Author: Fauzia Pesnani
Affiliation: Head of Oncology Nursing at Dr Ziauddin Cancer Hospital Karachi, Pakistan
I had the pleasure of attending wonderful ICCN 2016, it was a great opportunity I have ever had. Meeting with the Board members, founders and organizers was like a dream come true. Thank ICCN for providing me with this life-time opportunity.
It was a great learning in a very friendly environment. I interacted with people working in same field. This kind of work that have been done by them is remarkable.
I have attended every session and thoroughly enjoyed each program, from pre- conference workshops to the closing ceremony (Lions Dance performance), including welcome reception (get together evening), all conferences sessions, meeting with BOD, award & scholarship ceremony. I am very impressed with Dr Stella, ISNCC President. She is very down to earth and always has a beautiful smile on face, which make her personality more vibrant.
Dr Linda Krebs possessed exceptional leadership and made conference worthy 100million dollars. I did not meet any single person who was not happy with the conference arrangements, and everything was perfect and so well organized. The credit goes to Linda and her team.
Mr Andrew Dimech, the leading person of member development portfolio. The way he managed his time and spared his precious time for me, heard me in detail and encouraged and appreciated that I could do much more in my field, was simply Superb.
The experience of attending ICCN has not only expanded my horizon, but also provided me with a chance to make new friends and learn from their best practices. I also explored new country and was amazed to see beautiful university—“Chinese University of Hong Kong”. Many thanks to Dr Winnie SO for organizing the visit and delicious lunch.
It was a great experience to be a research poster judge and give your opinion and judgment about the great work done by young professionals.
ICCN 2016 was a global platform to discuss and learn about cancer prognosis, general issues in cancer care, unmet needs of patients and for improved handling for various types of Cancers. For an oncology nurse, to find the appropriate words to console a person who is suffering the loss of a loved one can be troublesome. And it’s challenging for us to deal with nurse’s role, health promotion, pain management, late effects of cancer treatment and long-term survivorship issues, end-of-life issues, psychological and family issues, nursing-sensitive patient outcomes and much more.
Things which I am going to apply are as follows;
- To develop a nursing society in my country and under this umbrella will do more organized trainings and developments for our novice nurses.
- I will give more focus on research work, and then publishing it which is hardly been done by nurses in my country.
- I will establish patient support group to help patients and family members deal with the physical and emotional suffering caused by the cancer diagnosis and treatment. The less distress patients have, the more energy they can direct toward recovery.
The ICCN was a great opportunity to all participants. I’m looking forward to attending the upcoming conference in 2017.
Authors: Bo Xu, Yong-yi Chen
Affiliations: Oncology Nursing Committee of Chinese Nursing Association
The 20th International Conference on Cancer Nursing (ICCN) was held in Hong Kong, China from September 4-7, 2016. Nearly 400 experts, who come from the United States, UK, Australia, Panama, Japan, Korea, Singapore, China, Zambia and other countries in the world, gathered together to share new developments on cancer nursing.
The theme of this conference was ‘Embracing globalization through leadership and partnership in cancer care’. The main contents covered 18 modules: the palliative care, nursing education, distance education, ethics, symptom management, quality and patient safety, policy, human resource, health system improvement, informed consent, clinical trials, etc.
The conference set various forms which contained oral presentation, rapid fire, keynote address, poster, etc. There were 70 participants from mainland China attending the conference, including 32 oral presentations, 10 rapid fires, 21 posters. Nurse education, symptom management, palliative care, quality safety and other oncology nursing aspects were involved.
Bo Xu and Yongyi Chen, the director and vice director of Oncology Nursing Committee of Chinese Nursing Association, respectively made oral presentations which showed the progress of cancer nursing in mainland China to scholars from all around the world.
The convening of the ICCN 2016 will help to promote the development of cancer nursing, disseminate new knowledge, promote international information exchange, further impetus the specialized development of cancer nursing and enhance the professional level of cancer nursing in China.
ISNCC and Union for International Cancer Control Collaborative: Cervical Cancer Program in Latin America (English, Español, Português)
Catherine Johnson, Newcastle, Australia
Luz Esperanza Ayala de Calvo, Bogota, Colombia
Marise Dutra Souto, Rio de Janeiro, Brazil
Myrna McLaughlin de Anderson, Panama City, Panama
Victoria Brunelli, Buenos Aires, Argentina
Project Team (L to R) : Maria del Rosario Caballero Tinoco, Lisseth de Campos (UICC representative) Maria Elena Reyes Nieto, Myrna McLaughlin de Anderson, Catherine Johnson, Marise Dutra Souto, Luz Esperanza Ayala de Calvo, Carla Ford (Association Coordinator, ISNCC) and Irma Medrano (Workshop Participant, Bolivia)
Workshop Partcipants in Bogota, Colombia.
Latin America has one of the highest rates of incidence and mortality from cervical cancer. Effective early detection strategies have been in place for many years and are now complemented by the availability of a vaccine to protect against some forms of cervical cancer. Vaccination prophylactic against Human Papilloma Virus (HPV) which can help prevent cervical cancer, is approved for use in most Latin American countries; however, few have implemented national immunization programs.
The International Society of Nurses in Cancer Care (ISNCC) and its partners, Union for International Cancer Control (UICC) and Centers for Disease Control and Prevention (CDC) conducted a review of cervical cancer in Latin America. The review identified 4 key issues for action, focused on i) education, ii) screening participation, iii) data monitoring and iv) cultural/ indigenous needs.
Subsequently an educational curriculum on Cervical Cancer, using WHO Guidelines was developed by 4 regional Nurse champions:
Victoria Brunelli from Buenos Aires, Argentina
Marise Dutra Souto from Rio de Janeiro, Brazil
Myrna McLaughlin de Anderson from Panama City, Panama
Luz Esperanza Ayala de Calvo from Bogota, Colombia
The curriculum is divided into 7 modules. The workshop topics included Introduction, Prevention and Control Programs, Community Mobilization, Education and Counselling, HPV Vaccination, Screening and Treatment of Cervical Pre-cancer, Diagnosis and Treatment of Invasive Cervical Cancer, and Palliative Care.
The curriculum has been successfully delivered via three ‘train the trainer’ workshops hosted in Lima, Peru, San Salvador, El Salvador (September 2015) and Bogota, Colombia (July 2016). The objectives of the workshops were to build capacity in cervical cancer prevention and screening amongst nurses from various countries in Latin America.
The San Salvador workshop was led by Myrna McLaughlin de Anderson and Luz Esperanza Ayala de Calvo. This workshop attracted 45 participants from Belize, El Salvador, Guatemala, Honduras, Nicaragua, and Panama.
The Lima workshop was led by Victoria Brunelli and Marise Dutra Souto. A total of 45 participants from Argentina, Brazil, Colombia, Paraguay, and Peru attended.
The final workshop, in Bogota, was led by Myrna McLaughlin de Anderson and Luz Esperanza Ayala de Calvo. A total of 32 participants from Bolivia, Colombia, Costa Rica and Mexico attended.
The workshop in Bogota, Colombia concluded current round of funding for the ISNCC and Union for International Cancer Control Collaborative project.
The project team has now commenced work on a new project funded by the American Cancer Society. The project is part of All of Me (Todo mi ser in Spanish); a program designed to encourage health care providers to integrate breast and cervical cancer education intervention in their practice. ISNCC will expand the scope of the curriculum to include breast health and breast cancer screening and to further develop the skills required for nurses to encourage their female patients to think of their bodies as a whole and what they can do over their lives to live well and stay healthy within three target countries (Brazil, Colombia and Mexico).
The project team welcomes Maria del Rosario Caballero Tinoco and Maria Elena Reyes Nieto from Mexico City, Mexico. The project team looks forward to reporting further on these projects at the International Conference on Cancer Nursing, Hong Kong, later this year.
Colaboración Internacional de la ISNCC y la Unión para el Control del Cáncer: Programa de cáncer cérvico uterino en América Latina.
América Latina tiene una de las tasas más altas de incidencia y mortalidad por cáncer de cuello uterino. Durante muchos años han estado en vigor estrategias eficaces de detección temprana y ahora se complementan con la disponibilidad de una vacuna para proteger contra algunas formas de cáncer de cuello uterino. La vacunación profiláctica contra el Virus del Papiloma Humano (VPH) que puede ayudar a prevenir el cáncer de cuello de útero, está aprobada para su uso en la mayoría de los países de América Latina, sin embargo, pocos han implementado programas nacionales de inmunización.
La Sociedad Internacional de Enfermeras en el cuidado del cáncer (ISNCC) y sus socios, la Unión Internacional para el Control del Cáncer (UICC) y los Centros para el Control y la Prevención de Enfermedades (CDC) realizaron una revisión sobre el cáncer cervical en América Latina. La revisión identificó 4 temas clave para la acción, se centró en i) educación, ii) participación en el tamizaje o cribado, iii) control de datos y iv) las necesidades culturales especiales y de grupos como los indígenas.
Posteriormente, utilizando las directrices de la OMS, fue desarrollado un programa de educación sobre el cáncer de cuello uterino, por 4 líderes regionales de enfermería:
Victoria Brunelli, de Buenos Aires, Argentina,
Marise Dutra Souto, de Río de Janeiro, Brasil,
Myrna McLaughlin de Anderson, de Ciudad de Panamá, Panamá,
Luz Esperanza Ayala de Calvo, de Bogotá, Colombia.
El plan de educación se divide en 7 módulos. Los temas de los módulos incluyen: Introducción, programas de prevención y control, movilización de la comunidad, educación y orientación o consejería, vacunación contra el VPH, detección y tratamiento del lesiones pre malignas de cáncer cervical, diagnóstico y tratamiento del cáncer invasor de cuello uterino, y cuidados paliativos.
El plan educativo se ha desarrollado con éxito a través de tres jornadas de un día, tipo taller de “formación de formadores” en tres ciudades: Lima, Perú y San Salvador, El Salvador (en septiembre de 2015) y Bogotá, Colombia (en julio de 2016). El objetivo de estos talleres fue incrementar la capacidad de las enfermeras de diversos países de América Latina, en la prevención y detección del cáncer de cuello uterino.
El taller de San Salvador fue desarrollado por Myrna McLaughlin de Anderson y Luz Esperanza Ayala de Calvo. Este taller atrajo a 45 participantes de Belice, El Salvador, Guatemala, Honduras, Nicaragua y Panamá.
El taller de Lima fue dirigido por Victoria Brunelli y Marise Dutra Souto. Asistieron 23 participantes de Argentina, Brasil, Colombia, Paraguay y Perú.
El último taller, en Bogotá, fue realizado por Myrna McLaughlin de Anderson y Luz Esperanza Ayala de Calvo, con un total de 32 participantes de Bolivia, Colombia, Costa Rica y México. Este taller en Bogotá concluyó la actual ronda de financiación para el proyecto colaborativo de la ISNCC y la Unión International para el Control del Cáncer
El equipo de trabajo ya ha comenzado a trabajar en un nuevo proyecto financiado por la Sociedad Americana del Cáncer. El proyecto forma parte de All of Me (“Todo mi ser” en español), un programa diseñado para motivar a los proveedores de atención en salud a integrar en su práctica la educación y la intervención sobre el cáncer de mama y el de cuello uterino. La ISNCC ampliará el alcance del plan de educación para incluir el cuidado de la salud de la mama y el cáncer de mama y para desarrollar las habilidades requeridas por las enfermeras para alentar a sus pacientes de sexo femenino a pensar en su cuerpo como un todo y lo que pueden hacer sobre sus vidas para vivir bien y mantenerse saludable, dentro de los tres países de destino (Brasil, Colombia y México).
El equipo del proyecto da la bienvenida a María del Rosario Caballero Tinoco y María Elena Reyes Nieto de Ciudad de México, México. El equipo de trabajo espera ofrecer más información sobre estos proyectos en la Conferencia Internacional de Enfermería Oncológica, en Hong Kong, próximamente, este año.
Projeto de Colaboração entre a ISNCC e a União Internacional para Controle do Câncer: Programa de Câncer do Colo do Útero na América Latina
A América Latina tem uma das mais altas taxas de incidência e mortalidade por câncer do colo do útero. Há muitos anos já está em vigor estratégias eficazes de detecção precoce e agora estão complementado pela disponibilidade de uma vacina para proteger contra algumas formas de câncer cervical. A vacinação profilática contra o papilomavírus humano (HPV), que pode ajudar a prevenir este câncer, foi aprovada para uso na maioria dos países latino-americanos; no entanto, poucos têm implementado programas nacionais de imunização.
A ISNCC e seus parceiros, a União Internacional para Controle do Câncer (UICC) e os Centros de Controle de Doenças e Prevenção (CDC) conduziram uma revisão sobre câncer cervical na América Latina. A revisão identificou quatro questões-chave para a ação, com foco em i) educação, ii) participação na triagem, iii) monitorização de dados e iv) necessidades culturais / indígenas.
Posteriormente um currículo educacional sobre o câncer do colo do útero, usando as diretrizes da OMS, foi desenvolvido por quatro enfermeiras líderes regionais:
Victoria Brunelli de Buenos Aires, Argentina
Marise Dutra Souto do Rio de Janeiro, Brasil
Myrna McLaughlin de Anderson da Cidade do Panamá, Panamá
Luz Esperanza Ayala de Calvo de Bogotá, Colômbia
O currículo está dividido em sete módulos. O workshop incluíu os temas: Introdução, Programas de Prevenção e Controle, Mobilização Comunitária, Educação e Aconselhamento, Vacinação contra o HPV, Rastreamento e Tratamento de Lesões Precursoras, Diagnóstico e Tratamento da Doença Invasiva, e Cuidados Paliativos.
O currículo foi apresentado com sucesso através de três worshops ‘formar o formador’ realizados em Lima, Peru, San Salvador, El Salvador (ambos em setembro de 2015) e Bogotá, Colômbia (julho de 2016). O objetivo foi capacitar enfermeiros de vários países da América Latina em rastreamento e prevenção do câncer do colo do útero.
O workshop de San Salvador foi liderado por Myrna McLaughlin de Anderson e Luz Esperanza Ayala de Calvo, e reuniu 45 participantes de Belize, El Salvador, Guatemala, Honduras, Nicarágua e Panamá.
O workshop de Lima foi liderado por Victoria Brunelli e Marise Dutra Souto. Representantes de Argentina, Brasil, Colômbia, Paraguai e Peru totalizaram 45 participantes.
O workshop final, em Bogotá, foi liderado por Myrna McLaughlin de Anderson e Luz Esperanza Ayala de Calvo. Bolívia, Colômbia, Costa Rica e México foram representados por 32 participantes.
Este workshop concluíu o atual ciclo de financiamento do Projeto de Colaboração entre ISNCC e UICC.
A equipe agora começou a trabalhar em um novo projeto financiado pela American Cancer Society. O projeto faz parte do All of Me (Tudo sobre Mim) um programa elaborado para motivar os prestadores de cuidados de saúde para integrar educação e intervenção sobre câncer de mama e do colo do útero na prática. ISNCC irá expandir o escopo do currículo atual e incluirá a saúde da mama e o rastreamento deste câncer. A partir daí desenvolverá competências necessárias aos enfermeiros para incentivar suas pacientes a pensar em seus corpos como um todo e o que elas podem fazer em suas vidas para viver bem e permanecer saudável. Essa ação abrangerá três países-alvo: Brasil, Colômbia e México.
Foram saudadas as novas integrantes Maria del Rosario Caballero Tinoco e Maria Elena Reyes Nieto, representantes da Cidade do México, México. A equipe aguarda ansiosa para trazer mais informação sobre estes projetos na Conferência Internacional de Enfermagem Oncológica, em Hong Kong, ainda neste ano.
Author: Gillian Blanchard
Affiliations: Conjoint Lecturer School of Nursing and Midwifery, University of Newcastle, Australia
MASCC 2016 brought together over 1070 delegates from 50 counties to Adelaide, South Australia.
The meeting’s motto is “supportive care makes excellent cancer care possible” and was held over 4 days from the 22nd to the 24th of June. It featured a pre-conference cancer nurse practitioner workshop and patient seminar; six pre-conference Study Group workshops (mucositis research, nutritional care in advanced cancer, supportive care and immunotherapy, end of life, cancer related cognitive impairment and sleep, drowsiness and fatigue), plenary sessions on survivorship, gastrointestinal toxicity, and the future of supportive care, a patient seminar, e-posters, and a parallel paper session for each MASCC Study Group.
ISNCC hosted a display at the conference; this provided Australian ISNCC members an opportunity to promote the work of ISNCC and the benefits of membership.
The Cancer Nurse Practitioner pre- conference workshop was organized by the Cancer Nurses Society of Australia Nurse Practitioner Specialist Practice Network (CNSA CNP SPN). This event was designed for Cancer Nurse Practitioners and Advanced Clinicians. The program incorporated plenary presentations and Supportive Care Interactive Learning Sets (SCILS) and was attended by 53 delegates.
The plenary sessions featured local and international speakers Prof Dorothy Keefe: Supportive care challenges, Dr Karen Mustian: Exercise oncology from behavior to biology – Treating cancer-related fatigue, Tracey Doherty: The role of the nurse in supportive care and Prof Lawrence Einhorn: Controversies in management of chemotherapy-induced nausea and vomiting.
The SCILS workshops focused on Breathlessness and persistent cough, Anxiety and Depression, Clots and novel anticoagulants and Oral health, mucositis and osteonecrosis of the jaw. Overall the workshop provided a great opportunity for networking and updating one’s skills and knowledge in the area of advanced practice nursing.
Prof Larry Einhorn presented ‘Nausea is the New Black’. Prof Einhorn proposed that in 2016, nausea not vomiting is the main element of toxicity for Chemotherapy Induced Nausea and Vomiting (CINV) and that Olanzapine, an anti-psychotic, may be the most promising drug for mitigating nausea. Indeed in 1974 when Prof Einhorn began using Cisplatin chemotherapy in testicular cancer patients they could experience up to 10 episodes of emesis a day and now the number is closer to zero.
Karen Mustian, an exercise physiologist and researcher spoke about the optimal dose of exercise for cancer related fatigue. She advised health care professionals (HCP’s) need to become aware of our patients limitations and as such exercise should be individually tailored. Karen emphasized that the bottom line is to avoid inactivity by starting slow and increase both intensity and duration of physical activity. Exercise interventions, it seems, are better than pharmaceuticals at reducing cancer related fatigue.
There were many other presentations that used improving patient engagement and partnering with others eg. Pharma, NGO’s and other HCP’s to meet the supportive care needs of our patients. As clinicians we must be better at toxicity management as reported by patients, including managing both the physical and psychosocial burden these toxicities cause.
The MASCC guidelines and assessment tools can be found on their website at www.mascc.org
Author: Annda Lum
Affiliations: Pamela Youde Nethersole Eastern Hospital, Hong Kong
[Special acknowledgement to Dr Kwok Sing Ng, CP Mr Victor Kong, SWA Ms Christy Lee]
Ms X was a 50 years old lady having hormonal-responsive, HER-2 positive breast cancer with multiple metastases in Feb 2013. She was initially managed in Hospital A, with chemotherapy and radiotherapy given, later defaulted follow-up. Afterwards, she had started to receive Tamoxifen and Herceptin since Mar 2014 in our Unit, eventually passed away in Dec 2015.
Characteristic Exceptions Demonstrated by Ms X
Throughout her treatment process, she demonstrated several characteristic exceptions.
Exceptional keen for hospitalization- prolonged stay in our Orthopedic unit for 537 days and 215 days in our unit without clinical indication.
Exceptional plan for hospitalization- after discharge from Hospital A, Ms X went to different hospitals and requested admissions.
Exceptionally being refused- because of Ms X’s violent behavior, several hospitals marked ALERT not to admit her.
Exceptional treatment refusal- Ms X refused most management as planned for her.
Exceptionally irritable- she attacked staff and generated ward conflicts multiple times. She was diagnosed having adjustment disorder, delusion disorder and personality difficulties.
Family Background and Psychosocial Formulation
Ms X had no contact with family after quarrel at her adolescence. She was an ex-jewelry saleslady. Lived alone in a public housing unit and a Comprehensive Social Security Assistance (CSSA) recipient. Ms X was discriminated by her neighbors too. After onset of her illness, she refused home. Ms X was defensive and hostile towards hospital staff. Nevertheless, she was nice and helpful towards other patients. For instance, she shared pizza with other patients in ward and assisted daily task of another elder in ward.
Ms X was referred to clinical psychologist for illness coping. Rapport building turned out to be a challenging task, as she appeared interpreting any assessment as an attempt to label her as mentally ill. Due to Ms X’s defensiveness and downhill physical condition, intensive psychotherapy targeting delusional beliefs or personality issues was not a realistic option. Instead, psychological intervention focused on providing emotional support and problem solving on her immediate concerns. Efforts were made to facilitate insight regarding how her cognitions affected emotions and medical treatment.
Last Journey and Team Reflection
When Ms X was very weak, she still did not disclose any after-death business. Our team paid much effort to find if Ms X had self-arranged her funeral matter before. Multiple NGOs were contacted and ultimately our social worker was able to identify one to address Ms X’s final need. During the last moments of Ms X, chaplain was invited to see her, our staff and social worker accompanied her at bedside. Conveyable comforts words like “let go” through her ears were done to enhance her spiritual peace. Ms X’s last wish of funeral concern was addressed and fulfilled at her final moment. She rested in peace without lingering time.
Even though Ms X was an exceptional challenging patient to care, we still tried our best to preserve her dignity and the humanity. Our team awareness was increased after debriefing was done regarding to our own emotions and feeling towards Ms X’s care. Mutual staff support with good team spirit was vital for this kind of challenge.