Institution: Chinese Anti-Cancer Association Oncologic Nursing Committee
February 4 is the 23rd World Cancer Day. Chinese Anti-Cancer Association Oncologic Nursing Committee has long been committed to the science popularization of cancer prevention and quality care. In response to this year’s World Cancer Day theme “Close the Care Gap”, the Committee has launched a series of activities highlighting the self-care ability of cancer patients under the theme “Empowerment， Together, We Better”. In order to maximize the benefit to more patients and caregivers, this series of theme activities consisted of one theme lecture and 149 sub-center activities. With a variety of activities in and out of hospitals, online and offline together, this year’s nurse-centered cancer prevention popularization activities obtained high social attention with the online web and App browsing over millions.
SCIENCE POPULARIZATION AND EMPOWERMENT, TOGETHER FOR BETTER CANCER CARE
Prof. Huiying Qin, the director of the Chinese Anti-Cancer Association Oncologic Nursing Committee and the Department of Nursing, Sun Yat-sen University Cancer Center organized and made a prologue for the online theme lecture. She emphasized the importance of patient empowerment and advocated empowering patients and caregivers through the dissemination of correct cancer care knowledge and skills, so as to enhance the level of patients and caregivers to integrate medical resources for better self-care. The theme lecture included their top cancer care topics, which were voted by patients and the public on the Committee website. The three topics were “Exercise is the best anti-cancer prescription”, shared by Prof. Wanmin Qiang from Tianjin Medical University Cancer Institute & Hospital, which echoed the theme of the 24th Winter Olympics; “Home Care for cancer pain”, explained by Prof. Yuhan Lu from Peking University Cancer Hospital; “Vascular protection in cancer patients with chemotherapy”, elaborated by Prof. Zhenqi Lu from Fudan University Shanghai Cancer Center. This theme lecture was broadcast live and played back free of charge on the official website and mobile APP of the Chinese Anti-Cancer Association, as well as the largest cancer knowledge promotion websites in China.
SCIENCE POPULARIZATION AND EMPOWERMENT, TOGETHER FOR A BETTER FUTURE
The 149 sub-centers were distributed in community health service centers and secondary and tertiary hospitals in different cities and provinces. Each sub-center organized its own online and offline science popularization and empowerment activities based on the local cancer epidemic characteristics, and hot pot concerns about cancer prevention from cancer patients and the public. These activities consisted of theme publicity, expert in-depth interviews, community free medical consultations, home visits of cancer survivors, dissemination of cancer prevention brochures, etc. Chinese Anti-Cancer Association Oncologic Nursing Committee appealed to family members and the public to adopt a healthy lifestyle and give more attention and support to cancer survivors so that we can enjoy a better life altogether.
Cancer is influencing more and more People’s daily life. As the main professionals in the field of cancer care and control, nurses have the power and opportunity to affect the cancer prevention activities and the quality of life of cancer survivors. For the 23rd World Cancer Day, the Chinese Anti-Cancer Association Oncologic Nursing Committee aimed to promote public awareness and access to medical knowledge through empowerment education. We are always on the road to cancer prevention and treatment.
Author: Ankie Tan Cheung (RN, PhD), The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
Pediatric cancer is an emerging global child health priority as it is a leading cause of death in children and adolescents (Miller et al., 2020). Ongoing advances in early detection and cancer treatment contribute to a significant increase in the overall five-year survival rate of pediatric cancer, currently approaching 85% (Miller et al., 2020). Despite improved survival rate, an estimated two-thirds of pediatric cancer survivors develop at least one chronic health condition, including cardiopulmonary disease, endocrine and musculoskeletal disease, cancer-related fatigue, functional impairment, and psychological distress, all of which jeopardize their quality of life (QoL) throughout the survivorship trajectory (Oeffinger et al., 2006).
Physical activity (PA) has protective and beneficial effects in attenuating the late effects incurred by cancer and/or its treatment (Morales et al., 2021). However, many pediatric cancer survivors do not participate in adequate physical activity to confer the health benefits associated with PA. The problem of physical inactivity is particularly critical in Hong Kong Chinese pediatric cancer survivors, with approximately 92.2% of Chinese survivors (vs 52.1% Western counterparts) do not comply with the World Health Organization recommended PA guideline for children and adolescents (i.e., minimum of 60 min of moderate-to-vigorous PA daily) (Chung et al., 2014; Stolley et al., 2010).
Adopting an innovative and sustainable approach to promote regular PA in pediatric cancer survivors is therefore necessary. Growing evidence suggests the efficacy of using motivational interviewing (MI) with parents to promote health-enhancing behavior in children, such as eating habits and weight management (Norman et al., 2016; Wong & Cheng, 2013). Yet, empirical evidence is lacking for its feasibility in promoting PA among pediatric cancer survivors. Therefore, we conducted a two-group pre-/post-test pilot randomized controlled trial to examine the feasibility and preliminary effect of a brief MI to promote PA, improve cancer-related fatigue, muscular strength, peak expiratory flow rate and QoL in pediatric cancer survivors. A total of 30 pediatric cancer survivors aged between 9 and 16 years and their parents were recruited. These parent-child dyads were randomly allocated to the intervention (n=16; a 3-month brief MI delivered via instant messaging applications) and control groups (n=14; usual care). According to Cohen’s (1992) guidelines, small-to-medium effect sizes were found for the outcome variables. All parents were satisfied with the intervention and supported the use of mobile instant messaging applications (i.e., WhatsApp/WeChat) to deliver the brief MI intervention. Many parents described the approach was feasible and acceptable to motivate them to encourage their children to engage in regular PA. Most parents reported that the intervention enhanced their awareness of the significance of PA for their children and understanding of the specific health benefits thereof. It is worth noting that parents perceived that the intervention provided them personalized support that suited the needs of their families. Further, the parents appreciated the flexibility of the communication with the counselor, the continuous and timely professional advice throughout the intervention period. However, a larger-scale randomized controlled trial is warranted to ascertain the efficacy of such an intervention in promoting PA in pediatric cancer survivors.
Physical activity plays a vital role in the healthy development of pediatric cancer survivors, thus healthcare professionals should encourage survivors to engage in regular physical activity using different feasible and appropriate approaches, e.g., brief motivational interviewing.
References
Chung, O. K., Li, H. C., Chiu, S. Y., Ho, K. Y., & Lopez, V. (2014). The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors. Cancer Nursing, 37(3), E43–E51. https://doi.org/10.1097/NCC.0b013e3182980255
Cohen, J. (1992). A power primer. Psychol Bull, 112(1), 155-159.
Morales, J. S., Valenzuela, P. L., Velázquez-Díaz, D., Castillo-García, A., Jiménez-Pavón, D., Lucia, A., & Fiuza-Luces, C. (2021). Exercise and Childhood Cancer-A Historical Review. Cancers, 14(1), 82. https://doi.org/10.3390/cancers14010082
Miller, K. D., Fidler-Benaoudia, M., Keegan, T. H., Hipp, H. S., Jemal, A., & Siegel, R. L. (2020). Cancer statistics for adolescents and young adults, 2020. CA: A Cancer Journal for Clinicians, 70(6), 443–459. https://doi.org/10.3322/caac.21637
Oeffinger, K. C., Mertens, A. C., Sklar, C. A., Kawashima, T., Hudson, M. M., Meadows, A. T., Friedman, D. L., Marina, N., Hobbie, W., Kadan-Lottick, N. S., Schwartz, C. L., Leisenring, W., Robison, L. L., & Childhood Cancer Survivor Study (2006). Chronic health conditions in adult survivors of childhood cancer. The New England Journal of Medicine, 355(15), 1572–1582. https://doi.org/10.1056/NEJMsa060185
Stolley, M. R., Restrepo, J., & Sharp, L. K. (2010). Diet and physical activity in childhood cancer survivors: a review of the literature. Annals of Behavioral Medicine : a publication of the Society of Behavioral Medicine, 39(3), 232–249. https://doi.org/10.1007/s12160-010-9192-6
Author: Dion Smyth, Senior Lecturer (Cancer and Palliative care), Birmingham City University, Birmingham, UK
The global Covid-19 pandemic has profoundly disturbed and continues to disrupt, cancer care and management. Despite professionals and cancer services responding rapidly to the challenges posed by the pandemic with a range of changes to their service delivery, we know that delayed or decreased access to screening, early diagnosis, and treatment has been a typical finding across the globe.
For example, research into the impact of Covid-19 has recounted that breast cancer screening declined in communities of color and populations of income deprivation in the US (Feweda et al, 2021); whilst, in the UK, Cancer Research UK estimates 3 million fewer people were screened, compared to pre-pandemic levels of activity (CRUK, 2021). Englum et al (2021) found that there was a significant reduction in the number of cancer diagnostic procedures, such as colonoscopies or prostate biopsies undertaken. Waiting lists and times for treatment of cancer are at record levels in the UK (NHS England, 2021), all of which clearly impact the mental health and well-being of patients waiting and worried about their diagnosis and, potentially, treatment outcomes.
So, what can nurses do?
Obviously, the various government and population and individual responses vary, and so practitioners will work within the political and practical frameworks of their nation-states; however, there is still much that can be done. For example, we might lobby for more resources, whether that is local or a broader societal issue.
Nurses can advise, inform or advocate for the vaccination program so that the impact of incidence in a population can be mitigated, just as the vaccination against oncogenic viruses, such as HPV is known to lessen the burden of cervical cancer.
We might also look at how we can share our experiences, examples of good practice, and practice development so that our colleagues across the globe can gain insights into new ways of working. To that end, writing a blog piece for the ISNCC site is a good and commendable place to start.
Author: Ariesta Milanti, BSN, RN, MHC, The Nethersole School of Nursing, The Chinese University of Hong Kong; ISNCC Policy and Advocacy Committee member
It was a great pleasure to attend the 5th AONS Conference on the 18th-19th November 2021 among more than 500 delegates from 17 countries. This conference was held on a virtual platform in respect of the pandemic control. It was held by the Taiwan Oncology Nursing Society (TONS) of China.
In the opening ceremony, it was an honour to see Dr Ching-Te Lai giving the welcome address. All the welcome remarks gave the tone of the conference’s theme: “Innovations of Science and Art in Oncology Nursing”. After the opening remarks, there was a keynote speech by Professor Chien-Jen Chen, addressing the achievements and challenges of the national cancer prevention programmes in Taiwan of China. Another keynote speech was delivered by Professor Patsy Yates from Australia. She underlined that the era of precision cancer care brings the implications for nurses to understand more about the influences of patient experience, to deliver tailored intervention, and to support self-management of the patients. Meanwhile, the second day keynote speaker, Professor Winnie So, emphasised that the cancer health disparities which may occur in the disadvantaged populations should be addressed by using innovations to promote their access to cancer care.
The invited speakers and their speeches are inspirational. They are prominent leaders and scholars who have made a huge number of significant contributions in cancer nursing. Their presentations brought important lessons about the trends and current situation of innovation in cancer science and how cancer nurses can be the innovators to improve nursing practice.
In the oral presentation sessions, I was able to learn from a wide range of research topics from psychosocial care and survivorship to the hospice palliative care. This learning opportunity has widened my horizon and increase my knowledge about what is happening in cancer nursing studies, especially in Asia. In the poster presentation sessions, hundreds of recorded posters were played in marathon. Some of the presenters used text-to-speech application to present, which echoed the technology innovation to address the language barrier. In these sessions, I was also struck by a great number of cancer nurses who have made a difference in their clinical or educational settings to improve quality of care.
Lastly, I was very grateful to receive the scholarship award from AONS and to have an opportunity to present my study in a special award session. This session also invited the winners of excellence awards – cancer nurses with major contribution in research and practice. It was a great honour to be in one stage with the stellar nurses from different countries in Asia. Overall, this AONS conference 2021 was a rewarding and enlightening learning experience to increase my knowledge in cancer nursing.
Presentation of Patsy Yates – President, International Society of Nurses in Cancer Care (ISNCC)
Special award presentation session (clockwise direction: Eunyoung Suh, AONS president; Winnie So, AONS past president, ISNCC president-elect; Sarita Chhetri (India); In Gak Kwon (South Korea); Eun Young Park (South Korea).
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.
Incidence
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).
Risk Factors
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).
Clinical Manifestations
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).
Survival
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
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).
Conclusion
Given that there is no reliable screening test available to detect pancreatic cancer, education and awareness is key to prevention and early diagnosis.
References
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/
