REPORT on 10 th ESO-ESMO- EONS MASTERCLASS IN CLINICAL ONCOLOGY 02/04/ /04/2011 Ermatingen (Lake Constance), Switzerland

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1 REPORT on 10 th ESO-ESMO- EONS MASTERCLASS IN CLINICAL ONCOLOGY 02/04/ /04/2011 Ermatingen (Lake Constance), Switzerland ESO-ESMO Masterclass in Clinical Oncology (MCO) Chair: N. Pavlidis, GR - R.A. Stahel, CH Scientific Coordinators: W. Gatzemeier, IT - R. Popescu, CH ESO-EONS Masterclass in Oncology Nursing (MON) Chair: S. Faithfull, UK Scientific Co-ordinators: D. Papageorgiou, GR and A. Margulies, CH In collaboration with the Flims Alumni Club Coordinator: C. Melcher The Masterclass was held for the third time as a joint venture with ESMO, the European Society for Medical Oncology, and for the fourth time with EONS the European Oncology Nursing Society. The Masterclass was part of the Sharing Progress in Cancer Care programme (SPCC) whose sustaining members are: Amgen, Eisai, Eli Lilly, GlaxoSmithKline Oncology, Merck Serono, Genomic Health and Novartis Oncology who supported the programme with unrestricted educational grants. ESO wishes to express its appreciation to Wolfsberg Centre for their consideration and support, and to the Flims Alumni Club for the collaboration in promoting the Masterclass. Aims and objectives This clinically oriented educational programme has been designed for medical or clinical oncologists who wish to improve their skills or those who are preparing for the national board exam. The programme exposed participants to a full spectrum of issues in clinical oncology and to practice-oriented training.

2 Clinical sessions focused on breast, colorectal, lung, genito-urinary, gynaecological, head and neck cancers. Spotlight sessions facilitated a compact update on haematological diseases, sarcoma, cancer of unknown primary, new drugs in breast cancer and in oncogenic-driven malignancies, neuroendocrine tumors, cancer stem cells, palliative care, supportive care and communication skills. Teaching format The Masterclass offers plenary lectures regarding state-of-the-art clinical evaluation and treatments with reference to clinical guidelines and which will conclude in take-home messages. Participants will deliver case presentations within small groups and discuss these with the chairmen and the faculty. All participants resided at the course venue and participation was compulsory throughout the course. The Masterclass was entirely in English and fluency in English was necessary for admission. Participants of the concomitant Masterclass in Nursing Oncology joined selected medical sessions, whilst topics like palliative care, supportive care and communication skills were joint nursing and medics sessions. Description of the educational event: The Masterclass is A 5-day residential educational event Full immersion Clinically-oriented Multidisciplinary An international faculty of top experts delivering lectures focusing on breast, colorectal, gynaecological, head and neck, urological and lung cancers. Ideal Masterclass candidate Age between 30 and 40 years At least 2-3 years experience in medical oncology or clinical oncology Involvement in scientific activities Fluency in English Attendance to the Masterclass was limited to 60 participants and admission was by competitive application only (deadline was 1 st December 2010). Successful applicants were granted free registration and accommodation.

3 Sessions format Clinical Sessions: Experts deliver clear knowledge on the state-of-the-art treatments, refer to clinical guidelines and conclude the lecture by short and clear take-home messages. Participants were invited and encouraged to actively contribute to the discussion slots. Furthermore, practical training was offered in the frame of clinical case presentations delivered by the participants. Participants were divided in three groups, followed by the Masterclass Chairs and Coordinator (N. Pavlidis, R. Stahel and R. Popescu). The session s faculty should was mostly participating in the case presentation session of their assigned tumour type/topic. Spotlight Sessions: Speakers provided a compact lecture focusing on the most important aspects and new developments in the field, considering the notions that were felt of highest interest to the ideal masterclass participant. Therefore, spotlight sessions were not overviews nor they delivered basic knowledge. Case presentations: A clinical case abstract was part of the participants application procedure, and selected participants had the opportunity to present their case to the Masterclass Chair and faculty for exchange and discussion within three small groups. The session s faculty was mostly available to participate in the case presentation session of their assigned tumour type/topic. THE MASTERCLASS 2011 PROGRAMME Masterclass in Clinical Oncology participants only Participants of the Masterclass in Oncology Nursing join the Masterclass in Clinical Oncology sessions Joint Masterclass in Clinical Oncology and Masterclass in Oncology Nursing sessions Saturday, 2 April Participants' arrival, airport transfers, registration 14:30-17:00 Clinical session: Genito-urinary cancers Chair: Alan Horwich Prostate cancer: 14:30-14:50 Local treatment: Surgery Tullio Sulser 14:50-15:10 Local treatment: Radiotherapy Alan Horwich 15:10-15:30 First-line endocrine treatment Alan Horwich 15:30-16:00 Castration-refractory prostate cancer Karim Fizazi 16:00-16:30 Testicular cancer Alan Horwich 16:30-17:00 Metastatic renal cell cancer: Evidence based treatment Thomas Powles 17:00-17:30 Coffee break

4 17:30-18:30 Spotlight session Haematological diseases (lymphoma and myeloma) Michele Ghielmini 18:30-19:30 Keynote lecture What medical oncologists must know today on clinical trials Martin Fey 20:00 Welcome dinner Sunday, 3 April 8:30-10:30 Clinical session Breast cancer I Chair: Aron Goldhirsch 8:30-9:30 Early systemic treatment Aron Goldhirsch 9:30-10:30 Treatment of metastatic disease and neoadjuvant therapy Elzbieta Senkus-Konef 10:30-11:00 Coffee break 11:00-13:00 Clinical session Breast cancer II Chair: Aron Goldhirsch 11:00-11:45 Pathology of breast cancer Giuseppe Viale :30 Radiotherapy: Key points Jacques Bernier 12:30-13:00 Tumour board - local treatment decision making (based on clinical cases) Panel (cases prepared by Wolfgang Gatzemeier 13:00-14:30 Lunch 14:30-15:00 Spotlight session New drugs in subsets of breast cancer Giuseppe Curigliano 15:00-16:30 Joint medics and nurses spotlight session Supportive care Chair: Lena Sharp 15:00-15:45 Fatigue management Agnes Glaus 15:45-16:30 Antiemetics, growth factors, bone health Matti Aapro 16:30-17:00 Spotlight session Triple negative breast cancer: An overview (SPCC lecture Sanofi-Aventis) Joseph Gligorov 17:00-17:30 Coffee break 17:30-19:00 Case presentations by participants - 3 groups (Genito-urinary, Breast, Supportive care) N. Pavlidis, R. Popescu R.A. Stahel 19:30 Dinner Monday, 4 April 8:30-10:30 Clinical session Gynaecological cancers Chair: Jan B. Vermork 8:30-9:30 Ovarian cancer Jan B. Vermorken 9:30-10:30 Cervical and endometrial cancers Cristiana Sessa 10:30-11:00 Coffee break 11:00-13:00 Spotlight session Head and neck cancer Chair: Jacques Bernier 11:00-11:30 Prognostic factors and surgical approach Andreas Dietz

5 11:30-12:00 Radiotherapy Jacques Bernier 12:00-13:00 Systemic therapy Jan B. Vermorken 13:00-14:30 Lunch 14:30-15:30 Spotlight session Recent developments in the field of cancer stem cells and implications in the clinical setting Malcolm R. Alison 15:30-16:00 Spotlight session EORTC G-CSF Guidelines What s new? (SPCC lecture Amgen) Matti Aapro 16:00-16:30 Spotlight session New drugs in oncogenic-driven malignancies (thyroid, melanoma) Rolf A. Stahel 16:30-17:00 Spotlight session Positron emission tomography-computed tomography in oncology: When, where and how to use it Chirag Patel 17:00-17:30 Coffee break 17:30-19:00 Case presentations by participants - 3 groups (Gynae, Head and neck, Colorectal) N. Pavlidis, R. Popescu R.A. Stahel 19:30 Dinner Tuesday, 5 April 8:30-10:30 Clinical session Colorectal cancer I Chair: Eric Van Cutsem 8:30-9:00 Imaging (correlation with pathology) Regina Beets-Tan 9:00-9:45 Management of rectal cancer (surgery and radiotherapy) David Sebag-Montefio 9:45-10:15 Adjuvant treatment (stage 2 and 3) Philippe Rougier 10:15-10:30 Neoadjuvant and adjuvant treatment of liver metastases of colorectal cancer Eric Van Cutsem 10:30-11:00 Coffee break 11:00-13:00 Clinical session Colorectal cancer II Chair: Eric Van Cutsem 11:00-12:00 Advanced disease and new developments Eric Van Cutsem 12:00-13:00 Gastric and pancreatic cancers Philippe Rougier 13:00-13:30 Spotlight session Targeted therapies in metastatic colorectal cancer: The impact for the surgeon (SPCC lecture Merck Serono) Graeme J. Poston 13:30-14:30 Lunch 14:30 Departure, social activity, dinner out Wednesday, 6 April 8:30-10:30 Clinical session Lung cancer I Chair: Rolf A. Stahel :00 Surgery Walter Weder 9:00-9:30 Radiotherapy Corinne Faivre-Finn 9:30-10:15 NSCLC systemic therapy Rolf A. Stahel

6 10:30-11:00 Coffee break 11:00-12:30 Clinical session Lung cancer II Chair: Rolf A. Stahel 11:00-11:30 SCLC Corinne Faivre-Finn 11:30-12:00 Mesothelioma Rolf A. Stahel 12:00-12:30 Tumour board (clinical cases prepared by the faculty) Panel 12:30-13:00 Spotlight session - Neuroendocrine tumours Kjell Öberg 13:00-14:30 Lunch 14:30-15:15 Spotlight session Sarcoma Paolo Casali 15:15-16:30 Joint medics and nurses spotlight session Multidisciplinary working and communication skills Andrew Hoy 16:30-17:00 Spotlight session Criteria to evaluate genomic tests (SPCC lecture Genomic Health) Christer Svedman 17:00-17:30 Coffee break 17:30-19:00 Case presentations by participants - 3 groups (Lung, Palliative care) N. Pavlidis, R. Popescu R.A. Stahel 19:30 Dinner Thursday, 7 April 8:30-9:30 Spotlight session Cancer of unknown primary Nicholas Pavlidis 9:30-10:00 Spotlight session Circulating tumour cells: Challenges and pitfalls Fiona Blackhall 10:00-10:30 Coffee break 10:30-12:00 Joint medics and nurses spotlight session Palliative care Chair: Anita Marguiles 10:30-11:15 Pain control Dirk Schrijvers 11:15-12:00 Advanced disease management Andrew Hoy 12:00-12:15 Closure 12:30 Airport transfers and departures

7 The European School of Oncology (ESO) is an independent organisation. It recognises that the industrial partners are crucial for the delivery of best cancer care and fosters the continuation of the dialogue and identification of synergies. It restrains, however, the influence of marketing and strives to maintain its independence from the sponsors with whom it interacts with a neutral approach. Since its inauguration in 1982, ESO has been promoting cancer education in Europe and abroad. The original idea of the school is to fight against cancer in optimising training and updating competence of physicians and health care workers dealing with cancer patients in providing them with a comprehensive understanding of oncology - covering all aspects from epidemiology, screening, primary and secondary prevention, molecular-biology, diagnostic procedures, interdisciplinary treatment modalities, rehabilitation, palliative care, to psycho-oncological skills and promoting the importance of controlled randomised trials in clinical oncology. ESO s mission is reflected in its motto "Learning to Care", which stresses the concept of studying and learning and also of caring for the patient in a global sense. By improving the skills of all health professionals dealing with cancer patients, ESO shortens the length of time needed to transfer knowledge from advanced research centres to daily practice, combining advanced technology with humanism in care. Summary: Participants appreciated the high level of this educational event and the broad opportunities for informal discussion with the faculty during sessions and beyond. Mediating oncological knowledge and principles in this way of full immersion in modern oncology create a collective spirit of teaching and learning to improving clinical skills and patient care. The evaluation of the participants opinion (questionnaire focussing on programme objectives, programme organisation, course organisation, facilities, and faculty) indicated that the Masterclass met the needs of the participants on most of the items and highlighted the necessity of such an event. The results of this evaluation will be in particular useful to further improve the upcoming 11thMasterclass which will be held in Wolfgang Gatzemeier, M.D. ESO Masterclass Scientific Co-ordinator Attachments: - 1.Evaluation of the Masterclasses 2011 (MCO; MON) - 2. Group photos (MCO; MON) - 3. Publications on Masterclasses

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12 Masterclass The ESO Masterclass: where those most eager to learn meet those most willing to teach Peter McIntyre Once a year, in a quiet location somewhere in Europe, 60 of the continent s brightest and most motivated young oncologists gather for a learning experience that can define their careers. This week-long Masterclass lies at the very heart of ESO s mission, building an army of brilliant and caring young oncologists, many of whom will be the leaders of tomorrow. 34 CANCER WORLD SEPTEMBER/OCTOBER 2011

13 Masterclass The European School of Oncology was famously founded on a misdiagnosis and its unique selling point is to prevent tragedies based on ignorance and lack of education. The legacy on which the School was launched in 1982 was bequeathed by an Italian businessman who was treated for a year for arthritis before discovering that his pain came from bone metastases originating from undiagnosed prostate cancer. The whole premise of the School is that mistakes like this would not happen if doctors were better educated about cancer and if specialists were up to date with and applied the latest research and best clinical practice. The Milan group who created ESO was evangelical about improving doctors knowledge and understanding about latest treatments and diagnostic tools. ESO education is about incorporating research that updates state-of-the-art best practice, while retaining tried and tested treatments that work. It is the application of knowledge to the treatment of patients that is at the heart of ESO initiatives, exemplified in its motto Learning to care. It does this by enlisting the best experts from around Europe to present the evidence for first-line therapies and subsequent treatments, asking and answering what if questions on the way. The emphasis is on multidisciplinary ways of working and the importance of becoming a true specialist so that all patients are in the hands of doctors who know the evidence and how to apply it. In the variety of ESO courses Inside Track, Insight conferences, a course for medical students the Masterclass in Clinical Oncology for young oncologists has come to be seen as a key event bringing together those most eager to learn and those most willing to teach. The annual Masterclass is a week of intensive learning and interaction for 60 of the brightest and best: 30- to 40-year-olds on the cusp of deciding their ultimate oncology specialism. The course is dedicated to medical and clinical oncologists and the focus is on the big killers: lung, breast, prostate, colorectal and gynaecological cancers. Alberto Costa, director of ESO, says that these Masterclasses take the School back to its roots. When we started ESO, courses were like this one week residential courses. But then people had no money and people were too busy, and the hospitals would not let them go for a week. So the courses were cut back to one or two days. Now we have 60 students for a week. This is exactly what people of this age need. They are now at the age when they have to choose what specialty they will follow but options are still open to them. You cannot come here through paying a registration fee. You have to write a motivation about why you want to come and you have to prepare a case study and then you may be accepted. LEARNING FROM DIFFICULT CASES What is now the ESO ESMO Masterclass in Clinical Oncology celebrated its 10th anniversary inapril 2011 at the Wolfsberg Centre, by Lake Constance, in Switzerland. The venue (it belongs to UBS investment bankers) exudes a sense of calm order. The Masterclass is a ferment of bubbling activity. The daily routine is rigorous: breakfast by 8.00am, first presentation at 8.30am, and (with breaks) presentations through till 4.30pm. Then the day begins again, as the participants split into groups and present and discuss case studies from their own hospitals. By the time they close, it has been 11 hours of intense concentration. The presentations read like a Who s Who of European oncology:aron Goldhirsch on breast cancer, Jan Vermorken on gynaecological cancers, Jacques Bernier on head and neck cancers, Eric van Cutsem on colorectal cancer, Rolf Stahel on lung cancer. For the case study discussions, nobody brings a straightforward case. The history is revealed step by step, usually with recurrence or complications following treatment and some tough choices at the end. With 15 to 20 young oncologists in each group there are echoes of the hit TV series House, in which bright young doctors outdo each other in diagnoses and suggested treatment. The faculty member for one group is Nicholas Pavlidis, professor at the Department of Medical Oncology in Ioannina, Greece, and joint chair of the Masterclass. He s far too nice to be Dr House, but there is something magical about his ability to pop up with a slide containing the most relevant research results during discussion. And (uniike the malignant Dr House) Pavlidis always brings the students back to the human perspective these are not cases but people. So one case study involves a mother of two children diagnosed with ENNIO LEANZA CANCER WORLD SEPTEMBER/OCTOBER

14 Masterclass What if? Students bring difficult case studies for discussion with international experts such as lung cancer specialist Rolf Stahel, pictured here ENNIO LEANZA colorectal cancer in She has been treated for aggressive disease and liver metastases with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). By March 2011, after many cycles of treatment, there is no obvious sign of disease. Should they be adopting invasive diagnostic tests? Pavlidisaskswhattheoutcomewillbeifthecancerhas returned and all agree that they will have run out of options. Gently, he suggests that the additional tests will bring distress to the patient without benefit. Another case concerns a young woman who presented with adenocarcinoma, and was initially treated apparently successfully. But, after recurrence and further treatment, hepatic metastases were found. Despite hepatic metastasectomy, it is clear that the cancer has not been cured. Pavlidis points out that she is still alive six years after her initial diagnosis, and for much of that time has been able to live a normal life. Is this a treatment that has failed, as the young doctor may feel, or one that has given this young woman years of good-quality life, critical years with her young children? Pavlidis has been described as the father of the Masterclass. Almost 30 years ago, in 1982, as a young Fellow at the Royal Marsden Hospital in the UK, he attended the first ESO course in Milan. If you look at who were participants then, more than 50% of them are now professors in universities inside oroutsideeurope, hesays.heissurethispatternwill be repeated with the current Masterclass series. We offer real education by distinguished experts from Europe. What makes the difference is that not only do you teach the big killers but you also have these people sitting in these kind of groups presenting their own clinical cases. We analyse and criticise and give directions. There is something magical about his ability to pop up with a slide containing the most relevant research 36 CANCER WORLD SEPTEMBER/OCTOBER 2011

15 Masterclass More than 50% of the class of 1982 are now professors in universities inside or outside Europe UP FOR THE CHALLENGE The participants are clearly up for the challenge. Jochan Bauer qualified as a doctor seven years ago and now works in internal medicine at the Esslingen Hospital in Germany, specialising in cancer and haematology. My consultant took part in this Masterclass several years ago and recommended it warmly, he said. He is certainly right about this. It updates you on the facts and on standard diagnosis and treatment. It is hard work, but it is definitely worth it. Andreia Costa, a medical oncology fellow at the Hospital de São João, Portugal, takes her final medical oncology exams in This is a fantastic revision for me and it is very important for my training. It is very intensive, but we do get some breaks between sessions. I particularly value the discussion of the cases in small groups and over coffee. Davit Zohrabyan, a medical oncologist at the Yerevan State Medical University Hospital inarmenia, sees the course as a lifeline to knowledge that is not easily available in his home country. He saved up the questions he could not answer at home so he could ask the experts here. Armenia is a small country and it is not rich and it does not have big research programmes. It is very important for me and for my country that I get acquainted with the new methods and practice. I want to be informed with all the important new scientific knowledge. I want to work together with science. Inevitably, after 10 years, the pupils start to become teachers. Elżbieta Senkus-Konefka was one of 53 students on the very first Masterclass held in Montecantini, Italy, in Now a specialist in radiotherapy and medical oncology in Gdansk, Poland, she has returned for the past two years to lecture on treatment for metastatic breast cancer. My career is an example of someone who graduates from these courses and then becomes an expert. When I applied I was just starting on medical oncology. I wrote that this was at a very important point for me because I had just switched to a second specialty. Ten years ago hardly anyone from eastern AN EXCELLENT REPORT CARD Students rate the Masterclass highly for useful and relevant education A review of doctors attending the first nine Masterclasses shows that almost 60% were aged 30 34, and 37% were aged Participants were evenly divided, males and females. The vast majority of participants (72%) were medical oncologists, with 6% radiation oncologists and 6% clinical oncologists. Some had not yet finally decided on their areas of specialisation. Two thirds (67%) came from European Union countries, 25% from non-eu countries of Europe and 8% from outside Europe mainly the Middle East and Latin America. Feedback by students is very positive. Over the first nine years the overall median score for the quality of education was of 3.54 out of 4. Information was rated as useful and relevant (median 3.64) and well balanced with good evidence (3.59), with adequate time for discussion and questions (3.51). Masterclasses have been held in Italy, Spain, Cyprus, Malta, Bulgaria and Portugal, but the Wolfsberg Centre, at Ermatingen, Switzerland, received almost perfect scores for facilities, management and organisation, and it is clear that ESO hopes it will be able to return. Source: N Pavlidis et al. (2010) The Masterclass of the European School of Oncology: The key educational event of the school. Eur J Cancer 46: Europe went to international conferences or was considered an expert. I was one of the few to do so. Razvan Popescu, medical oncologist at the Hirslanden Clinic in Aarau, Switzerland, is one of two scientific coordinators. One of the reasons why I became involved is because of the experience of both good and bad quality teaching that I have had myself. Popescu is active with the European Society for Medical Oncology (ESMO), and in his work on the ESMO awards committee he saw many CVs of young doctors from eastern Europe who needed support. Certain countries, not exclusively in central and eastern Europe, have teaching that is mandatory for them to attend, but it does not take them forward they don t learn. These young people are the future of CANCER WORLD SEPTEMBER/OCTOBER

16 Masterclass oncology in Europe. What ESO has been doing, and I am delighted it is now doing it in partnership with ESMO, has been to set up a very, very good course. One of the main drivers for me to continue to participate is the live interaction which develops between the faculty and students. They get the crème of European oncology coming and lecturing, but also interacting with them. Should the course ease up a little? Can anyone concentrate for 11 hours a day? The other coordinator, Wolfgang Gatzemeier, believes that the benefit is worth the pain. At the beginning, I say you are here for a marathon. I did it for 10 years and I survived and you will survive as well. I know it is not easy to follow presentations for such a long time, but they also have time to reflect and talk to each other. He points out that the students do not have to remember everything as they get a book of presentations and access to the slides online. THE LATEST DATA - IN CONTEXT Gatzemeier, a breast surgeon, believes that the Masterclasses have added value over the large scientific conferences. When you go to the major conferences and congresses you can get lost in all that they have to offer. Here, in this more relaxed ambience, people are taught by top faculty in a very intensive way. The most important information is presented and everybody has an opportunity to gain as much as possible from what is offered. We ask people at the end if it is too much and yes, some complain that it is too compressed, but they also always ask us to do something more as well! From our follow-up, we see that for many participants this was a crucial point in their career, so that they may have the opportunity to become head of a department. ESO is not resting on its laurels. In May this year it held a Balkan Masterclass in Clinical Oncology in Dubrovnik, Croatia, co-chaired by Popescu, who is originally from Romania, and by Semir Bešlija from the Institute of Oncology in Sarajevo, Bosnia. Like the full Masterclass, this was a residential course It s for nurses too. Twenty-two cancer nurses attended a nursing Masterclass held in parallel; this group is discussing issues in patient communication paid for by sponsors, although slightly shorter, at three days. The Balkans course was also open to surgeons, who are not covered by the main Masterclass. Popescu explained that the aim was to devise a course that was particularly relevant to the clinical environment in the region. Some people come and hear things that they won t ever be able to put into practice, like monoclonals and targeted small agents that cost a fortune. There are a few people from the region who are exceptionally bright and sometimes manage to come to western institutions and do superbly well. It is painful that if they want to return to their own region they find they are not only struggling with financial issues, they are also struggling with systemic issues and the culture. A MASTERCLASS IN CANCER NURSING The Masterclass in Switzerland was not only about doctors: 22 nurses also attended from 15 countries. It was the tenth Masterclass for doctors, and the fourth for nurses. Funding is in place for the nursing From our follow-up, we see that for many participants this was a crucial point in their career PETER MCINTYRE 38 CANCER WORLD SEPTEMBER/OCTOBER 2011

17 Masterclass course to take place alongside the medical course for the next two years. Some presentations are shared with medics, but the nurses also break out to look at the advanced practice of nursing cancer patients. Sara Faithfull, President of the European Oncology Nursing Society (EONS), chaired the nursing course with many of the same objectives. The idea is that we are training future leaders, so this is very much about clinical experience and about looking at key skills and developing practice. We have looked at putting in place the advanced assessment skills that in many countries aren t systematic or taught. It is not just about the latest breast cancer treatment, it is about how you would, as a nurse, manage targeted therapies and manage the side-effects and look more specifically at the quality of life issues and enhancing care. The pedagogical methods used by the nurses are very different, based around group work and group discussion. In a communication segment they discuss how to respond when a patient inevitably asks: How long have I got? or when a relative says: Don t tell them what they have got. Nurse training and practice differ across Europe, and EONS has been working to improve online training opportunities for nurses, many of whom get less than three days a year away from the ward for training. But as with thedoctors,thereis littlethat can beat the face-to-face interaction. Sandrine Decosterd, from the Geneva University Hospitals, feels that this personal sharing of experience and motivation is most valuable. This coursealso gives you alot of knowledge in a short time both scientific knowledge and nursing knowledge. Elana Laska teaches palliative care nursing in Albania, where there are few oncology nurses. As an advocate to improve the role and skills of nurses, she was keen to share her knowledge when she got home. Every time I go for training I prepare Happy 10th anniversary. Chatrina Melcher, one of the organisers, with ESO director Alberto Costa (right) and co-chair Nicolas Pavlidis (left) celebrate with cake and presents a report. I hold meetings with the team and give them my experiences. I write notes every night about what I have seen and all the things I am thinking about how we can do something differently. EONS is planning to get academic accreditation for the next nurse Masterclass using case studies online afterwards to see how it has changed nurses practice. Alberto Costa feels that the Masterclass concept is much stronger when it includes doctors and nurses and he praises the sponsors for putting money into education, without wanting to put their names all over everything. Cutting the cake to mark the 10th anniversary of the medical Masterclass, he pointed out that there are now more than 500 people who have been through the course, a little army of brilliant young oncologists all over Europe. The average age of those attending the course seems to be dropping and the majority are under 35. It will not be many years before the students attending the Masterclass will not even have been born when ESO began. For now, it can be said that they have grown up together and that together they undoubtedly make a difference to the practice of oncology. The Masterclass is funded by an unrestricted grant from a pool of sponsors through ESO s Sharing Progress in Cancer Care programme ENNIO LEANZA CANCER WORLD SEPTEMBER/OCTOBER