Something for Everyone: Surgeons' Corner

The ASCO Annual Meeting serves as a learning opportunity and chance to network for many specialists in addition to medical oncologists. Michael S. Sabel, MD, FACS, of the University of Michigan Health Systems, is a surgeon with expertise in breast cancer and melanoma. Dr. Sabel has been an ASCO member for 13 years, and he finds that attending the ASCO Annual Meeting allows him to better facilitate patient conversations and decision making.

Why do you continue to attend ASCO Annual Meetings?
The ASCO Annual Meeting is by far the most important meeting of the year highlighting the most noteworthy developments in oncology. As a surgical oncologist, it is imperative to keep up with the new clinical trial results that will affect how we treat our patients, as well as with the ongoing research that could affect disease management in the future. When patients see me for a surgical consultation, they want to know more than just what the surgery entails; they want to know about every aspect of multidisciplinary management, particularly new research that they’ve encountered online or in an article. I believe that being well-informed and able to discuss this with my patients not only instills confidence, but also helps them as they face multiple decisions about their own care. I think attending the ASCO Annual Meeting is the best way to facilitate these discussions.

What session types or tracks do you attend most often and why?
My practice primarily focuses on melanoma and breast cancer, so those sessions get the highest priority when I’m planning my time. I particularly enjoy the Poster Sessions (both General and Poster Discussions), because they provide great opportunities to interact with colleagues and researchers.

I think that most surgeons who haven’t been to the ASCO Annual Meeting (and I was guilty of this as well) imagine the Meeting as being nothing but phase I and phase II trials of new drugs in stage IV disease, many of which they, as surgeons, will never need to know about. However many of the major surgical and radiation oncology trials are also presented at this Meeting, and there is much more emphasis on local–regional management than one might expect. Over the past few years there has also been an increase in health services research in oncology, which is critically important to all oncologists—medical and surgical.

Two session types are particularly outstanding: the Education Sessions and the Clinical Science Symposia. These sessions do an excellent job of not only reviewing advances in molecular biology, targeted therapies, immunotherapy, and translational research, but they also do an excellent job of tying these considerations into all aspects of clinical care.

What are some short-term and long-term takeaways that you get from the Meeting?
The short-term takeaways are obvious; you return from that meeting feeling more knowledgeable about the latest advances in and the direction of the field. This is directly beneficial to both my patients and my trainees. I’m also a researcher, with a strong interest in outcomes research, biomarkers, and immunotherapy. Thus, I also benefit from hearing about the questions being asked and the methods being used to answer them. During the Meeting, I’m frequently thinking about how I can go back to my own institution and address some of these issues; I usually leave with a long list of notes and new projects. The Meeting also gives me an opportunity to share ideas with leaders in the fi eld and, in some cases, form collaborations for future projects. This has been an immense long-term benefit.

Do you have any advice for other surgeons as to how to maximize their time at the Meeting?
The first time you attend the ASCO Annual Meeting, the size and scope can be a bit intimidating. To get the most out of it and to avoid being overwhelmed, planning ahead is critical. ASCO provides some fantastic tools to do this. The online resources make this pre-Meeting planning particularly easy, so it is a good idea to take some time and map out what sessions are absolutes. I personally like the iPlanner for this. Be sure to download the iPlanner so that you have access to all the necessary information (e.g., maps, session times, and room locations) and can make changes as the Meeting progresses.

The ASCO Annual Meeting is an excellent opportunity to network and share ideas with our colleagues in medical oncology. Therefore, rather than rushing from session to session, plan on arriving early or staying after for a few minutes in order to interact. I often find that I learn just as much from the post-session discussions as from the sessions themselves. I also find that many medical oncologists attending the Meeting are extremely interested in a surgeon’s point of view. The Poster Sessions are an excellent opportunity for that type of interaction.

In the related interview with Dr. Sabel, he advises surgeons to plan on arriving early to sessions and on staying a few minutes after the end of each session to allow time for interaction with colleagues in other specialties. Multidisciplinaryfocused sessions are an excellent opportunity for this type of interaction, as they draw a diverse group of attendees. Here is a list of sessions of interest for a surgical oncologist, listed in order of presentation.

Today

Uterine Sarcoma: Challenging Cases for the Interdisciplinary Team (1:00 PM-2:15 PM, E Arie Crown Theater)
An overview of uterine sarcomas will be provided, in addition to a discussion of both radiotherapy techniques and surgical implications.

From Discovery to Standards of Care in Clinical Trials of Head and Neck Cancer (1:00 PM-3:15 PM, E354b)
Integrated molecular and immunologic approaches in surgical care will be presented in the context of a broader discussion about genetic information, targeted therapies, radiotherapy, and supportive care.

Saturday

Personalized Medicine in Lung Cancer in 2012 (3:00 PM-4:15 PM, E Hall D2)
This session will provide timely information on the clinical signifi cance of tumor genomics and on the roles of the various multidisciplinary team members who are necessary for successful incorporation of subtyping in daily practice. Clinical tests/assays that can be used to guide clinical treatments also will be discussed.

Multidisciplinary Management of Unusual Head and Neck Tumors (Ticketed Session, 4:45 PM- 6:00 PM, E451b)
This Clinical Problems in Oncology session will discuss disease management in the context of three different cases: medullary thyroid cancer, salivary gland tumor, and skin tumor.

Sunday

Curative-Intent Treatment of Colorectal Cancer Metastases (8:00 AM-9:15 AM, E Hall D2)
Steven A. Curley, MD, of the University of Texas M. D. Anderson Cancer Center will provide the surgeon’s perspective on liver surgery.

Stage I Testicular Cancer Management Options: Surgery, Radiation, Chemotherapy, or Surveillance (Ticketed Session, 8:00 AM-9:15 AM, E451a)
In this Meet the Professor Session George J. Bosl, MD, of Memorial Sloan-Kettering Cancer Center, will discuss nonchemotherapy management of stage I testicular cancer.

Medical Errors in Cancer Care: Prevention, Disclosure, and Patient and Family Member Responses (4:45 PM-6:00 PM, E353)
Information on preventing errors and reasons why patients do or do not pursue legal action will be discussed, as will suggestions regarding communication tactics for different cultural groups.

Monday

Key Questions In The Loco-regional Treatment Of Breast Cancer (9:45 AM-11:00 AM, E Hall D1)
This session will address the topic of logoregional breast cancer management from a multidisciplinary perspective. Continued dilemmas in surgical management will be discussed, including the continued effect of the Z0011 trial results on clinical surgical decision making, and personalization of treatment decisions based on age and comorbidity. In addition, the integration of tumor biology and genomics into local therapy decision making will be discussed and tough questions in radiation oncology will be answered.

A Multidisciplinary Approach to Integrating Local Therapies with Systemic Approach in Soft Tissue Sarcomas (Ticketed Session, 11:30 AM-12:45 PM, E451b)
Raphael E. Pollock, MD, PhD, of the University of Texas M. D. Anderson Cancer Center, will provide expert advice in a small, interactive setting.