COSA Diary – reflections on 3 days in Brisvegas

8 minute read

Personal accounts of COSA ASM 2022.

Dear Oncology Republic readers, if you will recall, Dr Amy Davies shared her experience of day one of COSA 2022 in last week’s Special Edition of Oncology Republic. This week we include her wrap of day two and Dr Jo Hudson’s reflections on day three.

Day Three

Dr Jo Hudson

Dr Jo Hudson

The final day of COSA 2022 reiterated many of the important themes that had been raised during the first two days of the conference, focussing again on the aspiration of equitable cancer care for all Australians.

The final plenary session of 2022 specifically delved into providing equitable cancer treatment and survivorship care. Firstly, Professor Elizabeth Ward spoke about providing speech pathology assessment and rehabilitation services to patients living rurally in Queensland, identifying that approximately 50% of their patient population live rurally, and the use of telehealth and of upskilling workforce in rural areas have been important. Dr Kalinda Griffiths then discussed the under representation of Aboriginal and Torres Strait Islander people in epidemiological cancer data, which remains an ongoing issue and barrier to providing equitable care.

Dr Gary Morrison spoke eloquently about his own experience as a gay man who was diagnosed with prostate cancer 14 years ago, and his advocacy work with the Shine A Light Support Group and the Prostate Cancer Foundation of Australia. One of Gary’s pearls of wisdom was to adopt an attitude of “ask and listen”, emphasising that caring for people with cancer who identify as LGBTIQ+ requires an open minded approach and recognising that there is always more to learn about our diverse patient group.

Finally, Dr Abhijit Pal discussed practical tools to promote equitable cancer care, including becoming individual champions for equality, diversity and inclusion in our respective health services. 

After morning tea, I attended presentations focussing on stigma in cancer care, including the stigma associated with lung cancer screening programs, which is a recognised but not fully understood issue.

This is particularly important given the impending introduction of a screening program in Australia, and mobile screening facilities have been suggested as a vital option to ensure screening can be provided to Australians living in regional and rural areas.

Associate Professor Christopher Steer also discussed ageism in cancer care, highlighting that many clinical trials still mandate upper age limits in their trial inclusion parameters.

After lunch, COSA 2022 closed with the Presidential Lecture, delivered by the Honourable Greg Hunt, where he discussed the role of health professionals as advocates in partnership with government, and highlighted successes including the Australian Genomic Cancer Medicine Program and the Zero Childhood Cancer Initiative. He also discussed his pride in participating in the early work to support the implementation of a lung cancer screening program.

In summary, COSA 2022 made the most of returning to face-to-face interaction, and I think has inspired all attendees to champion equitable cancer care in Australia. Bring on COSA 2023!

Dr Jo Hudson is a medical oncology registrar at Monash Health.

Day Two

Dr Amy Davies

Dr Amy Davies

Day 2 again delivered on the conference theme of ‘Gender, identity, culture, geography, and disease should not matter’, starting with the great breakfast session exploring the role of immunotherapy in dMMR endometrial cancer.

Endometrial cancer is the most common gynaecological cancer but fails to attract the funding and hype of ovarian cancer, so I was pleased this was the content of a breakfast session – now to await the PBS listing.

Then I shimmied to the morning plenary which again highlighted the significant disparity in cancer-related outcomes experienced by Aboriginal and Torres Strait Islander people. This occurs across the cancer continuum from screening and early diagnosis through to palliative care.

All four presentations were excellent, but I thought the work of Prof Fong was particularly exemplary in their work on co-designed lung cancer screening. I think it is now well accepted First Nations peoples must be involved in healthcare service planning.

We also heard some of the excellent work by the Queensland Government in their decision to involve this underrepresented group in design and adjustment of cancer information booklets.

Following on from the plenary I attended a session describing the legal battle of one patient who experienced significant harm from involvement in a trial. It was moving to hear her story and reminded me of the real concerns of any severe irAE in the adjuvant setting. It also made me wonder what would happen to the clinical trial community broadly if more people made legal claims – it’s an area of work that I hadn’t really considered much in the past.

To close out my day I listed to Prof Dorothy Keefe speak to the draft Australian Cancer Plan and boy-oh-boy is it ambitious! I agree with their decision to leave no stone unturned and if we can even achieve 70% of what they have set out to achieve in 10 years, the cancer community in this country would be so much better off.

Importantly this plan, much like this conference, pays specific attention to underrepresented and minority groups, including a goal of eliminating racism in cancer care in this country. Bravo Cancer Australia and may I wish them well in the implementation – I can’t imagine how painful it must be at times liaising with multiple government jurisdictions and varied levels of government to find a common path!

That was the end of my COSA, sadly cut a day early to get home to my young family. But tomorrow my wonderful colleague Dr Jo Hudson will provide her reflections on the final day of #COSA22. Many thanks to the organising committee and I can’t wait to attend in Melbourne next year!

Dr Amy Davies is a medical oncology registrar at Monash Health.

In case you missed it:

Day One (Dr Amy Davies)

Here I am, reporting back on day one of COSA 2022, held this year at the Brisbane Convention Centre – well positioned adjacent to the Brisbane cop shop to maximise good behaviour from all delegates!

I walk inside brimming with optimism for what the next few days might bring and the first breakfast session didn’t disappoint. The malnutrition and sarcopenia talk was a timely reminder that cancer-related cachexia is common, insidious and requires input from many (or most) MDT stakeholders.

Perhaps using serial CT imaging, which we are fortunate to use regularly to stage and restage in most patients, may become a way to monitor sarcopenia. I wonder if we could leverage that more often in clinical practice.

Following that was a very warm welcoming ceremony and a critically important plenary. Highlighting often marginalised aspects of cancer care for First Nations peoples, CALD persons and the LGBTQI+ community in a plenary was an important and timely programming decision and I applaud the organisers for this. Awareness is the first step and #COSA22 has achieved this.

But it will be up to my generation of clinicians to actually make changes. The time to tailor our care to include the unique needs of these cohorts is now: 41% of LGBTQI+ people reported high levels of distress in a recent study. This is unacceptably high.

Next up I plunged into the world of lung cancer, diving as deep as the genomic level. This session was fascinating and inspiring. The Aspiration study, presented by Professor Solomon, has provided NGS (next-generation sequencing) to over 600 people so far across the breadth of Australia.

There were also two basic science talks describing spatial genomics and deep analysis of proteins, which went completely over my head but were nonetheless fascinating.

The afternoon plenary highlighted another critical pillar in oncology practice: geriatric oncology. After all, cancer is a disease of ageing and with a population advancing in years the unique needs of older people with cancer are relevant to all clinicians.

To close out day one I attended the “power of language” session. In this we heard from two consumer advocates and their opinions were invaluable. I left resolute that patient information documentation can be improved by shifting away from generic cookie-cutter one-size-fits-all documents into tailored pieces, informed by consumer groups, that reflect the needs of various populations within the broader cancer community.

My takeaway from an enlightening first day is that we are doing so many things well and in the future we can all contribute to make most things even better! To wrap up, I shared a vino with my colleagues from Monash Health. I’m so glad we can now return to face-to-face events!

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