Support Care Cancer (1997) 5 :334–335Q Springer-Verlag 1997 MEETING HIGHLIGHTS

Fig. 1 Michael R. Milken (left), one ofthe main speakers, with Dr. J. Holland,Chief of the Psychiatry Service at Memo-rial Sloan-Kettering Cancer Center

Psycho-Oncology at Wall Street:

Third World Congress

of Psycho-Oncology, New York,

4–6 October 1996

The Third World Congress of Psy-cho-Oncology took place just a fewblocks away from Wall Street, oneof the world’s most important fi-nancial centers. And money wasone of the topics of this stimulatingmeeting, which was attended byabout 1000 participants from over40 countries.

Michael R. Milken, a well-known American financial expert,was one of the first speakers at aplenary session. In his compassion-ate presentation he incorporatedmany of the American paradigms,such as the notion that man canand should mold the future (“activ-ism”), that humans are constantlyimproving (“teleology”) and thatthe future will be better than thepresent (“positivism”). He illus-trated some of these views by pres-enting the major turning points ofhis life and the conclusions he wasable to draw from these experi-ences. Himself a victim of cancer,he now conceptualizes himself as a“soldier in the war on cancer” anddevelops different strategies toopen a new plan of attack against

this disease (including the estab-lishment of the Milken Foundationfor the support of researchers inoncology). While some of his pro-positions and his attitudes werechallenged later in the meeting,there is no doubt that his view ofthings as a “true American” and asa non-medical and non-psychiatricprofessional was very interestingand opened up new perspectives.Milken deplored and eloquently il-lustrated the lack of internationalcoordination, cooperation andcommunication within oncology; hechallenged the fact that some coun-tries put 20 times as much moneyas is spent annually on nationalcancer research into the Gulf war;and he tried to convince the au-dience that a major effort to curecancer now would later save mon-ey by reducing the costs of ad-vanced cancer and the mortality inan age group whose members arestill working. He also anticipated achanging distribution of roles be-tween scientists, clinicians and pa-tients and a consumer-orientedmedicine, where patient move-ments will have considerable in-fluence on the clinical and scien-tific developments of medicine.These messages were underlinedby the personal history of this man,who best illustrates the emergenceof a “new patient” who actively in-fluences and shapes his own medi-cal history. Although for many par-ticipants it may have been a newexperience to hear a financial ex-pert giving them advice on how tomanage their field of expertise, thispresentation was probably the onethat most clearly illustrated thetopic of this congress, which was“global psycho-oncology for thenext millenium.”

The issue of finance and eco-nomical restrictions was palpablywith us throughout the meeting,and it became obvious that the ac-tual financial situation of many

countries certainly influences clini-cal, scientific and educational de-velopments in psycho-oncology.While these developments may beperceived as a threat, it is also afact that the ongoing pressureshave contributed to positive devel-opments. Some years ago, moststudies in psycho-oncology wererestricted to epidemiological re-search and only a few evaluationsof psychosocial intervention de-monstrated scientifically the valueof psycho-oncology. The most re-cent studies are designed and car-ried out in a much more coherentand efficient way. Topics of inter-est, such as the increasing occur-rence of post-traumatic stress dis-order in cancer patients, are nowinvestigated by first obtainingsound epidemiological data, whichare used to design a specific psy-chosocial intervention that will beevaluated with clear out-come cri-teria. Such studies illustrate thatpsycho-oncology has come a longway and there is no doubt that thestrong input of American psycho-oncologists has been extremelybeneficial to these developments.One of them, Dr. Jimmie Hollandof Memorial Sloan-Kettering Can-cer Center, who organized thismeeting, is certainly one of themost powerful and stimulating per-sons behind this movement.

Last but not least, three differ-ent persons received awards duringthis congress. Stephen Greer, Pro-fessor and Emeritus Director ofPsychological Medicine at theRoyal Marsden Hospital in Eng-land, received the SutherlandMemorial Award for his scientificcontributions, which have in-creased awareness of the emotionalneeds of cancer patients. His con-tributions include the developmentof sensitive assessment tools, ex-ploration of personality factors incancer survival and the develop-ment of adjuvant psychotherapy

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and testing of it in a controlledtrial. Aruna Tole, a senior occupa-tional therapist from the TataMemorial Hospital in India, re-ceived the Medal of Honor forClinical Excellence for her contri-bution in the sector of physical andpsychosocial rehabilitation of can-cer patients. All those who hadhad the chance to learn from ear-lier presentations about the differ-ent aspects of rehabilitation she co-vers (from the construction of artif-icial limbs to her efforts in a voca-tional rehabilitation program) un-derstand how much she deservesthis award. Finally, Yosuke Uchi-tomi, Director of the Psycho-Onco-

logy Division at the National Can-cer Institute of Japan, received theInternational Psycho-Oncology So-ciety Young Investigator Awardfor his contribution as first head ofthis new division and his scientificachievements, such as the investi-gation of delirium in cancer pa-tients (see Supportive Care in Can-cer 1996; 4:390–392).

This congress, which dealt withall the different aspects of psycho-oncology, illustrated that despite fi-nancial, political or psychologicalobstacles, there are always individ-uals who can make a differenceand who are able to achieve theirideas in even the most difficult cir-

cumstances. Even in times of finan-cial restrictions, possibilities stillexist for continuing this valuablework. The key to success seems tobe a capacity for flexibility and ad-aptation: “Only for him who doesnot know where he wants to sail isno wind right” (Seneca).

F. Stiefel, M.D.

Editorial Assistant,Supportive Care in Cancer,Division Autonome de MédicinePsycho-Sociale, CHUV,CH-1011 Lausanne, Switzerland