ESMO at 30: Mission ongoing
Authors: P.A. Kosmidis, H. Ludwig, H. Mellstedt
Journal: Annals of Oncology (2005)

The beginning of medical oncology stems back to the early 1940 s when researchers on both sites of the Atlantic started to use nitrogen mustards for the treatment of malignant diseases [1.Gilman A. Philips F.S. The biological actions and therapeutic applications of the B-chloroethyl amines and sulfides.Science. 1946; 103: 409-415Crossref Scopus (327) Google Scholar, 2.Gilman A. The initial clinical trial of nitrogen mustard.Am J Surg. 1961; 105: 574-578Abstract Full Text PDF Scopus (225) Google Scholar, 3.Wilkinson J.F. Fletcher R. Effect of chlorethylamine hydrochlorides in leukemia Hodgkin's disease and polycythaemia vera report on eighteen cases.Lancet. 1947; ii: 540-545Abstract Scopus (22) Google Scholar]. The results of those early studies were only published with some delay after the end of the Second World War. Increasing progress in the field of medical cancer treatment finally led to the need for rapid exchange of scientific research and to the creation of a society of European experts in the field. This was in 1975 when Georges Mathé and Maurice Schneider created the Societé de Médicine Interne Cancerologique that was later renamed the European Society for Medical Oncology (ESMO). Hence, this year we celebrate the 30th anniversary of its foundation. Anniversaries, and the celebrating of anniversaries, are useful inasmuch as they allow us to assess our past and consider our present and future positions. It is not our intention here to dwell on the history of the Society. ESMO members have already received the excellent 30th Anniversary Book which considers ESMO's past and present activities in some detail. Similarly, regular readers of Annals of Oncology will be aware of ESMO activities [4.ESMO/ASCO Task Force on Global Core Curriculum in Medical Oncology Recommendations for a global core currriculum in medical oncology.Ann Oncol. 2004; 15: 1603-1612Abstract Full Text Full Text PDF PubMed Scopus (36) Google Scholar, 5.Cherny N.I. Catane R. Kosmidis P. et al.ESMO takes a stand on supportive and palliative care.Ann Oncol. 2003; 14: 1335-1337Abstract Full Text Full Text PDF PubMed Scopus (101) Google Scholar, 6.Ludwig H. European Society of Medical Oncology membership survey.Ann Oncol. 2004; 15: 181-182Abstract Full Text Full Text PDF Scopus (2) Google Scholar, 7.Stahel R.A. ESMO Minimum Clinical Recommendations: assuring common standards of care.Ann Oncol. 2005; 16: i5-i6Abstract Full Text PDF PubMed Scopus (3) Google Scholar, 8.Schrijvers D. Vermorken J.B. Bokemeyer C. Ludwig H. Continuing medical education: a must for every medical oncologist.Ann Oncol. 2003; 14: 1455-1459Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar]. ESMO is fulfilling its mission, which you can read in full detail in the ESMO Byelaws at http://www.esmo.org/about/about_bylaws.htm, but we can précis it here using just the verbs: improve, advance, disseminate, educate, promote, maintain. Taken together, to constantly improve the quality of prevention, early diagnosis, treatment, after care and palliation of patients with cancer and by improving training and education of oncologists [9.Ludwig H.A Foundation for the future.Ann Oncol. 2005; 16: 3Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar] and by fostering clinical and theoretical cancer research. Participants at the recent ESMO Scientific & Educational Conference in Budapest will have dipped their toes in the future of the specialty, and the future of the Society. As senior members of the Society, it was with great pride in the next generation of oncologists that we saw the free distribution of the ESMO Handbook of Oncological Emergencies [10.Kosmidis P.A. Schrijvers D. André F. Rottey S. ESMO Handbook of Oncological Emergencies. Taylor and Francis, London2005Crossref Google Scholar] to all participants at this meeting. This book was initiated by the Society's Young Medical Oncologists Working Group and has been written by a team of young medical oncologists in collaboration with more senior figures. The enthusiasm and vigor that the young medical oncologists brought to this project is a cause for great optimism to us. A further cause for optimism in Budapest was the success of the 4th ESMO Patient Seminar, with the participation of over 250 patients. The ESMO Patient Seminar series represents a cornerstone of our vital and ongoing dialogue with cancer patients—the people for whom ESMO exists and our daily partners in ESMO's mission. Optimism, tempered with realism, is required now of all of us, as the challenge of cancer remains a daunting one. Recent estimates indicate that in 2002 there were 10.9 million new cancer cases globally, with some 6.7 million deaths [11.Parkin D.M. Bray F. Ferlay J. Pisani P. Global Cancer Statistics, 2002.CA Cancer J Clin. 2005; 55: 74-108Crossref PubMed Scopus (17329) Google Scholar]. Over the 30 years of ESMO's existence increasing life expectancy has become a significant determinant of increasing cancer incidence, and the World Health Organization (WHO) has estimated that with this ageing of populations there could, by 2020, be 16 million new cases per year and around 10 million deaths. In Europe, where primary prevention, screening and application of modern cancer therapies has led in recent years to generally decreasing trends in age-standardized incidence and mortality rates [12.Boyle P. d'Onofrio A. Maisonneuve P. et al.Measuring progress against cancer in Europe: has the 15% decline targeted for 2000 come about?.Ann Oncol. 2003; 14: 1312-1325Abstract Full Text Full Text PDF PubMed Scopus (118) Google Scholar], it has nevertheless been estimated that there will be around 1.25 million cancer deaths in 2015, almost 130 000 (11%) more deaths than in 2000 [13.Quinn M.J. d'Onofrio A. Moller B. et al.Cancer mortality trends in the EU and acceding countries up to 2015.Ann Oncol. 2003; 14: 1148-1152Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar]. Facing this challenge will require an increase in efforts to prevent cancer and real courage of all of us, not simply in doing the best for our patients, the best in our research, but in making bold decisions, taking forward our dialogue with patients, our dialogue with governments. We must also be prepared to expand our cooperation with other disciplines, both within and outside the medical profession, working by means of common activities through ESMO to face the changing pattern of oncology practice. Be assured that practice must change; in Europe alone the disparities in cancer survival seen between countries [14.Coleman M.P. Gatta G. Verdecchia A. et al.EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century.Ann Oncol. 2003; 14: v128-v149Abstract Full Text PDF PubMed Scopus (412) Google Scholar] are intolerable, and that these disparities are susceptible to intervention only compounds that intolerability. ESMO must continue to emphasize the importance of the official recognition of medical oncology as a specialty and the enormous potential this has to raise standards of cancer care throughout Europe. That said, we must acknowledge that cancer is a global disease, and if the disparities that exist within Europe are susceptible to intervention, this is also true of countries throughout the world. WHO estimates suggest that as we move towards 2020 and those potential 16 million new cases per year the proportion of those patients living in developing countries will approach 60% [15.World Health Organisation and International Union Against Cancer. Global Action Against Cancer. WHO, Geneva, Switzerland2003Google Scholar]. ESMO is prepared to play its part in working towards global solutions to the cancer epidemic. Indeed, it must do so to fulfill its mission. Those figures, not just figures but real human lives, demand that we do not simply rest in the comfort zone of the Society's 30-year history. The lesson of that history is that to achieve we must first attempt, and that so much of what we have attempted was achieved. With this in mind, we must mobilize all the talents, energy and experience of our fellow oncologists to enhance cooperation and to further develop the practice, science and art of medical oncology and to take ESMO forward on its mission.