ASCO 2019 and vision for cancer control

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Published: 11 Jun 2019
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Dr Eduardo Cazap - Editor-in-Chief, ecancer

Dr Eduardo Cazap, Editor-in-Chief of ecancer, summarises his thoughts on the 2019 American Society of Clinical Oncology (ASCO) meeting in Chicago. 

He briefly covers ASCO's history, its fundamental aims, and how it became internationally recognised as a leading organisation in clinical oncology.

Dr Cazap reviews the meeting in regards to what he refers to as global cancer control, highlighting standout sessions that contribute to this theme.

Dr Cazap explains that he hopes to see more of this worldwide vision from ASCO in the future. He also stresses the need to expand these messages beyond the oncology community to those who may be in more of a position to create changes in policy - changes that, Dr Cazap says, oncologists working in underserved populations already know are needed.

Dr Cazap concludes by saying that while ASCO already makes a fantastic contribution to clinical oncology, in the future he would like to see the development of new strategies to become more proactive in improving cancer care globally.

We are today in Chicago at the 2019 American Society of Clinical Oncology, ASCO, meeting. As Editor-in-Chief of ecancer I would like to share with you some comments about this very important meeting. One of the points that I would like to stress with you is the fact that ASCO, for more than fifty years, has been one of the leading organisations for clinical oncology. At the beginning ASCO was a group of friends, constituted by a group of friends, mainly to communicate between each other about clinical outcomes and clinical research data. So with the growth of the organisation ASCO became a practical international organisation and today we have 40,000 people attending the meeting here in Chicago. From the medical aspects and other specialties more than 50% of the audience is from outside the US.

Another important aspect to consider is that 30% of the ASCO membership is constituted by international members. But, again, this is basically a US-based organisation and the main objective of ASCO is constituted by good science by data that will allow our doctors and patients to contribute for better cancer care.

But how I see the situation today, the situation today at the global scale is that the world is moving from a diagnosis and therapeutic modality or intervention to the wider concept of global cancer control. Global cancer control means education, of course research, but not only medical research – epidemiological research, implementation research and other types of research as, of course, basic translational and clinical. But also early detection, primary and secondary prevention, proper treatment and also in the range of cancer control the issues of survivorship, the issue of morphine access, palliative care, end of life, are relevant to the matter.

So let’s see the ASCO meeting of this year from this perspective. If you have the opportunity to access the ecancer platform and the webpage you will see videos and information relative to the best science available. The latest developments, the new drugs, new treatments, better care. If you enter any publication in the US or in the world related with health and cancer that will be possibly the number one observation. But the question now is how this meeting may or must contribute to the concept of global cancer control.

A few observations: if we see in the programme an interesting aspect of the meeting to share with you was the opening ceremony. Usually during the opening ceremony, in this case it was presented by ASCO President Dr Monica Bertagnolli, the topics are good science and new data. On this occasion the theme was a different one – how other stakeholders, doctors or people, can be interchanging information. There was a very nice presentation from a young oncologist working in New Zealand, the Chemo Boy. The Chemo Boy was a young oncologist working in a small place in New Zealand giving chemotherapy to the patients and he was making the blood count and preparing the drugs and having the responsibility of the administration of the chemotherapy and going to the pharmacy in order to look for the medicines. That was not exactly the same situation that happens here in this country in many top level institutions where you have pharmacies, you have specialised nurses. But the interesting issue to me was that the situation of this young doctor in New Zealand is a very common situation all over the world.

So this was a shift in ASCO’s vision and I think that also led by Dr Monica Bertagnolli following the concept that we need to work together because the concept of low and middle income countries is not correct. This is not an economic issue. There are states in this country, the US, like Ohio in which cancer mortality is higher than in some Latin American countries. That means that this goes to the other… there was another session about the issue of cancer disparities. Cancer disparities are not focussed in one specific country, the disparities are in all parts of the world and that was included in the programme. When you have now the situation of migrants, the population of some countries have more migrants than local population and that is a healthcare challenge, it’s a healthcare issue. For example, there are interesting publications about cancer in the Gaza Strip and the situation there is unbelievable.

So from this cancer control worldwide vision ASCO should make more. There is today another session, an ASCO/ESMO session about access to drugs. Actually I have some personal comment to make because of course it’s important to have a section, a session or something in the programme about access to drugs. But in my opinion it’s irrelevant because the people that can make a difference, they are not here because doctors discussing in an audience of 30,000 oncologists or other types of cancer specialists are suffering the problem, they do not have the solution of the problem. So we need to expand this type of action to the general population, to politicians, to policymakers, to other stakeholders of the society and mainly to patient organisations.

So as a summary of this, this is an editorial but actually this is a request that many of you will understand if you are working in underserved environments. I don’t need to explain to you nothing, you are the experts. But the point is that, of course, we need to support clinical science, we need to support good research, we need to really understand that the contribution of ASCO and the US community to the knowledge in the world is fantastic but that is not enough. We need to develop new strategies to become more proactive, not only for doctors or for patients, to push governments and to push international organisations to implement better actions in a proactive way to improve the cancer situation all over the world.