2017 ASCO Presidential Address: “Making a Difference in Cancer Care WITH YOU” [video]

Jun 03, 2017

Watch an exclusive video of Dr. Daniel F. Hayes delivering his Presidential Address at the 2017 ASCO Annual Meeting. Read the complete transcript of his address below the video.

By Daniel F. Hayes, MD, FACP, FASCO
2016-2017 ASCO President

Good morning! Welcome to the 53rd Annual Meeting of the American Society of Clinical Oncology!

I am thrilled to announce that we have 38,004 members and friends from across the nation and from 119 other nations around the globe.

In addition to acknowledging [ASCO CEO] Dr. [Clifford A.] Hudis’ superb leadership this year, I want to thank the incredible staff at ASCO for their tireless work. Can you imagine what it takes to arrange for you and 38,000 of your best friends to all meet over this 5-day period in Chicago? We owe them our deepest gratitude.

2017 marks my 35th year in oncology. In that span, I have witnessed astonishing progress in the diagnosis and care of cancer.

I have also witnessed, and been part of, the incredible growth of this society. ASCO represents and supports every one of its members in our battle against the burden that cancer places on us, both professionally and personally. Taken together, these areas underscore the entire theme of my presidency—and what I want to share with you today—which is how ASCO has, does, and will continue to make a difference in cancer care with you.

But before I begin, I’d like to digress for just a moment to thank my family for their support throughout my life and career.

First, to my brother, Dr. John R. Hayes. In college, I was actually on my way to becoming a high school biology teacher and basketball coach, but John talked me into going into medical school—thanks, John! I’ve never regretted that decision and your advice has served me well through the years.

Thanks also to my two sons, Dr. Benjamin T. Hayes and Stephen F. Hayes, who never cease to both entertain me and make me intensely proud, and especially thanks to my wife, Jane Hayes, who has been my best friend, confidant, and supporter for over 40 years.

Finally, I want to dedicate this talk to my parents, Robert and Betsy Hayes, and to Jane’s mother and grandparents, Faye Green and Jesse and Ivan Bedell, all of whom passed away from cancer or cancer-related complications.                     

Today, I would like to share two personal stories with you.

In 1959, when I was 8 years old, my cousin, Kim Yarling, became ill. I was told he had been diagnosed with something called leukemia. I had no idea what that was, but nearly 60 years later, I still remember the haunting vision of Kim watching us from the window of his room at Riley Children’s Hospital in Indianapolis as we walked to our car. He passed away the next week.

Now I’d like to fast forward nearly 20 years: In 1978, when I was a third-year medical student in Indianapolis, Jane and I had dinner with one of her coworkers and her husband, Judy and John Cleland. As the evening wore on, John confided that he was a patient of Dr. Larry Einhorn’s at Indiana University Medical Center and that Dr. Einhorn had cured him of widespread, metastatic testicular cancer just a few years previously. I didn’t know that was possible—but he sure looked good to me!

In the ensuing months, I was assigned to the oncology ward at University Hospital, and lo and behold, Dr. Einhorn himself was the attending physician. He made it clear to me that I was destined to be a medical oncologist. Through the years, John Cleland and I have continued to remain in touch, sharing our mutual passions of basketball, track and field, and, of course, Dr. Einhorn.

I tell you these two stories to highlight the progress we have made, but also to emphasize that we don’t make it fast enough. Had Kim been diagnosed just 10 years later, he would have had a 15% to 20% chance of being cured. Had he been diagnosed now, as I’ll show you in a moment, his chances of being cured would exceed 90%.

In contrast, had John been diagnosed 5 years earlier, I would not be telling you the wonderful story of his life. These two stories illustrate the challenges that we all face in fighting cancer. Challenges that we have overcome, in part, and challenges that we can overcome in the future.

“So, Dr. Hayes, when are we going to cure cancer?”

How many times have I heard that? How many times has every one of us here today heard that?

Of course, one answer is that we do cure many cancers through surgery, radiation, and systemic therapies. The problem is, we just do not cure enough of them, and we’re not curing them fast enough.             

Over the past year as ASCO president, I have seen many challenges in many different arenas that prevent our curing every cancer. This experience leads me to admit I don’t know when, but I do know how we will cure more, if not all, cancers, and how we will cure them faster: by working together to overcome these challenges. What are they?

  • Challenges in cancer research
  • Challenges in cancer education
  • Challenges in delivering high-quality cancer care
  • Challenges in helping cancer survivors live long, productive, and healthy lives

I have also seen glimpses of how we will address these challenges. I am excited about laboratory, translational, and clinical research that offers new hope to those for whom there was none. I am excited about educational initiatives that will help all of us translate these wonderful discoveries into our routine clinical care. I am excited about changes in health care delivery that will incentivize us even further to deliver high-quality care to our patients. I am excited about advances in survivorship.

And above all, I am excited about how your Society, the American Society of Clinical Oncology, is here to help us all overcome these challenges and accomplish our mission, “Conquering cancer through research, education, and promotion of the highest quality patient care.” Working together through ASCO, we will reach our vision, “A world where cancer is prevented or cured, and every survivor is healthy.”

Each of these areas represents not only enormous challenges, but opportunities as well.

Let’s start with research, a fundamental tenant of our progress. ASCO serves several roles in regards to research. One is as a sounding board for reporting major clinical and translational advances in cancer. We do this through our meetings, which is the reason we are all here this week, and through our journals, which are some of the most highly respected in our field.

But let me return to my cousin, Kim. If only our science could move faster! A graph taken from a paper by Drs. Stephen Hunger and Charles Mullighan last year is one we wish we could show for every cancer type. It shows the remarkable increase in expected overall survival and subsequent cure rates in cohorts of children with acute lymphoblastic leukemia [ALL] from 1968 to 2008. The respective Kaplan-Meier curves increase step-wise from an approximate cure rate of 10% in the first cohort treated from 1968 to 1970—a huge symbolic step above the 0% chance a decade earlier—to 90% in the cohort diagnosed from 2000 to 2005.

Even better news: these children are, increasingly, living normal lives. A subsequent paper authored by Dr. Greg Armstrong and his colleagues shows that these advances in cure rates for pediatric ALL have been accompanied by a reassuring reduction in late treatment-related mortality through the decades from the 1970s to 1990s.

This success story didn’t happen by accident. It is the culmination of years of laboratory, translational, and clinical research funded in great part by our federal government. But this success is threatened by diminished support for the National Institutes of Health [NIH] and specifically the National Cancer Institute [NCI]. NCI funding was flat from 2003 to 2016, while, of course, inflation was not. Accounting for inflation, NCI’s budget has decreased by more than $1.1 billion since 2003. This deficit is driving a wedge between where we should be and where we are in federally funded cancer research.

I fear this wedge is pushing young and highly gifted investigators out of biomedical and, in particular, cancer research. Look at the odds of being awarded an NCI-funded grant in 2016—which were 11.2%. Would you take a job if you only had a 1-in-10 chance of being paid?

So, what is ASCO doing about this funding gap?

First, through the Government Relations Committee, aided by our vice president of the Department of Policy and Advocacy, Dr. Deborah Kamin, ASCO has worked tirelessly to advocate for increased federal funding of all types of research. I don’t mind competition, but I find it sad that we need to compete with each other among the various types of research, and the various types of diseases, to make progress. We all know that cancer is our common enemy.

ASCO has been very supportive of the 21st Century Cures Act, passed with bipartisan support by Congress, which has provided increased funding for cancer research, including the Cancer Moonshot. Further, we deeply appreciate the additional $2 billion allocated to the NIH in the recently passed budget bill. But we need to ensure that this increase is sustained, and enhanced. To paraphrase President Ronald Reagan, we need to tear down that wedge!

We need to catch up and keep up over the next decade. We need to close that gap, and be sure we have a highly trained and well-supported cadre of cancer researchers who can keep the momentum rolling. ASCO will continue to advocate for increased research funding. But, we need your help to make it clear to our lawmakers that cancer is a nonpartisan disease that affects us all—Republican, Democrat, and Independent.

Trust me, elected officials pay attention to your personal entreaties. In fact, I’d like to take a minute to relate a personal anecdote about the importance of individual contact with legislators—in this case, not necessarily about research funding, but to make a point. A perverse circumstance arose in this country in which insurance companies have covered oral chemotherapy agents differently than those given parenterally. To address this issue, 42 states have now passed laws establishing oral parity reimbursement.

My state, Michigan, is not one of those. Last December, at the start of a busy clinic day, I received an email from my state affiliate society asking me to take 30 seconds to send a message to my state representative urging action on this issue.

At first I thought, “I’m too busy…” But, I realized, I’m the president of ASCO. If I don’t do this, who will? I hit the button to make it happen. Returning to my clinic patients, I figured, “Well, that was a waste of time—I’m just one person.” However, within an hour, I received a personal email from my state representative, telling me that he had been unaware of the issue, that he had looked into it and now realized how important it is, and that he would vote for it if it came to the floor. I felt like Jimmy Stewart in Mr. Smith Goes to Washington.

My point? Your voice does make a difference—in policy, in funding priorities, and in how our society fights cancer to help our patients.

ASCO does more than just advocate for increased public funding of research. We support it ourselves through grants administered by the Conquer Cancer Foundation of ASCO. I’m sure you’ve seen evidence of the Foundation throughout the convention center this week. In fact, at last year’s Annual Meeting, you might have seen me wearing a pair of orange Chuck Taylor Converse All-Star basketball shoes. The motivation for this daring fashion statement was to help draw attention to the Conquer Cancer Foundation of ASCO and the exceptional work it does to aid all of us in helping our patients.

Of all the programs supported by the Foundation, the Young Investigator Awards [YIA] and Career Development Awards [CDA] may be the most important. Since 1984, ASCO and the Foundation have funded more than 1,700 grants and awards, totaling more than $105 million—not just in North America but around the globe. This year, the Foundation will fund 10 Career Development Awards and a record 69 Young Investigator Awards, all given to deserving young researchers who are doing terrific work.

These grants are terrific, and the fact that donors made it possible to fund so many this year is remarkable. It is also rare. As [Conquer Cancer Foundation Board of Directors Chair] Dr. [Thomas G.] Roberts mentioned, this is the first time in history we’ve supported every fundable YIA applicant. In a typical year, only about 62% of the CDA and 73% of the YIA applications that pass muster with our Grants Selection Committee will be funded. Too often, we leave good ideas on the table because we lack the funds to invest in the research. We need every year to be historic, which is why we are getting a head start on 2018. This week, when the Foundation asks, “Why YIA?” this is the answer: to fund all the research we are not funding! To tear down that wedge!

Today I am asking for your help. Starting right now, I challenge everyone in this audience, and everyone here at the 2017 Annual Meeting, to help the Foundation fund at least two—and frankly, I want to go to four—new Young Investigator Awards.

To fund two YIAs, we’ll have to raise $128,000 this week. To fund four of them, we need to raise a quarter of a million dollars. It’s not as daunting as it sounds. There are more than 30,000 of us here this weekend. In fact, a single $10 bill from each of us will fund four extra YIAs. Indeed, I think we could go as high as half-a-million dollars this week. Why not?

It’s easy for you to contribute to this effort at any time, in any amount, directly from your phone by texting YIA to 91999. We will be reporting on the progress of this effort on Twitter at #WhyYIA.

I will prime the pump right now with the first donation of $1,000 in memory of my family members who have died of cancer. Dr. Roberts has agreed to donate an extra $4,000! Let’s keep this up! Please join me now! (During the rest of this talk, I’m going to assume that the cell phones I see in the audience are now being used to donate to #WhyYIA, and not to answer your emails or read tweets!)

ASCO doesn’t just support researchers—ASCO itself is now conducting research.

As we all know, precision medicine is a hot topic. However, as noted in a commentary by Drs. Ian Tannock and John Hickman last year, this movement has been met with justifiable skepticism. Prospective trials to test this strategy are critical. ASCO strongly supports the federally funded LungMAP and MATCH trials being conducted by the North American clinical cancer cooperative groups. These trials, which have accrued quite successfully, are designed to determine the value of precision medicine for patients with metastatic cancer. However, these trials both have strict eligibility and participation criteria.

Led by our chief medical officer, Dr. Richard L. Schilsky, ASCO has initiated the Targeted Agent and Profiling Utilization Registry (TAPUR) trial. The TAPUR trial is pragmatic: any type of assay, as long as it is performed in a CLIA-certified laboratory, can be used to identify a relevant genetic change that matches a drug already approved by the FDA for one type of cancer, but not for the one in which the biomarker has been found in the respective patient. Currently, ASCO has partnered with seven companies who have provided 17 drugs, and as of this meeting, 65 practices and institutions have already accrued 301 patients. We are anticipating 36 additional sites being activated for a total of 101 participating sites by the end of the year.

We owe it to our patients to not just assume the strategy of precision medicine is appropriate, but to prove it!

ASCO is also pioneering big data observational research through CancerLinQ®. CancerLinQ was designed to be a rapid learning system to improve quality of care for patients with cancer. In addition, it will become the largest and most granular clinical cancer outcomes database in the world. To date, CancerLinQ has enlisted more than 85 practices, encompassing 2,000 doctors representing a broad cross-section of cancer care delivery settings from around the U.S. We now have well over 1 million individual patient records in the database. We expect to be able to make these data available for observational research very soon, enabling what should be the most comprehensive source of real world cancer data ever assembled.

A second great challenge in cancer care is education.

From the very first, education has been one of ASCO’s strengths. In fact, our seven founders created ASCO principally as a means of education. I’ve read the minutes of their first meeting, held here in Chicago 53 years ago, and I would love to have been a fly on the wall. Can’t you just hear them saying, “How do you give cyclophosphamide?” or “What dose of vincristine do you use?”

This meeting alone demonstrates how critically important education is to our mission. I want to thank the volunteers who chaired and served on the Scientific Program and Cancer Education Committees, and especially the chairs of these two committees, my friends Drs. David Smith and Michael Thompson, respectively. They have worked overtime with ASCO staff, directed by our vice president of the Department of Science, Education, and Professional Development, Dr. Jamie von Roenn, to make this meeting such a success. Importantly, Dr. Thompson even sucked me into the Twittersphere! I hope you’re all following ASCO [@ASCO] and me [@hoosierdfh] during the rest of this meeting!

But the Annual Meeting is just the tip of the iceberg. I urge all of you to explore the educational resources on our website to better understand how ASCO works WITH you to help improve cancer care—whether you are an established doctor or nurse, one in training, or a patient or other lay individual.

However, we can do better. Just this spring, ASCO has established two new educational initiatives that we believe will transform our offerings to you and our patients.

The first, the Education Scholars Program (ESP for short) will mirror the highly successful ASCO Leadership Development Program, which I’ll discuss in a minute. The ESP will focus on teaching interested members of ASCO how to be better teachers. They, in turn, will teach us how to be better oncologists.

ASCO will also establish an Education Council, which will be charged with reviewing and coordinating all educational offerings and services within the Society. The Education Council will not only better organize these services, it will revolutionize what ASCO offers to us all by taking advantage of innovative methods in learning science.

Another aspect of education is mentorship.

Dr. Einhorn not only saved the life of my friend John Cleland, he also inspired me to enter oncology and has continued to encourage, and inspire, me throughout my career. In my subsequent journey through the Dana-Farber Cancer Institute, Georgetown’s Lombardi Cancer Center, and over the last 15 years at the University of Michigan, I’ve been lucky to have been mentored by many giants in the field, several of whom have been past ASCO presidents themselves. I’ve been in the right place at the right time with the right people. In fact, I feel like the Forrest Gump of oncology.

This experience highlights the importance of mentorship. In 2009, Drs. Robert Mayer and Allen Lichter started the ASCO Leadership Development Program (LDP). The LDP is a great example of ASCO’s commitment to mentorship. We’ve now had 104 LDP awardees, who have tackled important issues that challenge taking better care of our patients. Several of their recommendations have become ASCO policies, including how to make your experience at this meeting more meaningful and rewarding. Many of our volunteer committee members and even chairs are former LDP graduates. Two are now on the Board of Directors, Drs. Arti Hurria and Reshma Jagsi. Dr. Thompson, the Cancer Education chair of this meeting, is also an LDP graduate. It’s fair to say that this program is working!

We have also made mentoring available globally so that oncologists from around the world see ASCO as their home. When he was president, Dr. Einhorn initiated the International Development and Education Award (IDEA), administered within our Department of International Affairs, led by Mr. Doug Pyle. Every year, the IDEA program brings 24 young oncologists from low- and middle-income countries to the Annual Meeting, then helps them visit and be mentored by a senior member oncologist from an academic institution in the U.S. and Canada. If you practice at such an institution, I encourage you to participate as a mentor. I have done so several times, and I loved it!

However, tragically, my first IDEA awardee, Dr. Lina Cassols from Brazil, was killed in a commercial aviation accident soon after attending the ASCO Annual Meeting in 2007. To honor her memory, we initiated the Long-term International Fellowship (LIFE) to promote a young faculty member from a low- or middle-income country to spend a year in research at an academic institution in an upper-income country. Since then, we have supported 16 LIFE fellows, who have returned to their home institutions to continue their academic careers. These are truly wonderful programs and if you qualify for these awards yourself, or know someone who does, I urge you to apply.     

All this talk of mentorship raises an important issue. ASCO leaders through the years have been mostly (although not exclusively) white male medical oncologists, like me. But cancer is, of course, an equal opportunity disease. We recognize how tremendously useful the insights and perceptions of different professional disciplines, cultures, geographies, genders, races, and sexual orientations can be to delivering high-quality care to diverse populations of patients with cancer. ASCO is working hard to embrace this challenge.

Inspired by one of our seven founders, Dr. Jane Wright, ASCO past president Dr. Sandra Swain began the Women Who Conquer Cancer program to support young women entering the field, guiding them among the various challenges to becoming a leader in oncology.

ASCO has also worked to become more than just a society of medical oncologists. For years, we have had designated specific seats on the Board of Directors for oncologists from the surgical and radiation oncology disciplines. Highlighting both of these efforts, we look forward to June 2018 when we will install Dr. Monica Bertagnolli as ASCO’s first woman surgical oncologist president. Congratulations, Dr. Bertagnolli!

I want to continue this mentoring theme for a bit longer. In the last few weeks, we have rolled out our new Workforce Diversity program. This program, led by Dr. Karen Winkfield, will provide mentoring opportunities to our younger colleagues from underrepresented racial backgrounds who want to serve in ASCO but just don’t know how.

In summary, we are good at mentoring, and we will offer it throughout the organization to our members who need and want it.

With all these opportunities, I’ve still been asked repeatedly, “How do I volunteer for ASCO? Who do I have to know?”

When I was in grade school, President John F. Kennedy challenged us to “ask not what your country can do for you, ask what you can do for your country.” Nearly three decades later, President George H.W. Bush spoke of “an endless, enduring dream and a thousand points of light.” This year, I’ve been overwhelmed by seeing how the call to give back motivates so many ASCO members.

Indeed, we face an embarrassment of riches among members who would offer their time and talents. When I was elected, more than 2,000 of you volunteered for just 250 slots on ASCO’s 20 standing committees and roughly 100 task forces. This is a good problem to have, but it is a problem: volunteering for your society should not be a competitive sport!

We cannot increase the size of our committees—that would be too unwieldy. To that end, Dr. Hudis and I are pleased to announce at this meeting the creation of a new initiative, the ASCO Volunteer Corps. The Volunteer Corps will act as a conduit in which those of you who want to serve as volunteers can gain experience in how our committees and other volunteer activities work. It will enable you to move towards formal membership and recognition for all of ASCO’s many opportunities to serve, and you will earn credits to apply to designation as a Fellow of ASCO for your participation in the Volunteer Corps.

Further, I cannot tell you how many of my friends and colleagues complained that their terms had ended and they had to rotate off an ASCO committee or task force. Again, a great problem to have! For these members, the Volunteer Corps will provide an opportunity for experienced members to remain actively involved at the end of their committee terms, therefore still contributing to the success of the Society and to the mentorship of younger members.

We see the Volunteer Corps not unlike a Triple-A baseball club—giving everyone a conduit into the big leagues. Our goal is to provide many opportunities to engage with ASCO to improve what we do, and to do so in a manner that fits your needs and circumstances. I urge you to sign up soon.

Our next challenge is the delivery of high-quality care to everyone who needs it, when they need it.

My friend John Cleland was lucky, not just by timing, but by geographic location. He happened to be in the right place, at the right time, with the right doctor, to be cured, and frankly, he had the right insurance to pay for it. How many other “Johns” are out there now who do not receive the proper diagnosis and treatment, just because they are geographically or economically in the wrong place? As our treatments become even more complex, this issue becomes even more acute. All the advances in the world will do no good if they are not applied properly—or at all. Medicine does no good in the bottle, it only works in the patient!

I want to show an example that makes it clear we need to standardize oncology care across the entire cancer continuum.

Cancer mortality in the United States has declined by as much as 20% over the last 20 years. However, a disturbing figure, taken from a recent paper by Dr. Ali Mokdad and colleagues, shows that this decline is geographically disparate across our country. These disparities are not due to differences in cancer incidence. They are related to differences in cancer treatment.

I find this unacceptable. When you are diagnosed with cancer, where you live should not dictate whether you live.

ASCO is addressing practice heterogeneity in two ways: by advocating for support of delivery of high-quality care, and by generating guidelines and improving practice pathways.

In order to advance this fundamental goal of making sure the right treatment at the right time is available to every patient, ASCO is actively engaged in shaping Medicare’s change from a fee-for-service model to the new Quality Payment Program. This change has grown out of the Medicare Access and CHIP Reauthorization Act (MACRA).

Although it will be difficult, this change in our reimbursement model is the right thing to do. For years, I personally have felt that we should be paid for doing the right things for, and not just to, our patients, but the incentives have been against us. We are not “chemotherapists” or “radiotherapists”—we are oncologists. Our payment should be because we provide high-quality oncologic care that improves the lives of our patients. We should be rewarded for being well-trained oncologists who provide our cognitive services, our experience, and our compassion to help patients who place their trust in us.

The transition to Medicare’s new Quality Payment Program is already underway, and it will be transformative for not just how we are reimbursed, but how we practice. ASCO has been at the table as Medicare has implemented MACRA. Led by ASCO’s newly established Clinical Affairs Department, directed by Dr. Stephen Grubbs, we have responded. Working with our Clinical Practice Committee, the State Affiliate Council, and other volunteer leaders across ASCO, we have developed tools that will support the practice transformation all of us must undertake. For example, ASCO’s Quality Oncology Practice Initiative (QOPI) has already served as a model for documenting adherence to quality measures, and ASCO’s new COME HOME initiative will help you adapt, survive, and thrive in this new environment.

To quote yet another U.S. president, Bill Clinton, “I do feel your pain”—none of us wants more intrusion into our daily practice. But, in today’s world of rapidly evolving information, none of us can know the vast amounts necessary to deliver the complex care required of a general oncologist. In other words, we need to make it easy to provide standardized care throughout our country, and even the world.

To this end, more than two decades ago, ASCO began what is now a highly successful practice guidelines program. Thanks to many of you who have served on the Clinical Practice Guidelines Committee, we have generated a set of highly respected practice guidelines that are recognized worldwide, and have, frankly, raised the bar for how all of us practice.

However, ASCO guidelines tend to be deep, evidence-based dives within specific nodes along the care continuum. In this regard, much of our practice sits in the areas between these nodes, and in this case expert consensus pathways can help inform our daily clinical activities.

Since several other different organizations have developed oncologic clinical pathways, and rather than reinventing the wheel, ASCO, led by Dr. Robin Zon and colleagues, has proposed a set of criteria that we feel are required for a pathway to be adopted, regardless of who develops it. I have no doubt that when taken together, guidelines and pathways will lessen, if not eliminate, the kinds of geographic and practice-to-practice variations that led to the disturbing mortality map published by Dr. Mokdad.         

What else is ASCO doing to improve cancer care delivery? CancerLinQ will provide an immediate high-quality analysis that physicians and practices can use to determine if they are compliant with current pathways and guidelines. If not, it will suggest how they can adjust to do so. Moreover, CancerLinQ will also tell us if the pathways and guidelines themselves are out of sync with good practices. If so, we can then rapidly implement effective revisions to fix them.

I want to stick with the guidelines theme for a just a minute longer, since in my own academic career, I’ve seen how the ASCO guidelines process can improve oncologic care. I will never forget sitting in a small hotel room in San Francisco in 1995 with a diverse array of laboratory and clinical investigators, community clinicians, statisticians, and guidelines experts to develop the second ASCO clinical practice guideline, directed towards tumor biomarkers in breast and colorectal cancer.

This experience, now more than 20 years ago, led to one of my favorite mantras: “A bad tumor biomarker test is as bad as a bad drug.” As we move into the era of precision medicine, this statement could not be more true. If we are going to use tumor biomarker tests to direct care for our patients, then we need to be sure that the test we are using is technically accurate and truly improves a patient’s outcome. ASCO has, and will continue to, advocate that the diagnostics we use to direct care are just as safe and effective as the therapeutics on which we depend so much. Our patients deserve nothing less.

We are not doing this in a vacuum. I am particularly proud of the growing collaborations between ASCO and other societies, and in this case in particular, the College of American Pathologists (CAP). In 2007, we began with the generation of joint guidelines regarding both the clinical use and the analytical issues surrounding HER2 testing in breast cancer, which have been practice changing. This productive collaboration has now extended to other biomarkers, both in breast and many other cancer types, and has led to other educational and scientific initiatives in partnership with CAP, both in the U.S. and around the world.

I’d like to address a final challenge that we should all be thankful to have, and that’s cancer survivorship.

We have come so far over the last 30 years. When I was a fellow in the 1980s, there were few discussions of what sort of quality of life adult cancer survivors might have. Rather, we were more focused on whether they would survive at all! But my friend John Cleland and his family, including his 3 children born after his treatment, are a happy reminder that our patients can, indeed, live productive and healthy lives.

A great example of the maturity of our field was provided at the Annual Meeting 17 years ago, in the year 2000. I was asked to be the discussant for a Plenary Session presentation by Dr. Charles Loprinzi, who reported that a commonly used antidepressant, venlafaxine, was effective in reducing hot flashes in breast cancer survivors taking anti-estrogen therapies. I was struck that this presentation, at our Annual Meeting’s Plenary Session, represented a maturation point in clinical oncology. We had moved from “Can we cure some patients?” to “Can we improve their quality of life when we do?”

This year, the American Cancer Society estimates that in the United States alone, there are more than 15 million Americans who have survived a cancer. To address the many complicated issues experienced by these patients, ASCO has specific scientific and educational survivorship tracks at this meeting, and we have initiated a highly successful Cancer Survivorship Symposium. I hope you have heard about it, and I encourage you to attend one in the next year or two. You will not be disappointed.

As I come to an end of my term, on a personal note, I want to take this opportunity to thank my colleagues at the University of Michigan who have supported and covered for me during the last 24 months. I haven’t been around Ann Arbor very much, and they have jokingly called me the “Delta Airlines Visiting Professor of Medicine!” Thanks, gang!

I also want to thank my administrative assistants, Kerry Humphrey and Catherine Kinzel, who unfailingly—and cheerfully—have somehow brought order out of the chaos that has so often occurred in dealing with my complex life over the last 2 years!

However, the greatest reward of my career has been in receiving the trust and confidence of my patients, who have provided me the privilege of being their doctor for the last 35 years, and to them I give my heartfelt appreciation.

Members of the Society, colleagues, friends, and family, if it has not yet been apparent, I will say it directly: I am incredibly optimistic about the future of preventing, treating, and curing cancer, while ensuring patients with cancer live as productive and happy lives as possible. This future will only occur through research, education, implementation and delivery of high-quality cancer care, and a focus on our survivors.

ASCO is your Society, and ASCO will work WITH YOU to pursue our vision of a world where cancer is prevented or cured, and every survivor is healthy. We want more stories like my friend John Cleland’s, and fewer like my cousin Kim’s.

Thank you for the opportunity and great privilege to serve you and this Society.

Editor's note: Transcript has been edited slightly for style and clarity.

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