December 2011

Where are we going next in the global battle against cancer? A great place to find out was the Montreal Neurological Institute’s Jeanne Timmins Amphitheatre, November 21, when Simon Sutcliffe delivered his lecture, Cancer Control – Life and Death in an Unequal World. The impetus for the inaugural Bronfman lecture series – the upcoming 20th anniversary of the Gerald Bronfman Centre for Research in Clinical Oncology – motivated McGill to take stock of its contributions to a battle that is at once international, local and deeply personal. Also shining a light on the science and treatment of cancer were renowned McGill researchers and leaders, Eduardo Franco, Michel Tremblay, and Michael Pollak, MDCM’77.

Simon Sutcliffe. Photo: Nicolas Morin

International and historic battle

Simon Sutcliffe is president of the International Network for Cancer Treatment and Research in Canada. The native of the United Kingdom moved to Canada when he was thirty-three, trained and practiced as an oncologist, eventually going on to steer British Columbia’s Cancer Agency for over a decade, first as vice president, then as president and CEO. He has held numerous other prestigious appointments, devoting himself to understanding the past, present and possible future of cancer in the developed and developing word.

In his lecture, he described how communicable diseases such as tuberculosis, scarlet fever, and cholera once ran rampant in western nations. But in the late 19th century and early 20th century, death rates from these diseases dropped dramatically. What happened, and why does it matter for the fight against cancer?

Better hygiene and sanitation, clean air, and an improved standard of living brought about huge increases in life expectancy. Those changes have achieved more than even medical interventions. “The medical management of illness is only one, modest contributing factor in the health of the whole population,” Sutcliffe argued.

Much of the developing world is currently undergoing a similar demographic transition that Western societies experienced over a century ago. This is leading to the relative decline of communicable diseases. That’s the good news. But the bad news is the impending rise of chronic conditions like cancer. The charts Sutcliffe presented tell a disturbing story. Cancer will very likely be a scourge in countries that are the least well equipped to respond.

Cancer Incidence and Mortality [click to enlarge]

The chances of surviving cancer are illustrated by the portion of the red line (incidence) taken up by the blue line (mortality). The more the blue line approximates the red, the more likely it is that a cancer diagnosis is, in the words of Simon Sutcliffe, “tantamount to a death sentence.” Source, GLOBOCAN 2008. International Agency for Research on Cancer.

Predicted Changes in Cancer Mortality [click to enlarge]

“The growth rate in cancer mortality will be considerably more rapid in the developing world,” Simon Sutcliffe. Source, Annals of Oncology: Kanavos: Volume 17; Supplement 8; June 2006.

Is McGill prepared for the future?

McGill is lauded for its clinical and basic sciences successes both past and present. Sutcliffe’s lecture, however, raised questions about how the University can continue to play a relevant role in a drastically different future.

The experts that followed Sutcliffe gave very different but similarly concrete glimpses at this future. Lifestyle – a critical factor, because westernized habits of eating (and not exercising) are going global – was the focus of a talk by Michael Pollak, Director of the Cancer Prevention Centre at the Jewish General Hospital. Studies by him and his colleagues have described the dramatic link between diet and cancer. Variations in diet influence hormones which in turn effect cancer cell growth. As these mechanisms become better understood, it paves the way to new drugs that slow cancer cell growth via hormone regulation.

Michael Pollak. Photo: Nicolas Morin

Michel Tremblay. Photo: Nicolas Morin

 

The final afternoon lecture was delivered by Michel Tremblay, Director of the Rosalind and Morris Goodman Cancer Research Centre. As well as remarking on the sheer complexity of cancer as expressed genetically, he returned to the global theme by drawing attention to the pioneering work of the McGill Institute for Health and Social Policy. The Institute, directed by Jody Heymann, examines how social policies affect the ability of individuals, families and communities to meet their health needs, and so provides essential tools for helping policy makers prepare for the future.

Tremblay discussed an overseas project he is involved with personally in Guinea, Africa, where he is helping establish a cancer centre in cooperation with local partners – taking a small step forward in addressing the developing world’s dire need for better basic health care. Tremblay also recognized the inspiring global health work of fellow McGillian, Mark Wainberg, BSc’66. As Co-Chair of the 13th International Congress on AIDS in Durban, South Africa, in 2000 (among numerous other accomplishments) Wainberg has provided a model for how world leaders, policy-makers and health experts can come together in a collaborative and focused way to tackle a disease such as AIDS. Tremblay believes this model of collaboration has valuable lessons for how cancer can be combated globally.

Local heroes

At a VIP reception after the lectures, Eduardo Franco, Interim Director of the Gerald Bronfman Centre, as well as Interim Chair of the Department of Oncology, brought the focus back to individuals, to the patients who struggle with cancer as well as the professionals whose job it is to help them. He explained the importance of clinical trials in developing new cancer therapies. The Centre manages the hundreds of such trials every year that are conducted in the affiliated McGill hospitals. There have been landmark breakthroughs over the Centre’s history: the trials of Herceptin, approved for breast cancer in 1998, and Ipilumumab, approved for melanoma just earlier this year, to name only a couple.

Eduardo Franco. Photo: Nicolas Morin

Local patients gave testimonials about their experiences, lauding the compassion and expertise of Bronfman centre investigators and staff, as well as describing the sense of pride that comes from contributing to the fight against cancer. One of the patients was Richard Pelletier, who in February 2010 was diagnosed with non-small cell lung cancer which subsequently metastasized. He was told there was no cure. “That’s a killer, that floors you when you hear that,” he said. Nevertheless, the care and treatments he received helped him rally, and on the day of the reception, he was there to watch his own video testimonial in person. “There’s a big benefit to these clinical trials,” he explained. “Well, there’s more than one! You’re being seen much closer. They’re paying very close attention and monitoring you constantly. The other benefit is that if you happen to fall on a good one [a treatment], you’re one of the first to get it.”

[Laurence Miall]

ABOUT THE BRONFMAN CENTRE

The Gerald Bronfman Centre for Clinical Research in Oncology, at 546 Pine Ave., is the home base and administrative hub for the McGill’s Department of Oncology, the first such department in Canada, and several of its major programs, including the Clinical Research Program, the Division of Cancer Epidemiology, the Cancer Nutrition and Rehabilitation Program and the Program on Whole Person Care. These programs have helped McGill earn a reputation for leadership in advancing research on cancer prevention, treatment and palliative care. The Bronfman Centre was established thanks to a generous donation by the Marjorie and Gerald Bronfman Foundation, represented on November 21 by Judy Bronfman-Thau. To read more and see photos from 20th anniversary celebrations, read the story in Med e-News.

Note: A modified version of Simon Sutcliffe’s Bronfman lecture was  published online in Current Oncology.

 

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  1. […] This major milestone was marked by several events, including the start of a brand new McGill tradition, the Bronfman Scientific Lecture. The Faculty was delighted to welcome international cancer control expert Dr. Simon B. Sutcliffe to deliver the keynote address, Cancer Control – Life and Death in an Unequal World. Dr. Sutcliffe’s thought-provoking lecture was followed by a panel discussion moderated by Dr. Eduardo Franco, Interim Director of the GBC.  Dr. Michael Pollak and Dr. Michel Tremblay, two of McGill’s pre-eminent cancer researchers, weighed in on McGill’s contribution to the worldwide fight against cancer. See associated story in Focus. […]