2010 - 2018
The new decade began with over 130 people, including 37 exhibitors and 37 members of the New Zealand Nurses Organisation, attending the meeting in Auckland. Members discussed the possibilities for expanding the breadth of the Society to include pathologists, laboratory diagnosticians, and others working in public health.
While such discussions signalled members' hopes for the growth of the Society, meeting organisers also once again raised concerns about the declining number of clinicians who attended the meetings.
The NZSO had initially provided cancer researchers and clinicians with a rare forum to meet and exchange ideas with one another. Bridget Robinson has been involved in the NZSO since the late-1980s. She explains,
I think in a sense it was much more important in people's lives in the early stages because there was less competing stuff going on. One problem is that cancer has become much more site orientated and so you go to a breast cancer meeting or a bowel cancer meeting, whereas this was covering everything. So, it's been a bit of a struggle.
Bridget Robinson
David Perez cites the lack of funding for clinical research as the main reason few clinicians attended the meetings:
It did go through a period there where clinical research was almost disappearing for all those reasons. But fortunately, with more oncologists coming through and having better research training it's changing, [and also] – the funding has been available for high-quality clinical research, so we are making more progress. But I still think we're behind Australia and the UK.
David Perez
In addition to clinicians' limited time and funding, Michael Jameson explains that many of the 'early leaders' of the Society have retired and 'there's a much younger generation, a lot of whom just haven't grown up with NZSO as a major part of their academic activity'. Consequently, 'there's not as much collective interest and engagement and ownership of NZSO among the medical oncology community anymore'. He discusses the challenges of connecting with younger medical oncologists and his hopes that the Society will 'engage them as advanced trainees and keep them coming back as consultants'.
In 2013, the executive committee discussed strategies to encourage higher clinical attendance at the meetings. These strategies included holding the conference immediately after the Cancer Trials NZ meeting which had attracted more clinicians in 2013 than expected, hosting tumour-specific sessions, and offering travel awards for registrars and students. These efforts proved to be worthwhile, and the balance returned the following year. Thirty-eight clinicians and forty-two non-clinicians attended the meeting in 2014.
Maintaining the involvement of clinicians continued to be a priority. In 2017, meeting organisers made concerted efforts to increase the number of clinicians in attendance. They featured more presentations by clinicians and hosted breakfasts that focused on clinical care.
Conference programmes from 2014 and 2015.
The executive committee has also worked to modernise the culture of the NZSO which had remained 'too consistent'.
Ben Lawrence was president of the NZSO from 2016 to 2017. He explains that the motivations for establishing the NZSO were 'quite farsighted at the time; getting clinicians and scientists working together, working across all different cancer types'. Yet, 'we started to have a sense that clinicians were leaving because they thought it was too "sciencey"' and the meetings did not reflect the diversity of cancer researchers in New Zealand. The executive committee concluded that 'each of those relationships needed to be renegotiated'.
For the 2017 meeting, the organisers agreed to overspend in order to create a meeting that generated excitement in preparation for the fiftieth-anniversary celebrations in 2018. The committee was conscious that enthusiasm for the Society 'seemed to be waning'. They 'wanted to get a buzz going so that people would be enthusiastic about it again and would be part of the celebration'. The 2017 meeting reported a record number of over 200 attendees, including approximately 36 exhibitors.
The executive committee also agreed to launch a project into the history of the NZSO in preparation for the anniversary celebrations in 2018. Ben explains that by learning about the Society's past, they hope to discover 'how we got to where we are so that we can reflect on where we are going in the future'.
Ben Lawrence
Conference dinner held at the Auckland Art Gallery Toi o Tamaki in 2017. Conference Innovators.
ESMO president, Josep Tabernero, delivering the Bruce Cain Memorial Lecture in 2017.
Achieving a gender balance among the invited speakers and the people who chair the sessions has been a key part of modernising the Society. Lai-Ming Ching suggests the gender imbalance among invited speakers reflects the lower number of women working in oncology rather than 'obvious discrimination':
It's still heavily – in the oncology arena there is still more males in the profession and so if you're choosing speakers there are more males. But there has been a push that we should try and make it more equal.
The NZSO also had to renegotiate its relationship with the pharmaceutical industry. The visibility of sponsorship at the meetings had been a point of discomfort among some members for several years. These tensions came to a head in the mid-2010s. Several companies felt unwelcome at the conferences and noted the low number of clinicians in attendance. They planned to discontinue their sponsorship.
Some clinicians and scientists involved in the NZSO felt more comfortable with the prospect of continuing meetings without sponsorship. Others wanted pharmaceutical companies to return to the meetings as research partners who were instrumental in facilitating clinical trials in New Zealand.
Ben explains, 'I understand why some of my colleagues feel uncomfortable, but I think for best patient care and advocating for my patients we need to have a relationship'.
In preparation for the 2017 meeting, Ben held roundtable discussions with pharmaceutical representatives. He asked the representatives to return to the meetings and stated:
'We don't want all the marketing stuff, all the banners and all that, we'd actually like you to come as research collaborators, as part of the research scene in New Zealand'. There's just as many pharmaceutical employees just purely in research in New Zealand as there are scientists, well nearly as many. It seems crazy in such a small country to separate that off, especially a country where we have such bad cancer funding.
Ben Lawrence
Several pharmaceutical companies accepted the invitation to return to the NZSO meetings. They continue to support the Society by sponsoring the annual events. One company also established an NZSO mid-career research fellowship and created a mobile app to facilitate communication among cancer researchers in New Zealand.
The modernisation of the NZSO also involved solidifying their international networks by connecting with the European Society for Medical Oncology (ESMO). The incoming president of ESMO, Josep Tabernero delivered the Bruce Cain Memorial Lecture in 2017. The committee also contacted the ESMO Young Oncologists Corner to invite a representative to attend the NZSO meeting in August 2018. In doing so, the executive committee aimed to 'make our trainees feel like they're part of an international scene' and to create future opportunities for registrars.
Ben Lawrence
The modernisation of the NZSO offers enhanced opportunities for scientists and clinicians working in oncology in New Zealand. Michael Jameson explains that the Society continues to offer registrars a chance to 'get a sense of whether or not science excites them' and whether clinical research is an avenue they wish to pursue.
Michael Jameson
The ongoing relevance of the NZSO also reflects the changing landscape of cancer research more broadly. Bill Denny explains that the earlier meetings primarily involved 'scientists talking to scientists and clinicians talking to clinicians'. Yet, in recent years, 'cancer treatment has become much more scientific, and the scientists have become much more interested in – especially people who are developing drugs – in how they get on'.
Bill Denny
He attributes these changes to the effectiveness of medication:
It was really difficult in the old days I think. You were working largely on your own probably and you didn't get many successes, and I think there's a much more collaborative, forward-looking, encouraging atmosphere today … because treatments work. You know, you can confidently expect you'll get a reasonable number of long-term survivals and you'll certainly rescue people who come in late for a few years, and I think that's much more positive arrangement all around. And things are changing very rapidly: the methodologies are changing, the genetics are revolutionising the whole thing … It's just a much more positive feeling all around.
Bill Denny
The collaboration that the NZSO offers also creates particular opportunities for clinicians. David Perez explains:
The main difference is this interface stuff – which is where real science now has a direct application at the bedside – has generated a great deal of interest on both sides. And it's brought us all together … The genetic revolution is going to be going strong for another twenty years at least, if not longer. So that will offer all those opportunities for local research to be translated into treating patients. And you know, by doing that you feel as though you're making a real contribution. You're not just a passive participant, you're an active participant.
David Perez
Over the last fifty years, the NZSO has created a forum for cancer researchers and clinicians in New Zealand to meet one another, share ideas, and to pursue opportunities for collaboration.
For Bill Wilson, the NZSO 'sat at that interface between clinical practice and research'. He concludes, 'the conversation between clinicians and basic scientists – I mean, often we talked past each other – that was always the raison d'être for the Society and it's continued to be so'.
References
1Minutes of the 39th Annual General Meeting, 4th May 2010, Auckland, NZSO archives.
2Interview with Bridget Robinson, 6 March 2018.
3Interview with David Perez, 8 March 2018.
4Minutes of the 42nd Annual General Meeting, 2 July 2013 Dunedin Centre, NZSO archives.
5Minutes of the 43rd Annual General Meeting, 22 October 2014 Trinity Wharf, Tauranga, NZSO archives.
6Interview with Ben Lawrence, 29 March 2018.
7Ibid.
8Interview with Lai-Ming Ching, 16 February 2018.
9Interview with Ben Lawrence.
10Ibid.
11Ibid.
12Interview with Michael Jameson, 23 April 2018.
13Interview with Bill Denny, 7 February 2018.
14Interview with David Perez.
15Interview with Bill Wilson, 12 February 2018.