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2	"Summary of Workshops and Cross..." Summary of Workshops and Cross Cutting Issues in the Working Groups
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15	Meeting Summaries Chris Williams
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17	Opening Congratulations for another successful meeting Reactivation of AORTIC, initiated in 2000 in San Francisco, continues on course A few comments about this meeting may be of value for the ones to follow
18	How Did We Do? Venue: Excellent Hotel facilities: Close to perfect Hospitality: Excellent Academic Program: Fabulous Rapporteurs’ role: needs improvement Security: Good Networking Opportunities: Extraordinary
19	How Did We Do? Organization: Could be better Difficulty with assignment of meeting rooms Secretarial facilities: inadequate Business centre facilities are very good Meals: Timing of lunch: could have been more internationalized Touring opportunities: Deficient
20	How Did We Do? A Very Successful Meeting AORTIC and Meeting Organizers have every reason to be proud
21	Etiology of Breast Cancer Disproportionately excessive mortality risks in women of African ancestry Heterogenous disease: subclassification now possible on the basis of ER status, Her-2 status DNA microarray analysis identifying Luminal A, Luminal B, Basal-cell types, differential p53 expression P53+/Her-2+/ER- disease: A>AA>CA contribute to the biological behavior of the disease Africa likely to help the international community in resolving the problem of breast cancer
22	Etiology of Breast Cancer Unique sequences with 90%-98% homology to env gene of MMTV identified by PCR in human br.ca. tissue: Named HMTV Serological evidence of its association in 38% USA; 60%-75% in West Africa, 1%-10% in China, Japan, and Vietnam Suggestion: Most br. cancers in Africa caused by an infections agent carried by house mice.
23	Etiology of Prostate Cancer Risk factors -> family history and race Incidence/mortality 34%/123% higher in AA vs CA Disparity in outcome likely the result of complex gene-environment interaction Relatively little information available worldwide to predict outcomes Research opportunity for AORTIC
24	Etiology of Prostate Cancer Prostate Genetics Research in Senegal (PROGRÉS) Study Aim: To understand the factors that could explain the nature of CaP in Senegal Variation by ethnicity in the frequency of certain high-risk genes (CYP3A4 and SRD5A2 – [testosterone metabolism]) -> SEN>AA>CA Dietary history of SEN being evaluated by questionnaire
25	Screening With the possible exception of cancer of the uterine cervix, cancer screening in Africa appears to be controversial Lack of treatment facilities There appears to be consensus that methodologies for early detection should be promoted
26	Treatment Advances New knowledge of breast ca. biology translating to novel treatment approaches Trial of Capecitabine (Xeloda) plus Trastuzumab (Herceptin) à ÎÎ of Her-2/neu overexpression in br.ca case of A/AA women Neoadjuvant approach to locally advanced/inflammatory breast ca. may allow for rapid testing of novel agents and treatment tailoring New opportunity for collaboration for AORTIC
27	International Atomic Energy Agency and Cancer in Africa Through Its Program of Action for Cancer Therapy (PACT), IAEA: Has since 1974 spent $180+ for 170 projects in developing countries Today: $12 million/year for cancer therapy projects Tomorrow: Needs at least 10 times this much to meet spiraling demand 2006-07 Focus: Tanzania Pilot
28	Recommendation on Radiotherapy AORTIC should collaborate with the IAEA as an “anchor to build the ship” of populating Africa with much needed radiotherapy units AORTIC should work together with IAEA, IACR, ACS, UICC, WHO, and others to define an irresistible funding proposal to place cancer on the global health agenda – and save millions of lives and ameliorate suffering.
29	Advocacy Strategic use of power, persuasion and people to achieve positive change in government policies related to cancer Example: Mary Woodard Lasker, the Nixon Presidency and the “War Against Cancer” Main instrument for change by ACS Global and African cancer burden is intolerable and will only get worse without effective advocacy Need to mobilize African nation for change to influence the morbidity and mortality of cancer in the region.
30	Advocacy AORTIC should ensure that African people SPEAK WITH ONE VOICE when it comes to speaking for cancer control
31	Advocacy - Recommendation Make AORTIC more visible to enhance its capacity to influence policy on cancer care, attract funding for training and research Set advocacy goals for education and awareness programs towards prevention and early cancer detection Activate political support through the African Union (AU) and establish within this body a cancer specific mechanism Build linkages with health training institutions and major umbrella colleges, e.g. CPS, Medical and Nursing Schools
32	Advocacy - Recommendation 5. Network with major cancer organizations worldwide 6. Advocate the creation of AU Cancer Awareness Day 7. Promote a “Cancer Walk Day”, facilitated by prominent cancer survivors 8. Stimulate activities, such as: Anti-tobacco award winning essay competition Grants for research students for MPhil, MMed, and PhD Grants for medical and nursing students in the area of prevention and palliative care
33	Advocacy - Recommendation 9. Establish a Scientific Advisory Committee 10. Establish an African Cancer Society as an umbrella for national cancer societies 11. Develop an AORTIC Advocacy Policy
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35	Conclusion It has been a tremendously exciting four days Our bilingual collaboration at this meeting is a far cry from the experience of 22 years ago, when AORTIC was almost a stillborn because of language differences. Je suis absolutement comment! AORTIC is on the move Please, let us keep the momentum