Spotlight on... ESO marks 25 years of championing excellence in cancer education § Anna Wagstaff The European School of Oncology was set up in 1982 to help prevent needless death and suffering by educating Europe’s young cancer doctors. ESO looks to a future where all patients are treated by specialist teams who keep abreast of developments and keep an eye on their own level of performance. But we’re not there yet. his year the European is not their own – the official language of cine. It was also becoming exceptionally School of Oncology cele - ESO is ‘bad English’. Furthermore, no complex, demanding close cooperation brates 25 years dedicated matter how hard the alumni work or between disciplines that traditionally to its mission of reducing how much they learn, it will never count neither trained nor worked together. deaths from cancer due to towards their yearly requirement of “Medical oncology was an emerging Tlate diagnosis and inadequate treat - CME points, because the CME system specialty, surgical oncology was also a ment. During this time, many thou - only works within national borders. Yet new specialty, and even radiation oncol - sands of young oncologists from every whether the course is a full-immersion ogy was changing from the old died-in- discipline and every European country Masterclass on Palliative Care held in the-wool practice to a new modern style,” have benefited from the chance to come Tbilisi, or on Oncology Nursing in Malta, says Peckham, who had himself been together to absorb cutting-edge know- or three days on Predictive Modeling in responsible for developing some of these ledge from leaders in the field, and to Prostate Cancer in Venice, or two days modern techniques, including ‘mantle’ exchange ideas and experiences. Many on Evidence-Based Management of radiotherapy, which had transformed have been stimulated to join the Euro - Lung Cancer in Belgrade, these courses the outlook for patients with Hodgkin’s pean clinical research effort – some - have never been short of applicants. Disease. The problem was how to trans - times joining forces with people they The reason for this, says Sir Michael fer the knowledge that was being gener - first met at an ESO Masterclass. It Peckham, one of the school’s founders, ated in isolated cancer centres to the won’t be long before the first ESO is that ESO filled a big need – and con - clinicians who were actually treating the alumni are themselves invited back as tinues to do so, though the landscape has patients in hospitals across Europe. faculty to teach the next generation. changed significantly over the interven - Peckham often recounts the story of Being a European school has its dif - ing 25 years. Back in the early 1980s, how, as head of radiotherapy at London’s ficulties. Teachers have to teach and oncology was rapidly becoming one of flagship Royal Marsden Hospital, he students have to learn in a language that the fastest developing areas of medi - was reluctantly called away from a busy 40 I CANCER WORLD I SEPTEMBER/OCTOBER 2007 Spotlight on... clinic to meet a dashing young surgeon “It’s a great chance to share experiences from Milan whose mission was to get his with experts. We learned about the most backing for the proposal to launch a advanced treatments, but we also European educational initiative. “I don’t covered the basics as well as social think he in any sense had to twist my aspects, and palliative and community arm. I approved of the idea tremen - care. Because people come from so dously. I’d already been interested in many countries you get a really good the idea of bringing different interests flavour of international practice, and and specialties together in the UK, and can compare what happens elsewhere I’d written about it in the Lancet , with the practice at your own hospital. because I thought the competition It really boosts your confidence.” between different cancer specialties – Rana Mahmood, Beatson Oncology Centre, surgeons and oncologists in particular – Glasgow, UK wasn’t terribly good and it would be perfect if there was a sort of umbrella, and education was the perfect medium for that.” The dashing young surgeon was Alberto Costa, who would later go on to become director of ESO. Though more than happy to give the project his blessing, Peckham did won - der at the time if they might be aiming a bit high. “I suppose I thought, My God! Have they got a hope in hell of pulling this off? A European school sounds very grand, and the track record of Europeans working together in this area hadn’t been brilliant.” The group who were leading the bat - tle for a European School were by no means sure they could ‘pull this off’. The next generation. Students at the 6th ESO Masterclass in Clinical Oncology spent a packed However, they had a lot going for them, week at the end of February learning from 35 experts based in 13 countries not least tremendous self-belief.At their core was the ‘Milan group” headed by “You can always go to congresses to Umberto Veronesi, a surgeon based at the hear the latest data, but when you city’s Istituto Nazionale Tumori, whose are new to oncology, you need to development of the quadrantectomy learn all the data. ESO Master- technique for breast conservation had classes are led by experts in their recently propelled him onto the world field, and they can summarise 30 stage. The Institute was at that time also years’ worth of data for you. They are playing a pivotal role in the growing field very focused at your level and let you of medical oncology. It was here that really get into the subject, part- Gianni Bonadonna developed the gold- icularly when you break into standard ABVD protocol for Hodgkin’s groups to discuss specific cases.” Disease, led the first trials of adjuvant Annemiek Walenkamp, Groningen University CMF, and conducted the clinical devel - Hospital, Netherlands opment of adriamycin – an Italian drug which became one of the most widely CANCER WORLD I SEPTEMBER/OCTOBER 2007 I 41 Spotlight on... WITHOUT FEAR OR FAVOUR The vast majority of continuing medical boss Gianni Agnelli – ESO had education courses today are reliant on been spending a fortune on sponsorship from companies who have a taxis transporting faculty vested commercial interest. ESO is finan - members to and from the cially independent, which is why it is able to course venues. set its own agenda. Topics in medical oncol - The Principessa also mentioned ogy form an important part of the curricu - the work of ESO to the iconic lum, but so do psycho-oncology, cancer designer, Hubert de Givenchy. nursing, and advances in surgical tech - Givenchy at that time was griev - niques. The big killers have traditionally ing over the death of Audrey been a priority for ESO, but it also runs Hepburn, who had been his courses on rarer cancers that are of scant great inspiration and an ambas - commercial interest, such as brain tumours sador for his chic ’60s designs and paediatric cancers. and Amarige perfume. Hepburn That it has been able to do so is thanks in had died of appendiceal cancer, large part to a few powerful people whose having been misdiagnosed for a commitment to ESO emanates from their per - year as suffering from ‘stress’. sonal experiences… Givenchy went on to embrace When she was diagnosed with breast cancer, the work of ESO, giving both the Principessa del Drago – a member of the use of his name, and a sub - Italy’s former royal family – flew straight to the stantial donation to finance a Memorial Sloan Kettering in New York, only French-language programme to be told by her surgeon that the operation that ESO wanted to run. she had undergone had been invented in Italy But it was the promise of a leading figure in It wasn’t stress. When Hepburn died from by Umberto Veronesi. She felt ashamed Italian industry that was to give ESO the con - cancer of the appendix after having been that she had assumed the US was more fidence it needed to launch its activities, and wrongly diagnosed for a year, Givenchy, who advanced in treating breast cancer than her continues to sustain the school to this day. had designed this and many other of her own home country, and His was another story of dresses, offered ESO valuable support on her return she met misdiagnosis. His general with Veronesi, who told practitioner had treated Veronesi must have made a convincing case, her of his idea for a him for arthritis for a because in 1982, ESO was bequeathed the European school that whole year before the nec - family fortune, in the form of yearly interest could build on the good essary scans were done from a trust fund. The money would become work being done in can - and it was found that the available once the last member of the fam - cer in Europe. pain he had been suffer - ily had died. This, Veronesi was assured, The Principessa be- ing was from bone metas - would not be long, as the last member of the came ESO’s President, tases originating from family was 82 years old. The School was she gave the school its prostate cancer. He went launched on the strength of this promise. The first major donation, to Veronesi as Italy’s lead - last surviving family member, went on to live and she continues to ing cancer doctor, and to the ripe old age of 101. use her influence to Veronesi told him of the Those were difficult years of pitching for open doors.