Publication Of Cancer Control 2015

by Ian MagrathIan Magrath 26 Aug 2015 09:04


The third edition of Cancer Control (2005) is now available on line []. Hard copy versions are in the mail. All members and those who register at the site will receive a free copy of the hardback version.

Imminent Publication Of Cancer Control 2015 Info

by Ian MagrathIan Magrath 24 Jul 2015 21:07

The third edition of INCTR's increasingly widely known annual journal, Cancer Control (2015) will be published in the next week.

Presentation of African Burkitt Lymphoma Study in Lugano

by Ian MagrathIan Magrath 24 Jul 2015 20:52


In the 1st Quarter edition (2015) of the NewsFlash, the results being achieved at St Mary's Hospital in the district of Gulu (Uganda) in


the treatment of Burkitt lymphoma were described. It was also mentioned that the the scientific committee of one of the must prestigious meetings on lymphoid neoplasia, held in Lugano every 3 years, had selected the project for oral presentation. Since then, Dr Valeria Calbi, who coordinates the study at St Mary's Hospital, Lachor has given the presentation, which was extremely well received. The remarkably high survival rate of 71% at 3 years is a result of INCTR's long standing interest in the disease, (which is the most frequently observed lymphoma in Ugandan children and accounts for half of all pediatric cancers), and its efforts to demonstrate what can be achieved in Africa with due attention to the basic principals of oncology. An extensive analysis of the detailed information that has been collected in patients treated with the treatment protocol described by Dr Calbi has been performed. This work was made possible with the help and support of Nick and Emma Seaford (see picture), who, as mentioned in another article in this edition of the NewsFlash, after visiting Brussels for their own training, assisted the team at St Mary's Hospital, Lachor, in the conduct of the study and the collection of accurate information regarding response and toxicity using a purpose-built data base designed by Ms Melissa Adde, Head of the INCTR Clinical Trials Office and presently also Executive Director of INCTR, and Jovan Vladic, a highly skilled and knowledgeable informatics expert with whom INCTR has worked for many years. Their work has confirmed that extensive abdominal disease with additional extraabdominal sites, excluding solely facial tumor, is an indicator of a high risk for recurrent disease. New approaches to improving the results even more will now be considered. I essence, the so-called "first line" (initial) treatment, which is given to all patients will be alternated with the second line regimen which is normally used only if patients do not achieve complete remission or relapse shortly after achieving complete remission (a state in which no tumor can be detected). The first line therapy is known as "COM" (cyclophosphamide, vincristine and methotrexate) Although the INCTR African Lymphoma Group has shown that the second line therapy, a cytosince arabinoside and the mesna/Ifosfamide combination are active in Burkitt lymphoma patients, even in a proportion of those who have not achieved a complete response, or who have relapsed very soon after completion of COM, not all of them have returned for treatment with the salvage regimen. This approach (alternating the two regimens) has been successful in Burkitt lymphoma in both Egypt and India, and it is, therefore, likely to succeed in Africa. It ensures that all patients receive both of the active regimens incorporated into the protocol. Only 4 cycles of this alternating regimen will be given unless there is evidence of incompletely eradicated disease, when up to two additional cycles will be given. An alternative approach would be to give the alternating regimen only to high risk patients - namely those with both abdominal disease and disease elsewhere. This will now be discussed and a new protocol written. In addition, the staff of surrounding hospitals will be trained to recognize Burkitt lymphoma and rapidly refer patients to St Mary's Hospital for urgent treatment. These two measures - treatment at the earliest possible time after diagnosis and assurance that all high risk patients at least, will receive both regimens is likely to result in even more patients with this disease being cured. This should provide encouragement to other countries with similarly limited resources to treat at least selected patients with cancer with potentially curative therapy. See also the article on membership Expanding the INCTR Membership.

New President of INCTR USA Elected

by Ian MagrathIan Magrath 24 Jul 2015 19:46


INCTR is pleased to announce that the governing board of INCTR USA has appointed a well known oncologist, Elmer Huerta, to lead the US Branch. Dr Huerta has a special interest in cancer prevention - an area that has not previously been a major focus of INCTR. Dr Huerta's task in taking over the reigns of INCTR USA have been greatly simplified by Dr Raj Shah, INCTR USA's outgoing president, who has completed a full administrative restructuring of the branch, including appointment of a new advisory board. Since INCTR is planning to establish cancer prevention as an important element of its work, Raj Shah suggested to the Board of Governors that it consider appointing a new President with a strong interest in prevention. After some discussion the board was convinced that Dr Elmer Huerta, a well known oncologist currently working at the George Washington University was the right person for the job. The board was excited by Raj's suggestion and Elmer was elected unanimously by the board. Elmer delightedly accepted the post - he had just returned from a period in Peru, a long time friend and partner of INCTR , where he has worked with Dr Dr Tatiana Vidaurre, Director of INEN (Instituto Nacional de Enfermedades Neoplasicas) on establishing a network of small cancer prevention centers in and around Lima. INCTR has designed a similar program, and in the coming weeks, we hope to work closely with Dr Huerta in the development of a prevention program that could form the basis of prevention programs in almost any country in the world. INCTR is looking forward to Elmer's Presidency and collaboration with Lima and Rajastan, where INCTR's prevention project is about to begin. Fortunately, INCTR will not lose the wise counsel of Raj Shah, who, although he will not run the organization on a day to day basis, will retain considerable interest in its well-being and success in its programs. It looks as though the US Branch is about to take off!

Expanding INCTR's Membership

by Ian MagrathIan Magrath 07 Jul 2015 19:44


Two of INCTR's faculty members Emma and Nicholas Seaford spent 9 months in East Africa last year, assisting INCTR with its studies on Burkitt lymphoma, which are yielding excellent results even in the midst of such poor circumstances. This is not a little due to the efforts of Nick and Emma, who worked with the local team in Lachor, Uganda. In this picture they are "on safari" checking up on some patients that we had not heard from recently. For accurate conclusions to be drawn from out studies, we need to make sure we know what has happened to every patient on one INCTR's implementation trials (well, almost everyone. Even in clinical trials performed in the very high income countries occasional patients are lost to follow up). Nick and Emma were struck by the kindness and gratitude of the people who insisted on giving them food and sometimes gifts. In several villlages, they came away with a couple of live chickens! But there are many on-going INCTR projects around the world, and the more fellows we have, and the more they are willing to do, the better will be the outcome of cancer therapy across the world. In addition, to a large degree. should our members wish to actively engage in fund-raising or specific projects, they will be working in their own country and expanding its capabilities.


by Ian MagrathIan Magrath 07 Jul 2015 19:42

We certainly need some new strategies, for at a global level, cancer, which accounts for more deaths than ischaemic heart disease, is increasing rapidly -from the 8.1 million incident cases estimated in 2008 to a predicted 22 million in 2030. Even the wealthy economies face a continually worsening situation, since although the overall number of deaths from cancer has, begun a slow downward path, many patients with cancer may live for many years before they die (many patients with prostate cancer die from other diseases while treatment for chronic leukemias has improved greatly prolonging lifespan. Thus, more people will be required to spend more time caring for cancer patients. Unfortuately, the numbers of nurses and doctors required in more developed countries is constantly rising, such that more and more trained health professionals are migrating from their country of origin either before or after training as a health care provider, worsening the plight of patients with chronic diseases, or diseases that may progress over a number of years. One of INCTR's strategies, therefore, is to markedly increase the number of members, both health professionals and a variety persons from other disciplines, and tp develop functional networks linked to cancer centers in order to increase to the extent possible the number of health care workers in low resource countries. This, coupled to research training and increased living standards arising from health research will alleviate the problem of migration while increasing the educational standards in the low income countries. INCTR members across the world could play an important role in helping to mitigate the serious lack of resources in low and middle income countries, while at the same time educating more, with the future in mind.

5th "What Can We Learn From Africa" Workshop

by Ian MagrathIan Magrath 20 Apr 2015 16:05


The 5th in a series of workshops called "What Can We Learn from Africa,?" which deal primarily with the pathological diagnosis of hematological malignancies in equatorial Africa, will take place on 12th to 14th November at the Hotel Méridien in Dakar, Senegal. The meeting will be organized by Martine Raphael, President of AMCC (INCTR's French branch) and a member of INCTR's Pathology Program in collaboration with SAFHEMA, the Societé Africaine Francophone de l'Haemotologie. The main topic of the meeting will be plasmacytic differentiation and lymphomas. For more information (in French), please go to:, or click on Safhema.

WHO Maintains Official Relations with INCTR

by Ian MagrathIan Magrath 20 Apr 2015 14:18

The WHO Executive Board has decided to maintain the INCTR in Official relations with WHO,. In its letter to INCTR, the WHO Board commended the continuing dedication of INCTR in support of the work of WHO. The Board, however, is in the process of re-examining its framework for engagement with non-state actors, which includes NGOs, and this may result in changes to the present modus operandi.

ASCO Annual Meeting

by Ian MagrathIan Magrath 20 Apr 2015 12:38

Register and reserve your hotel today for the 2015 ASCO Annual Meeting (May 29-June 2, 2015, in Chicago, Illinois). The ASCO Annual Meeting brings together nearly 30,000 oncology professionals to discover and discuss the latest in cancer care and research. Take advantage of multiple networking opportunities to meet with colleagues, share ideas, and create foundations for future collaboration. View preliminary program details including session titles, dates and times, and education program faculty, and start planning your Meeting including Hotel and Early Registration Deadline: April 22, 2015 at 11:59 PM (EDT)

5th International Symposium on Lymphoma in Children, Adolescents And Young Adults

by Ian MagrathIan Magrath 20 Apr 2015 09:17

Additional information is available regarding the program in a downloadable file. Click on "files" on the menu below and then on the file called: 2.22.15Updated Brochure - 022115.pdf


Meeting with INCTR India

by Ian MagrathIan Magrath 18 Apr 2015 10:47


While in India, as well as attending the Hyderabad Conference on palliative care, several days were spent by Dr Magrath and Melissa Adde, from INCTR's headquarters in Belgium, with the President (Dr Shivraj Singh), Trustees and some of the Advisory Board members of INCTR India. During the visit a press conference was held to provide information about the recently established branch as well as the ever-increasing cancer problem in India and the role the branch would play to lessen its impact. An important meeting was held with Dr Agarwal, President of the prestigious Indian Medical Association and Advisory Board member. INCTR India is planning to form a public-private partnership with the government of Rajasthan (Where INCTR India's offices are located). Unfortunately, this has been delayed because of a severe outbreak of swine flue in Rajasthan, which is now abating.

22nd Annual Conference of Indian Association For Palliative Care

by Ian MagrathIan Magrath 15 Apr 2015 09:55


This year's annual conference, the 22nd, of the Indian Association for Palliative Care was hosted in Hyderabad by Dr Gayatri Palat, Director of a new hospice which recently opened in Hyderabad as a collaborative project between the Pain Relief and Palliative Care Society of Hyderabad, (PPCH) which provided the funding, and the MNJ Oncology Center (MNJOC) which is the major oncology center for the state. Dr Palat is also INCTR's Director of the Indian arm of the Palliative Care Program, presently located in Hyderabad and works closely with the MNJ Institute of Oncology. Recognition of the Hyderabad program as capable of planning and hosting the Annual Meeting of India's most important organization for palliative care indicates the high regard that exists for Dr Palat and her team. She provides a broad array of palliative care services while continuing to campaign for greater access to opioids and expanding the program to other regions. Most of the INCTR or INCTR-associated experts who have given their time to help develop the Hyderabad program, are located in Vancouver, and work together via INCTR Canada/Two Worlds Cancer Collaboration.

Cancer Control 2015 In Press

by Ian MagrathIan Magrath 12 Apr 2015 19:13

Cancer Control 2015

Abstract Regarding The Treatment of Burkitt Lymphoma Accepted

by Ian MagrathIan Magrath 10 Apr 2015 18:40


Since its inception, six African hospitals have participated in an INCTR


project designed to Improve the survival rate in African Burkitt lymphoma, a very rapidly growing tumor in which chemotherapy is essential for curative therapy, and in which neither surgery nor radiation are effective. An abstract describing the results of treatment in over 100 patients treated at St Mary's Hospital, Lacor was submitted by Dr Valeria Calbi, Project Leader at St Mary's Hospital, Lacor, and accepted for oral presentation at the 13th International Congress on Malignant Lymphoma, which is held every three years in Lugano, Switzerland (picture). In this group of patients, overall survival at 3 years is 72% (relapse is rare after one year free of disease). This is an excellent result for African Burkitt lymphoma since there are few centers capable of treating this very rapidly progressive neoplasm in equatorial Africa, because of limited resources, human and otherwise, for supportive care during chemotherapy. Very often the family cannot afford the cost of care and an unknown number of children may never reach a hospital capable of giving chemotherapy to cancer patients. In the present study, the data provided in the abstract gives the results of a treatment regimen (known as "First Line") consisting of three drugs with intrathecal therapy to prevent or treat central nervous system disease. The regimen, referred to as COM from the initial letters of the three drugs which comprise it has now been used in 6 different hospitals in 4 African countries (although not all at the same time). Results in these hospitals has ranged from 40% to 71% overall survival at three years (average, 62%), an observation that is being further examined, along with the value of early diagnosis and use of a salvage regimen in patients who achieve only partial response or relapse after achieving a complete response. Financial support for the study is provided by the Christopher Niblett Memorial Fund, the OPEC Fund for International Development and funds donated to the project via Global Giving. The study coordinator is Melissa Adde, Director of INCTR's Clinical Trials Office. An earlier analysis describing patient characteristics, therapy toxicity and outcome has been published in the British Journal of Haeatology (Br J Haematol . 2013 158:749-762. Click on "files" below to download a copy (filename African BL in BJH.pdf).

Burden Of Cancer in the Gulf Region

by Ian MagrathIan Magrath 06 Jan 2015 16:10

INCTR participated in an important meeting entitled "The Burden of Cancer in the Gulf Region: Bridging the Gaps" that took place in Riyadh from 21-24 October, The meeting covered a broad range of topics ranging from the size and relative importance numerically of various cancers, the efforts presently ongoing, as well as considerations for future actions to improve cancer control in the region. It was opened by the acting Minister of Health. For a complete program and access to presentations, go to []

ESMO Meeting 2014

by Ian MagrathIan Magrath 06 Jan 2015 11:48

The annual meeting of the European Society for Medical Oncology in 2014 attracted almost 20,000 participants from 131 countries. INCTR participated in a session entitled "Personalized Medicine in Developing Countries - Myth or Reality? INCTR's presentation, delivered by INCTR's President was entitled "Overcoming cancer in developing countries - how to control cancer in resource limited countries." The session was very well attended, but in spite of the trend towards "personalized medicine" and the emphasis on "precision medicine" which refers to targeting therapy towards the molecular mechanisms that underlie cancer, it seemed clear from the presentations that the high cost of targeted agents at the present time essentially prohibits this approach in low and middle income countries, at least for the general population. For a copy of the presentation, click on "files" in the menu at the bottom of this page, then click on "Overcoming-cancer-in developing-countries-audio.pptx"

A Visit To Lacor

by Ian MagrathIan Magrath 06 Jan 2015 10:31


Roberto Ferrara, who is undergoing specialist training in oncology in Verona,


Italy spent 3 months at St Mary'sHospital, Lacor assisting in the ongoing INCTR Burkitt lymphoma project. While at St Mary's he helped with patient treatment, data management and also assisted in making a film which will be used to educate primary care providers and the public to recognize possible cases of Burkitt lymphoma and act immediately to ensure that treatment is begun as soon as possible. Burkitt lymphoma is one of the most rapidly growing of all tumors and it is known that the greater the tumor burden in a patient's body, the lower the likelihood of cure. Since it accounts for 50% of all childhood cancer in equatorial Africa, it is important to ensure that the public as well as primary care providers are familiar with the sites of tumor at the time of presentation. These are quite unusual (e.g., jaw and/or orbital tumors are present in some 50-60% of cases in children) and should make earlier detection possible and since radiation and extensive surgery are not a part of therapy, and curative therapy requires cheap and readily available chemotherapy agents, it ought to be possible to ensure that every child with this disease has access to therapy.

World Oncology Forum, Lugano, Switzerland

by Ian MagrathIan Magrath 01 Jan 2015 16:38

INCTR was present at the second World Oncology Forum which, like the first, was held in Lugano, Switzerland on 24th and 25th October. The meeting addressed several critical issues that will affect the future of cancer treatment across the world - at a time when cancer is becoming increasingly important as a cause of premature mortality. The topics discussed included the translation of basic cancer research into new, effective treatments for cancer (and the related issues of the cost of developing such agents and their cost-effectiveness), the new role of immunotherapy in cancer treatment, the provision of cancer drugs to Eastern Europe and the Global Taskforce on radiotherapy for cancer control. There was considerable discussion about the very high cost of developing new anti-cancer agents and the fact that this often has little relationship to the effectiveness of the agent, although it was recognized that some agents that are of limited efficacy in late stage patients with metastatic cancer, they may prove to be more effective in earlier stage patients or in combination with other agents. Cancer in developing countries was discussed, and the enormous differences in resources between the low income countries and the high income countries was emphasized. WOF does not intend to simply discuss these issues, but to explore measures that can be taken that will ensue that patients with cancer will have access to the treatment they need, and that research is made more patient-centric rather than profit-driven. For more information see []

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