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World Cancer Congress 2008

Thursday28 August 2008

Daily news Thursday 28 August 2008

Outgoing president DrFranco Cavalli opened theWorld Cancer Congress witha speech that underlined thelooming disaster of cancer indeveloping countries yet,paradoxically, ended on anoptimistic note.

The crisis of cancer in thedeveloping world is the sumof mainly poverty-relatedtumours (cervical, oesopha-gus, liver), tumours linked towestern style of life (breast,lung, prostate, colorectal),the lack of primary and sec-ondary prevention, and thelack of resources for treat-ment, he said.

If we are to save millions oflives, it is essential to put canceron the global public and politicalagenda. The World CancerCongress and the World CancerSummit that will take place onSaturday are important stepstowards doing that.

And yet there is hope.The new World Cancer

Declaration 2008, which will becentral to both encounters, cantake an optimistic approach totackling the cancer crisis. It isbased on the evidence, whichhas been growing recently, thatconcerted actions can make ahuge difference even within ashort period of time.

Pascal Couchepin, president ofthe Swiss confederation, insistedon the need to promote pallia-tive care. “This is one of my pri-orities as minister of health,” hedeclared. “The quality of life ofpeople at the end of their life canbe improved considerably bypalliative care.”

He spoke of the importantprogress in recent decades: moreand more, treatments are avail-able that have good or reason-able chances of lasting sucess.But he emphasized a change ofparadigm: “our goal changesfrom treatment at whatever priceto care and respect for theintegrity and dignity of the per-son.”

Dr Tabaré Vazquez,president of Uruguay,referred to socio-econom-ic conditions, and specifi-cally to poverty, as a can-cer risk factor: the socio-economic condition of anindividual has an effect onthe person’s likelihood ofgetting cancer and, shouldthe individual fall ill, theeffect on the person’s like-lihood to survive will alsobe negative.

In Latin America, hesaid, “we do not have

‘poverty and inequality’.In Latin America we havepoverty because there isinequality... If inequitywere not so ruthless, howmany cases of cancerwould be prevented,detected early or evencured? Many cases, nodoubt. And this is precise-ly our challenge.”

“We must not resignourselves to reality.Neither should we breakup with it... Because thebest way to improve realityis by looking at our fellow

men and women in the eyeand learn about their needs,

their hopes, their rights and theircommitments. Needs, hopes,rights and commitments thatbelong to them but, as fellowbrothers and sisters, also belongto us.”

John Seffrin, CEO of theAmerican Cancer Society andUICC president 2002-2006, pre-sented a progress report on theWorld Cancer Declaration 2006.

The origins of the declarationlay in the World Summit AgainstCancer for the NewMillennium, where the Charterof Paris 2000 was adopted. Tobuild on this call to action, theorganizers of the World CancerCongress 2006 decided to devel-

There is hope

Margaret Chan and Franco Cavalli open the congressexhibition

Tabaré Vazquez Pascal Couchepin

2 World Cancer Congress 2008


“This is an outstanding document,”Dr Margaret Chan, director-generalof the World Health Organization,said of the World Cancer Declaration2008. Recent trends make the worldreceptive to its arguments, she said.

“Diseases like cancer are a leadingcause of so-called catastrophic healthexpenditure. This is especially true inlow- and middle-income countries,where most people rely on out-of-pocket payments for health care.”

“For cancer, out-of-pocket pay-ment is a double-edged sword. It dis-courages people from seeking treat-ment early, when the chances of cureare greatest. And it deepens house-hold and community poverty.”

“Health systems in developingcountries can usually cope with theintermittent emergencies caused byinfectious diseases. The patient eithersurvives or dies. In contrast, thedemands of chronic care can push afragile health system to the breakingpoint.”

“In just the past few years, theinternational community has comeface-to-face with the consequences ofdecades of failure to invest adequatelyin basic health systems. This is thebiggest obstacle to health develop-ment.”

“For cancer control in low- andmiddle-income countries, break-

throughs do not come in the form ofspectacular new drugs for cure. Truebreakthroughs come when researchshows how existing tools can beadapted to work well in resource-poor settings.”

“Developing countries are nowface-to-face with problems that afflu-ent countries confronted decades ago.Policies were devised. Lessons werelearned. Incidence rates for some can-cers dropped, while cure and survivalrates improved.”

“These experiences need to beshared as urgently as possible. We areindeed on the brink of a disaster. Aspopulations age, we must anticipate acontinuing rise in cancer incidence.But what we cannot accept is thehuge gaps in prospects for cure, sur-vival, and a dignified death thatdivide the world according towealth.”

“This is where the true break-throughs are needed – in the interestof health development, in a spirit ofsocial justice and solidarity, and forthe sake of fairness in the preventionof human suffering.”

op the first ever World CancerDeclaration. Its stated purpose wasan urgent call to action to address theworldwide cancer burden with 11high-priority, evidence-based actionsteps that could be achieved in thenext 2-3 years, particularly focusingon the developing world. The decla-ration required partnerships betweengovernments, the private sector,NGOs, and international organiza-tions to develop and implement theadopted strategies before the nextWorld Cancer Congress in 2008.

The progress report tells what has

been achieved but also underlines thelimitations of our knowledge. Forseveral of the action steps, ongoingorganized surveillance systems existthat can be used to assess progressmade, at least in part. For others, nosuch surveillance activity is known oravailable. Some information concernsactivities and measures occurringbefore 2006. Often, data that will beused to describe what happenedbetween 2006-2008 are still beingcollected and analysed. The report,nevertheless, is the most comprehen-sive overview of what has been doneand what remains to be done in the11 areas identified by the declaration.

Isabel Mortara, UICCexecutive director, spokeof an original characteristicof the congress. Today, wewill launch the first inter-national Cancer FilmFestival.

An integral part of ourmission is to build greaterawareness of cancer.Challenge stigma - and

deliver the best possible care topatients. The film festival will honorand give a voice to cancer patients,their families and friends and the pro-fessionals who care for them whilerecognizing the catalytic role of can-cer associations in saving livesthrough their work and public service

“I was personally struck by the out-standing quality of these films and bytheir powerful messages voiced bychildren, adolescents, young women,men,” she said. “Each is a uniquestory. I take this opportunity to salutethe talented film directors who havejoined us this evening.”

The time is right to make cancer control a development priority


Daly news Thursday 28 August 2008 3

Not to miss08:30 - 10:00 Cervical cancer: the place for vaccination PS1.01

Chaired by: H Zur Hausen (Heidelberg, Germany)X Bosch (Barcelona, Spain)

10:30 - 12:00 Movement for a global treaty to control tobacco: CT2.01the FCTC and beyondChaired by: D Bettcher, WHO (Geneva, Switzerland)

J Samet (Baltimore, USA)

10:30 - 12:00 Breast health care in low- and middle-income countries CT5.04Chaired by: B Anderson (Seattle, USA)Session supported by the Breast Health Global Initiative (BHGI)

15:30 - 16:30 Oncosexology: The interface between sexuality and cancer WS4.02Chaired by: D Akkerman (Victoria, Australia)

17:00 - 18:30 Predicting and staging FC3.01Chaired by: R Jakob, WHO (Geneva, Switzerland)

B O’Sullivan (Toronto, Canada)

12:45 - 13:45 Risk for osteoporosis and SAT1invasive breast cancer in postmenopausal womenChaired by: D Agnusdei (Florence, Italy)Satellite Session organized by Lilly

12:45 - 13:45 Shared experiences from patient groups in various SAT2therapeutic areas on meeting the needs of their patient populationSatellite session organized by Novartis

Final Programme, pg 45. Room A

Final Programme, pg 47. Room C

Final Programme, pg 50. Room G

Final Programme, pg 53. Room A

Final Programme, pg 54. Room B

Final Programme, pg 55. Room C

Final Programme, pg 63. Room Mont Blanc

08:30 - 08:45 The history of HPV PS-1H Zur Hausen (Heidelberg, Germany)

08:45 - 09:00 Results of vaccination trials PS-2I Frazer (Woolloongabba, Australia)

09:00 - 09:15 HPV vaccination programme for prevention of cervical cancer in PS-3developing countries: the WHO perspectiveT Aguado, WHO (Geneva, Switzerland)

09:15 - 09:30 Futures strategies for screening and vaccination PS-4M Schiffman (Rockville, USA)

09:30 - 09:45 Perspective for therapeutic HPV vaccines PS-5A Schneider (Jena, Germany)

09:45 - 10:00 Discussion PS-6

Satellite sessions



Out of the past into the futureJanus-like, the general assembly that

met on Wednesday morning in theCrowne Plaza Hotel looked bothback and forward. Outgoing presi-dent Franco Cavalli reflected on howfar UICC has come since he tookover the presidency in 2006, andincoming president David Hillsketched out a vision of the future.

When John Seffrin changed com-pletely the structure and governanceof UICC, Franco Cavalli told theassembly, no one knew whether thiswould work or not, but he was verypleased to say that it is working.

In the last two years, UICC hashad a positive experience with theboard of directors, Cavalli said. Thekey role of the strategic coordinatingcommittee as an intermediarybetween the board and the secretariatneeds further thought, however.

Later in the session, Dr Cavallithanked the outgoing strategic leaders -Hélène Sancho-Garnier and KazuoTajima (cancer prevention and control),Luk Joossens (tobacco control), JoeHarford (knowledge transfer), and JeffDunn (capacity-building and supportivecare) for their diligent work. But thefunctioning of the strategic coordinat-ing committee is likely to change sig-nificantly in the next few years.

Likewise, Cavalli said, “We wereall a little terrified when we agreedthat the congress should be for thefirst time entirely organized by thesecretariat and that next time it wouldmove very far to Beijing.” But theexperience of organizing the Genevacongress has been entirely positive.“We have completely refocused ourcongress by comparison with thecongresses of the past,” he said, ,even though the positioning of the

congress is still uncertain.The World Cancer Declaration is

becoming a very important tool - aroad map for the UICC but also forits members. “This declaration shouldserve as a template for national,regional, continental declarations thatspecify more precisely quantitativegoals to be reached.”

The activation of members and theavailability of resources remained themain problems, he said.

“I’ve been interested to observewhat we do in the UICC,” saidDavid Hill, speaking about the way

forward. He agreed with FrancoCavalli that the World CancerDeclaration is an absolute centrepieceof how we go forward. It provides anorganizing framework for our priori-ties and actions.

But Hill took the assembly beyondvision, mission and organizing frame-works to a deeper reflection on theprinciples that underpin what theUICC does.

Traditionally, these have to do withpeople, knowledge and advocacy.

People - the more skilled the peo-ple, the more effective their actionswill be. Knowledge - the better theevidence base, the more effective willthe actions be. Advocacy - cancercontrol requires “buy in” from deci-sion-makers both inside and outsidethe cancer/health sector.

We are moving into an era wherewe are much more explicit that we’reinvolved in advocacy, but equally, weshould be quite unapologetic aboutthe fact that some research needs tobe done to drive advocacy.

For the UICC, the best expertise isone phone-call away. Our authoritylies in the strength of the knowledgeand the expertise of the people wecan call on. We think about UICCnot as the people around the table,but the entire membership. We havesome plans and mechanisms to makethat idea a reality.

Two key moves are� Positioning the World Cancer

Congress as the professional devel-opment vehicle for staff and volun-teers of member organizations

� Positioning the UICC as the voicefor global cancer advocacy, com-plementing national cancer controladvocacy

Franco Cavalli

David Hill

Fine-tuning the constitution and bye-lawsThe constitution and bye-laws underwhich the UICC works were agreedat the general assembly in Dublin in2004 and took effect at the generalassembly in Washington DC in 2006.Two years of experience have shownthat they work well but also that theyneeded minor amendments.In a closed session, the general assem-bly agreed unanimously to make six

changes: clarifying that commoninterest groups may be set up by theboard of directors but once createdare autonomous or independentgroups; changing the quorum formeetings of the board of directors toa simple majority; specifying that apresident-elect, once chosen, doesn’tneed to be elected again as president;spelling out the rules governing pay-

ment of membership dues; andexplaining what happens if a boardmember leaves the organization thatnominated them, the organizationceases to be a UICC member, or themember moves to or is considered tohave inappropriate links with anorganization whose aims are contraryto the UICC mission (an obviousexample being the tobacco industry).



Dr Eduardo Cazap was chosenunanimously by the general assemblyas the new president-elect.

Dr Cazap trained in internal medi-cine and clinical oncology in BuenosAires and Washington. He has been afellow of the American CancerSociety and was one of the first LatinAmerican specialists to obtain theEuropean Recertification in MedicalOncology.

His clinical and research interestsare mainly focused in breast and cer-vical cancer, epidemiology, and pri-mary and secondary prevention. Hehas carried out research through pro-grammes of the Pan American HealthOrganization, the US NationalCancer Institute, and the BreastCancer Research Foundation, and haspublished more than 150 papers.

Dr Cazap was director for morethan 25 years of the Instituto Dr.Estévez, a leading cancer clinic in

Argentina, and professor of oncologyat Universidad Del Salvador andUniversidad Católica Argentina. Hehas participated for more than 30years in the Asociación Argentina deOncología Clínica (AAOC), the spe-cialty's leading organization, of whichhe was president for two terms.

In 2003, with six other oncologyleaders, he founded the Latin-American and Caribbean Society ofMedical Oncology (SLACOM) ofwhich he is the first president. Thisyoung but very active organizationassembles today more than 1,700 spe-cialists from every country in theregion.

Global comprehensive cancer con-trol is one of Dr Cazap's priorities.He was one of the founder signatoriesof the Charter of Paris against Cancer(2000). He has served in the WorldHealth Organization cancer technicalgroup.

Dr Cazap works actively in theEuropean Society of MedicalOncology (ESMO). He promotedthe membership of Argentina - thethird non-European country to beaccepted after Israel and Turkey. Hehas represented Argentina and LatinAmerica in ESMO for many yearsand recently became a member of itsdeveloping countries task force(DCTF).

Eduardo Cazap, president-elect

New board membersThe assembly also elected or re-elected six membersof the board of directors. They are:

Dr Mary Gospodarowicz, chair and professor,Department of Radiation Oncology, University ofToronto, chief, radiation medicine programme, andmedical director, cancer programme, PrincessMargaret Hospital, University Health Network,Toronto

Dr Arun P Kurkure, honorary secretary and man-aging trustee (CEO), Indian Cancer Society

Dr Tezer Kutluk, president, Turkish Associationfor Cancer Research and Control, and CEO,Hacettepe University Hospitals

Sir Alex Markham, West Riding professor of med-icine, University of Leeds, and senior medical advi-sor, Cancer Research UK

Dr Twalib Ngoma, director, Ocean Road CancerInstitute, Tanzania

Dr Luiz Antonio Santini, general director,National Cancer Institute of Brazil

Mary Gospodarowicz

Twalib Ngoma

Arun P KukureAlex Markham

Tezer Kutluk Luiz Antonio Santini

The general assembly also elected six people to the new nominating committee.

Nominating committee

Outgoing president Franco Cavalli is ex officio chair of the committee.

Ms Elizabeth Hjorth, DenmarkDr Jamal Khader, JordanDr Eliezer Robinson, Israel

Dr Ignacio Musé Sevrini, UruguayDr Kazuo Tajima, JapanDr Roberto Zanetti, Italy



The world of cancer informationThe challenge of communicating

accurate information to cancerpatients is one that all cancer organi-zations share.

On Wednesday 27 August, theInternational Cancer InformationService Group (ICISG) and UICCdelivered an all-day course on how tostart and manage a cancer informationservice (CIS). Fifty participants from18 countries attended to learn moreabout the steps needed to start a CIS,the basics of an information service,how to recruit and train staff, ele-ments of quality management, andkey resources and technology.

“The ICISG was formed in 1996 atthe first World Cancer Congress inAustralia. We share a commitmentto providing quality cancer informa-tion and to assisting other organiza-tions set up informationprogrammes. This workshop cap-tures the spirit of the International

CIS Group,” says Chris Thomsen,president of the ICISG.

Congress participants who missedthis workshop may like to know thatthere is a Track 4 Plenary Session onCIS and cancer control at 14:15 on

30 August 30 in Palexpo Room F.For more information about cancer

information services and the ICISG,please visit www.icisg.org or stop bythe ICISG exhibition booth.

Controlling cervical cancer in the developing worldHow effective are HPV (human

papilloma virus) vaccination andscreening programmes in the globalfight against cervical cancer? The costof HPV vaccination and deliverycosts are often cited as a barrier toimplementing vaccination pro-grammes, so how can this be over-come, particularly in developingregions?

Recent advances in cervical cancerprevention offer new hope for con-trolling the disease in developingcountries, where 80% of cases occur.

In a new series of papers to belaunched by the journal Vaccine atthe World Cancer Congress onThursday, leading researchers will setout the best independent, globalthinking on the issue, provide newresearch on the cost effectiveness ofHPV vaccines in two of the hardesthit regions of the world – LatinAmerica and the Asia-Pacific region –and offer new insights into the mostpromising strategies for tackling thedisease in low-resource settings.

Cancer capacity-building fundThe UICC cancer capacity-build-

ing fund supports efforts to strengthenthe work of member organizations inresource-constrained countries inreaching out to local communitieswith evidence-based activities.

The fund was established withfunds from countries implementingRelay For Life, an event that islicensed and supported through train-ing and technical assistance by theAmerican Cancer Society, a UICCmember organization.

The fund was launched in October2007. The project theme for 2008was promotion of tobacco preventionactivities related to the "I like mysmoke-free childhood" campaign.

Out of 51 applications submitted,the review committee approved 18projects for activities and two applica-tions for small grants to finance studytours.

A new call for projects will belaunched in September 2008.

disease in low-resource settings.

Anne Vézina, outgoing ICISG president, Chris Thomsen, incoming president, and Silvia Denof InfoCancer (Switzerland), who joins the ICISG board this week



Promoting a smoke-free environmentfor children in Burundi

The Alliance burundaise contre lecancer (ABCC) was one of 18 organ-izations to receive a grant from thecancer capacity-building fund.

The project proposed by thealliance aims to promote a tobacco-free environment for children agedfive and younger in the Gitega regionof Burundi through awareness raisingand education.

In February 2008, educationalmaterials on this subject were pro-duced and adapted. The process beganwith the in-depth training of regionalvoluntary educators on the harms andnegative side effects of tobacco use,provided by a selected qualified edu-cator specializing in this field.

Following the training, 300 preg-nant women are being educated bythese volunteers in a series of threeworkshops held in March, June, andOctober. The project also providesmaterials for the volunteer educators,including t-shirts, caps, and umbrellaswith the project logo.

The project officer is GorethNyandwi, one of the founding mem-bers of the Alliance burundaise contrele cancer. She takes care of thealliance’s book-keeping, works onproject development , and is also in

charge of the ABCC’santi-tobacco cam-paigns, aimed at rais-ing awareness in thepopulation, particular-ly the youth, on thecauses of cancer andthe harmful effects oftobacco use.

The alliance, found-ed in 2006, aims tosensitize the Burundipublic, health profes-sionals, and potentialpartners about canceras a public health con-cern in order to promote cancer pre-vention. Through media coverageand grassroots teaching, ABCC dis-penses information, educates, andcommunicates the need for earlydetection and diagnosis of cancer.

Within its three-year plan ofaction, the ABCC is confident ofsensitizing the public, organizing sys-tematic prevention and detection, andreaching a national financial agree-ment for the treatment of cancer dis-eases.

In 2007, the ABCC met withpolitical authorities and health offi-cials in broadcast seminars and con-

ferences. In 2008, ABCC will con-struct a functional national cancercentre anchored in the existing carestructures of the communities,including a new referral system.Finally, the ABCC is dedicated tocreating a local care unit in 2009,integrating medical and surgical treat-ment and radiology under a singleroof, while also taking advantage offoreign treatments centres where nec-essary.

The ABCC became an associatemember of UICC in 2007.

Tackling the global cancer epidemicAbout 25 million people world-

wide are living with cancer. Cases areon the rise across the world, but sur-vival rates are improving in affluentcountries because more cancers aredetected early and treated appropri-ately. However, the developingworld has been left behind, with boththe incidence and the death ratesworsening.

Cancer is the second leading causeof death worldwide and the thirdleading cause of death in the develop-ing world.

It is no longer a disease only ofaffluent nations. The burden hasalready shifted to low and middle-income countries, where more thanhalf of all new cancer cases occurtoday.

The gap is expected to widen sub-stantially, due to aging populations,high smoking rates and the spread ofwesternized lifestyles rich in fattyfoods and lacking in exercise. TheInternational Agency for Research onCancer warns of an explosion of can-cer within two decades. The brunt ofthat burden will be borne by poorcountries, which are ill equipped tohandle the coming crisis.

Most have no strategy for tacklingcancer and few even know howmany of their citizens are affected.

The predicted crisis will put pres-sure on already strained health sys-tems struggling to get on top ofinfectious and other chronic diseases.

Health economists predict that can-cer could become a major impedi-

ment to socio-economic develop-ment in low income and economical-ly emerging nations.

But much can be done to help devel-oping countries cope with the impend-ing crisis and to lessen the toll of disease,suffering and death from cancer.

The World Cancer Summit 2008,chaired by former UN high commis-sioner for human rights MaryRobinson, aims to step up efforts totackle the global cancer crisis. Itbrings together a broad panel of 63high-level policymakers and expertsto discuss the key challenges faced incombating cancer in the developingworld. The group will meet onSaturday 30 August to recommendtargets for 2020 and define priorityactions needed to meet those targets.

Dr Rosa Paula Manariyo welcomes Dr Pie Ntavyohanyuma


8 World Cancer Congress

Off the pressBetter together

Assessing the organizationalneeds of cancer patient groups inCroatia and Romania

Cancer patient groups providemuch-needed services to cancerpatients and their families, buttheir actions are rarely recordedor assessed. To support thedevelopment of effective andsustainable cancer patient groups,particularly in resource-con-strained countries, the

International Unionagainst Cancer(UICC) conducted apilot project withselected groups inRomania andCroatia.

Based on a series ofinterviews and obser-vations, theresearchers evaluatedthe capabilities ofeach group and made

specific recommen-dations to increasetheir capacity.“Better Together”,the report summingup the findings ofthe pilot project,can help build thecapacity of patientgroups in South-Eastern Europe andelsewhere.

Conferences

The annual meeting of the International Societyof Paediatric Oncology (SIOP) is the prime paedi-atric oncology event of the world.

For its 40th annual meeting, held for the firsttime in Berlin, Germany, SIOP will focus on newhorizons in care and cure.

“More specific targeted drugs using knowledgeobtained by molecular biology studies of cancerhave been developed during the past years,” theorganizers say. “Furthermore, according to recentlegislation, Europe after the US has become thesecond largest region with legislation aimed atstrengthening and improving paediatric pharma-ceutical research. This will offer new prospects andperspectives for children and adolescents with can-cer. Other legislative measures concerning the roleof paediatric oncology nurses will change theworking situation in our hospitals.”

You can still profit from a reduced fee if youregister for the congress before the end of August.

Read more: [email protected]

Uniting to defeat cancerAnnual report 2007

Cancer killed almost 8 millionpeople in 2007 - about one ineight of all deaths. If we do noth-ing, deaths from cancer world-wide will soar to an estimated 12million deaths in 2030. New casesof cancer are expected to jumpfrom over 11 million to almost 16million in the same period.

Human tragedy on this scaledemands a decisive response.

This annual report outlines ayear of progress, victories, setbacksand innovation. UICC has madeevery effort to put cancer on pub-lic and donor agendas, transfer

knowledge from those who haveit to those who don't, and buildlocal capacity particularly in low-and middle-income countries,where cancer presents a growingchallenge to public health.

We work in part-nership with ourmember organizations– now over 300 inmore than 100 coun-tries – and otherstakeholders. Wecould not achieve allwe do without theaid of hundreds ofvoluntary experts,decision-makers,

caregivers and patient groupswho give of their time, energyand dedication to further ourvision of a world where cancer isno longer a major life-threaten-ing disease for future generations.

Together, we haveopened doors toensure that preven-tion, effective treat-ment and supportivecare are more acces-sible. Yet there isstill so much morethat we must do.

United, we candefeat cancer.

Molecular Targets and Cancer Therapeutics20th EORTC-NCI-AACR SymposiumGeneva, Switzerland, 21-24 October 2008

Oncology Nursing Society Institutes ofLearningSeattle, USA, 14-16 November 2008Under the auspices of UICC

10 Congreso Uruguayo de OncologíaMontevideo, Uruguay, 20-22 November 2008Under the auspices of UICC

Molecular Markers in CancerNCI-ASCO-EORTC Annual MeetingHollywood, Florida, USA, 30 October-1November 2008

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