The head of Europe's cancer research and treatment body, Françoise Meunier, tells Susan Carroll one thing will certainly help in tackling the disease - banning tobacco
Forget smoking bans. Forget advertising campaigns. Forget tax increases. If you want to get serious about fighting cancer, according to Françoise Meunier, the best place to start is by banning tobacco.
For the head of the European Organisation for the Research and Treatment of Cancer (EORTC), this is a no-brainer. "We are making such a fuss about the dangers of chemical pollution, where we know of only one or two compounds that can cause cancer so far. With tobacco, the link is obvious," she says.
Set up in 1962, the EORTC employs 105 people in its Brussels headquarters, but its reach in the global fight against cancer is far larger. The unique body conducts and co-ordinates vast clinical trials of cancer treatments, linking 6,000 patients a year with 2,500 volunteer doctors in 300 clinics in 32 countries.
It may not have the prestige of fundamental research but, put simply, its trials cut the amount of time it takes new anti-cancer drugs and therapies to get from the lab to the patient.
Put even more simply, it stops people dying and suffering. And with cancer causing seven million deaths a year, or 12.5 per cent of total worldwide deaths, it's never been more important.
Holding this sprawling network together is Prof Meunier, a Belgian doctor and winner of one of the 2004-5 Prix Femmes d'Europe. With her bright eyes, plain-speaking manner and what she has described as her "dreadful efficiency", the EORTC director-general is a formidable figure in a profession dominated by men.
Meunier's career has run parallel to the EORTC, which was started by Henri Tagnon, the visionary former director of the Jules Bordet Institute, Brussels's pioneering cancer clinic.
The organisation was initially based in the institute, where Meunier trained in the 1970s and later became head of infectious diseases, after a stint in New York's Memorial Sloan Kettering centre.
She was motivated to stay in cancer research by the professionalism and scientific rigour of both institutions.
"It was the start of major improvements for cancer treatment and an area where you felt you could achieve something," she says.
When Tagnon asked Meunier to become director of the EORTC in 1991, it meant leaving her prestigious research career and entering something of a hornet's nest.
The EORTC was in financial trouble and lacked medical expertise in its co-ordinating body. Meunier is credited with turning it around, orchestrating an ambitious restructuring plan, finding new funding and creating jobs.
Fourteen years later, she is still highly motivated by the challenges and potential of cancer research.
"It's a very interesting field because there are still many situations in which we don't know the best treatment for patients. The only way to find out is to do high-quality clinical research," she says.
"It's particularly important and complex for cancer, as opposed to other diseases, because of the multidisciplinary approach to treatment. You need to discover how best to combine surgery, radiation, chemotherapy, immuno-therapy and so on."
It's an exciting time, she says, because scientists are starting to understand what is going on at the molecular level of a cell when it develops cancer.
"This means we are much closer to breakthrough treatment. If we understand what is wrong with the cell, we can try to selectively salvage or correct the mechanism. Before, we were going in all directions, trying to kill everything, including the good cells."
The past 30 years have seen major strides in cancer treatment, cutting death rates in Hodgkin's disease, testicular cancer, breast cancer and child and adult leukaemia, as well as improving the quality of patients' lives.
Thanks to the sheer scale of its trials, the EORTC has been at the forefront of a swathe of these advances; last March it published the results of a trial that found a new form of chemotherapy could help save the lives of people with brain tumours.
But despite all this, cancer will soon start to affect far more people than ever before.
"People will think 'They are not making any progress, everyone around me has a cancer'," says Meunier. "Why? Because the population is ageing."
Some 60 per cent of cancer occurs after the age of 60, she says.
"Medical progress means that fewer people die in car accidents, or from measles or pneumonia. The fact is that there are more of us around at 60 to develop cancer."
All this makes EORTC's research more vital than ever but, according to Meunier, it is being hampered by the European Union's Clinical Trials Directive. Introduced last year, the legislation was intended to simplify and co-ordinate the rules governing trials.
For scientists, says Meunier, it has been a "catastrophe".
"It does not protect the patient and has not improved the quality of science," she says.
The EORTC estimates that the directive has increased the cost of a trial fourfold. "Before, we could activate a study in nine months - now it takes 18," says Meunier.
"The implementation has not been harmonised and each country interprets the directive in its own way."
The problem, she believes, is that the directive was developed by the Commission's enterprise directorate-general, to create jobs for the pharmaceutical industry.
"This has nothing to do with non-commercial academic clinical research," she says.
The EORTC is funded by its own charitable foundation, various cancer charities, Belgian lottery funds and an annual grant from the National Cancer Institute in the US.
Meunier refutes the suggestion that the pharmaceutical industry has too much control over research. "We rely on industry because they have the money to invest in the discovery of molecules," she says. "But when you find one, you still need a therapeutic strategy. It's important to have an independent evaluation of new discoveries and how they can be integrated into existing treatment."
Banning tobacco may be a far-off dream, but there is something that Europeans could do to help future cancer patients. Compared with the US, where advocacy groups campaign for more trials for diseases like Aids, people are reluctant to take part in clinical trials.
"In Europe, they say they don't want to be 'guinea pigs', says Meunier. "But you are likely to be much better treated in a clinical trial. You may benefit from state-of-the-art treatment and will be in a framework with a lot of control."
She adds that we must accept the fact that we are not going to eradicate or "cure" cancer.
"What's important is how we are going to treat cancer and learn to live with it."
To find out more about the EORTC, see www.eortc.be.