The 15th of February is International Childhood Cancer Day, and this year it is particularly significant for nurses looking after children and adolescents with cancer across the globe. 2020 is the year when the World Health Organisation (WHO) Global Initiative for Childhood Cancer (GICC) converges with the WHO and International Council of Nurses’ Year of the Nurse and Midwife. We have an unprecedented opportunity to bring childhood cancer, and children’s cancer nurses, to the attention of policymakers, service providers, physicians, and our nursing community.
Cancer is almost universally thought of as a disease of adulthood, but it is also a leading cause of global childhood mortality from non-communicable diseases, affecting approximately 300,000 children and adolescents annually. In high-income countries like the UK, it is the number one cause of death in children 1 to 15 years of age. However, the burden of childhood cancer falls most heavily on low and middle-income countries (LMIC), with higher populations of children and adolescents and where many are never even diagnosed of their disease; many never reach treatment, and those who do have significantly lower survival rates than those treated in high-income countries, where over 80% now survive.
Over 80% of children and adolescents with cancer live in LMIC, where cure rates may be as low as 20%, and it is the shocking inequity in access to treatment, and the outcomes of care which led to the launch of the WHO Global Initiative for Childhood Cancer (GICC) in 2018, funded by St Jude Children’s Research Hospital in the US. The aim of this initiative is to improve the global survival rate of the commonest childhood cancers to 60% by 2030. To achieve that target, capacity building is required in all aspects of childhood cancer care in all LMIC. The workforce is a critical element of capacity building; nurses together with midwives, constitute the largest group of health workers across the globe.
Expert pediatric oncology nurses are fundamental to providing high quality, safe and effective care to children and adolescents with cancer and their families, and yet nurses in LMIC frequently lack specialized training, and hospitals often have inadequate staffing and resources to provide quality care. This is a major impediment to treatment programs and contributes to low survival rates in these settings. The Nurse Specialists of the GICC is a coalition of nurse leaders from across WHO Regions. The group seeks to advocate for nurses caring for children and adolescents with cancer, with an emphasis on nurses in LMIC. We have published an open-access paper on the ethical imperative to provide a safe work environment and specialist training for nurses working in this field.
On International Childhood Cancer Day in the Year of the Nurse and Midwife, we call upon all engaged in childhood cancer services to acknowledge and support the critical role of nurses and to provide those in LMIC with the training, resources and leadership opportunities they so richly deserve to contribute to the goal of improving both care and cure.
Ariesta Milanti, BSN, RN, MHC, Public communication committee, Indonesian Oncology Nurses Association
Indonesian Oncology Nurses Association (IONA) organized a simultaneous anti-tobacco campaign on the 18th of October 2018 in seven provinces throughout Indonesia. The campaign marked the IONA’s anniversary and responded to the call of the International Society of Nurses in Cancer Care (ISNCC) tobacco position statement that nurses should take the lead in tobacco control activities.
The campaign was held successfully at Dharmais Cancer Hospital, Jakarta; Bantul 2 Public High School, Yogyakarta; Dr. Karyadi Hospital and Tugurejo Hospitals, Semarang, Central Java; Sanglah Hospital, Denpasar, Bali; Dr. Wahidin General Hospital Sudirohusodo, Makassar, South Sulawesi; Dr. Soetomo Hospital, East Java; and Adam Malik General Hospital, Medan, North Sumatra. In all sites, we conducted public education on the dangerous effects of tobacco smoke and called the public to protect themselves from tobacco use and exposure. We also played a short video illustrating the ‘epidemic’ of tobacco smoke in Indonesia. In the video, a former heavy smoker described his process to quitting tobacco smoking. We invited people to build their personal commitment to fight tobacco smoke and to sign in our anti-tobacco declaration.
Our message was to take action against tobacco smoke.
In addition to those programs, each IONA chapters created their unique approaches as well. IONA chapter Yogyakarta successfully gathered 100 high school students in Bantul 2 High School and held a photo contest with the theme of an anti-tobacco movement. The photos were uploaded to the @himponidiy Instagram account to be more visible by the young people, the most vulnerable population targeted by the tobacco industry. IONA Yogyakarta will also conduct a continuous community service activities in this high school to sustain the program’s impacts.
The high school students recorded their anti-tobacco declaration and sent it to the local police office as proof of their commitment to avoid tobacco smoke.
IONA chapter Makassar-South Sulawesi held a series of anti-tobacco campaign programs at RSUP DR Wahidin Sudirohusodo. A total of 50 patients and their families enthusiastically participated in the education on the effects of tobacco smoke and signed their anti-tobacco declaration. Our anti-tobacco video was played continuously at the general polyclinic televisions.
Meanwhile in Bali, the anti-tobacco campaign day was also a huge success. The education and signing of the anti-tobacco declaration were attended by dozens of people. The local committee also released the balloons into the air as a symbol to stay away from the dangers of cigarettes.
The simultaneous anti-tobacco campaign was also carried out successfully by the IONA chapter North Sumatra. The activity began with the signing of the declaration “Supporting the Anti-Tobacco Movement” by the patients, family and hospital staff of the Adam Malik Hospital, the public education, and the coloring competition for the children with cancer. The participants said that the anti-tobacco campaign greatly motivated patients, families and all employees to stop smoking and support the anti-tobacco movement.
On the day of the campaign there were several participants who were committed to quitting smoking.
IONA Chapter Central Java organized the anti-tobacco campaign in two places at once, namely Dr. Karyadi hospital and Tugurejo hospital, Semarang, Central Java. The public education and the signing of the anti-tobacco declaration were attended by dozens of patients and families in the polyclinics of the two hospitals.
Meanwhile, IONA chapter East Java installed the large banners displaying the anti-tobacco movement at Dr. Soetomo General Hospital and FKP Airlangga University, Surabaya, East Java. They held a community education on tobacco smoke dangers and its prevention in November 2018.
In Jakarta, the anti-tobacco campaign day was hugely celebrated at the Dharmais National Cancer Center. The entire board of directors of RS Dharmais initiated the signing of the anti-tobacco declaration. Patients, families, nurses, doctors, and staff enthusiastically joined the education program, flash mobs, and various entertaining activities.
Among the feedback from the participants was the intention to spread the dangers of tobacco smoke information to their families and the plan to bring the heavy smokers in the family to get smoking cessation interventions.
This campaign demonstrates the strong intention of IONA to be at the forefront of tobacco control in Indonesia as one of the cancer prevention activities Tobacco smoke and exposure have proven to cause various types of cancer and other serious diseases. We hope to sustain and scale up the campaign across Indonesia.
Submitted by Fedricker D. Barber, PhD, ANP-BC, AOCNP, University of Texas MD Anderson Cancer Center, Houston, TX
Did you know that November is Pancreatic Cancer Awareness Month and that November 21, 2019 is World Pancreatic Cancer Day? Pancreatic cancer is one of the deadliest cancers worldwide and is one of the leading causes of cancer mortality in developing countries (World Health Organization, n.d.). In 2018, approximately 458,000 people were diagnosed with pancreatic cancer, and an estimated 456,280 people are expected to die from this disease by 2020 (World Health Organization, n.d.). Currently, there is no cure for pancreatic cancer and there are no screening tests to detect this disease, therefore, education and awareness are key to preventing pancreatic cancer.
The incidence rate for pancreatic cancer varies, for example, the highest incidence rate was in North America (50,745) and Europe (128,045) in 2018 (World Health Organization, n.d.). Whereas, the lowest incidence rate was in Africa (15.458) in 2018 (World Health Organization, n.d.). Generally, pancreatic cancer is more prevalent in men than in women and is a disease of older adults, with a median age of onset of 71 years (Ilic & Ilic, 2016; McGuigan et al., 2018; McWilliams et al., 2016).
Researchers are making progress in understanding the causes of pancreatic cancer, however, the precise cause is unknown. Epidemiological data suggests that family history of pancreatic cancer, smoking, obesity, diabetes mellitus, and chronic pancreatitis are associated with pancreatic cancer (Ilic & Ilic, 2016; McWilliams et al., 2016). Additionally, alcohol use > 26 grams daily has been identified as a risk for pancreatic cancer (Ilic & Ilic, 2016; McWilliams et al., 2016).
Unfortunately, clinical manifestations of pancreatic cancer usually do not occur until the cancer has invaded other organs (McGuigan et al., 2018). Common symptoms include: unexplained weight loss, epigastric pain that radiates to the back, jaundice, anorexia, abdominal bloating, clay-colored stools, nausea, and fatigue (McGuigan et al., 2018).
The major factor impacting survival and outcomes in patients with pancreatic cancer is the tumor stage. For instance, the 5-year survival rate for patients with pancreatic cancer is 6% worldwide, however, with localized disease, the 5-year survival rate is 37% versus 3% for stage IV disease (McGuigan et al., 2018).
Treatment for pancreatic cancer varies depending on the stage of the disease. Surgical resection such as pancreatico-duodenectomy or total pancreatectomy potentially can cure pancreatic cancer (McGuigan et al., 2018). Other treatment options such as chemotherapy and chemo-radiotherapy have been showed to increase overall survival (71%-76%), however, patients tend to have recurrent disease within two years (McGuigan et al., 2018).
Given that there is no reliable screening test available to detect pancreatic cancer, education and awareness is key to prevention and early diagnosis.
Ilic, M., & Ilic, I. (2016). Epidemiology of pancreatic cancer. World J Gastroenterol, 22(44), 9694-9705. doi:10.3748/wjg.v22.i44.9694
McGuigan, A., Kelly, P., Turkington, R. C., Jones, C., Coleman, H. G., & McCain, R. S. (2018). Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol, 24(43), 4846-4861. doi:10.3748/wjg.v24.i43.4846
McWilliams, R. R., Maisonneuve, P., Bamlet, W. R., Petersen, G. M., Li, D., Risch, H. A., . . . Lowenfels, A. B. (2016). Risk Factors for Early-Onset and Very-Early-Onset Pancreatic Adenocarcinoma: A Pancreatic Cancer Case-Control Consortium (PanC4) Analysis. Pancreas, 45(2), 311-316. doi:10.1097/mpa.0000000000000392
World Health Organization. Cancer tomorrow. (n.d). Retrieved from http://gco.iarc.fr/
As part of the World Cancer Day 2019 program the International Society of Nurses in Cancer Care (ISNCC) and our partner the Union for International Cancer Control (UICC) are celebrating the contributions of nursing internationally. ISNCC represents over 60,000 cancer nurses worldwide, all of whom are vital to cancer care and control.
The International Society of Nurses in Cancer Care (ISNCC), founded in 1984, is an international federation of National Cancer Nursing Societies. Globally ISNCC represents nurses from 80 countries. ISNCC’s mission is to lead the global community to reduce the burden of cancer and that nurses worldwide are vital and central leaders in cancer care and control. As an international society the ISNCC will develop and engage nurse leaders and influence global health policy. With our global mission the ISNCC is pleased to announce its new Global Citizen Program.
The Global Citizen
ISNCC has recently launched the Global Citizen program at the International Conference on Cancer Nursing (ICCN) 2018 in Auckland, New Zealand. The program recognizes nurses or other professionals, whether or not they are members of their national society, who wish to support the ethos, objectives, strategy and philanthropic goals of the ISNCC. The program provides various contribution options and benefits to the global community.
ISNCC Global Citizens have access to exclusive functions, benefits and offers including:
Attendance at the President’s Social at the International Conference on Cancer Nursing (available for Silver and above Global Citizens)
Recognition on the ISNCC website and at the International Conference on Cancer Nursing (ICCN)
Opportunity to support an ISNCC scholarship to enable nurses from low resource countries attend ICCN
Acknowledgement of your contribution, including provision of an ISNCC Global Citizen Ribbon (available at ICCN)
Electronic subscription to Cancer Nursing, ISNCC’s official journal, a bimonthly publication that addresses the whole spectrum of problems arising in the care and support of cancer patients
Participation (non-voting) in the Annual General Business Meeting
Networking opportunities through participation in society activities such as the International Conference on Cancer Nursing, educational and research initiatives, workshops, task forces, committees, and joint initiatives with other international health groups
How do I become an ISNCC Global Citizen and support ISNCC to achieve its Mission?
You can now become an ISNCC Global Citizens! The ISNCC has established a tiered annual contribution structure to allow you to contribute according to your circumstances and preference. The funds raised through the Global Citizen contributions are used to support ISNCC’s work, including contributions to Scholarships and Organizational Memberships for low resource countries.