
Efebera has been seeing patients with this type of rare disorder for several years and is one of the leading experts on treating patients with amyloidosis.
“The clinic just started and we meet once a month with patients. We have a hematologist, cardiologist, neurologist, nephrologist and physical therapist in one place rotating to see patients and giving comprehensive care.” Efebera says. “This teamwork has allowed us to make diagnoses faster and get patients feeling better faster. This is great for our patients and, starting in July, we’ll hold the clinic twice a month.”
Approximately 24,000 patients a year are diagnosed with multiple myeloma, and around 4,000 are diagnosed with amyloidosis, according to Efebera.
Her biggest idea—and biggest challenge—is the clinic in Sierra Leone
“My country has no healthcare system and so many people die needlessly,” said Efebera, who gets emotional when she discusses this subject. She has many relatives in Sierra Leone, and her beloved grandmother, who pushed her toward a career in medicine, died of a heart attack while Efebera was about to enter high school.
“My dream in the next 10 years is to open a comprehensive medical facility,” she says, adding that it would include primary care physicians, as well as specialists. “There are no mammography centers there, there are no CAT scans and people with curable ailments are not getting diagnosed. I want to change that.”