European Multidisciplinary Cancer Congress (EMCC) 2011, 23-27 September, Stockholm

Multi-disciplinary approaches and e-learning within ESTRO

Professor Vincenzo Valentini – Università Cattolica del Sacro Cuore, Rome, Italy


Professor Valentini from Rome, you are one of the bastions of radiation research and delivery in Italy. You have an absolutely superb centre in Rome and you have followed a mentor from whom you will shortly take over. Tell us about it.

Yes, I had the very great opportunity when I was young to meet Professor Cellini that at the time was Dr Cellini. It was incredible that we found immediately a very deep correspondence in what are the major values for a professional: to have respect of value, to respect patients, to respect science, to respect our colleagues and, in the meantime, to be creative, to look at what could be implemented in the daily practice because it’s something that will change our practice, but looking always at what is behind the corner. Not to stop, not ever to consider that what we have done is forever. This was the major teaching that Professor Cellini offered to me with the friendship to live with him. So we started a story that is lasting more than forty years and we work together very closely. He will be retired and I will have all the responsibility to continue to offer such a methodology to work, also to my colleagues, to my friends that work in my department.

You have a very good radiation therapy session, you also work, obviously, in a multi-disciplinary team with the surgeons and the medical oncologists and so on, how does that work on a day-to-day basis?

OK, this is really one of our priorities. Radiotherapy is a very reliable treatment modality because it’s effective, it’s organ sparing, it’s very cost-effective but in the meantime it has to be managed in a proper way and the best way to use radiotherapy is to set its own indication inside a multidisciplinary frame. In our hospital we have every week eighteen meetings of different tumour sites where people meet together to tailor for each individual patient what is the best treatment.

And there is another kind of discipline in oncology and that is laboratory research and inter-disciplinary can also mean basic science and translational science and clinical science. How do you function in that sense in Rome?

Obviously our biological background is based in the platform for innovation, for understanding what is the best approach that we have to offer to our patients. But be careful, there is another laboratory that is, for us, really, really important and that’s the imaging. More and more imaging became molecular; more and more imaging is dynamic, showing us the function of the tumour. So if we have to be honest with you, one of our priorities is to introduce the full understanding of the imaging inside our frame and our daily practice.

One of your big hobbies, I know because I’ve interviewed you before about this, is teaching. You are moving way ahead of any of the other trade unions in oncology by developing e-learning. How is that getting on? It’s really, really pioneering.

Many years ago I had the privilege to visit a strange laboratory where there were many seeds with a slide projector and a tape recorder. What was amazing, it was to understand that it would be possible to link one image with comments and to call them like the smallest piece of knowledge, like the byte in the informatics world. What was really attractive at that time was that this byte, this learning object, could be built and put inside a chart of many other learning objects allowing people to navigate inside the environment of the learning object according to their knowledge that is different for each of us, and according to their own time. And building on this idea, the navigation inside of learning or just the opportunity to become more expert in what you need to become expert, we built many different systems. Obviously with the diffusion of the net, of the internet, to put these learning objects in a circuit of the web was the natural step, the natural growth of this process.

And you’ve already got a couple of schemes running within ESTRO which you’ve been leading, how are they getting on?

Yes.

They have interesting names, as I recall.

Yes, exactly. We called one is the EAGLE programme, the other one is the FALCON programme. EAGLE is actually to exploit a library of learning objects, to build accordingly a programme to educate or to share knowledge in some cancer treatments. We already have a programme with EAGLE for rectal cancer where we put on top of this library a live library of learning objects, also a system for a web-conference, for a virtual classroom. Because very often the e-learning programme provides a service that is one-to-one, so you and the computer and you are missing the human relationship behind. So integrate this kind of important learning process that is one-to-one with the inside frame of a virtual classroom where you can work with other students and in the meantime you have available, by the teleconferencing system, of a mentor or a tutor, ready to  answer all of your needs, educational needs. This is the frame of EAGLE. FALCON is a little bit more sophisticated because it’s one to us where one of the major, critical needs that radiation oncologists have is to delineate the target of their own therapy. To delineate the target we need to be expert in radiology anatomy and also in the natural history of the tumour growth, which means which are the compartments in the body that are at higher risk of being contaminated by the tumours. To identify them in the on-going available imaging requires a lot of expertise. So we have a simulator, a big simulator that provides you this kind of imaging. You can do your own delineation, identification of the target, and then you can compare it with the delineation that was made by experts and in such a way you can double check by yourself what is the part that you have fitted with the experience of the much wiser people. But also this kind of frame of simulator is put inside a teleconference system that also will provide the participants to be part of a virtual classroom the same, just not only with the question why the expert makes such a delineation but also to interact with a tutor and mentors that can offer you the explanation why there are such differences.

I think this programme is exciting, I really, really do. I don’t need to be convinced about the importance of using the internet because this is what ecancer.tv is here. And, of course, what we can do with ESTRO is introduce the multi-disciplinarity of our net, which is everybody in oncology, and learn from you to see how you do it in a single discipline. Thank you very, very much indeed for sharing this really exciting avenue with us and good luck in your ESTRO Presidency, I think it will be spectacular, I’m sure you will be very good.

We’ll see. Thank you very much to you for your activity too.