The American Society for Radiation Oncology (ASTRO) has named Angelita Habr-Gama, MD, PhD, as the 2014 Honorary Member, the Society’s highest honor. Dr. Habr-Gama is Professor of Surgery at the University of Sao Paulo School of Medicine and Staff Surgeon of Coloproctological Surgery at Hospital Alemao Oswaldo Cruz in Sao Paulo, Brazil.
Dr. Habr-Gama will be inducted as the 2014 ASTRO Honorary Member during the Awards Ceremony on Tuesday, September 16, at ASTRO’s 56th Annual Meeting in San Francisco.
“Dr. Habr-Gama’s extensive research in developing and promoting nonoperative treatment approaches for rectal cancer, including radiation therapy, is important to providing optimal cancer care for each patient’s unique situation,” said Colleen A.F. Lawton, MD, FASTRO, chair of ASTRO’s Board of Directors. “Her continued study of additional treatment strategies and her emphasis on a change in the standards of care demonstrate her dedication to improving the lives of cancer patients worldwide.”
Nonoperative Approaches for Treating Rectal Cancer
Dr. Habr-Gama is internationally recognized for her work in developing and supporting selective nonoperative treatment approaches for rectal cancer. She has published 177 articles in peer-reviewed medical journals. Dr. Habr-Gama founded the Division of Coloproctology at the University of Sao Paulo School of Medicine, and has been a member of the Board of the Oncology Foundation of Sao Paulo since 1990.
In the late 1980s, Dr. Habr-Gama discovered that patients with rectal cancer who had received neoadjuvant chemoradiation therapy did not have residual cancer; however, the patients were still undergoing abdominal perineal resections.
“When we discovered this, I could not offer this operation anymore without at least a suspicion that the tumor was still there and without a thorough discussion with the patient,” Dr. Habr-Gama said. “This led us to start reassessment of response 8 weeks after completion of chemoradiation therapy instead of immediately scheduling an operation. When I started reassessing these patients, I realized that some tumors actually completely disappeared on clinical evaluation.”
Landmark Paper Shows 100% 5-Year Overall Survival
This assessment led to Dr. Habr-Gama’s landmark paper, “Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results,” published in the Annals of Surgery in October 2004.1 Her team’s research showed a 100% 5-year overall survival rate and complete clinical response of the primary tumor in patients with locally advanced rectal cancer treated with chemoradiation therapy and managed only with observation. Two patients experienced local failures; however, they were successfully managed without radical resection. This strategy avoids the surgery that has been the standard of care for this disease.
“This approach has been criticized for years. All of the downsides and potential harms have been pointed out, and we have worked hard to demonstrate that, in experienced hands, this is a safe and valid alternative that has to be considered individually for each patient,” continued Dr. Habr-Gama.
Strong Advocate for Radiation Therapy
Dr. Habr-Gama is a strong advocate for the role of radiation therapy in rectal cancer treatment, explaining the benefit of preoperative radiation for rectal cancer and encouraging investigators to reconsider before marginalizing radiation from the standard treatment of rectal cancer.
“Many people outside of Latin America thought I was a radiation oncologist,” Dr. Habr-Gama said. “I am a big proponent of preoperative radiation because I know it works and because our fantastic group of radiation oncologists have made us comfortable with the process and have delivered treatment with very low complication rates.”
Dr. Habr-Gama believes that her research will impact treatment approaches for rectal cancer, both in the United States and internationally. In the decade since this research was first published, her team has published several prospective and retrospective studies that further refine the protocol to help maximize the clinical response and safety of this treatment approach.
“Our research on this approach has provided a considerable amount of evidence to suggest that select patients with complete clinical response to neoadjuvant chemoradiation therapy may be safely spared from immediate radical surgery. There is indication that there will be trials in the United States using this treatment strategy,” she said. “This represents a significant change in the surgical, medical and radiation oncology communities and will allow a more robust understanding of the role of ‘watch and wait’ for the management of select patients with rectal cancer.”
ASTRO first awarded Honorary Membership in 1989. Including Dr. Habr-Gama, 31 individuals have been selected to receive Honorary Membership in ASTRO.
For more information about ASTRO’s 56th Annual Meeting, visit www.astro.org/AnnualMeeting. ■
1. Habr-Gama A, Perez RO, Nadalin W, et al: Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: Long-term results. Ann Surg 240:711-717, 2004.