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Reports
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Two Reports: 16th Asia Pacific Cancer Conference, Manila, Philippines and Psycho Oncology Conference 2001, Bangalore Given below is a report on two conferences, the 16th Asia Pacific Cancer Conference (APCC), held between 18th-21st November at Manila, Philippines and the Psycho Oncology Conference 2001 held between 26-27th November at Bangalore, which were attended by CPAA representatives. The APCC is organised every alternate year by the Asia Pacific Federation of Organisations for Cancer Research and Control (APFOCC). The federation is a non-political and non-profit organisation organised and existing under the collaborative and cooperative participation of Asian and Pacific region countries in the common fight against cancer in all its aspects. Its primary objective is to promote all aspects of the campaign against cancer in Asian and Pacific region countries. This year, the theme was "Fighting Cancer in the New Millennium." Alka Kapadia attended the conference, which aimed to showcase innovative ways and measures, developed for the prevention and control of cancer through healthy lifestyles. The conference consisted of an international symposium with 70 speakers from Australia, UK, US, India, China, France, Netherlands, Singapore, Norway, Italy, Canada, Indonesia, Germany, Korea, Israel, Japan, Denmark and Switzerland. Philippine speakers presented 11 papers under the local symposium. The topics ranged from Cancer Prevention to Screening to Treatment, Tobacco Control programmes and Alternative forms of medicine. Along with papers from the medical fraternity, the conference papers dealt with the role of NGOs in cancer control in the UICC COPES Workshop. The conference was especially useful since it allowed exchange of ideas between representatives of different countries showing how similar the effect of cancer is in otherwise dissimilar cultures and societies. It was also interesting to note how comparable the problem of tobacco cessation is worldwide. During an anti-tobacco session chaired by Dr. Dilip Bal from the US, many participants felt the most important prerequisite is to change norms, making it socially unacceptable to smoke. A special session was held on Knowledge, Attitudes and Practice of Care-Givers in Oncology, thus recognising the importance of this often disregarded group. The other conference was conducted by the National Institute of Mental Health and Neurosciences, Bangalore (NIMHANS) from November 26-27 and related to emotional, social, psychological, spiritual and caring aspects of cancer for health professionals involved in care of cancer patients and their relatives. The conference, which has become an annual feature, is meant for medical, surgical or radiation oncologists, psychiatrists, psychologists, social workers, neurologists, neurosurgeons, general physicians, nurses and volunteers, consists of a symposium, workshop and research forum. Three representatives of CPAA, Shubha Maudgal, Mrinal Marathe and Smita Khante attended the conference and presented two papers, "The Role of the Counselor in Understanding Treatment Options" and "Psycho-Social Aspects in Palliative Care." The main highlight of the program last year was a demonstration of how a simulated role play along with active group feedback could be used as an effective technique for imparting counseling skills to healthcare professionals. Dr. Peter Maguire, Director, Cancer Research Campaign, Psychological Medicine Group, Manchester, UK, conducted this demonstration. This year, due to uncertain conditions in air travel, Dr. Maguire was unable to come. Drs. S. K. Chaturvedi and Prabha Chandra substituted the demonstration with an enlightening workshop on burnout among healthcare workers. The exercise measured negative effects of a participant's level of burnout in terms of emotional exhaustion and depersonalization, balancing these against personal satisfaction derived by the individual during the course of their work. Eight papers were presented during the morning sessions by oncologists covering topics such as psychosocial issues of cancer screening, psychiatric morbidity, psychological distress at treatment such as chemotherapy due to side effects and when told about an unfavourable prognosis, the extent to which doctors should provide information, staff-patient communication and coping with death and dying. The paper on chemotherapy and recent progress in the field was a unique source of technical information, especially useful for social workers working in the field. The papers generated a stimulating debate with participants from the medical fraternity, caregivers, patients and social workers trading their experiences and putting forward their viewpoints. The organizers of the conference also arranged a visit to Karunashray, the local hospice for terminally ill cancer patients. This recently started hospice has been built just outside Bangalore city limits and is housed in beautiful green surroundings with fountains and pools incorporated in such a way that every patient can see them from their bed. The hospice has a permanent staff of trained sisters. They also have 60 trainees who are recruited from among local girls and taught to take care of the patients over a 6 month period. They are then encouraged to go for further training in reputed nursing schools where they get admission relatively easily considering their background work at Karunashray. The conference was an enriching experience for CPAA representatives in providing much needed feedback and ensuring a higher level of confidence in respect of activities, especially counseling at hospitals. All the participants appreciated our activities . As a part of CPAA's initiative to raise awareness about cancer in society, Alka Kapadia visited the Umerkhadi Observatory Home at Dongri and gave lectures to the inmates about the dangers of smoking cigarettes and beedis, gutkha and other addictions. These lectures are conducted annually and were initiated by social workers from Nirmala Niketan stationed at the home, who contacted CPAA to give lectures. 500 convicted and undertrial felons; destitute, runaway and retarded children and juvenile delinquents under the age of 18 were covered in 6 lectures for groups of 40-80 children at a time. The children were then screened for head and neck cancers and pre-cancerous conditions and counseled regarding their habits. Many children shared the history of their addictions. At different ages they are addicted to different substances, from sniffing ink, solution and turpentine to smoking and gutkha. A convicted murderer talked about running away from his village and earning money by sweeping trains. He was coaxed to start his addictions by taunting friends. On hearing the lecture he told the counselor that he was determined to give up the habit. However, withdrawal proved to be extremely difficult and during the next session, he confessed that he had got up at night and smoked rather than let others find out that he had slipped. On a different level, Alka also addressed the heads of the Godrej group of companies at Vikhroli to promote the insurance policy. Neeta More gave a lecture organised by National Association for the Blind for volunteers who had come to Mumbai from various places to undergo training. The Digambar Jain Mahila Samiti had organised a lecture at Nehru Planetarium as a part of their celebrations to mark the 2600th birth anniversary of Mahavir . Prevention and Early Detection
18 camps and OPDs were held during the month of December. Out of the 8 camps held, 2 each were organised for Shree Yogvedant Seva Samiti, Sion Koliwada; Rashtriya Congress Party, Umarkhadi Remand Home (ENT only) and Asmita College of Arts and Commerce. A total of 466 people, 261 males and 205 females were screened in the camps and clinics. 170 people were advised follow up. 10 OPDs and clinics were held during the month. 82 males and 112 females were screened. 47 people were advised follow up. A 70-year-old man, who was detected with cancer of the larynx during an OPD at Agripada, is now undergoing treatment at Tata Memorial Hospital. Smt. Lila Kishanchand Shahani Clinical Diagnostic Centre The Smt. Lila Kishanchand Shahani Clinical Diagnostic Centre screened screened 238 persons during December. 574 tests were performed, out of which 415 were pathology tests. 102 sonography, 47 x-ray and 10 mammography investigations were carried out. During December, 92 people were examined, of whom 28 had come for the first check-up and 64 for renewal check up. 2 claims were settled and an amount of Rs 1.37 lakhs was disbursed. 97 claims have been settled to date. 29 policyholders have been found to have cancer since the inception of the policy, out of which 18 are surviving.
At Smt. Panadevi Dalmia Cancer Management Centre A total of 727 patients were aided, counseled and given guidance at our locations in Mumbai-Srimati Panadevi Dalmia Cancer Management Centre; at Nair Hospital Radiation Centre; Cama & Albless, Wadia and Tata Memorial Hospitals. 178 patients availed of ambulance facilities, including 4 patients who availed of the stretcher service for long distance. 120 persons were given clothes, 50 packets of biscuits and 80 boxes of Complan and Feredol were distributed. 13 home and institutional visits were made. 9 of our patients expired during December. Donations amounting to Rs. 60,200 were collected. Rs. 2,76,643 was disbursed. At Tata Memorial Hospital: Room No. 189, Golden Jubilee Block 348 patients were aided, guided and counseled by CPAA's Halima Aurangabadkar at Tata Memorial Hospital's Golden Jubilee Block Room No. 189 during December. 350 packets of biscuits were distributed. 57 patients were given clothes, 130 bedsheets were donated, 8 kgs of sweets and a box of apples were distributed. 8 referred cases were helped. 15 ward visits and 4 home visits were made. 11 patients were given medicines and toys were distributed to 15 children. 165 patients were given Complan and Horlicks. 135 patients utilized the ambulance facility including 7 for long distance travel. "Can I Help You?" CPAA’s Desk at Tata Memorial Hospital’s Private OPD Jennifer Quadros helped 539 patients during December, providing literature on various kinds of cancers to 187 patients and their family members, helping 105 in filling up registration and other forms and answering questions about the hospital for 178. 13 ward visits were made.
At Bai Jerbai Wadia Hospital for Children Vinaya Chacko registered 14 new patients during the month of December. 268 patients attended follow up of whom 87 patients are undergoing chemotherapy. 20 patients were counseled and given guidance and 5 patients were visited in their wards. 40 children were given sweets, toys and biscuits. Palliative Care Unit at Tata Memorial Hospital CPAA's Mrinal Marathe counseled 32 patients, 13 males and 19 females during the month of December. There were 10 cases of head and neck and cervical cancers, 5 cases of cancer of the abdomen, 1 case of breast cancer and cancer of the ovary and 5 other cases of cancer. One of the most difficult emotions the counselor is forced to address is guilt on the part of a sorrowing parent. Mrinal met the mother of a terminally ill 6-year-old who shared her feelings of remorse towards her other children. Being poor, she had to sacrifice their needs to try to fulfill those of the child who was undergoing treatment. Even after two years of chemotherapy and radiation, the child had a relapse and no further treatment appears to be possible. His mother wondered if this was punishment for neglecting his siblings . Counseling at Tata Memorial Hospital’s Radiation Treatment Centre CPAA's Smita Khante visits the radiation centre at TMH every Tuesday and Thursday between 10am to 2pm to counsel patients regarding diet restrictions, care and cleanliness of the radiated part and boosting nutrition during radiation therapy. Patients are also given advice on accommodation and travel. One patient was provided with utensils for use during their stay in Mumbai. Counseling of Breast Cancer Patients at Tata Memorial Hospital While all kinds of cancers generate fear, breast cancer patients are especially vulnerable. The breast cancer patient sees herself diminished as a woman not only by the loss of the breast but even due to relatively minor and reversible side effects such as loss of hair during chemotherapy and need a great deal of reassurance which family members cannot give. In today's scenario, patients have many options, which must be carefully decided upon while taking into account the compulsions of the individual. Doctors can offer breast conservation therapy (BCT) followed by radiation against radical mastectomy, both treatments having similar long term prognosis. While most women may prefer a lumpectomy, some may not be able to spare the time required for radiation treatment, which is essential after BCT. Others do not feel safe with a "diseased" part left after surgery and prefer to have the breast removed even though the doctor assures them that results are precisely the same. There is often a great deal of confusion regarding treatment options in spite of the best efforts of the doctor, simply because the patient is not in a state of mind to absorb the facts. In these cases, a counselor who can take the time to guide the patient through the treatment steps being followed by the doctor along with the rationale behind them can be an invaluable resource. When CPAA discussed the possibility of a support system with Drs. I. Mitra and R. Badwe of the Breast Care team at TMH, they agreed that it would be useful. Representatives from CPAA, Alka Kapadia, Smita Khante and Shubha Maudgal, were told to accompany Sisters Rupal and Alyamma of TMH on their rounds and witness chemotherapy and follow up OPDs to observe how doctors interacted with patients in various situations. CPAA representatives have now started visiting breast cancer patients in the General, Semi-Private and Private wards. Patients awaiting surgery are told about the procedure, lymph node dissection, the feeling of numbness, importance of exercise, care of the drainage tube, schedule for discharge and subsequent return to hospital for wound drainage and suture removal and precautions to be taken for the arm. Treatment options such as chemotherapy, hormone therapy and radiation, one or more of which may be necessary are also explained. Patients have expressed their satisfaction with the counseling and the opportunity to clear their doubts Counseling at Cama & Albless Hospital Cancer Ward 35 patients were counseled and given guidance by Iva Athavia during December. Among these are 7 new patients. 8 patients were registered with CPAA. 35 ward visits were made. 3 patients were offered ambulance service. 20 patients were provided guidance regarding alternative therapy. 2 terminally ill patients were referred to Shanti Avedana Ashram. Rs. 7,780 were donated towards medicines and radiation costs. 42 patients were given boxes of Complan, chocolates and biscuits. Nair Hospital (Radiation Department) 40 patients were counseled and given guidance at the Counseling Cell at Nair Hospital Radiation Department by Iva Athavia during December out of which 21 were new patients. 7 ward visits were made. 3 terminally ill patients were referred to Shanti Avedana Ashram. 20 patients were given information about alternative forms of medicines. Rs. 20,308 was donated towards radiation treatment. 108 packets of biscuits, sweets, Complan, Feredol and Resource powder were distributed. 2 boxes of clothes were given to patients. The Rehabilitation Centre adopted one new patient during December. A total of 77 patients were helped. 3 cases of mastectomy were attended and breast prostheses were provided. 235 patients were given rations worth Rs. 29,578. Rs. 18,860 was spent on teachers' salaries, for patient education and vocational training. Rs. 1.01 lakhs were spent on patients' wages and Rs.28,428 was spent on welfare activities, conveyance and diet supplements.
Cancer
Patients Aid Association Monthly Review is compiled by Dr. Shubha Maudgal
and printed by Mr. Suresh Mishra at Saraswati Printing Press Please
write in with your comments to: Smt. Panadevi Dalmia Cancer Management
Centre, Anand Niketan, King George V Memorial, |
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