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ASCO 2011 Is A Wrap, Along With Redemption, Blisterwalks, And Whether I Will Remem

I am on the plane home from the 2011 American Society of Clinical Oncology annual meeting trying to figure out the best way to write a "wrap up" blog about my sense of what I learned and saw in Chicago over the past 4 days.

I wish I could tell you all the highlights of all the new studies and all of the exciting breakthroughs, but I can't.  Realistically is it impossible to attend all the sessions, read all of the thousands of abstracts and view the additional thousands of posters that are presented at this meeting.  There is so much information that trying to get one's arms around even a fraction of what is available is a monstrous effort.

I will leave it to others to write the headlines and the stories about what they think the latest and greatest research and/or treatment may be, and how it will impact the future of cancer care (they are frequently wrong).

For me, what is more important is the general sense of where we are today and where we are headed when it comes to reducing the burden and suffering from cancer.  Are we really making progress, or basically stalled at the status quo?

And then there where the lighter sides of the meeting, including redemption, blisterwalks, and whether I can ever become part of the social media scene if I keep forgetting my hashtags.

It's fair to say that my blog yesterday about the genomic era sums up my feelings that there is a major shift building in cancer research and treatment that will be a new dominant theme for the next several years.  Yes, I know we have been studying cancer genetics for some time, and yes I understand that things don't always go smoothly, and yes I understand how complex all of this is.  But despite all of those considerations, genomics is still to me the major thematic message coming out of this conference. 

I base my judgments on having heard experts discuss those same barriers outlined above and well-articulated by fellow blogger Gregory Pawleski in response to my blog post yesterday and how they view our ability to recognize and deal with those barriers.  Obviously, I come out a bit more optimistic than Gregory.  Time will tell whose vision is more on target, or whether the future will end up somewhere in between total failure and total success (but in the meantime please know that I have a great deal of respect for what Mr. Pawleski writes.  I am in awe of his knowledge and his ability to synthesize all of this information).

There are other areas of great promise, such as the melanoma studies I discussed two days ago.  Hope now is "in the house" for some among us who have a very serious and too frequently fatal disease where no hope existed before.

This morning I sat in on a discussion of new treatments for prostate cancer. All of a sudden it seems like experts are talking about actually making a dent in the outlook for men with advanced prostate cancer, where hormonal manipulations no longer control the disease.  They are beginning to move the pieces around the chess board trying to figure out how to properly position those pieces, and how to take advantage of our new drugs and immune therapies to get the best results. 

As noted by one of the lecturers, we would not have had that type of conversation about prostate cancer as recently as 2009.   In a sense, this has come upon us while we weren't looking for it.  As was also mentioned this morning, the past 12 months have been terrific for melanoma, and they haven't been so bad for prostate cancer either.

There was a study on the use of an established drug called exemestane--which is used to treat advanced breast cancer--that is now proven to be effective in preventing breast cancer in women at high risk.  This drug joins two other proven breast cancer prevention treatments called tamoxifen and raloxifene that can be used to significantly reduce the risk of breast cancer in post-menopausal women.  But significant barriers remain in getting women to take this drug, such as the basic fact that most health professionals never talk to their female patients about their particular risk of getting breast cancer and most women don't ask or for whatever reason don't want to know. 

Until we can effectively cross that awareness hurdle we won't have a workable medication-driven prevention strategy for breast cancer.  Or, we will have to wait until drugs with fewer side-effects are available. 

And then there is the fundamental question of whether women and those who take care of their medical problems really think the juice is worth the squeeze.  We know that chemoprevention reduces risk of getting breast cancer, but how many lives are actually saved? Are women and their health professionals really telling us that they don't perceive benefits are worth the risks?

When I have had conversations with women who understand the issues, I am constantly confronted with those questions. I am not certain that this current study is necessarily going to leap the hurdle of skepticism that some women express.  If the experts believe in the research, then they have to work on the message.

And, before wrapping up on the science portions of the meeting, I can't forget the myeloma presentation I discussed in my first ASCO blog this year.

I am left with the feeling that if we could only marshal our efforts to address the science and the clinical trials piece more effectively and efficiently, then we could make huge progress in reducing the burden and suffering of cancer.  But I will also admit to being a bit "pollyannish" with that thought. We should never forget that there is much in basic science that has to do with chance and opportunity, and trying to control, guide and/or focus research may prevent us from finding the next "big thing."  You simply cannot always predict success.  Sometimes--and not infrequently--great ideas spring from random thoughts.

So what were some of the lighter observations from this meeting?  After all, there is always something to talk about that would never make "the news."

"Something #1" is personal: this meeting is held at McCormick Place which is a huge convention center--and there are somewhere north of 30,000 people running around this place for four days straight.

Before the meeting started, there was actually a contest (Twitter: #blisterwalk) which was supposed to provide a prize for the most innovative suggestion of how to navigate the halls of (walking) misery.

Me? I have a pair of old, old, old black leather sneakers that I bring out every year just for ASCO. Otherwise they sit in the closet and gather dust.  And then I measure--and report--the number of steps I take every day just walking along the halls from place to place as I go about my business.

This year, my daily total in the center was about 10,000 steps (give or take a few) which is about 5 miles.  And that was just at the convention center!!! Throw in the rest of the walking I did around Chicago after the daily sessions and you can add another couple thousand.  No need for the elliptical these past couple of days!

"Something #2" was the booth of a pharmaceutical company which caught my eye.

For the past several years I have written a blog about some unusual thing I see on the convention floor where the pharma and other companies display their wares, many housed in gargantuan booths which defy description.  One year it was the little rooms where the pharma folks could tell things to foreign docs that they couldn't dare say to an American physician.   Then there was the year where the companies were forbidden from giving anything of value to doctors--even ball point pens and notepads--for fear of corrupting them.  Last year it was the free coffee, which couldn't be consumed by docs from Minnesota and Vermont because their state laws forbade it.  And every other doc was told she/he would have their names posted on the pharma website as having received something of value from a pharma company, in this case, a cup of coffee.

I simply didn't see anything nearly as exciting or interesting this year, but this is the closest I came: 

As I was walking through the hall, my eyes were caught by a pharma company's booth where there was a rather large, plain wall perhaps about 30 or 40 feet long and about 15 or 20 feet high.  The wall was covered in a warm, beige covered carpet-like material which was bathed in lights with a soft orange glow.  Sitting in front of the wall was a young lady, right behind a fairly plain counter, adorned with a simple vase of flowers.  Nothing else was near the wall, and the young lady clearly wasn't doing anything except waiting for people to come up to the desk.  It sort of looked like one of those settings you might see in a funeral home where the surroundings are supposed to put you into a sense of meditation and solitude at the moment of your loss.

What caught my attention were the large capital letters displayed high on the wall behind the lady.  The letters spelled out the word: REDEMPTION.

Now, given that I thought this had a somewhat religious-looking appearance (and this was after all an oncology meeting) I asked myself what type of "redemption" I might receive at this wall.  No pearly gates nearby, and no St. Peter.  

Then I thought this may have been a bit of parody, a little tongue and cheek perhaps. 

After all, this particular company has gone through quite a lot of difficulty getting its primary product for the treatment of cancer approved by the FDA.  Perhaps since they finally got their medicine approved, they felt there was redemption for all of their efforts and this was a sly way of sending a message to certain government agencies and perhaps others that they had finally gained redemption in their quest. As the meeting went on and I talked to some other folks about "the wall," I discovered a number of them had the same thoughts I did. 

As it turned out, the purpose of "redemption" was nothing so grand.  It was much simpler than all of that.  The young lady was simply redeeming tickets or coupons for some sort of promotion. 

So, my redemption will have to wait another day.

"Something #3" has to do with the observation that information technology and social media were very much incorporated into the fabric of the meeting, makig life a lot more interesting than in years past.

There was universal access to the internet throughout the meeting halls (although some were vexed by the fact that occasionally the bandwidth was insufficient to accommodate everyone simultaneously.  I for one was just glad to get an internet connection 95% of the time). 

And the use of social media was definitely on the rise (Twitter: #ASCO11).  I tried to become one of the "Twitterati" but don't know that I succeeded very well. I kept forgetting to put the hashtag on "ASCO11", making my Tweets too long, and coming under criticism from my corporate media colleague from time to time as he wrung his hands and wondered whether his quest to get me to use Twitter was in fact a hopeless cause.

So that's it for ASCO 2011 and all its glory. 

For the most part this is very serious business.  Just as life itself, we have to make an effort to see the lighter side from time to time and laugh a little while we work as hard as we can to gather in all that is happening around us.

As I mentioned before, this was an exciting meeting and I look forward to next year with anticipation.  Hopefully, I won't have to worry about "redemption" in the meantime.



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