Globalizing the Fight against Cancer

Jun 19, 2014

ASCO continues its evolution as an international society

By Faith Hayden, Senior Writer

ASCO may be known as the American Society of Clinical Oncology, but its reach extends far beyond U.S. borders. ASCO welcomed its first international members in 1965—just one year after the Society was founded. In the nearly 50 years since, ASCO has expanded its membership to 31 countries with 31% of its approximately 35,000 members practicing outside the United States.

ASCO’s evolving international profilehas resulted in a much-welcomedexpansion of global programs, includingthe founding of the InternationalAffairs Committee; the implementationof worldwide Best of ASCO® Meetings;the creation of internationally focusedgrants and awards from the ConquerCancer Foundation, including the InternationalDevelopment and EducationAward (IDEA), International Developmentand Education Award in PalliativeCare (IDEA-PC), the Long-TermInternational Fellowship (LIFe), and theInternational Innovation Grant; and thelaunch of ASCO International.

ASCO began to expand its internationalprograms with the founding ofthe International Affairs Committee in1997. Its mission, said David Khayat,MD, PhD, FASCO, of Pitié-SalpêtrièreHospital in France and Immediate PastChair of the International Affairs Committee,is to understand the variouscountry-specific situations regardingthe treatment of patients with cancerand develop programs to help addressthose needs.

“The strength of ASCO’s internationalprogram really began about 15 yearsago,” said Tony Mok, MD, of theChinese University of Hong Kongand former Chair of the InternationalAffairs Committee. “With theestablishment of the InternationalAffairs Committee, internationalmembers had more of an opportunityto be directly involved in ASCO.This program made us part of theorganization rather than spectators.”

Educational programs geared towardinternational members
During his tenure with the InternationalAffairs Committee, Dr. Mok helpedestablish ASCO’s MultidisciplinaryCancer Management Courses—atwo- to three-day program thatprovides multidisciplinary training forphysicians, nurses, pathologists, andresidents in low- and middle-incomecountries—and brought the programto China. Now in its 10th year, there arefive course locations planned for 2014:Armenia, Mexico, Vietnam, Brazil, andthe Philippines.

Dr. Mok was also instrumental in bringingthe Best of ASCO (BOA) Meetingsoverseas. The BOA Meetings presentthe most practice-changing sciencefrom the ASCO Annual Meeting in atwo-day program. ASCO licenses theprogram to oncology organizationsboth in the United States and aroundthe world. The first international BOAMeetings were held in 2005 in Japanand Mexico. This year, as of April, BOAMeetings are scheduled to be held in23 countries, including India, Peru, andPanama.

Nagahiro Saijo, MD, PhD, of the KinkiUniversity School of Medicine in Japanand former member of the ASCO Boardof Directors, spoke to ASCO Connectionon the importance of the BOAMeeting to Japanese oncology. “Morethan 1,000 people from Japan attendthe ASCO Annual Meeting yearly,although many more want to go. Everybodyknows that new global standardsare presented at ASCO,” Dr. Saijo said.“BOA Japan has been an importantnews source not only for investigatorswho could not attend the ASCO AnnualMeeting but also for those who went tothe Meeting but couldn’t attend all theimportant sessions.”

ASCO has a number of other educationalprograms, including the InternationalClinical Trials Workshop,a two-day course for economicallyemerging countries that teaches cancerresearchers how to conduct clinicaltrials. “The International Clinical TrialsWorkshop is trying to address thefact that a lot of clinical trials are nowconducted in Latin America, southernand eastern Europe, India, and China,”explained Alexandru E. Eniu, MD, PhD,of the Cancer Institute Ion Chiricuta inRomania and member of the InternationalClinical Trials Workshop WorkingGroup.

In 2009, ASCO began collaboratingwith Health Volunteers Overseas,an international medical educationorganization, to send ASCO membervolunteers to medical centers in lowresourcecountries. The program,known as the International CancerCorps, matches volunteer oncologyprofessionals with a medical centerwhere volunteers spend one to fourweeks training staff in priority areasof cancer care. There are currentlyfive locations now accepting oncologyvolunteers: Asuncion, Paraguay; Tegucigalpa,Honduras; Thimphu, Bhutan;Hue, Vietnam; and San Jose, CostaRica.

Grants and awards nurture thenext generation
The Conquer Cancer Foundationof ASCO offers a number of grantsand awards designed especially for thenext generation of international oncologists.The International Developmentand Education Award (IDEA), which wasestablished in 2002, nurtures futureoncology leaders in low- and middle-incomecountries by pairing themwith a scientific mentor based in theUnited States or Canada. Recipientsattend the ASCO Annual Meeting andparticipate in a post-Meeting visit totheir mentor’s institution, and receive athree-year complimentary ASCO membership(including a subscription to theJournal of Clinical Oncology). Perhapsmost importantly, IDEA recipientsexperience an acceleration of theircareers and an enhanced engagementwith ASCO: today, past IDEA recipientsare organizing ASCO courses in theircountries, coordinating InternationalCancer Corps visits to their home institutions,serving on ASCO committeesand serving in their local professionalsocieties. Since its launch, more than220 individuals from 45 countries havereceived the IDEA.

The IDEA in Palliative Care (IDEA-PC)was created in 2011 for oncologistsspecifically interested in palliativemedicine. Recipients must have ademonstrated interest in integratingpalliative and supportive care servicesin their current institution. Since 2011,18 people from nine countries havereceived the award, including AndrewT. Olagunju, MBBS, FWACS, MSc, of theLagos University Teaching Hospital,University of Lagos, in Nigeria. Accordingto Dr. Olagunju, who received theIDEA-PC in 2013, disparities in painmanagement and quality of life forpatients with cancer exist in Nigeriabecause of a lack of training andresources in palliative care.

“The IDEA and IDEA-PC programs havecontributed immensely to improvementsin the field of oncology inNigeria,” Dr. Olagunju said. “Cancerresearch and palliative care in Nigeriaare evolving, and ASCO, through itsprograms focused on human resourcedevelopment and transfer of skills, hasimpacted cancer research and palliativecare in Nigeria positively.”

ASCO and the Conquer Cancer Foundationalso offer international membersthe Long-term International Fellowship(LIFe), which was first awarded in 2010.LIFe helps early-career oncologists indeveloping nations advance their trainingby supporting a one-year mentoredfellowship at an institution in the UnitedStates or Canada.

“The IDEA and LIFe grants and awardsprograms are extremely important todistribute global standards in cancercare to developing countries,” Dr. Saijosaid. “Cancer care is usually far behindin those countries because they needto fight against more emergent diseases.Increasing the recognition ofcancer care support in these countriesis mandatory.”

Finally, the Conquer Cancer Foundationoffers the International InnovationGrant, which was established in 2013.This year, four people received thegrant, which provides up to $20,000in support of novel and innovativeprojects that could positively impactcancer control in low- and middle-incomecountries.

ASCO International’s promisingfuture
Last year, ASCO took its global outreachone step further with the launchof ASCO International and the commitmentto double ASCO’s support for itsinternational programs by 2016.

“ASCO International was created inorder to encompass and integrate allthe activities of our Society that couldbe connected with a non-U.S. situation.The idea was also to make these activitiesmore visible through the setup ofa global ‘brand’ in order for non-U.S.oncologists to be able to understandwhat the Society was doing and whatthe Society could do for them,” Dr.Khayat explained.

Funding for ASCO International hasincreased significantly in the last year,Dr. Khayat said, and progress has beenmade toward the program’s ambitiousgoal.

“There are already more peopleinvolved in in-training programs,endorsements of symposiums and educationaltools from different countriesare selected on a regular basis, andcooperation with sister societies aredeveloping, including with the EuropeanOrganisation for Research andTreatment of Cancer,” he said.

“In a sense, ASCO is no longer justthe biggest, most prominent oncologyorganization. It’s integrated witha lot of international societies,” Dr.Mok said. “This is the world trend.The world is getting smaller becauseof Internet connectivity. Research isno longer country-based. Any majorresearch program, especially clinicaltrials, is almost always a global program.It’s a matter of which part of theworld is being linked.”

The increase in resources contributedby ASCO and other organizations tocancer in low- and middle-incomecountries couldn’t be more timely.According to the World Health Organization(WHO), more than 60% of theworld’s total new annual cancer casesoccur in Africa, Asia, and Central andSouth America.1 Furthermore, WHOexpects worldwide annual cancer casesto rise from 14 million in 2012 to 22 millionwithin the next two decades.1

“Forecasts from WHO show that lowandmiddle-income countries are goingto face a cancer epidemic in the comingyears, and it is obvious that manyof these countries are unprepared toface this new threat,” Dr. Khayat said.“Our duty is to help them raise thelocal awareness regarding the futureof cancer in their part of the world andprepare them by training oncologistsand nonphysician cancer specialiststo provide the best possible care tothese upcoming patients in relation tothe local epidemiology and resources.The war on cancer cannot be won bya single country, not even the UnitedStates. Together, the world needs toset up an alliance to be strong enoughto win this battle.”

1. World Health Organization. Cancer Fact Sheet.Accessed May 1, 2014.

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