Monday at the NCRI Conference got off to a good start when I attended the plenary lecture by Cheng-Har Yip from Malaysia on the subject 'Challenges in the management of breast cancer in low and middle income countries'. So much of the conference is about high tech solutions which are not always available in low and middle income countries so it was good to have this reminder. We heard about challenges at all stages from late presentation because of fatalism and a preference for trying alternative therapies first, though lack of access to reliable pathology and onto low access to radiotherapy. Some countries have a multitude of languages so patients may face a language barrier on top of problems such as distance and the cost of treatment. The importance of a multidisciplinary approach was stressed along with collaboration between the high income countries and the LMICs. It was very encouraging to hear the stress the speaker put on listening to what women say that they want.
This last point also came up in another excellent Monday plenary, namely Stan Kaye giving his Lifetime Achievement Award lecture on drug development and ovarian cancer. He spoke about BRCA testing now becoming routine, the use of the PARP inhibitors and the management of recurrent disease. He also spoke about new targets, heterogeneity and the importance of listening to the patient. One of his last points was 'never forget who you are treating.'
The Molecular Diagnostics workshop was a great opportunity to reflect on lessons learnt from several initiatives. Louise Jones of Barts Cancer Institute reflected that the transformation of the NHS is a significant legacy of the 100,000 Genome project.
Monday evening saw the traditional Independent Cancer Patients' Voice lively meal in the local Pizza Express to which we invite a number of our friends an colleagues in the research and clinical practice community.