Monthly Archives: November 2014

Bold policies for progress north and south

anna portrait  picWorking in silos has long been a problem within the cancer community, as people engaged in increasingly specialised fields struggle to remain aware of the bigger picture. So it can be important, on occasion, to bring the different constituents together around a single agenda.

One might have wondered, however, whether the World Oncology Forum, which gathered almost two months ago in Lugano, Switzerland, might not have been a little over-ambitious in setting an agenda that focused on two topics that are poles apart in almost every respect, including the geographical.

The first of these, fixing the ‘broken model’ of new drug development, is a priority issue for the northern hemisphere. The second, addressing unmet need for the most rudimentary detection, treatment and palliative care, is the priority in the South. The opportunity to explore these challenges and the associated policy implications, within a single gathering, however, turned out to be remarkably constructive.

wof collage Hearing about some of the best examples of low- to middle-income countries that have taken well-planned, system-wide, sensibly financed steps to get the widest possible access to the best possible early detection, treatment and follow-up showed just how much can be achieved for cancer patients, even with modest resources, by simply getting the fundamentals right.

While hearing about the cost, both in health expenditure and overtreatment, of squeezing out additional survival benefit for patients in better resourced health systems brought home how unsustainable current approaches to developing new treatments are becoming, even for world’s wealthiest countries. The message that came out was about priorities.

  • Don’t waste resources on expensive equipment and therapies if the money can be better used getting the fundamentals right for everybody who needs them.
  • Don’t waste resources on developing new therapies unless they aim high – which means tackling resistance rather simply chasing cancer cell evolution from dependence on one mutated pathway to the next.

Bold policy initiatives that champion the public interest will be needed at international and national level to achieve what must be achieved. The task of the 35 assembled experts, leaders and innovators in their own fields, was to spell out the core elements of such initiatives.

As keynote speaker Paul Workman, chief executive of the UK Institute of Cancer Research, points out in the video below, the level of agreement among participants was remarkable, given the differences in their geographic and professional backgrounds and the strong views held by all.

The exact wording of the final policy appeal is currently being finalised. It will be published on this blog and in the March issue of Cancer World, which will carry a full report of this remarkable meeting. It will also feed into a discussion at the ‘Davos’ World Economic Forum on meeting the challenge of the global cancer epidemic, if and when the organisers confirm that the issue has made it onto the final agenda at the end of January 2015.

Slides from most of the presentations are available now on the ESO website (access requires you to register with Club ESO).

(How) do you use social media? We investigate

social-networks

ESO and our magazine Cancer World wanted to find out whether, by engaging more with social media, we could make it easier for people in the cancer community to interact with us and with one another.

We therefore contacted everyone on the ESO, e-ESO and Cancer World email lists, to ask them about whether they use social media, and if so how. The survey population included everybody who has ever attended an ESO educational event or conference (plus others signed up to Club ESO), everyone registered for e-ESO’s e-grandround and e-oncoreview webcasts, and everyone on the Cancer World email list.

The 660 responses we received represent a broad spectrum of ages, disciplines and countries. They are probably not, however, broadly representative of oncology professionals in general. The population as a whole is self-selected, having already chosen to engage with ESO and/or Cancer World, and those who responded are likely to be more involved with social media than those who did not.

Nonetheless, we feel the results offer a very interesting picture of social media use among a section of the professional cancer community, including some surprises.

Respondents come from all walks of the cancer community:

Who?
Almost half are medical oncologists, followed by surgical oncologists, radiotherapists, patient advocates, cancer nurses, pathologists, psycho-oncologists, and radiologists.

Where?
More the two-thirds are from Europe.

How old?
They covered a wide age range: the 31–40 and 41–50 age groups accounted for around 30% of respondents each, with around 20% in the 51–60 age group.

We asked: who uses social media?

tick image
85% said yes

cross image
15% said no

Interestingly older respondents were just as likely to use social media as younger ones. Lack of time and relevance were listed as the main reasons for not using it.

We asked how and why respondents use social media
We were pleasantly surprised by the response:

What best describes you use

 

Two out of three respondents who said they use social media, use it to keep up with developments in their field – not surprising.

But many of them are also using social media to interact with other people:

  • to interact professionally: more than half
  • to be part of a community and join discussions: 1 in 3
  • to initiate discussions: 1 in 5

how active are you

While 4 out of 10 respondents  say they use social media only to read what others have posted, almost half of  comment on what they read, 4 in 10 ‘like’ or share links to what others have posted, and a surprisingly high 1 in 4 contribute their own posts.

More than half belong to some form of online group, such as a LinkedIn, Facebook or Google group or email forum, or they follow a blog.

Preferred platforms
We asked which platform people use for ‘professional use only’ or ‘professional and personal’ use

linkedinLinkedIn is by far the most popular, used by almost 75% of respondents (more than 50% of them for professional reasons only)

YouTube-iconYouTube comes next at 54% (just over 10% for professional use only)

 

FB-f-Logo__blue_29Facebook comes in at nearly 44% (less than 3% of them for professional reasons only)

 

Followed by

btn_g_red_pressed.png-27Google+ at around 40% (10% professional only)

 

Twitter_logo_blueTwitter at 30% (11% professional only)

 

This is the first survey we know of investigating social media use among cancer professionals in Europe.

Even allowing for above average engagement among our survey population as a whole, and among respondents in particular, we were surprised and encouraged at the number of oncology professionals who use social media to interact, to join conversations and to start their own.

This survey was conducted as part of an effort to improve our own level of interaction, to play more of a role listening to and sharing what others in the community are saying, as well as spreading the word about conversations that we are promoting through this blog – Conversations for Collaboration and Change – and our magazine Cancer World.

The results of the survey can be found in more details Social Media Survey Results

Join the conversation!
If you’ve not visited this blog before, we hope you will take a look at what we’ve posted in its first few weeks. If you like what you see, we hope you will follow us and join the conversation.

You can follow The Cancer Blog, and contribute your own insights, experiences and comments, via LinkedIn (join the Cancer World group), Twitter (@ESOncology) or Facebook (ESOncology).

If you follow us, we will follow you, and share what you post where it is relevant to our followers, so together we can promote more inclusive and interactive discussion about how to achieve our common goals.

You can also sign up directly to receive alerts about new posts by entering your email address in the subscribe box, on the left-hand side.

War Against Cancer: the audited accounts

 


The truth in samll doses
Efforts to cure cancer are being hobbled by a culture that obliges researchers to think small and cautious while systematically overstating how much is being achieved.

Journalist and lymphoma survivor Clifton Leaf argues this case in his book The Truth in Small Doses: Why We’re Losing the War on Cancer and How to Win It.

His book is the culmination of almost 10 years of research, which generated a number of articles in Fortune, the New York Times and other publications along the way.

It is a call for a change in the cancer research culture, written by someone who knows what it is like to have their life hang in the balance, who believes in medical research, and who has devoted many years to trying to understand why progress is so slow and how we can do better.

In recognition of his achievement in opening up a lively and informed discussion within and beyond the cancer research community,  ESO awarded Leaf the first ever Best Cancer Reporter Lifetime Achievement Award, commending in particular his meticulous research and his ability to make sense of his material and tell the story in a way that is both compelling and constructive.

Resonance
The Truth in Small Doses is a joy to read, with a wealth of anecdotes that on their own justify the cover price. Like the one about the one-eyed surgeon, Denis Burkitt, who – in a goal-oriented collaboration with pathologists, virologists and an entomologist – solved the riddle of the aggressive tumours of the jaw that were killing so many children at his mission hospital in Kampala, with support from a £250 research grant, a 1953 Ford Jubilee station wagon, and a neighbouring hospital director who had a way with cars.

But Leaf also describes a world that cancer researchers are all too familiar with: endless applications for research grants; keen young scientists, full of ideas, obliged to focus on ‘safe’ well-explored topics, with enough a priori evidence to convince grant panels there is a good chance of a positive outcome.

Some points in the book are certainly open to challenge. When it comes to playing it safe, it could be argued that industry is more of a problem than academia. And while there are good reasons to argue, as Leaf does, for more research to be directed at tackling the disease at its earliest or precancerous stages, there are other innovative approaches with an equally strong scientific rationale that suffer the same neglect.

His core message, however, clearly resonates with a widespread sense of frustration within the cancer research community. Leaf speaks the truth, which explains why this book has been widely welcomed.

Going over the accounts
A financial journalist by background, Leaf makes good use of numbers to illustrate his points.

Numbers like these:

691 – the number of times “cancer breakthrough” was mentioned in the media between January 1990 and November 2003
71 – the number of new cancer drug approvals over the same period
45 – the number of approvals for new drugs (rather than new uses for existing drugs)
12 – the number of those new drugs that could show they actually helped keep people alive

Or these:

65,000 – the number of papers published by 2013 on p53
24,000 – the number of papers published by 2013 on c-Myc
$100,000 – estimated cost per study
0 – the number of cancer therapies based on these targets

Or on the process of applying for an R01 grant, the bedrock of medical research funding in the US:

260 – the number of pages in the Application Guide
23 – the number of steps in the application procedure
1 year – the average duration of an application process
1 in 10 – the chance of success

Or these, on the chances of becoming a principal investigator before your 36th birthday:

1 in 20 – the figure for 2013
1 in 4 – the same figure back in 1980

What the figures reveal, argues Leaf, is a culture centred on generating data that can be published rather than generating knowledge that could lead to a cure.

Everyone who wants to see faster progress in curing cancer, and young scientists who don’t want to waste their most creative years, have an interest in reading this book.

Clifton Leaf is deputy managing editor at Fortune. He will be formally presented with the Best Cancer Reporter Lifetime Achievement Award by Franco Cavalli, chair of ESO’s scientific committee, at the International Conference on Malignant Lymphoma in Lugano, June 2015.