ASCO President Clifford Hudis, MD, FACP, will be serving during a particularly notable year: 2014, the Society’s 50th anniversary. This occasion brings with it much to reflect on, from the advances in the field of oncology to the growth of ASCO’s influence, but Dr. Hudis takes a moment to simply ponder the milestone—in fact, the concept of milestones in general. “Perhaps we attach too much importance to specific years,” he reflected. “But it is also true that from time to time we have to pause, look around at our environment and ourselves and make sure we know what we aim to accomplish, and that we are working optimally toward our agreed-upon goals. Our 50th year seems like as good a time as any for this exercise!”
50 Years of Advances in Oncology
Fifty years ago, our Society’s founders were also looking around at their environment, which was one similar to ours. There were exciting advances in cancer treatment and patient care both realized and on the horizon. Heartened by these advances and the promise of more to follow, the founders sought to equip the fledgling field of oncology with a valuable resource: an educational and scientific forum in which oncologists could learn from one another.
In the 50 years since ASCO’s birth, the founders’ optimism has been fulfilled in many ways. Since the 1970s, the 5-year survival rate across all cancers has increased from one-half to two-thirds of patients. Dr. Hudis noted, “Additionally, in many cases, quality of life during treatment is also better, as side effects that used to be severe have been minimized to the point that most patients can be treated in an outpatient setting and function close to normally.”
“In other [areas of the field], we have made less progress,” he said. However, unanticipated advances have been made in a few areas, and Dr. Hudis contended that “This provides reason for even greater optimism than our founders had, [and serves as] a reminder that the path from point A to point B is sometimes circuitous and surprising.”
Bridging the Gap
Thinking about were we were, where we are, and where we want to be, and as members of our many local and global communities, Dr. Hudis has identified a challenge for ASCO, one from which he developed the theme of his term: “Science and Society.”
The challenge arises from the environment that we find ourselves in: Although scientific advances in patient care and cancer treatment are growing at an increasing pace, society’s understanding of these developments is not. This limits the speed of innovation and in some cases the acceptance of the results of studies. Dr. Hudis explained, “There is evidence of a rift between the thinking of scientists and that of many other members of society, and I have been repeatedly struck by it. It’s frustrating to me that straightforward scientific advances are often poorly understood or even rejected by society while unscientific pronouncements can quickly gain traction.” To bridge this potential gap between science and society, Dr. Hudis has identified three aspects of our environment that must be transformed.
Lifestyle Choices and Cancer
According to Dr. Hudis, the first aspect of our environment that must change is society’s awareness of how behaviors and lifestyle choices contribute to cancer. The effect of these modifiable lifestyle choices—such as overeating and smoking—has been supported by scientific evidence, but our behavior has not always followed suit. In light of this evidence, Dr. Hudis noted that science can assist society in recognizing the detrimental effects of these behaviors and in developing remedies.
Additionally, as an organization that represents the oncology field, “ASCO is in a unique position to help guide society in critically examining lifestyles and nutritional standards in the same way it has studied the biology and genetic causes of cancer in the past,” he said. This is becoming critical as energy imbalance and obesity are approaching tobacco as the leading modifiable risk factors for many cancers. ASCO can use its scientific standing to work with all of society to look for acceptable approaches to reducing the disease burden from this increasingly common problem.
Building a Better Health-Care System
The second aspect of our environment that must be addressed is the country’s fragmented health-care system, which hinders scientific progress and advances in cancer treatment. Millions of patient experiences and outcomes are locked away in file cabinets and unconnected digital file servers. To address this, Dr. Hudis supports the idea of gathering, synthesizing, and analyzing every patient’s experience through a connected database. ASCO is already addressing this solution through CancerLinQ, a health information technology initiative that gathers and analyzes data on millions of patient experiences, but its further development is a critical and time-sensitive step. To make this happen, we will need to go beyond financial investment and achieve societal understanding of the value and utility of “big data” as it relates to health care, and we will have to work together to identify feasible strategies to gather and analyze it.
The Value of Research
The third aspect Dr. Hudis deems in need of change is the barriers that scientists—specifically, young investigators pursuing careers in cancer research— now increasingly face. Many of these prospective cancer treatment pioneers are unable to conduct their research and contribute to the field because they lack funding and resources. He explained, “Advancements in cancer care can’t be made without resources and commitment to research, and yet there is the constant threat that these foundational components of research will be curtailed.”
Dr. Hudis stressed the importance of changing society’s view of the value of this research—and science in general—by emphasizing how science develops understanding and treatments that benefit everyone. He added, “This research should never be seen as discretionary or as a luxury. To change such views we need to engage all members of society in the scientific process. In the end, it all comes back to illuminating the intersection of science and society so that we all see clearly the importance of the other.” ■
© 2013. American Society of Clinical Oncology. All rights reserved.