Mary Gospodarowicz
Dr. Mary Gospodarowicz says the new commission will "advocate for better cancer systems and improved outcomes that also strengthen the health systems." (Photo: Visual Services, UHN)

Dr. Mary Gospodarowicz, former Medical Director of the Princess Margaret Cancer Centre, will co-chair a new "The Lancet Commission on Cancer and Health Systems" as it examines and makes recommendations to improve global cancer care and health systems.

Dr. Gospodarowicz, who held the leadership post at PM for more than 15 years until 2020, together with Felicia Knaul, Professor at the Miller School of Medicine and Director of the University of Miami Institute for Advanced Study of the Americas, and Patricia Garcia, Professor at the School of Public Health at Cayetano Heredia University in Lima and the past Minister of Health in Peru, will lead the group of 33 commissioners working under the umbrella of the prestigious medical journal.

The Commission will work over the next two-and-a-half years and will draft a final report with recommendations for release at that time. Its task is to identify pathways that improve access to technology and innovations which provide more equitable cancer control, while also strengthening health systems to be better prepared for health challenges including future pandemics.

Dr. Gospodarowicz says the COVID-19 pandemic has spurred incredible change in health systems around the world as they grappled with the new disease, large patient volumes, and rapid vaccine development.

That energy and innovation can be harnessed to prepare for a growing wave of cancer cases anticipated in the coming years, Dr. Gospodarowicz says.

"COVID-19 came and everyone banded together to fight it," she says. "But because cancer is complicated, and also requires a lot of resources, it has been largely ignored although 10 million people die of cancer each year.

"The Commission will advocate for better cancer systems and improved outcomes that also strengthen the health systems."

In a comment piece about the new commission in The Lancet on August 18, the authors say COVID-19 is a "catalyst for disruptive innovation" that cancer control must harness.

"We are confronted with both a challenge and an opportunity to raise the bar for cancer control for everyone, everywhere, and to shake health systems out of an equilibrium of apathy through which some have access to ever-improving treatment and prevention, while many – mostly the poor – do not have even pain relief and palliative care," the article says.

Intended to spark discussion and debate

With more than 400 different types of cancers and constantly evolving technologies and research, and geographic disparities when it comes to available treatments, the Commission will also focus on equity, Dr. Gospodarowicz says.

"The issues may be different in Canada than in South Africa, or Ghana, or Brazil," she says. "We're going to try to determine what we can learn from each other."

Dr. Gospodarowicz is a graduate of the University of Toronto and practiced radiation oncology focusing on clinical research in lymphoma and urological cancers. She stepped back from her clinical work last year to focus on global cancer, an area she has worked in for decades.

Dr. Gospodarowicz's interest in cancer staging and prognosis led to her work with the Union for International Cancer Control during the 1990s and serve as its president from 2012 to 2014.

In 2015, Dr. Gospodarowicz was named an Officer of the Order of Canada, the country's highest civilian honour, "for contributing to improved cancer radiotherapy and for her leadership in advancing cancer care around the world."

Dr. Gospodarowicz previously initiated a 2015 Lancet Oncology Commission on expanding global access to radiotherapy.

The in-depth researching and crafting of this report is intended to spark discussion and debate, she says.

"We are encouraged not to be afraid to be controversial, to have transformational ideas, to be disruptive," she says. "But we have to back it up with evidence."

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