In the 1990s, the late King Hussein of Jordan was diagnosed with a non-Hodgkin lymphoma. At that time, he was one of the first world leaders who would voluntarily make his diagnosis and medical condition public information. He raised concerns about the status of research for curing patients with cancer. He wanted to raise awareness about cancer, improve treatment of patients, and called for support of research to find more cures. He traveled to the United States and had his treatment at the Mayo Clinic. He had chemotherapy at diagnosis and a bone marrow transplant after relapse, and died on February 7, 1999.
I recently pulled out an article that I had written for the February 22, 1999, issue of Al-Afkar (a weekly magazine that covers politics, social issues, and culture), and found it still relevant 22 years later. It was not enough then, and it is not enough now, to offer wishes and prayers to the king nor to other patients. We still need to raise awareness about cancer in our communities worldwide, including Arab countries, spread knowledge, reduce fears and anxiety, encourage people to report symptoms, establish early detection infrastructures, build facilities, invest in human resources, and make all that available for people and patients across all world communities. Although we have made extraordinary progress since 1999, most of those issues remain relevant, particularly the issues of disparities in access to state-of-the-art care, or even basic care!
I remember hearing people say at that time that lymphoma is a disease of royals, and that if the king could not be cured then there is little chance that ordinary people would be. We all do emphasize to our communities that cancer diagnosis is no longer equivalent to a death sentence: 50% to 60% of all patients with cancer now experience long-term survival that we can define as cure, including 80% to 90% of women diagnosed with early-stage breast cancer.
King Hussein was fortunate enough to be able to travel to Mayo Clinic for treatment, something that ordinary people cannot do. Governments should work on building hospitals and attracting more experts locally, and reducing their own brain drain. I wrote in that article that I wished that King Hussein’s legacy would be immortalized not only for his political leadership but also for his visionary call to support cancer research in Arab countries. I called for the creation of a King Hussein Cancer Education Treatment and Research Center and Funds. It is very uplifting to see that his successor King Abdullah pledged support and helped establish the King Hussein Cancer Center (KHCC) in Amman, Jordan, which rapidly became one of the leading cancer centers in the region and the world.
Recognition and awards, especially by scientific committees of peers, make us really feel good! It is nice to see that one’s work is considered important and is having an impact by helping advance medicine and improve care of patients with cancer and communities. I was very honored last month to receive the Susan Bulkeley Butler Leadership Excellence Award of Purdue University and International Breast Cancer and Nutrition (IBCN) in Nantes, France, and the King Hussein Award for Cancer Research in Amman, Jordan. I felt especially overwhelmed and humbled to receive the award plaque from Queen Rania Al-Abdullah of Jordan and Princess Ghida Talal of the King Hussein Cancer Foundation (KHCF) for making a difference and having an impact on cancer research and treatment. Getting recognition with a Lifetime Achievement Award makes you feel that you’re getting old; however, it becomes another milestone in your career to continue to be a role model, and encourages your students, mentees, and colleagues to pursue the path of science and of professional and community service.
Being recognized presents an opportunity for reflection on the work that came before. I was happy to be reminded that I had written the first series on chemotherapy for small intestinal lymphoma back in the 1990s, and of my work in cancer epidemiology, particularly breast cancer in Lebanon and Arab countries, wound healing, chemotherapy extravasation, screening and early detection of breast cancer, treatment of young women with breast cancer, hormonal therapy, multidisciplinary management, germline mutations in Lebanon and Arab countries, international clinical trials, ASCO/ESMO Global Curriculum recommendations, Breast Health Global Initiative (BHGI) and ASCO resource-stratified guidelines, international ABC consensus guidelines in advanced breast cancer, and many others. My research was coupled with very busy clinical practice, extensive professional and community services at my institution, the American University of Beirut (AUB) Medical Center, in Lebanon, other Arab countries, and internationally. I have been active in medical student education, residency and fellowship training, post-graduate education, Lebanese Society of Medical Oncology, Beirut Breast Cancer Conference, Best of ASCO, Pan Arab Cancer Congress, ESMO and ASCO meetings, as well as Lebanese Breast Cancer Foundation awareness and fundraising activities, and many others.
Being recognized is also an opportunity for gratitude. I am very grateful to my patients for their confidence and happy to have received their overwhelming kind words and thank you notes. I am thankful to AUB, my colleagues, collaborators, students, residents, fellows, research teams, nurses, volunteers, survivors, and supporters. I am very grateful to my parents, who came from Bint Jbeil, Lebanon, and worked very hard to make sure their children could pursue higher education in Beirut, Europe, and the United States. Last, but not least, I am immensely grateful for the love and tolerance of my wife and children who endured my long working hours at the hospital and at home and promised to carry on the torch, everyone in their own way!