Download Clinical Oncology Society of Australia (COSA) Conference 2nd – 4th

Clinical Oncology Society of Australia (COSA) Conference 2nd – 4th December 2014 By Kate Butler Thanks to Kylie and OMT, it was a privilege to attend 2 days of the Clinical Oncology Society of Australia Conference this year, and I felt proud to be flying our green flag in amongst the many hundreds of clinicians, researchers, nurses, psychologists and allied health workers at the Melbourne Convention and Exhibition Centre – what an enormous space that is -­‐ just look at the scale of the stage in the photo – the speaker is a tiny dot somewhere down there! The speakers included an impressive list from here and overseas, and I noted down some of the key points that seemed of most interest to us from the many presentations I attended. Here are a few: Dr Timmerman from Peter Mac spoke of the challenges and benefits of using radiation for the treatment of lung cancer. Given that radiation is best delivered to a very specific target (the tumour) with as little healthy tissue involved as possible, one of the biggest challenges is that the lungs are constantly moving from breathing, and the heart and spinal cord are often so very close to the targeted area, as well as the liver and oesophagus. Peter Mac have been using a new scanner that works in conjunction with the “Linnax” so that the radiation can be delivered with the assistance of live imaging. Cone Beam CT scans assist radiation delivery to a much more defined target area as the tumour shrinks. I didn’t realise that some cancer cells from specific lung tumours that might survive radiation treatment can proliferate at double the speed of the pre-­‐
treated tumour. Early intervention is the way to go where possible (even the difference between 30 and 90 days can be crucial) and when delivered accurately and timely, radiation is extremely effective as a treatment for this cancer type. There’s an advertising campaign that you might have noticed that is encouraging people to see their doctor if they are experiencing a persistent cough and weight loss. It’s on TV, and at bus and tram stops here. I think one of the things that struck me about this and other presentations, was how cancer treatments are moving and changing so incredibly rapidly. Treatment types depend so much on where the patient is upon diagnosis and which health facility they are admitted into, and where research happens to be at that particular time. Variations occur within one location or city (such as Melbourne) – let alone the rest of the advancing world. There was a wonderful presentation by Julia Downing on the inclusion of palliative care education to patients at diagnosis. Too often there is a large gap between aggressive curative treatment and the shift to medical treatment that focuses more on quality of life. This is an issue that constantly comes up at the Austin, and is an ongoing issue for all major treatment centres. The presentation was research-­‐based and contained excellent stats and graphs and models that show the shift of care. I was left wondering how this can be implemented, when the two disciplines come from such different viewpoints, and the actual integration is an ongoing issue. There’s no question that everyone seems to want the shift, but actually making the change is the big challenge! The highlight for me was from Dr Donald Abrams from the USA. He is chief of Hematology and Oncology at San Francisco General Hospital, as well as a cancer and integrative medicine specialist at the UCSF Osher Center for Integrative Medicine at Mount Zion. This man is an inspiration, I think mostly because of his depth of experience, professional maturity and breadth of vision. He is the embodiment of integration, and had a great deal of inspiring things to say about the use of cannabis in cancer care, the benefits of eating mushrooms, and how best to empower patients in their own self care – all of this delivered in ordinary inclusive language! Rather than try to summarise, I’ve found a lot of information on him on you tube – VERY interesting! It was wonderful to meet up with Deb Hart from South Australia and exciting to think that we are representing a highly professional, expanding group of therapists increasing our presence in the medical community. Highly recommended! Union for International Cancer Control (UICC) Conference 3rd – 6th December 2014 By Deborah Hart The World Cancer Congress was hosted by the Cancer Council Australia and its state and territory Cancer Council members. Combining the COSA and UICC conferences was done by overlapping a day at the end of the COSA conference and the first day of the UICC one. According to a follow up email the attendance was up 74% on the previous WCC with 2,700 participants from 115 countries attending the event. There were 120 sessions presented by 350 speakers over the 3 days and I can safely say I have never attended a conference like it! Everything about this was huge including the programme which will make a good doorstop at 363 pages and this was just for the UICC part of the conference! Sponsors included American Cancer Society, BUPA, Roche, National Cancer Institute, Amgen Oncology, Bayer, Bristol-­‐Myers Squibb, GSK, Canadian Partnership Against Cancer, Australian Government Cancer Australia, Pfizer and the list goes on. An eclectic blend of pharmaceutical companies and cancer support agencies with a focus on early detection, patient advocacy and the latest cancer drugs. The first plenary session on that Thursday set the scene with three speakers and a presentation called Sustainable Health Systems which identified the cost of cancer on the American society and asked who is going to pay for it, governments, consumers? Laura Levit from the American Society of Clinical Oncology spoke about the Institute of Medicine (IOM) recommendations to address the cancer care crisis in the US. There was a focus on survivorship with that client population expected to grow by an estimated 30% by 2022 and an increase in the incidence of cancer increasing by 45% by 2030. These statistics are true for the US and their health system was described as being in crisis with spending on cancer care increasing from $72b in 2004 to $125b in 2010 to $173b in 2020! Irene Higginson from the UK talked about palliative care and the benefits of integrating the principles of palliative care earlier mentioning that this approach was more beneficial than chemotherapy in some lung cancer patients. Palliative care included in curative cancers improved outcomes, reduced side effects and improved quality of life. Integrating Palliative Care earlier also lowered costs of treatment. A presentation by Nobel Prize winning Professor Peter Doherty from the Dept of Microbiology and Immunology, the University of Melbourne and the Dept of Immunology, St Jude Children's Research Hospital, Memphis followed. He was an inspiring speaker who talked about the fact that cancer can only proliferate if the immune system is not functioning properly. Cytotoxic T Lymphocytes, the 'Hit Men' of immunity, can now be targeted with immune-­‐oncology, the newest and most promising branch of oncology. I couldn't help thinking if we had access to some of those research dollars we could seriously look at the effects of our gentle massage on the immune system! Presentations from pharmaceutical companies about their latest drug and that the government seemed slow to put it on the PBS was a theme I heard a few times. There were consumer advocacy groups pushing for quicker access to drugs that were already accepted by the FDA in the US. I don't think I heard 'Wellness' mentioned once! There was an interesting presentation on how exercise can reduce prostate cancer treatment related muscle waste and bone loss. The terms 'exercise oncology' and 'exercise prescription' were used in relation to specific exercise which had been found beneficial such as resistance or strength training being preferred over cardio workout. A Danish presenter spoke about out an exercise program being approved for use in hospitals across Denmark as part of cancer treatment for symptom control following only a small pilot study as the evidence was so compelling. Jennie Ritchie-­‐
Campbell was from a charity in the UK called Macmillan Cancer Support. They have developed a program to get cancer patients to be more active in the UK and have raised awareness of the benefits of exercise. She said that when surveyed 70% of patients said they had been failed by the system. She told of the success of partnering with a large corporation (Boots Chemist) which has provided the exposure, funds and resources to develop their programs and launch a media campaign. The movie A Day Without Cancer was screened on the first night. It's also available on You Tube in case you're interested, many of the presenters from the conference appear in the movie. It talks about what we have done well in cancer treatment and what we do not so well. An odd workshop was one that included writers from several well known TV shows such as Home and Away, Neighbours, Private Practice from the US and a couple of Indian shows. Apparently when a health department of government need to get a message out it's far more effective to have it written into a popular soap opera than it is to embark on an advertising campaign. Shows will focus on domestic violence, a cancer diagnosis, the importance of early diagnosis and screening or as in the Indian show the focus was on improved birth control. I certainly saw how easily we are manipulated. Maybe we could get them to write into the show the benefits of regular massage! A couple of outstanding presentations made it worthwhile for me. One by Nicola Roxon former health minister on how to make your idea stand out to the decision makers. It was really interesting with some very useful insights from the health minister's perspective. Apparently everyone has a great idea so her advice is to get your pitch and your research right! Know who your decision makers are and their priorities and try to be one of them. Reading their speeches, policies and press releases helps to target the right people. Align with like minded organisations, make your case and document well were key points. Stephen Morris was a great speaker, he would have rubbed everyone up the wrong way! He's been involved with the UN for over 30 years and is rather cynical! Decisions are made for women by men, money is spent on drones and fighter planes but not on health and prevention and in the world of cancer and other non communicable diseases (NCDs) there is not enough unity between organisations, associations and countries. Apparently new drugs released in the EU cost $100,000 per year to administer and cost of cancer drugs has increased by 76% and he asked 'has the world gone mad?' Drug companies should reduce their costs as they did with AIDS drugs but that was only after international pressure. Overall I found the conference hard to follow, the facilities weren't shared on the first day with COSA so access to their posters presentations (or lunch!) was not allowed unless you had a joint registration. Not sure what that would have cost but at over $800 I was disappointed that lunch was not provided and morning tea was available from 2 outlets where you needed to provide a coupon issued with registration. With so many delegates the queues were long and the break between presentations was very short. Using the weighty program to work out where I wanted to be was impossible but an App I had downloaded helped. This did not help to synchronise with the electronic poster presentations however as unlike regular poster presentations that stay up for the duration of the conference, these only 'screened' for half hour or so.