CPAA activities were covered in Excerpta Medica, Japan's KIRIN Information on Drugs and Science: Volume 12, No. 1, 2002.

The journal studied cancer related issues in India and interviewed Ketayun Dinshaw at Tata Memorial Centre and Vaidya Jagjeet Singh at Sri Ram Cancer Clinic besides Shubha Maudgal at CPAA. The journal used CPAA statistics extensively qouting from our results of cancer screening camps, gutkha addictions, etc.

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Visit to INS Vikrant 3rd December, 2001.

As a part of Navy Week celebrations which were held to mark the first anniversary of the Kargil War, CPAA took 50 cancer patients for a visit to INS Vikrant. The patients were awed to see the huge aircraft carrier, which is the size of an average highrise building. It was impressive to see the helicopters, arms and ammunition it carries on board. Many saw a submarine for the first time.

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VII INTERNATIONAL CONFERENCE ON PALLIATIVE CARE

Organised by Kidwai Memorial Institute of Oncology and Indian Association of Palliative Care, Bangalore, February, 17-19, 2000.

A Report – Viji Venkatesh

Palliative Care means providing support and care for patients in the last phase of their disease, so that they can live as fully and comfortably as possible. The fact that cure is no longer a reality does not mean that care cannot be made available and Palliative Care provides care and support not only to the patients but also to their family or caregivers, looking after their physical, emotional, social and spiritual needs. The concept of Palliative Care has developed in the last decade with the medical community also recognising the importance of this aspect of cancer care. Experts from the fields of Anaesthesiology, Oncology, Psychology and Psychosocial work have all contributed immensely to the growth of Palliative Care. At CPAA it has always been an integral part of our Counseling and Patient Care activities. Since the Tata Memorial Hospital set up its Palliative Care Clinic two years ago, CPAA has also been volunteering its counseling services there.

Meetings such as these organised by the IAPC allow for interaction between individuals who are actively involved in this field of patient care and the learning and sharing experiences enriches further our knowledge of palliative care issues.

Besides attending the conference, it was an honour to represent the CPAA as chairperson of the Free Paper Session on Home Care.

The conference which lasted for three full days had Plenary Sessions and Symposiums each day presided over by experts in the respective fields of Pain Management, Palliative Care issues in Breast Cancer, Head & Neck Cancers and Gynaecological Malignancies. Extremely interesting and informative Symposia were also devoted to Palliative Care in HIV-AIDS and Radiation Therapy. The Free Paper Presentation Sessions followed. Post lunch slots were devoted to informative, interactive workshops on relevant topics such as "Pain Relief" and "Coping with Patient Fatigue and Depression."

Dr. Robert Twycross of Oxford, UK, rightly looked upon as the father of Palliative Care, conducted both the plenary and the workshop sessions on Pain Management. His approach to pain relief stressed upon certain key issues like

• importance of careful clinical evaluation,
• patients will have more than one pain,
• not all pains are malignant,
• muscular pains can be as severe or even more so than those caused by cancer.

He also stressed upon the importance of explaining the pain to the patient and giving reassurance at all times. The main principles of pain control aim at giving relief at night, at rest during the day and on movement. He also spoke about different kinds of pain relief agents like non-opioid analgesics, weak opioids (codeine) and strong opioids like morphine and different kinds of pain needing different levels of management.

Prof. Geoffrey Hanks from the Bristol Oncology Institute UK, another very senior and expert presenter, spoke on Palliative Care in general and the need for giving it the importance it deserved as a crucially important component of patient care.

Breast Cancer issues covered were those of pain in bone metastases, Dyspnoea, management of lymphoedema and psychosocial issues. There was also a display of breast prostheses available.

The issues in Head and Neck Cancers were those related to symptom management, radiation therapy and rehabilitation, especially in relation to speech and swallowing.

Gynecological Malignancies were dealt with in a separate session. It was very informative and useful because of the large number of women we see in the course of our work with advanced malignancies of this kind. Besides intestinal obstructions and other complications, informative sessions were presented on the psychosocial issues pertaining to dealing with women with gynecological cancers in very late stages. An interesting presentation was made on the need for sensitive counseling and guidance and also one on the nursing of female patients. Special emphasis was laid on counseling and guidance in issues pertaining to sexual matters. It was observed that patients, counselors and nursing staff are all equally ill at ease when discussing such matters.

After two and a half days of cancer related palliative care information, there was a change in the form of a whole session devoted to HIV and AIDS issues. The speakers were all from Bangalore. Dr. Murali Mohan, a pulmonary physician, spoke brilliantly about his experiences with caring for HIV–AIDS patients. He highlighted the fact that most medical personnel who were looking after HIV-AIDS patients rarely had the specialist training required for this kind of specific care. A speaker from NIMHANS spoke on the psychosocial aspects of caring for AIDS patients. A representative of a non-governmental agency providing care and support for HIV positive patients- informational, practical and emotional support, rounded off the session.

The Free Paper sessions covered a range of topics – from Psychological Issues in Palliative Care to Home Care facilities for terminally ill patients. Two very interesting sessions were those on Ethical and Spiritual issues and Organisation of Palliative Care Services.

Non-medical and para-medical personnel who attended the meeting, appreciated the fact that the Scientific and Clinical sessions were formatted in such a manner that they provided useful and relevant guidelines. The Nursing Care Sessions were also interesting especially the one on "Oral Care and Wound Care" and "Communication and Bereavement."

The two-hour Workshop Sessions organised every afternoon covered a range of issues from Pain Management to Symptom Management and Psychosocial issues to Home Care. Delegates were requested beforehand to state their preference and the groups were formed accordingly.

I chose to attend the workshops on Psychosocial Issues – Fatigue and Depression and came away feeling enriched with the discussions and interaction with others involved in caring for patients in the last stages of their diseases. The moderators of this particular workshop, Dr.Steven Passik from Indiana, USA and Dr. Chaturvedi from NIMHANS, Bangalore, were very effective and allowed a lot of participant involvement.

The conference concluded with a Round Table Conference on Total Care. Dr. Jeremy Johnson and his team of caregivers from the Shropshire & Mid-Wales Hospice, U.K conducted this session. It was very interesting to learn how this group managed the total care of the patient. The group spoke eloquently and was very easy to identify with. A short but illuminating talk by Dr. Nagarathna on Yoga was also incorporated in this session.

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REPORT ON XV ASIA PACIFIC CANCER CONFERENCE (APCC)

(Chennai, 12^th – 15^th DECEMBER 1999)

A Report – Alka Kapadia

The fifteenth Asia Pacific Cancer Conference held at Chennai from 12^th December to 15^th December under the auspices of the Asia Pacific Organisation for Cancer Control (APOFCC) and Union Internationale Contre Cancer (UICC), covered various cancer related issues, not only medical and scientific, but also those pertaining to nursing and paramedics. Special programmes for non-governmental organizations and other similar work groups were conducted under the auspices of the COPES program. Different sessions covered non-medical cancer related issues such as Awareness, Early Detection, Prevention, Fundraising, Volunteerism and Rehabilitation. These sessions were chaired by eminent speakers and were followed by a very informative, interactive workshop session. The conference proved to be a great source of learning for all of us who attended the conference.

Five representatives from Cancer Patients Aid Association participated in the conference. Ms. Viji Venkatesh, Director, Diagnostic, CPAA chaired two sessions, on Palliation and Volunteerism. She presented two papers, the first being " Professional Caregivers in Palliative Care-Coping with Burn Out."

The presentation on Professional Caregivers in Palliative Care covered the following topics:

• Nature of the Job of caregivers
• Causes of Stress and Burn Out
• Needs of a Caregiver
• Collective Strategies to assist Caregivers
• Role of Organization which the Caregiver represents
• Reward of Care Giver- Tangible as well as intangible

Ms. Venkatesh also chaired the session on Volunteerism, which had 4 speakers presenting different aspects of volunteerism. Ms. Venkatesh introduced the topic "With the Right Volunteers a Cancer Society Can Move the Earth. How to Recognize, Empower and Motivate Volunteers." In her introduction she introduced volunteerism in its most ideal form and spoke about the following:

• Factors which motivate an individual to become a volunteer
• Volunteer’s Expectations
• Recruitment Of Volunteers
• Activity Plan For Volunteers
• Dissatisfaction in Volunteers
• Retaining Volunteers

This was followed by presentations by three different persons who highlighted different aspects of Volunteerism and their practical implications. Mr. Jeff Dunn, from Queensland Cancer Fund, Australia, presented the positive utilization of volunteers as a work force in Brisbane, which worked with perfect networking with the employed staff of Queensland Cancer Fund. Following his presentation, Ms. Alka. Kapadia, Director, CIP, CPAA, presented a paper entitled "Volunteerism in India –CPAA’s Experience" which highlighted the following:

• Patient Requirements
• Lack of Financial Remuneration to Volunteer vis a vis lack of Accountability/Commitment
• Emergence of Volunteer Employee Service Group – CPAA’s Experience
• Cancer Survivors – Volunteer Force
• Benefits Of Survivor groups
• Negative Impacts
• CPAA’s Volunteer Force Aspiration

This was followed by a presentation made by Ms. Vandana Gupta on success in utilization of volunteers in day-to-day activities and management of V Care, a totally volunteer-based organization. Thus a very diverse and total picture of Volunteerism, its applications, success and failures emerged in a balanced fashion.

The following CPAA members made Poster presentations:

Ms. Nita More presented a poster on Well Women Clinic – a project sponsored by KSB Pumps where annually 800 high risk women will be screened for early signs and symptoms of cancer totally free of cost

Ms. Anita Peter presented The Cancer Insurance Policy

Ms. Alka Kapadia presented Fund Raising Strategies for the Millennium

Various activities of CPAA were presented and shared with all present in the conference. Also present with us was Ms. Shailja Singh who was sponsored by UICC to attend this conference in Chennai. There was intense participation by CPAA members who contributed via Papers, Poster presentations, and Workshop participation. All the participants agreed that the conference had been extremely instructive and imparted valuable knowledge of newer principles of working in the field of "Total Management of Cancer."

Ms. Anita Peter presented The Cancer Insurance Policy

Ms. Alka Kapadia presented Fund Raising Strategies for the Millennium

Various activities of CPAA were presented and shared with all present in the conference. Also present with us was Ms. Shailja Singh who was sponsored by UICC to attend this conference in Chennai. There was intense participation by CPAA members who contributed via Papers, Poster presentations, and Workshop participation. All the participants agreed that the conference had been extremely instructive and imparted valuable knowledge of newer principles of working in the field of "Total Management of Cancer."

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