As I set off on my term as ASCO President, thinking about the many goals of our Society and what I would like to accomplish while at the helm, I am struck by how often it all comes back to the patient.
I chose as my theme “Building Bridges to Conquer Cancer,” with those “bridges” representing our many current needs and challenges—the needs of the global oncology community, the need to close the gap in health disparities, the need to connect science with the clinic, and the need to bring the highest quality care to the patient. But we hear these general concerns and phrases so often that they sometimes begin to lose meaning. It often takes the reality of a patient experience to bring home that sense of urgency.
One story I heard recently really summed it up for me—not only did it speak to the “why” I got into oncology in the first place but it also demonstrated how all the bridges we hope to build all lead back to the patient.
At a recent NSABP (National Surgical Adjuvant Breast and Bowel Project) meeting, a colleague told a story about a young mother of two children diagnosed with locally advanced breast cancer. After surgery, which revealed many positive nodes, the patient was seen regarding adjuvant therapy and was offered the option of participating in NSABP protocol B-31, a randomized clinical trial evaluating the addition of trastuzumab to standard adjuvant chemotherapy with Adriamycin/cyclophosphamide followed by paclitaxel. The catch—she would need to go to the site every week for 52 weeks for treatment. But she lived two hours away and owned an unreliable car. “I want to join the study,” she said, “but my car will never make it. I barely made it today!”
Her oncologist explained that there was nothing he could point to post-operatively that was a positive prognostic feature of her breast cancer. He told her, “We don’t know at this point whether this new medicine [trastuzumab] will make a difference but it is certainly worth testing.”
Fortunately, for her, a family member came through and bought her the car necessary to make the long trip. She enrolled in the trial and was randomly assigned to receive trastuzumab on the investigational arm. Ten years later, she is cancer-free, in excellent health, with two more children.
I found this story deeply moving—I thought “this is why we do what we do.” This case also shows the power of clinical trials to make progress in a previously deadly form of breast cancer. It is not just about economic and geographic disparities and how they can affect treatment and outcome, it’s also an inspiring story about the progress we have made in fighting cancer and why we need such targeted therapies and precision medicine.
For me, the story also underlines and unites the main initiatives that I plan to focus on during my term. These include 1) addressing health care disparities in ways that help doctors care for patients in every setting—community practices and academic research centers, developed and developing countries, inner cities and rural areas; 2) preparing the oncology workforce as we address upcoming shortages, foster diversity, and create new models of collaborative care; and 3) continuing efforts to help our membership achieve the highest standard of quality care for our patients in this time of great technological change and scientific discovery.
Regarding the latter, I have the honor to be in a leadership role as the Society launches its ambitious CancerLinQ
program, a powerful new tool to mine the knowledge and data gained from every patient experience to improve patient care. As our understanding of and approach to cancer grows ever-more complex, we will need more sophisticated systems and tools to process the mounting data.
I am extremely honored that I have been elected President during this exciting time. As I embrace the challenges, I thank my predecessors who built a strong foundation and whose work I continue to find inspiring; I thank and rely on the work of our excellent committees, whose rosters include the best minds in the field of oncology; and I thank the staff at ASCO, who are always ready and willing to help fulfill our mission.
I also hope to continue to build bridges between ASCO leadership and our global membership. We are more than 30,000 strong, spread out over more than 100 countries. Let’s use that strength and diversity to bring quality care and hope to all of our patients.
Thank you for entrusting me with this role. I look forward to hearing from you and working with all of you in the year ahead.