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Mon, Feb 19, 2018 12:00pm

In the Halls of Hematology: Meet Dr. Duma

By Mayo Clinic Hematology Staff, @mayoclinichematologystaff

Dr

Meet Narjust Duma, M.D., a hematologist and oncologist Fellow at Mayo Clinic, Rochester, Minnesota. In addition to her dedication to her patients as a provider, Dr. Duma is committed to her research and advocacy in diversity and inclusion. She was recognized as the 2018 resident of the year by the National Hispanic Medical Association.

Dr. Duma was selected by her peers to be a diversity and inclusion champion. She works with medical students and residents to help them feel more comfortable with Rochester, Minnesota and Mayo Clinic. Her research also focuses on underrepresented patient populations in clinical trials and how it affects the treatment of cancer patients.

Dr. Duma credits her background and upbringing with helping prepare her for her career:

As a diversity and inclusion champion, would you mind sharing a bit about your own background?

My family story is quite complicated but fascinating at the same time. My grandfather was from a small village in Colombia. He worked hard to make a name for himself. He met my grandmother in medical school. Later, due to the political instability in Colombia and better opportunities, my grandparents and my mother moved to Venezuela.

baby NJ

Dr. Duma as a child

My mother went to medical school in the Dominican Republic where she met my father. Growing up, we celebrated as many holidays as possible to include all the members of my family. Growing up, lunch was always my favorite meal. Every day we did not know if we would eat Venezuelan, Colombian, Spanish or Dominican food. It was delicious every time!

Also, my husband is a second-generation Ukrainian from North Dakota, adding pierogis and borscht to the mix. In short, we have just about everything in my family.

With an extensive background like that, it is clear why you were chosen to be a diversity and inclusion champion.

Diversity is beautiful. It enriches every environment and makes us appreciate and understand other cultures. Sometimes I hear someone crack the joke, ‘You don’t belong anywhere,’ but I think I belong everywhere. Plus, I get to cook a lot of great foods from a lot of different backgrounds.

Rochester is very diverse. We have everything here if you look for it. I am part of a group that meets with visiting medical students and residents to show them the rich culture of Rochester.  We help prospective employees learn about Rochester and its different cultures, churches, restaurants, and what activities Rochester has to offer to help newcomers feel more welcome and comfortable. As a person who went through it here, I understand their concerns, even if they don’t talk about them.

Dr. Duma Medical_Mission_DR

Dr. Duma on a Medical Mission in the Dominican Republic

With such a storied journey, how did you find your way to Rochester, Minnesota?

In 2003, the Venezuelan government was in turmoil and the political situation pushed me out and I went to the Dominican Republic to restart my medical school. From there, I had an opportunity to go to Seattle to continue my training. When it came time to do my residency, I matched with Rutgers University in New Jersey.

At Rutgers, I had the opportunity to work with refugees and a large Hispanic population, this allow us to fund the first Spanish speaking breast cancer support group in Newark, New Jersey. This initiative was motivated by many Hispanic breast cancer patients who would go to other support groups just to be around other breast cancer patients, but not be able to understand what they were saying. I am happy to say, the support group is still going on its own and I am still very close to them, they are like my aunties.

My interest for hematology/oncology started during medical school. When the time came to look for a fellowship, I had no doubt I wanted become a hematologist/medical oncologist. During my fellowship interviews, I visited Mayo Clinic Rochester on a cold September day. After several hours, I noticed at Mayo Clinic, the patients’ needs really do come first and that sealed the deal! The husband and I moved to Rochester in July of 2016. Since then, I have had the pleasure of taking care of many patients in the hematology and medical oncology department.

You were named a diversity and inclusion champion in research. Would you mind expanding on what that research is?

Cancer is an ultimate diagnosis. When it comes, it affects every family member.

There are a lot of health disparities in the United States, but they are significant in cancer care. As a fellow, I hope to bring attention to this issue and to help create a change. I focus on inclusion research. Inclusion research targets understudied and underserved groups. It is not only about racial differences. It is about the elderly, women, and underserved populations.

One example is that most of the data from clinical trials comes from studies where the majority of participants were young non-Hispanic white men. This leaves us with a gap in knowledge regarding the safety and activity of many drugs in a great majority of patients. Improving the representation of minorities, women, and the elderly in clinical trials will allows us to understand which are the best treatments for each subgroup, instead of extrapolating data from other populations. Chemotherapies are life changing treatments with long-term consequences, this should not be taken lightly.

Pharmacogenomics is the study of the unique mechanisms in how patients metabolize drugs. This allows us to understand how certain populations tolerate and benefit from treatment. Unfortunately, many community hospitals do not have access to this type of testing.

Several new studies are taking place here and we hope the results will help us provide the best cancer care for patients from all backgrounds. In the past year, I received support from the Office of Health Disparities Research and the Medical Oncology department to conduct several projects about sex differences in tolerability and response to immunotherapy as well as trying to understand the factors affecting treatment decisions in lung cancer patients.

You also recently started a new gathering in your time away from the Clinic. Tell us more about that.

We started a new series called, ‘Women in Medicine.’ The goal of this series is to talk about and address the unique challenges that women in medicine face every day. Every person encounters different challenges and we can learn from one another. We will try to find solutions together, but most importantly, we want to have fun. A happy doctor provides better care. Our meetings are about sharing our experiences in a way that is meant to inspire each of us to create change and to know we have others to lean on for support. No matter the situation, or person, complaining is not enough; you have to do something about it.

Dr. Duma’s ongoing outreach

Beginning in March of 2018, Dr. Duma will participate regularly in Conexion Contigo, a Spanish radio show based in Seattle that reaches across the United States. Dr. Duma’s collaboration will include discussions about breast and lung cancer as well as cancer prevention measures in the U.S. Latino population. You can catch Dr. Duma Thursdays at 9:30 am at

www.blogtalkradio.com/conexioncontigo.

We are unique and we need to encourage that. We need to identify those unique things in our patients as well and make sure that everyone is represented. It is important that we respect our patients and all of the differences each one may have.”

Thanks and nice to know Dr. Duma, Hematologist, Oncologist at Mayo. I have mild anemia 10-11g.Hb; on few CBCs. Normocytic, normochromic. Ferritin 100 (WNL); Serum Iron 39 Low (59-168mcg/dL)on Jan.16'18; taking
Ferrous Ascorbate 100mg + Folic acid 1.1mg; Serum Iron 70 -!5/2; being contd. on the combination; to repeat CBC in 3/18. Serum B12-1396 pg (200-911) on Mecobalamine 1500mcg for 2 months, for neuropathy. Please comment or advice, as courtesy (Hoping free consult,if possible)

@ramakambhatla

Thanks and nice to know Dr. Duma, Hematologist, Oncologist at Mayo. I have mild anemia 10-11g.Hb; on few CBCs. Normocytic, normochromic. Ferritin 100 (WNL); Serum Iron 39 Low (59-168mcg/dL)on Jan.16'18; taking
Ferrous Ascorbate 100mg + Folic acid 1.1mg; Serum Iron 70 -!5/2; being contd. on the combination; to repeat CBC in 3/18. Serum B12-1396 pg (200-911) on Mecobalamine 1500mcg for 2 months, for neuropathy. Please comment or advice, as courtesy (Hoping free consult,if possible)

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Hello @ramakambhatla, thank you for your comment. Unfortunately, we are not able to diagnose or provide consultation on Mayo Clinic Connect. Should you want a second opinion from Mayo Clinic, I suggest clicking on the following link, https://www.mayoclinic.org/appointments and going through the appointment process as they are better suited for addressing how a consultation and the appointment process works.

@ramakambhatla, if you don't mind me asking, how are you feeling with your current diagnosis. Was there something in Dr. Duma's story that you connected with?

I am happy to say that Dr.Duma is a very compassionate physician and as a Hematology problem, I just thought
that she could give an advice, on the clinical presentation. I enjoyed reading about the doctor's story, as referred to
herein. Best wishes. If it is possible, may refer this message to Dr. Duma (Hematologist,Oncologist at Mayo, possibly, could have completed the fellowship) With thanks, a Physician from India.

@ramakambhatla

I am happy to say that Dr.Duma is a very compassionate physician and as a Hematology problem, I just thought
that she could give an advice, on the clinical presentation. I enjoyed reading about the doctor's story, as referred to
herein. Best wishes. If it is possible, may refer this message to Dr. Duma (Hematologist,Oncologist at Mayo, possibly, could have completed the fellowship) With thanks, a Physician from India.

Jump to this post

@ramakambhatla, If you are physician from India, I suggest using the following link to the Provider Relations for Medical Professionals site on Mayo Clinic's website, https://www.mayoclinic.org/medical-professionals/provider-relations/overview. They will be far better informed on how to assist your request. As I am not a medical professional, I hope this information is of more help.

I know that there are very few like me left, with everyone wanting to work on what will be the next new drug we are forgotten. I was diagnosed in 1975 with stage 4 "nodular" lymphoma – Hodgkin's Lymphoma. Yes, I am still here with all the joys that followed. The chemo I was given took care of all but the left groin node. After 6 weeks of radiation the lymphoma has been sleeping for almost 40 years. The doctors said the best they could ask for was 20 years. The radiation did the most damage. My Sigmoid is gone, after working hard for over 30 years it finally gave up in 2014. I am an ostomate now. A part of my bladder was damaged and I now have 3 kidneys. When the doctors were doing my staging I had a lymphanglogram, now I have lymphedema. No one told me about all the fun and most doctors don't know what to do with me when I go in to see them now.

When you are working with a new wonder drug, please follow your patients for 20-50 years. I was only followed for 10.The long term side effects from the drugs may be worse than the drugs themselves. mlmcg

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