Chapter 17: Thinking Outside the Box to Stage the World Summit Against Cancer for a New Millennium
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Description
To demonstrate thinking out of the box, Dr. Hortobagyi describes how he and Dr. Charles Jacquillat organized an important millennium event for the Congress of Anti-Cancer Therapy (formerly the International Congress of Neoadjuvant Therapy). He describes the “crazy” way of free-associating that led them to envision (and successfully plan) the World Summit Against Cancer for a New Millenium held in Paris. The event also introduced the Charter of Paris, a list of patients’ human rights. Between fifty and sixty nations sent delegates to sign the Charter; MD Anderson president John Mendelsohn went to Paris to participate in the signing, and there is a photograph of the document in the Rose Building on MD Anderson’s main campus. Dr. Hortobagyi also explains the purpose of the Charter–to draw attention to the fact that in most countries, cancer patients are undertreated, ill-treated, or ignored. He notes that the UACC adopted their Charter and that in 2012 the World Health Organization adopted the Charter as a basis for its continued efforts to encourage governments to improve patient care.
Identifier
HortobagyiGN_03_20130123_C17
Publication Date
1-23-2013
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Gabriel Hortobagyi, MD, Oral History Interview, January 23, 2013
Topics Covered
The Interview Subject's Story - Professional Service beyond MD AndersonThe Administrator Beyond the Institution Career and Accomplishments Institutional Mission and Values Discovery, Creativity and Innovation Patients, Treatment, Survivors The History of Cancer Research and Care The History of Health Care, Patient Care Global Issues –Cancer, Health, Medicine
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Gabriel Hortobagyi, MD:
In a different part of my life, I have had another very exciting association with another colleague. It has less to do with science, but I think it illustrates a little bit the same process of how you get beyond what you think your limitations are. Since about 1983, I have been organizing or co-organizing a meeting—a scientific meeting—in Paris. The first time this very well-known French clinical investigator, Professor [Claude] Jacquillat, invited me to present the paper because he became interested years after we had started here in neoadjuvant chemotherapy. Since my group had done the bulk of the work with neoadjuvant chemotherapy up until then, he invited me to do that. He assigned to me one of his trainees as my bodyguard during my stay in Paris to sort of cater to my needs and make sure that I was well cared for—I showed up on time for the conferences and all of that. This young man later became one of my best friends, and when his boss died—died of cancer, in fact, of kidney cancer—he took over as not only the head of the department in Pitié-Salpêtrière but he also took over as the co-organizer of this meeting, and then he asked me to join him as the co-president of the meeting, and we have been doing that ever since every year.
Tacey Ann Rosolowski, PhD:
Let me just pick up the detail—this was Professor Jac—and I think I missed—
Gabriel Hortobagyi, MD:
Jacquillat. That’s J-A-C-Q-U-I-L-L-A-T.
Tacey Ann Rosolowski, PhD:
—L-L-A-T. Oh, Jacquillat. Okay. Thank you.
Gabriel Hortobagyi, MD:
The young man is Professor [David] Khayat. That’s K-H-A-Y-A-T. And David Khayat and I have been organizing this meeting now for a while. I remember first as we organized every yearly meeting, we would sit down and think of what would be the interesting topics to include here, but who would be the best speakers and then try to put together a well-rounded program. Then we realized that as we became more experienced that we also needed to organize a social program so that those who came from out of the country and out of the city would have a better exposure to Paris and to French culture and French art and all of those things. And then as we got closer to the year 2000—remember the big millennium when everything was going to happen? So one day we are sitting in at an ASCO meeting at a coffee shop or a bar or something like that. We were thinking of what can we do to sort of make an impact for the millennium with our meeting. Of course, we had limited resources. We couldn’t go too crazy. So we are enjoying our while there, and we just started to free associate. So we said, “Well, you know, why don’t we ask whether we can rent the Cathedral of Notre Dame for a concert.” So the other guy laughs, saying, “That’s a crazy idea. There’s no way we can pull that off.” So the other one says or I did—I don’t know who—this is just the two of us throwing crazy ideas. “Maybe we could ask the mayor of Paris to throw a cocktail party for all of our speakers.” “Yeah.” “Well, maybe we could then ask the president of France to give a reception in the presidential palace.” “Yeah. That sounds great.” “Well, maybe we could organize a reception dinner at the Versailles Palace—the palace of Louis XIV.” And this went on and on. It was like a soufflé that grows and overflows its thing. If someone more reasonable than us had been listening to us, they would probably have called the men with the white coats—with the shirts. But we sort of got all excited about this. Then we had all of these things written down on a napkin, and we said, “Oh, my goodness. How are we going to do this? But it’s a great idea.” So we thought about it for a couple of days. Again we met, and I said, “You know this not such a crazy idea. I think we can pull this off.” So then we said, “Well, this is all fluff. So why don’t we put some really high-powered science behind it to justify the fluff?” I said, “Okay. So why don’t we organize a world summit on cancer research? And let’s invite a number of very high-profile investigators.”
Tacey Ann Rosolowski, PhD:
So eventually we put together a list of about forty, forty-five Nobel Prize winners. You have to realize that we were relatively unknown in the context when you are contacting people of the Nobel Prize sphere and heads of state and what not. To make a long story short, we contacted a number of them. About half of them accepted to come and speak. So we put together this incredible program with the top biomedical investigators of the latter part of the twentieth century. Then we said, “Well, we have our meeting—our traditional meeting—which is already done with the program. So what are we going to do with these people?” So then we asked for City Hall in Paris to be lent to us. We were able to infect with enthusiasm the mayor, who later became President Chirac. He said, “Let’s do that. We have a wonderful large conference area. You can take that for a one-day conference for the world summit, and I put the City Hall’s resources to your disposal. And that evening I’ll organize a reception.” The City Hall in Paris is this gorgeous nineteenth century classical building with these great staircases and incredible frescos on the ceiling. So we had ourselves a summit. We had ourselves a reception. So then we said, “Okay, well, check one off. Now let’s go to the president’s palace and see if we can play the two against each other.” So we went to—we managed to get an appointment with one of the secretaries of the president and explained our plan. And I said, “You know, it would be a shame if all of these personalities came and the leadership of the country is nowhere. So we would also propose that we write a charter.” And by then we had written like a ten-point rights of cancer patients, which we wanted to call initially the Charter of Versailles. Actually we wanted to call it the Treaty of Versailles, but you might remember that World War I ended up in rather tragic circumstances for some countries in Versailles. So we said, no, that’s not a good idea.
Tacey Ann Rosolowski, PhD:
(laughing) Bad precedent. Bad connection.
Gabriel Hortobagyi, MD:
Bad connection. So we changed it to the Charter of Paris. Then we said—to sort of entice the president and his entourage, we said, “We can bring all of these personalities, plus we can invite a bunch of heads of state or their delegates to come and sign this in the French president’s palace.” So then he got all excited about it. He said, “Okay. So I’ll offer a signing ceremony here followed by a reception at the Palais de l'Élysée.” So check number two, and then we did something similar with the Versailles Palace. Eventually, not only did we get the Museum of History—not the Museum of History—the Minister of History or whatever that it’s called—to give us for free for one night the Versailles Palace but we convinced two of the top chefs in Paris to provide food for free.
Tacey Ann Rosolowski, PhD:
Wow!
Gabriel Hortobagyi, MD:
For 700 of our closest friends. So you can’t do this unless you let that crazy side of yourself think big and think way beyond where our traditional thinking would restrict us because had we been rational about this we would have said from day one, “This is not possible. Let’s not even try it. We are just going to waste a lot of time being frustrated, and at the end of it won’t have anything.” Instead we kept feeding each other’s craziness in this. I say craziness for lack of a better word, but it’s just—
Tacey Ann Rosolowski, PhD:
It could be enthusiasm, creativity—
Gabriel Hortobagyi, MD:
Right. Right.
Tacey Ann Rosolowski, PhD:
—energy—all of those good things. Yeah. I don’t want to miss out on some of the details. I’m not sure if I was able to get the name of this organization that you were participating with Dr. Jacquillat.
Gabriel Hortobagyi, MD:
Okay. Originally it was called the—oh, what was it called? The International Congress of Neoadjuvant Therapy—yes. Then eventually in the late ’90s after Claude Jacquillat died, we renamed it the International Congress of Anti-Cancer Therapy. The acronym for that is ICACT—I-C-A-C-T. In fact, I’m just going for that next Wednesday because it’s our annual meeting.
Tacey Ann Rosolowski, PhD:
You’ll enjoy Paris in the almost spring.
Gabriel Hortobagyi, MD:
Since I’ve digressed, I might as well tell you that for the signing of the Charter of Paris, we got something like fifty or sixty nations to send us either president, prime minister, or head of health to sign this charter. I invited Dr. Mendelsohn, who is also one of the signers of this document. He was there at the Élysée Palace and City Hall and at Versailles. He got a copy—which is exhibited somewhere in the Rose Building—of this beautiful charter which has the rights of the cancer patient and the signatures of several hundred people who signed on then. Then we put that up on the web and by now we have I don’t know how many tens of thousands of signatures from around the world.
Tacey Ann Rosolowski, PhD:
Why was it important to put forth a list of a rights of patients at that time?
Gabriel Hortobagyi, MD:
Well, part of it was that we wanted this to be something of true international impact. Cancer in most of the world—certainly outside of the U.S.—you could say perhaps outside of Western Europe—is still a dirty word. It’s still a taboo about which nobody talks. In consequence, it a stepchild in the public health budget of most countries around the world. So cancer patients go untreated, mistreated, ignored. In consequence, the differences in mortality rate in different countries are huge—are enormous. To give you an example, the US has a population of 300 million people or so. This year we will have unfortunately about 40,000 women die of breast cancer. Around the world we have 7 billion people. All right. That would be roughly fourteen, fifteen times the population of the US But mortality from breast cancer is much higher in proportion, especially considering that life expectancy is much shorter in most of the other parts of the world. Breast cancer being largely a disease of the aged, it should have a lower frequency, lower incidence. This is a big issue. While one could think that in modern times the declaration of human rights should be something that everybody is familiar with, that’s just not the case. A definition of the rights of patients and cancer patients we thought would have a greater impact. In fact, eventually the UACC adopted our Charter of Paris as the UACC’s credo for cancer patients’ rights. And more recently in Ireland last year, there was a major meeting of the World Health Organization about non-communicable diseases—so chronic illnesses of the heart, lungs, diabetes, and cancer. They adopted the same declaration as the basis for continued deliberation and how this should twist the arms of governments throughout the world to think about what they needed to do in order to address this. Because this is, of course, as countries—even the poorest countries—grow and their economy improves, the life expectancy of their citizens will improve, and they will increasingly face this time bomb of cancer for which they are very poorly prepared. That was a very long digression.
Tacey Ann Rosolowski, PhD:
No. Not at all. The last time after we turned the recorder off you had mentioned that you had wanted to address international outreach issues as part of one of the subject areas you wanted to make sure we covered, so we’ve embarked on that now. I’m sure we’ll come back to it. It’s also a great example of thinking outside the box, too. I’m wondering if you could maybe talk a little bit about some instances in either the research you did for the breast cancer research—under the Breast Cancer Research Foundation grants or in other areas where you, yourself, went through that process but with a research focus.
Recommended Citation
Hortobagyi, Gabriel N. MD and Rosolowski, Tacey A. PhD, "Chapter 17: Thinking Outside the Box to Stage the World Summit Against Cancer for a New Millennium" (2013). Interview Chapters. 1122.
https://openworks.mdanderson.org/mchv_interviewchapters/1122
Conditions Governing Access
Open
