IMPRESSIONS OF ASCO:
THE ROAD TO INTEGRATED ONCOLOGY

The Cancer Chronicles Spring 1998

© 1998 by Ralph W. Moss, Ph.D.


May 20--I have just returned from the meeting in Los Angeles of the American Society for Clinical Oncology (ASCO). This is one of the premiere annual events in the cancer world, one of the two famous "spring meetings." (The other is the American Association for Cancer Research.)

I have been attending these meetings in a desultory way for years, but for the first time, our cancer report service, The Moss Reports, took a booth in the massive Exhibition Hall at the Los Angeles Convention Center. Anne Beattie, coordinator of The Moss Reports, Melissa Wolf, our outreach director, and I spent several days meeting and talking with a wide variety of cancer specialists. We engaged scores of them in fruitful discussions about The Moss Reports and our books, especially The Cancer Industry and Questioning Chemotherapy, which were prominently displayed at our booth.

A highlight for me was a conversation with David Rosenthal, M.D., the Harvard professor who is current president of the American Cancer Society. This was a entirely friendly encounter, and I had a chance to review with him the figures in my book, The Cancer Industry, on ACS's now discarded evaluations of non-conventional methods. Dr. Rosenthal explained that he has tried to launch a new era of openness towards such ideas. He and I will, in fact, be speaking on the same podium June 12-14, 1998 at the Center for Mind-Body Medicine Conference on Integrating Cancer Care in Arlington, VA.

I am sure many readers would like to hear about the scientific presentations, on Herceptin, Camptothecin, Angiostatin and the like. Unfortunately, I did not get to attend many scientific presentations. I spent my time this year at the booth as well as "schmoozing" with various friends and acquaintances whom I ran into.

IMPRESSIONS OF AN EXHIBITOR

I would like to share with you my impressions of the meeting from the perspective of an exhibitor. One of the astonishing things about ASCO these days is the size. Old-timers recall when ASCO was a relatively small organization, and the exhibition area was a modest appendage. This year it was huge. The New York Times (5/18/98) reported that there were 19,000 cancer specialists in L.A. for the meeting. And that's just a fraction of the organization. Nineteen thousand! They seemed to be everywhere. Hotels 15 miles away from "ground zero," the massive L.A. Convention Center, were packed with oncologists. You could see greetings to ASCO members on the white fluorescent display signs all over town. About 20 special busses were zipping all over the sprawling city carrying attendees back and forth from their hotels. I couldn't help but think of the laetrile-era complaint, "There are more people living off cancer than dying of it." Unfair, but there's a grain of truth to it. Cancer treatment, for better or worse, has become a big business all over the world.

Another surprising feature was how many non-Americans were in attendance at the "American" Society for Clinical Oncology. There were large numbers of doctors from Latin America (especially it seemed Argentina), Europe, the Middle East, etc. Our guess was that 50 percent of the people who came to our booth were not from the U.S.A. and many of the Americans were foreign born. We also were surprised by how male-dominated this profession still is. This was even more so for the South American doctors. I know very well that a woman (Karen Antman of Columbia-Presbyterian) has been president of ASCO. However, many of the women we met seemed to hold less prestigious or even subordinate jobs (such as in public health services). The high-powered honchos are still mostly male.

SELLING CHEMOTHERAPY

The Exhibition Hall was taken up mainly with the displays of cancer drug manufacturers, such as Bristol-Myers Squibb, Amgen, Genentech, and the like. And what displays these were! Each of the drug companies active in the chemotherapy field was there, and each display vied with the others for glitziness and or even gaudiness. As you entered the hall there was a high-tech loudspeaker that announced something like, "Oncologists! Your hard work has finally paid off. The American public salutes you for your acknowledged victories in the war on cancer. Come visit our booth...." and so forth. Amgen was selling Neupogen, a drug which basically enables doctors to give their patients a "fighting chance" by giving them more chemotherapy. Since Neupogen gives patients a "fighting chance," the theme this year was militaristic. The company posted guards in white Napoleonic- type uniforms at each corner of the display. Each guard wore a white visor and his face was also painted white. It was eerie. These guards stood at erect attention at the strategic corners of the rented space. They were so immobile that one of my companions was convinced they were statues! Occasionally, they left their assigned spaces and marched single-file through the exhibit hall. In front of them they carrying not rifles but streamlined silver N's, presumably for Neupogen. Unlike the guards outside Buckingham Palace, we discovered you could talk to the Neupogen soldiers, and they would talk back. It was strange standing in the middle of a carpeted, two-story high chemotherapy display chatting about L.A. weather with a Neupogen soldier.

VIRTUAL REALITY

I can't tell you how large the Exhibition Hall actually was. Six football fields would be a good guess. The hall was probably five or six stories high. But these are guesses. Everything associated with this huge room suggested that you had left the ordinary world behind, that you were in a Borg-like space where resistance was futile. Even my friend Jim McCoy said it reminded him somehow of "Star Trek."The high tech theme was sounded again and again. Doctors stood on platforms trying out Virtual Reality devices. There was even a walk-through Virtual Reality display, where you could seek enlightenment by recreating the feeling of a cancer's patients fatigue. I didn't see anyone signing up for that one. I fled from there to the freeze-dried ice cream pellet dispensary.

Yes, I admit it, I sold out for a mass of giveaways. Bristol Myers Squibb, the self-declared "World Leader in Chemotherapy," was giving away box loads of L.L. Bean-style floppysided attache briefcases. Each one would cost you $30 or $40 in the store. Greedy people (none of them known to me) were grabbing five or six for friends back home. Plenty of people were giving away tote bags of course, but the tactfulness of BM-S was especially appreciated since these bags did not carry any crass advertising on the outside. Only when you open the briefcase do you see the company's name inside. This reminds you over and over again of the company's generosity and good taste. Not for nothing are they the world leader.

There were at least four booths offering doctors prizes or money for filling out survey forms. One came right out and gave each oncologist $150 in cash just for answering a few marketing questions. Suddenly, I realized my parents were right--I should have gone to medical school! There were also free sherbet, soft drinks, bottled water and water holders, cappuccino, espresso and latte, the aforementioned freeze-dried ice cream pellets ("They can't cure cancer but they can make a dry ice cream," cracked one wit), in fact anything at all to get those doctors away from their meeting and onto the floor of the exhibition hall.

I am sure many very important lectures were given. But spending my time in the nitty-gritty world of sales gave me a peculiar impression of this august meeting. My overall impression was one of fabulous wealth and power. I mean, I literally wrote the book on The Cancer Industry. I have followed the growth and consolidation of this industry in many of my writings. But it has all remained rather academic for me. I kept thinking of the argument I had with the late Lawrence Burton, Ph.D. in 1988, when I visited him in his Bahamian exile. "You just don't get it," he yelled at me in his insulting way. "It's a biz-ness! It's a biz-ness!"

QUESTIONING CHEMOTHERAPY

In this rah-rah atmosphere of the ASCO meeting it was certainly strange to be displaying my book, "Questioning Chemotherapy." The only other people questioning chemotherapy at that meeting, oddly enough, were the editors of The Lancet. The Lancet did a special feature on cancer (presumably to coincide with the event) which called into question the use of high-dose chemotherapy for most solid tumors of adults. A great article. I didn't notice any huge crowds around their booth. Most people seemed too preoccupied seeking out attache cases.

Yet most reactions to Questioning Chemotherapy were friendly or at least intrigued. We went with the goal in mind of meeting about 20 oncologists we could work with at various levels. We had personal encounters with several hundred and handed out our colorful flyer. We exchanged cards with many of them. Only two people were downright hostile. One thought our views were "too negative." From this meeting I conclude that there there is a significant minority of oncologists who are upset by the commercialization of their field and are looking for answers. Once we engaged them in conversation we were able to find many points of agreement.

We weren't entirely alone, either. We shared a space with James McCoy, Ph.D., whose company, ImmunoComp, markets an experimental tumor vaccine. Right behind us, by serendipity, was the display of Robert Nagourney, M.D, an unconventional oncologist from Long Beach, California. Also present was one herbalist whose product could seemingly reduce the side effects of chemotherapy. (They reported very little interest from the attendees.) Also, Lane Laboratories, makers of a popular brand of shark cartilage. Although they were promoting clinical trials of their product they encountered more hostility. There was also a wide variety of patient groups, and representatives of the forthcoming March, an event that seems to have garnered quite a bit of pharmaceutical company support.

By and large ASCO--1998 was a very positive experience for us. We hope that others who march to a different drummer will be heartened by this field report and come to next year's meeting in Atlanta. The future of cancer treatment for a long time to come will involve a skillful combination of both conventional and nonconventional medicine. Such a synthesis will be made not just by alternative practitioners but by many of the people who attended this meeting. The sooner non-conventional practitioners and innovators seek out such encounters with oncologists, the sooner will a truly useful integrated approach emerge.


Ralph W. Moss, Ph.D. is director of the The Moss Reports for cancer patients. Dr. Moss is the author of eleven books and three documentaries on cancer-related topics. He is or has been an advisor on alternative cancer treatments to the National Institutes of Health, the National Cancer Institute, the American Urological Association, Columbia University, the University of Texas, the Susan G. Komen Foundation and the German Society of Oncology. He wrote the first article on alternative medicine for the Encyclopedia Britannica yearbook. He is listed in Marquis Who's Who in America, Who's Who in the World, Who's Who in the East, and Who's Who in Entertainment (as a film documentarian). This Web site does not advocate any particular treatment for cancer. We urge you to always seek competent medical advice for all health problems, especially cancer. Before consulting our site please read our full Disclaimer statement.



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