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What health behaviours are observed in survivors of adolescent and childhood cancer? A recent study has highlighted the risk for un-healthy behaviours, and especially of cigarette smoking.
From a psycho-educational point of view, such results urge us to implement the preventive strategies and education more diligently with adolescent, young adult and childhood cancer survivors.
The JAMA Oncology editorial published in the September issue focusses on the connection between physical wellbeing and colorectal cancer. The journal provides additional studies that report how weight management and physical activity can prevent the risk of developing certain cancers as well as reducing the mortality once diagnosed.
This year IPOS became a member of ECCO which represents 24 member organisations. This gives IPOS greater visibility within the group of professional cancer societies in Europe.
We are participating in their working groups such as the Oncopolicy Committee and the Quality Cancer Care guidelines group. Neil Aaronson went to the first meeting of this year’s Oncopolicy Committee. This committee is constituted to help set ECCO’s priorities and ensure communications from ECCO provide a clear and assertive voice within the cancer policy community. Elisabeth Andritsch is participating in the Quality Cancer Care guidelines groups, which are addressing colo-rectal cancer and sarcomas. Luzia Travado represented IPOS by participating in the General Assembly, and by attending the ECCO Membership Strategy group, and the congress programme development session.
IPOS will have a presence in ECCO’s congress next January in Amsterdam, which may encourage IPOS members and their local associations to participate in this large congress together with all major cancer societies in Europe. Although our participation is somewhat limited due to the fact that the programme had been finalised when we became members and were involved in its discussion, it is a major breakthrough for IPOS to have a presence and participation at this major event in Europe regarding cancer.
2016 has seen further revisions to the recommended training documents for physicians studying medical oncology. Advisers from both ESMO (European Society for Medical Oncology) and ASCO (American Society of Clinical Oncology) collaborated with experts from around the world to provide comprehensive training guidelines that now include sections on aspects of cancer care that are essential across all tumour groups:
IPOS president, Dr Luzia Travado, worked with a colleague from the United States to contribute to the section on Psychosocial Aspects of Cancer (Section 5 in the draft document). The IQ News editors note with pride that several of the articles cited in this lengthy document as references were authored by IPOS members!!
A PDF of the entire document is available online and was available to conference delegates attending the ESMO conference in Copenhagen in early October.
For a press release from ESMO/ASCO regarding the revised Global Curriculum see the link here.
A few months have passed since the last issue, and we are very excited to be presenting the next one. We would especially like to highlight three main topics that are very relevant for the present (and hopefully the future) of psycho-oncology and for IPOS too.
FIRST: In the Up to Date, section we have summarized a few interesting studies about the role of socio-economic variables in cancer care. The society’s official journal Psycho-oncology will publish a Special Issue in the Autumn/Fall of 2016 on Equality and Diversity issues, including socio-economic factors impacting cancer care . The SI Guest Editors Dr Iain Lawrie and Dr Laura Ashley, of the British Psychosocial Oncology Society, have compiled an interesting set of papers selected from the 47 submitted. These will be disseminated widely – look out for this Special Issue later this year.
SECOND: In the Let’s Talk section, we have decided to stress the need for an effective African network in psycho-oncology care. We assume such a network is nowadays missing, and we hope the forthcoming launch of the new African psycho-oncology society will support this mission. In the next few issues, we would like to focus on “state of the art” of psycho-oncology across different regions of the world. Tell us what is happening in your region and help us in developing the next issue!
THIRD: As we anticipated in the previous issue of the IQ-News, we are launching a survey devoted to collecting information about needs and feedback from all our IPOS members. In the Stay Connected section, you can find the link to the survey and the basic instructions. Your input can help IPOS to support you! Therefore, we hope many members will complete the survey.
Contract Professor, School of Human Health Sciences at the University of Florence Chief of Research, Psycho-Oncology Unit, Oncological Department of Florence, Italy
Oncology Social Work Supervisor, GVI Oncology, Cape Town, South Africa
######The newsletter includes 5 sections:
Up to Date
• Socio-Economic Status (SES) and Cancer Care
• Recently Published Guidelines
• The Healthy Role of our Lifestyle
• Establishing psycho-oncology care in Africa
• IQ-News Survey on IPOS Members’ Needs
• Bultz named Daniel Family Leadership Chair in Psychosocial Oncology
• IPOS Treasurer Dr. Anja Mehnert Awarded
• New award instituted
• Completed conferences
• Grants and funding available
• Training courses
• Trends and Advances in Cancer Care
• Facing Life and Facing Death
• The Destiny of the War against Cancer
• Is homeopathy something more than placebo?
Recent research papers are stressing the relevance of SES in cancer care; that is the primary role of education and income in accessing the best available cure. Some papers note the influence of unemployment and the global economic crisis (associated with increased unemployment) on cancer mortality (unemployment increases are associated with rises in cancer mortality). A British study estimated that the 2008–10 economic crisis was associated with about 260 000 excess cancer-related deaths in the Organisation for Economic Co-operation and Development alone (link: http://bit.ly/1sAeFEr). Moreover, patients’ income seems to be correlated to cancer clinical trial participation (link: http://bit.ly/1ttJCut).
At the same time health literacy seems to be linked with cancer screening (link: http://bit.ly/1SBU2hx). Communication remains a critical issue in cancer care and is discussed in the May 2016 edition of JAMA Oncology (http://bit.ly/1UXYibo).
In the next few months Psycho-oncology is going to publish a special issue on Equality and Diversity including factors such as sociodemographic inequalities in cancer care (link: http://bit.ly/1sIgL5u). The proposal for the Special Issue was supported by the British Psychosocial Oncology Society and the global response in terms of papers received was exceptional with 47 papers submitted for consideration. While not all could be included, it demonstrates that the psycho-oncology community has a buoyant research agenda focussing on these important factors affecting the care of patients and their families.
At the risk of stating the obvious, Africa is a large continent with several regional differences in terms of climate, socio-economic circumstances and access to health care. Several countries have state-funded cancer treatment centres, with a few countries offering private health care facilities for oncology treatments. Oncology care in Africa is developing gradually, with the focus necessarily being on aspects of prevention, screening and early detection of disease as access to treatment is a challenge in most African countries. Psycho-oncology is still an under-resourced aspect of cancer care across the continent.
In the early 1990s a small group known as PAPOS (Pan-African Psycho-Oncology Society) was formed and held its inaugural conference in Cape Town in 1992. Several PAPOS conferences followed into the early 2000’s, embracing practitioners from different disciplines across Africa and including input from professionals from further afield such as the United Kingdom, Australia and the United States. Sadly PAPOS was unable to maintain its momentum and no longer exists.
Since then, the palliative care and Hospice movement have offered much training and guidance across Africa in terms of end of life care, with a particular focus on psycho-social needs of patients and families. Discipline-specific groups such as National Oncology Nursing Society of South Africa (NONSA) and South African Oncology Social Work Forum (SAOSWF) were formed at the beginning of this century. In Nigeria the Association for Psycho-Oncology in Africa (POSON) is active, as is evident in the pieces below. 1993 saw the formation of AORTIC (African Organisation for Research and Training in Cancer) and this organisation has grown in terms of scientific input, but has latterly offered specialised input from psycho-oncology experts such as Dr Jimmie Holland, Dr David Kissane, Dr Maggie Watson, Dr Andrea Patenaude and others from IPOS who have generously shared their time and knowledge.
The possibility of a new psycho-oncology organisation for the whole continent was explored during an AORTIC conference in 2013 resulting in further discussions at the 2015 conference with the formal inauguration of the Association for Psycho-Oncology in Africa taking place this year (see (2) below). With closer connections between the scattered individuals practising psycho-oncology in different countries, there is once more a possibility of sharing resources and skills, and of reaching communities that are remote. Working in environments where logistics can be challenging and access to information difficult, it makes a huge amount of sense for practitioners to work together to increase the awareness of psycho-social needs of our patients and their families, and improve the care that we can provide!
News from IPOS in Africa kindly contributed by Dr. Jimmie Holland:
1) African Organisation for Research and Training In Cancer (AORTIC) Conference Marrakech, Morocco, November 19, 2015
The 4th Biennial International AORTIC IPOS-WHO Academy on Psychosocial and Behavioral Aspects of Cancer Care in Africa was held on the topic of Special Issues for Children, Adolescents and Young Adults. This is part of the continuing IPOS efforts to improve education and clinical care in Low-Middle Income countries. The convenors were Chioma Asuzu, PhD, psychologist, University of Ibadan; Jimmie Holland, MD, Memorial, New York and Maggie Watson, PhD, Royal Marsden, UK. Andrea Patenaude was Chair of the Program Committee. Ten African professionals were awarded competitive travel scholarships. (See photo)
Attendees and Faculty Members of the 4th Biennial International AORTIC IPOS-WHO Academy on Psychosocial and Behavioral Aspects of Cancer Care in Africa
2) Formation of the Association for Psycho-Oncology in Africa (APOA)
At the Marrakesh meeting, a Task Force of approximately 15 people met and agreed on the formation of APOA to encourage and network professionals across the 52 countries in Africa in education and clinical issues in the psychosocial care of patients with cancer. This builds on the Nigerian Psycho-oncology Society which is already a member of the IPOS Federation, and efforts to form a Kenya Society. The inaugural meeting of APOA will be in late July, 2016. Dr. Asuzu was asked to serve as President until such a time that an election can be held. The meeting will be held in Calabar Convention Center in Nigeria. APOA will encourage work in Nairobi, Kenya with nurses doing palliative care through Philip Odiyo, and training opportunities for professionals from francophone countries, through Sokhna Ndiaye who works in Dakar, Senegal with children with cancer.
Chioma Asuzu is the seminal figure who has moved psychosocial oncology forward in Africa. Beginning as a member of AORTIC and supporter of psychosocial issues there, she applied and was awarded one of the first grants given by the National Cancer Institute to African investigators through AORTIC. Her study is an important one in providing information on a major reason for delay in diagnosis in Africa: treatment first by traditional healers. She interviewed patients who came to the University Hospital in Ibadan about their experience and then spoke with their traditional healers who were interviewed. Overall, they expressed a wish to know more about the early symptoms of cancer and wanted to cooperate with cancer care in their community, referring those with early disease. She is submitting to the AORTIC second round of grants to pilot an educational program for traditional healers in the region around Ibadan. She is also proposed as the Chair of the Psychosocial Research Core of a grant to NCI for a Center of Excellence in Cancer Research in Ibadan.
In addition, Dr.Asuzu has developed, with the Departments of Psychology in Ibadan University and Radiation Oncology in the University Hospital, an accredited Masters level program to train clinicians from any background in psychosocial oncology over a two year period. The program is in its second year and she proposes to add a PhD level in the future. She plans to work with the Ibadan Distance Learning Office and explore ways that professionals from other countries can train in the program, taking part at home through online education, and then spending time in Ibadan for the clinical supervised training component. Dr. Asuzu is the moving force for psychosocial oncology in Africa
In March 2016, Dr. Asuzu was awarded a competitive AACR Scholarship to attend the American Association for Cancer Research in New Orleans in April, 2016. There were over 150 applications and she was awarded one of six. She is now also on the Research Committee of AORTIC and on the IPOS Board of Directors.
In recent years genetics has become a leading tread in medical research, and, specifically, in cancer research. Charles Swanton, an expert on cancer evolution who led the latest study at the Francis Crick Institute in London, said the discovery of surface proteins shared by all of a patient’s cancer cells provided an “Achille’s heel” for future therapies to target (link:https://www.theguardian.com/science/2016/mar/03/genetics-of-cancer-tumours-reveal-possible-treatment-revolution).
We are launching a survey devoted to collect information, needs and feedbacks by all you IPOS members. The survey will close on 30 June. All the data we are going to collect will help to shape future editions of the IQ-News and may assist services provided by IPOS to members. The more data we collect, the more members’ needs can be addressed. We guarantee confidentiality and the anonymity of our responses. Here you can find the link to the survey: http://goo.gl/forms/Zl9hel9PIBSQ687t1.
All the efforts we put into prolonging life are of questionable value if we do not consider that the quality of life should also include the way we face death. This is the moral foundation of Atul Gawande’s Being Mortal. In his book, Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified (link: http://iconsa.co.za/networkmembersnews/review-being-mortal/ ).
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