Supportive Care Abstract from World Cancer Congress

The following is my abstract for the recent in World Cancer Congress. Supportive Care is one of the five "streams" followed by the UICC:
SUPPORTIVE CARE IN BUSY CANCER TREATMENT CENTRES: AN EFFECTIVE AND INTEGRATED TEAM APPROACH
Background - What is the role of ‘supportive care’? Articles, research and practice wisdom reinforces the importance of its salutary effect. When various components of supportive care function in isolation efficacy diminishes. The importance of supportive care as a central component of well-being is recognized by doctors and mental health professionals. How supportive care is fully integrated is little understood and infrequently practiced. Can there be an integration of all the practices associated with supportive care throughout the cancer continuum? A practitioner with a strong academic background is part of a team in a busy centre treating about 100 cancer patients daily. The idea of the disciplines working in a coordinated manner was built into the treatment design. Without a blurring of professional boundaries, all the delivery has integrated services usually associated with supportive care – palliation, spiritual care, counselling, social work, patient groups, advocacy, nursing, telemedicine, cultural and religious diversity, survivorship. This is framed by concerns for a cost effective patient centred practice.
Objectives - Can supportive care teamwork be effective in a time of specialties? The base of integrated work will be discussed. Above all else, can extensive supportive care make a difference in the lives of the practitioners, assist oncologists in their medical practice, cause changes to the patients’ QoL and have a positive outcome in healing – all while having significant cost-offsets.
Methods - Insights will be shared as to how the oncologists meet with the other professionals as new patients are presented. What is expected from each person – from the music therapist through to the pharmacist or dietician? What is the role of a nurse practitioner? How do palliative specialists fit into this practice? Does the supportive care extend into the community through cancer support groups and patient advocacy? How does all this reflect on caregiver health? The frequency of referrals from oncologists to the interprofessional team might surprise many. A unique supportive care assessment tool becomes part of each patient’s chart, which in turn give other referral indicators.
Results - Oncologists, clinicians, palliation practitioners, psychosocial and community workers, spiritual care specialists, community engagers, will be able to reflect on their own practices and determine what can work for them for the forwarding of the cancer agenda - according to their stage of development and the medical culture out of which they operate. Academically, research areas will be suggested.
Conclusion - The importance of highly functional and cost effective support systems will be the emphasis of this century. As physical medicine modalities develop and more emphasis is placed on prevention, we will require further research and practice models into the dynamics of supportive care teamwork. Supportive care according to cultural sensitivities will enhance the field. Models for the integrated field of supportive care will change the fabric of cancer care delivery.
References - A streamed reference list will be provided. For example, for the English speaking world, one of the best textbooks for consideration is "Psychosocial Nursing Care Along the Cancer Continuum," 2006:pp. xviii + 670. Several medical journals have helpful studies, as found The Lancet, BMJ and specific cancer journals.

Blogs to come

I apologize for missing promised dates. It was hoped to start during the World Cancer Congress. The Congress was great, but I only attended in a background and quiet mode. Unfortunately I had an accident in Geneva resulting in fractured ribs. Didn't feel like doing much else. The airlines were great, but to my embarrassment insisted on a wheel chair through the Geneva, Paris, Boston and local airports. The closing was memorable... more about that later.

Next week will commence with reflections on Vitamin D, the international movement against cancer, human rights and cancer control ... and so on. The first poste will concern supportive care... an abstract of work for the Congress.

Would start this week, but a family wedding (daughter) is taking precedence.

Cell Phones now, and 'why me'?

A couple of days ago, a call to the surgical ward at the hospital ... the familiar scene - a patient (and in this case, friend) had just learned that she had a very serious cancer. It was discovered after what was thought to be a regular gall bladder operation.... She was ‘healthy’ .. Had never smoked, been a drinker, was in good shape and all the rest. The inevitable question, ‘why me?’ is hidden on the lips of family, friends, and of course, the patient. The fact is that we don’t have an answer to this question, except in obvious cases. We’ve long been concerned about environmental factors - especially in agrarian parts of the country. And now, once more, we have another news story to reinforce the list - cellphones. This past week, Ronald Herberman, the director of the U of Pittsburgh Cancer Institute, issued a warning to his faculty and staff about limiting cellphone use because of the possible risk of cancer. He said that "… at the heart of my concern is that we shouldn't wait for a definitive study to come out, but err on the side of being safe rather than sorry later." Dr. Herberman's advice once again raised concern among many cellphone users and especially parents. In the memo he sent to about 3,000 faculty and staff last Wednesday, he says children should use cellphones only for emergencies because their brains are still developing. The issue that concerns some scientists - though nowhere near a consensus - is electromagnetic radiation, especially its possible effects on children. We know that children and adults are exposed to electric and magnetic fields (EMF) from a variety of sources every day. For example, coffee makers, hair dryers, computers, household wires and high voltage power lines emit both electric and magnetic fields. To date, following more than 25 years of research, scientific evidence has not found a consistent relationship between exposure to EMF and cancer risk in adults. However, some research studies have found a relationship between EMF exposure and childhood leukemia, and even the scientific evidence looking at the risk of childhood leukemia and exposure to EMF is inconsistent. Some studies show an increase in risk – particularly when the EMF level is high – while others show no increase in risk. As an amateur in this research area, it just seems to me that we should err on the side of caution until definitive results are forthcoming. Certainly, it appears that there are limitations to current research. To date, in my country, Health Canada suggests that taking special precautions is not necessary. What is obvious, is that more and smarter research is necessary between environmental factors and certain cancers. At the end of August, I’ll be at the World Cancer Congress … and looking for any current research statements concerning cellphone or electronic devices and cancer potential. For now, it adds to the list of ‘why me’ or, as another ‘healthy’ friend and colleague put it as he was dying of cancer … "why not me"?

Tuesday, July 22. I wasn’t planning to start the ‘blog’ for another month ... but returning from a movie tonight changed that. The off-beat movie Young@Heart, playing here at City Cinema, was so great that for the first time in that theatre the audience applauded at the end ... what else could you do? It is poignant and happy for anyone interested in the possibility of an intersection between music therapy, palliation and caring with seniors! The magic and power of music therapy as we have discovered in our cancer treatment centre through Peter Mutch’s sensitive application of his skills, this realistic [movie] presentation is simply wonderful. It couldn’t be more highly recommended for our own integrated palliative care team ... or anyone ... and we just kept saying - Peter has to see this! Heck, he could make one like it pretty soon. The movie is at 7 o’clock each night for the rest of the week. Here is how the advertising stringer puts it: - “To judge from the opening shots - a packed theater, screaming fans - Young@Heart could be your average concert documentary. But then the first member of the band steps forward, opens her mouth ... and seems to be missing a few teeth. She is, in fact, 92 years old and one of the most charming participants in one of the most delightful movies to come along this year. The concept sounds gimmicky... Senior citizens from Northampton, Mass., perform songs by the likes of Coldplay, the Clash and Sonic Youth. But the chorus members and their director, Bob Cilman, take the group so seriously that their story turns out to be a profound testament to perseverance and passion... The movie becomes something special, a unique chronicle that is alternately sweet, funny and heartbreaking. Songs like Talking Heads' Life During Wartime or Bob Dylan's Forever Young take on entirely new meaning when interpreted, with thoughtful sincerity, by someone who's seen the better part of a century. Watch ailing octogenarian Fred Knittle sing Coldplay's Fix You, in honor of two recently deceased colleagues, and you may feel as if you're learning something new about life itself.” - Elizabeth Weitzman, New York Daily News.If you see it, let me know what you think. Missing you all on the IPCT!!!!