Serving as ASCO’s 60th President over the past year has been an honor and a privilege, said Lynn M. Schuchter, MD, FASCO, who will end her Presidential term during ASCO’s Annual Meeting, being held from May 31 to June 4, 2024, in Chicago, and welcome incoming President Robin Zon, MD, FACP, FASCO, whose tenure begins in June. The past year has been a productive one for Dr. Schuchter, who has spent much of her Presidential term meeting with members of ASCO’s State and Regional Affiliates and traveling internationally to talk with representatives on ASCO’s four regional councils in Asia Pacific, Latin America, Sub-Saharan Africa, and Central and Eastern Europe, to learn about their unique challenges in providing high-quality cancer care in their respective regions and how ASCO can adapt programs to help address these challenges.
Lynn M. Schuchter, MD, FASCO
Dr. Schuchter has also been focused on raising Congressional awareness of the ongoing crisis in cancer drug shortages plaguing the United States through ASCO’s Impossible Choices advocacy campaign, which was launched this past December. Currently, 15 cancer-related drugs, as well as some supportive care medications, continue to be in short supply.
“What we hear from oncologists, and what I’ve experienced myself with my patients, is the very difficult situation of being in clinic and not having access to a treatment that can help a patient,” said Dr. Schuchter. “We will continue addressing cancer drug shortages. In addition, medications such as lorazepam, which is a key supportive care medication for patients with cancer, are also in short supply.”
In keeping with her commitment to ensure that all patients with cancer have access to the highest quality cancer care from diagnosis through the end of life, Dr. Schuchter chose as her Presidential theme “The Art and Science of Cancer Care: From Comfort to Cure.” That theme is a constant thread running through the programming sessions planned at the Annual Meeting and will be the continued focus of Dr. Schuchter’s remaining 4-year term, next as Chair of ASCO’s Board, in 2024, followed by her year as Past President.
Dr. Schuchter is the University of Pennsylvania Perelman School of Medicine’s Madlyn and Leonard Abramson Professor of Hematology-Oncology and has served as Chief of the Division of Hematology-Oncology for 15 years. She is Director of the Tara Miller Melanoma Center at the Abramson Cancer Center.
In an interview with The ASCO Post, Dr. Schuchter discussed her momentous year as ASCO President; the challenges ahead; and her commitment to advancing ASCO’s mission to conquer cancer through research, education, and promotion of the highest quality, equitable care for all patients.
Advancing the Incorporation of Palliative Care Into Standard Oncology Care
Your Presidential theme is “The Art and Science of Cancer Care: From Comfort to Cure.” How did you integrate the art of cancer care into your Presidential work over the past year, and what were some of the results?
I would say that this part of the theme informed much of my goal of serving the diverse needs of our members and patients, as well as the planning that went into the hundreds of sessions for this year’s ASCO Annual Meeting. What has been very meaningful is having the opportunity to speak not only to United States–based ASCO members around the country, but to members across the globe as well.
I have been especially focused on communicating more effectively with all types of providers, including clinicians, nurses, and pharmacists, on the importance of integrating palliative care into standard oncology care early after a diagnosis of advanced cancer, as well as the integration of hospice care at the end of life. Highlighting these aspects of care has led to wonderful conversations with oncology leaders around the world about their incorporation of palliative care into their practices. For example, when I traveled to Abu Dubai for the Emirates Oncology Conference this past fall, I met a physician who had started the first palliative care program in the United Arab Emirates. I also attended the 2023 AORTIC (African Organization for Research and Training in Cancer) International Conference on Cancer in Africa, in Dakar, Senegal. It was so rewarding to hear from providers who are integrating new technologies to advance oncology care into their practices and also emphasizing access to palliative care for their patients.
When I began my term, I talked about how it has been 25 years since palliative care was first incorporated into a Presidential theme by Robert J. Mayer, MD, FASCO. He focused on issues related to end-of-life care as part of his Presidential term in 1997 to 1998. From there, ASCO’s work in palliative care and end-of-life care grew exponentially, and you can feel the progress that has been made over the past nearly 3 decades. Clinicians, especially this generation of new oncologists, are very committed to providing palliative care to their patients and to being prepared to have the challenging conversations with patients about their goals and ensuring they understand their patients’ values and priorities. And patients want this support from us.
In recognition of the benefit of introducing palliative care in conjunction with active treatment, in the course of disease, ASCO is publishing updated guidelines on palliative care for patients with cancer, expected in May 2024, which will emphasize using this care early after diagnosis.
Combining State-of-the-Art Care With Palliative Care
There are more than 200 sessions complementing your Presidential theme planned at this year’s ASCO Annual Meeting. Please talk about the types of sessions that were added as a result of your work in improving how to help and support clinicians as they engage patients and their families in difficult conversations about a serious cancer prognosis.
I selected Thomas W. LeBlanc, MD, MA, FASCO, Associate Professor of Medicine and Director of the Duke Cancer Patient Experience Research Program at Duke Cancer Institute, as Chair of the ASCO Annual Meeting Education Program Committee. He is an expert in both hematologic cancers and palliative care. We partnered to ensure that every disease-focused tract at the Annual Meeting included specialists in a specific cancer who have expertise in supportive and palliative care.
Our intention is to give everyone attending an educational session an opportunity to hear not only about state-of-the-art treatment for patients with a specific type of cancer, but also about symptom management and communication skills. So, attendees will see woven into every educational track some component of tailored communication on risk and prognosis and the latest research on treatment and symptom management to expertly manage symptoms to improve the patient experience of cancer care.
In addition, we are planning to hold two in-person workshops: Genomics 101 for Oncologists and a VitalTalk workshop Navigating Communication With Seriously Ill Patients. Jamie H. Von Roenn, MD, FASCO, ASCO’s Vice President of Education, Science, and Professional Development, has been my partner in developing this workshop, which will also include physician/patient role play.
About 2 years ago, ASCO launched Communities of Practice sessions in medical education, geriatric oncology, and palliative care, to provide an opportunity for a specialized collaborative experience during the Annual Meeting and throughout the year. This year, in addition to these three sessions, we have expanded the number of topics to include Adolescent and Young Adult Community of Practice, Artificial Intelligence Community of Practice, and Survivorship Community of Practice, among others (https://conferences.asco.org/am/communities-practice).
Addressing the Art and Science of Cancer Care
At this year’s Annual Meeting, I have chosen to have two keynote speakers who will address both the art and science of cancer care. Physician and author Abraham Verghese, MD, MACP, will present the art side on oncology care and focus on communication and the relationship between physicians and patients. He is Linda R. Meier and Joan F. Lane Provostial Professor and Vice Chair for the Theory and Practice of Medicine at the School of Medicine at Stanford University and author of The Covenant of Water (Grove Press, 2023). Peter Lee, PhD, will speak to the perils and promise of artificial intelligence (AI) in oncology care. He is Corporate Vice President of Research and Incubations at Microsoft and coauthor of The AI Revolution in Medicine: GPT-4 and Beyond (Pearson, 2023).
In addition, more than 145 scientific abstracts on the topic of artificial intelligence were submitted for the Annual Meeting, and many of them have been selected for presentation. Four Educational Sessions related to the application of AI in cancer treatment and clinical care are also planned for this year’s Annual Meeting.
Engaging Lawmakers to Solve the
Drug Shortage Crisis
Another important goal of your Presidential term was to influence, through advocacy, policies that impact research funding and patient access to high-quality cancer care, including protecting patients from drug shortages and addressing aggressive prior authorization practices. Please talk about the impact of your efforts in these areas.
I want to emphasize that these policy areas are among ASCO’s chief concerns, and the progress that has been made is the result of the collective efforts of ASCO staff and members. This year, I got to work very closely with ASCO staff and with the Government Relations Committee to address the devastating drug shortage crisis and to urge Congress to take action through ASCO’s Impossible Choices campaign. Julie R. Gralow, MD, FACP, FASCO, ASCO’s Chief Medical Officer and Executive Vice President, has also done remarkable work in this area. She has testified before Congress multiple times about the impossible choices physicians face when they have to decide which patients receive their recommended therapy and who has care delayed or makes do with alternate treatments during drug shortages.
Through the Impossible Choices campaign, Congress is hearing from thousands of ASCO members and our patients. I think members of Congress are beginning to get the message, but we will have to see if they act.
Prior authorization is another huge concern for ASCO, its members, and our patients. It adds administrative burden on clinicians and leads to delays in access to care and to the use of less expensive and potentially less effective therapies that have greater risk for toxicity. And we see the adverse impact of prior authorization on cancer care in physician surveys, including higher rates of burnout.
We are working very closely with our State and Regional Affiliates to increase legislative efforts on the state level to streamline this burdensome insurance practice. During the 2023 state legislative session, ASCO tracked 51 prior authorization bills in 29 states,1 so we believe reform will come from the state level rather than from the federal level.
Working Together to Improve Cancer Care Globally
Over the past year, ASCO increased its global regional councils in Central and Eastern Europe to address region-specific challenges in accessing high-quality cancer care. Please talk about the progress being made globally as a result of ASCO’s international collaboration with the current four active regional councils (Asia Pacific, Latin America, Sub-Saharan Africa, and Central and Eastern Europe).
Our goal with the four regional councils is to play an integral role in helping our international members deliver high-quality, equitable patient care throughout their regions. We are working with leaders from the four active regional councils to learn more about the challenges they face, identify opportunities and best practices that could be applied in specific regions, and provide a forum for their members to network, collaborate, and work on local solutions.
We are committed to the success of this program. We know that cancer incidences and mortality are continuing to rise around the world. I will emphasize this concern in my Presidential Address during the Annual Meeting and the need for collaborative efforts to solve this problem. It has been encouraging to work with ASCO’s international partners on these issues, including the Union for International Cancer Control, the African Organization for Research and Training in Cancer, and the European Cancer Organisation, among others.
Continuing ASCO’s Mission to Conquer Cancer
How will you pursue your goals of improving cancer care for all patients as you continue your term next as Chair of the Board, followed by Past President?
I have been working in close collaboration with Dr. Von Roenn to develop resources to help clinicians integrate primary palliative care policies into their practices through education and innovative fellowship programs. Dr. Von Roenn has announced her retirement from ASCO, and I want to voice my deep appreciation for all she has done to move this field forward.
Beyond my time as ASCO President and Dr. Von Roenn’s time as ASCO’s Vice President of Education, Science, and Professional Development, our work will continue.
I am excited to work with ASCO’s leadership and staff and ASCO’s Board of Directors on how best to empower oncologists to leverage artificial intelligence, which has the potential to revolutionize cancer diagnosis, personalize treatment plans, improve prognostic assessments, and enhance cancer care delivery to benefit patients with cancer. This past year, ASCO established the AI Task Force to better understand AI’s opportunities in oncology and how best to support our members with these new technologies. Artificial intelligence in oncology care was also the focus during our recent Board of Directors retreat, and we will have much more to come on this topic in the future.
As I end my tenure as ASCO President, I feel grateful to members for giving me this opportunity to serve them and look forward to continuing to promote ASCO’s mission to conquer cancer through research, education, and promotion of the highest quality, equitable care for all patients. As I look over our collective accomplishments over the past year, I am excited and encouraged by the accelerated advances in oncology care that are improving outcomes for patients and for the future ahead.
DISCLOSURE: Dr. Schuchter has received institutional research funding from GlaxoSmithKline, Merck, and Bristol Myers Squibb and reimbursement for travel, accommodations, and expenses from Stand Up To Cancer.
REFERENCE
1. ASCO in Action: State of Play: Prior Authorization. Available at https://society.asco.org/news-initiatives/policy-news-analysis/state-play-prior-authorization. Accessed April 23, 2024.
