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Bourlon MT, Bhatt AS, Lopes G, Asirwa FC, Eniu AE, Loehrer PJ, Shulman LN, Close J, Von Roenn J, Tibbits M, Pyle D, Gralow JR. Envisioning Academic Global Oncologists: Proposed Competencies for Global Oncology Training From ASCO. JCO Glob Oncol 2024; 10:e2300157. [PMID: 38603655 PMCID: PMC11018164 DOI: 10.1200/go.23.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/21/2023] [Accepted: 02/06/2024] [Indexed: 04/13/2024] Open
Abstract
Recognizing the rising incidence, prevalence, and mortality of cancer in low- and middle-resource settings, as well as the increasingly international profile of its membership, ASCO has committed to expanding its engagement at a global level. In 2017, the ASCO Academic Global Oncology Task Force sought to define the potential role for ASCO in supporting global oncology as an academic field. A set of recommendations to advance the status of global oncology as an academic discipline were created through a consensus-based process involving participation by a diverse group of global oncology and global health practitioners; these recommendations were then published. The recommendations included developing a set of global oncology competencies for trainees and faculty interested in a career in academic global oncology. Here, we describe the global oncology competencies developed by this task force. These competencies consist of knowledge and skills needed in general global health as well as cancer-specific care and research, including understanding global cancer health disparities, defining unique resources and needs in low- and middle-resource settings, and promoting international collaboration. Although the competencies were originally developed for US training programs, they are intended to be widely applicable globally. By formalizing the training of oncologists and supporting career pathways in the field of global oncology, we can make progress in achieving global equity in cancer care and control.
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Affiliation(s)
- Maria T. Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | | | - Patrick J. Loehrer
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN
| | | | | | | | | | - Doug Pyle
- American Society of Clinical Oncology, Alexandria, VA
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2
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Lordick F, Lorenzen S, Hofheinz R. Oncology in Europe. Oncol Res Treat 2023; 46:345-347. [PMID: 36780881 DOI: 10.1159/000529681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 02/15/2023]
Affiliation(s)
- Florian Lordick
- Department of Medicine (Oncology, Gastroenterology, Hepatology, Pulmonology), University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany, Leipzig, Germany
| | - Sylvie Lorenzen
- 3rd Department of Medicine (Hematology and Oncology), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Ralf Hofheinz
- Mannheim Cancer Center, University Hospital Mannheim, Mannheim, Germany
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Zielinski CC, Cufer T, Seruga B, Jassem J, Dediu M, Thallinger C. Perspectives for Cancer Care and Research in Central and Eastern Europe. Oncol Res Treat 2023; 46:80-88. [PMID: 36463856 PMCID: PMC10015746 DOI: 10.1159/000528487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/24/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Discrepancies between the outcomes of cancer patients between Western European and Central and Eastern European (CEE) countries have often been observed. Despite the enormous economic and civilizational progress made in these countries after the abolishment of the communist regime, structural problems persist. SUMMARY The present article reviews the domains of medical oncology education, human resources in oncology, cancer care, and clinical research in CEE in order to comprehensively assess the current situation and needs, describe important initiatives, and also propose ways to improving cancer outcomes in the region. Activities are under way to address these issues in national action plans to divert funding into oncology-related education, research, the purchase of equipment, and the attainment of modern hospital organization and structures. KEY MESSAGE Over the past more than 30 years, CEE countries have made enormous economic and societal progress. Nevertheless, challenges especially in the health care sector persist.
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Affiliation(s)
- Christoph C Zielinski
- Wiener Privatklinik, Central European Academy Cancer Center, Vienna, Austria.,Central European Cooperative Oncology Group, Vienna, Austria
| | - Tanja Cufer
- Medical Faculty, University of Ljubljana, Slovenia, Ljubljana, Slovenia
| | - Bostjan Seruga
- Medical Oncology Department, SANADOR Oncology Center, Bucharest, Romania
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Mircea Dediu
- Division of Medical Oncology, Institute of Oncology Ljubljana and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Christiane Thallinger
- Central European Cooperative Oncology Group, Vienna, Austria.,Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
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Ribi K, Kalbermatten N, Eicher M, Strasser F. Towards a novel approach guiding the decision-making process for anticancer treatment in patients with advanced cancer: framework for systemic anticancer treatment with palliative intent. ESMO Open 2022; 7:100496. [PMID: 35597176 PMCID: PMC9271509 DOI: 10.1016/j.esmoop.2022.100496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 01/06/2023] Open
Abstract
Background Weighing risks and benefits is currently the primary criterion for decisions regarding systemic anticancer treatment (SACT) in far advanced cancer patients, also in the modern immunotherapy- and molecular-targeted driven oncology. Decision aids rarely include substantially key concepts of early integrated palliative care (PC) and communication science. We compiled decisional factors (DFs) important for guiding the use of SACT with palliative intent (SACT-PI) and explored these DFs regarding their applicability in routine clinical care. Patients and methods Clinician (participants: n = 28) and patient (n = 15) focus groups were conducted in an integrated oncology and PC setting. Thematic analysis was used to identify DFs. A Delphi survey of clinicians ranked the importance of DFs in routine decision-making. DFs were aligned with elements of the typical decision-making process, resulting in an eight-step guide for making SACT-PI decisions in clinical practice. Results Eight focus groups revealed 55 DFs relating to established topics like providing information and risk–benefit analysis, as well as to PC topics like patients’ attitudes, beliefs, and hopes; patient–physician interaction; and physician attitudes. Agreement on the relative importance was reached for 34 (62%) of 55 DFs, assigned to five elements: patient/family, clinicians/system, patient-clinician-interaction, information/patient education, risk–benefit weighting/actual decision. These themes are embedded in a potential clinically useful SACT-PI Decision Framework, which includes eight steps: assess, educate, verify, reflect, discuss, weigh, pause, and decide. Conclusions The SACT-PI Decision Framework integrates subjective patient factors, interpersonal factors, and PC issues into decision-making. Our findings complement existing decision aids and prompt lists by framing DFs in the context of SACT-PI and enforce the decision ‘process’, not the decision act. Further research is needed to explore the relative importance of DFs in specific patient situations and test structured decision-making processes, such as our SACT-PI Decision Framework, against standard care. Patient-centered decisions in advanced cancer care demand a stepwise decisional process, not a single decision act. The decision process includes key palliative care domains, e.g. illness understanding, symptom control, or end-of-life preparation. Patients’ attitudes, beliefs, hopes, patient–physician interaction, and physician attitudes demand structured observation. The SACT-PI Decision Framework includes concrete steps: assess, educate, verify, reflect, discuss, weigh, pause, decide. Interprofessionally working oncology clinicians may transform decision-making processes in oncology beyond decision aids.
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Affiliation(s)
- K Ribi
- International Breast Cancer Study Group, Coordinating Center, Quality of Life Office, Bern, Switzerland.
| | - N Kalbermatten
- Clinic Medical Oncology and Hematology, Department Internal Medicine, Cantonal Hospital, St. Gallen, Switzerland
| | - M Eicher
- Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - F Strasser
- Cancer Fatigue Clinic at Onkologie Schaffhausen, Schaffhausen and Center Integrative Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Center Integrative Medicine, Department Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Morris L, Turner S, Thiruthaneeswaran N, O'Donovan A, Simcock R, Cree A, Phillips J, Alibhai S, Puts M, Szumacher E, Lane H, Berger A, Agar M. An International Expert Delphi Consensus to Develop Dedicated Geriatric Radiation Oncology Curriculum Learning Outcomes. Int J Radiat Oncol Biol Phys 2022; 113:934-945. [DOI: 10.1016/j.ijrobp.2022.04.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
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Cufer T, Kosty M, Osterlund P, Jezdic S, Pyle D, Awada A, Close J, El-Saghir N, Lordick F, Rutkowski P, Tfayli A, Wildiers H. Current landscape of ESMO/ASCO Global Curriculum adoption and medical oncology recognition: a global survey. ESMO Open 2021; 6:100219. [PMID: 34924144 PMCID: PMC8710493 DOI: 10.1016/j.esmoop.2021.100219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background With the implementation of multidisciplinary treatment and development of multiple novel anticancer drugs in parallel with expanding knowledge of supportive and palliative care, a need for separate training and specialisation in medical oncology emerged. A Global Curriculum (GC) in medical oncology, developed and updated by a joint European Society for Medical Oncology/American Society of Clinical Oncology (ESMO/ASCO) GC Task Force/Working Group (GC WG), greatly contributed to the recognition of medical oncology worldwide. Material and methods ESMO/ASCO GC WG carried out a global survey on medical oncology recognition and GC adoption in 2019. Results Based on our survey, medical oncology is recognised as a separate specialty or sub-specialty in 47/62 (75%) countries participating in the survey; with a great majority of them (39/47, 83%) recognising medical oncology as a standalone specialty. Additionally, in 9 of 62 (15%) countries, medical oncology is trained together with haematology as a specialty in haemato-oncology or together with radiotherapy as a specialty in clinical oncology. As many as two-thirds of the responding countries reported that the ESMO/ASCO GC has been either fully or partially adopted or adapted in their curriculum. It has been adopted in a vast majority of countries with established training in medical oncology (28/41; 68%) and adapted in 12 countries with mixed training in haemato-oncology, clinical oncology or other specialty responsible for training on systemic anticancer treatment. Conclusions With 75% of participating countries reporting medical oncology as a separate specialty or sub-specialty and as high as 68% of them reporting on GC adoption, the results of our survey on global landscape are reassuring. Despite a lack of data for some regions, this survey represents the most comprehensive and up-to-date information about recognition of medical oncology and GC adoption worldwide and will allow both societies to further improve the dissemination of the GC and global recognition of medical oncology, thus contributing to better cancer care worldwide. ESMO/ASCO Global Curriculum (GC) supported medical oncology (MO) as a standalone specialty or sub-specialty worldwide. The ESMO/ASCO GC Working Group regularly updates the GC and conducted a worldwide survey on GC adoption and MO recognition. Based on the survey, MO is recognised as a specialty or sub-specialty in the majority (47/62; 75%) of participating countries. ESMO/ASCO GC has been adopted or adapted in 68% of participating countries without significant differences around the world. This most comprehensive information about MO recognition and GC adoption will support their further dissemination worldwide.
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Affiliation(s)
- T Cufer
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
| | - M Kosty
- Division of Hematology/Oncology, Scripps Clinic, La Jolla, USA
| | - P Osterlund
- Department of Oncology, Tampere University Hospital and University of Tampere, Tampere, Finland; Department of Oncology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - S Jezdic
- Scientific and Medical Division, European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - D Pyle
- International Affairs, American Society of Clinical Oncology (ASCO), Alexandria, USA
| | - A Awada
- Medical Oncology Clinic, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - J Close
- University of Florida College of Medicine, Gainesville, USA
| | - N El-Saghir
- Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - F Lordick
- Department of Oncology, University Cancer Center Leipzig, Leipzig University Medical Center, Leipzig, Germany
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - A Tfayli
- Department of Internal Medicine, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
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El Saghir NS, Anderson BO, Gralow J, Lopes G, Shulman LN, Moukadem HA, Yu PP, Hortobagyi G. Impact of Merit-Based Immigration Policies on Brain Drain From Low- and Middle-Income Countries. JCO Glob Oncol 2021; 6:185-189. [PMID: 32023124 PMCID: PMC7051246 DOI: 10.1200/jgo.19.00266] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Brain drain is the migration of educated and skilled individuals from a less developed region or country to a more economically established one. The Trump administration proposed a merit-based immigration plan. This article addresses its potential impact on health care delivery in low- and middle-income countries (LMICs) and their preparedness to deal with it. MATERIALS AND METHODS Data on immigration policies, numbers of international medical graduates practicing in high-income countries (HICs), various scientific exchange methods, and efforts for capacity building in LMICs. RESULTS Talented individuals seek to advance their knowledge and skills, and may stay in HICs because of greater rewards and opportunities. HICs also rely on immigrant international medical graduates to supplement their physician workforces. CONCLUSION Ambitious individuals from LMICs need and should have opportunities to advance their education and training in more advanced countries. LMICs should increase their educational efforts, research capabilities, infrastructures, and living conditions to better serve their own populations and reduce their brain drain phenomenon.
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Affiliation(s)
- Nagi S El Saghir
- Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Benjamin O Anderson
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Julie Gralow
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center at the University of Miami and the Miller School of Medicine, Miami, FL
| | | | - Hiba A Moukadem
- Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Lichtman SM, Cohen HJ, Muss H, Tew WP, Korc-Grodzicki B. From Assessment to Implementation and Beyond in Cancer and Aging Research. J Clin Oncol 2021; 39:2217-2225. [PMID: 34043443 PMCID: PMC8260919 DOI: 10.1200/jco.21.00317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Hyman Muss
- Department of Medicine and UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Kanesvaran R, Mohile S, Soto-Perez-de-Celis E, Singh H. The Globalization of Geriatric Oncology: From Data to Practice. Am Soc Clin Oncol Educ Book 2021; 40:1-9. [PMID: 32347757 DOI: 10.1200/edbk_279513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Older adults with cancer are a unique group of patients who require specialized care and treatment. The field of geriatric oncology (GO) was born more than 3 decades ago to address the needs of this growing group of patients. Some challenges in the GO field include establishing a GO clinical service, educating and training personnel, and conducting research in GO. These issues are addressed to varying extents with global initiatives in GO, which are largely dependent on the socioeconomic status of the countries involved. To overcome disparities seen globally, scientific journals that reach an international cancer audience should publish content related to improving care of older adults with cancer around the world, develop an organizational structure that encourages global dissemination of GO knowledge, and advance reporting policies that encourage higher-quality reporting of data relevant to older adults with cancer worldwide. A number of international scientific journals have risen to the occasion to address these disparities. A key battle in enabling access of this vulnerable group of patients to clinical trials is now being fought and won on the global front with numerous regulatory initiatives. The U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) recently issued draft guidance on the inclusion of older adults in cancer clinical trials. This and other global initiatives led by the FDA have the potential to further improve the evidence base for older adults with cancer.
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Affiliation(s)
| | - Supriya Mohile
- Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | | | - Harpreet Singh
- Division of Oncology 2, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
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10
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The impact of the European School of Oncology masterclass in clinical oncology on self-professional development. Crit Rev Oncol Hematol 2020; 151:102976. [PMID: 32389896 DOI: 10.1016/j.critrevonc.2020.102976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 12/27/2022] Open
Abstract
We investigated the impact of the European School of Oncology's (ESO) Masterclass (MCO) in Clinical Oncology on the career development of young participants. MCO represents the flagship educational activity of ESO and is organized annually, mostly in collaboration with the European Society for Medical Oncology (ESMO) in five different geographical regions. A questionnaire consisting of 21 questions was sent to all doctors who attended the ESO MCOs from 2009 to 2016. The 228 responders were mostly from European countries and hold the specialty of Medical Oncology. Ninety-five percent of them evaluated ESO MCOs as "extremely useful" or "useful" for their professional career. Around 60% were trained at University Hospitals or Cancer Institutes and currently, one-third of them are employed in Academic Centers. Eighty percent have performed translational or clinical research and 77.5% were able to publish in pertinent international journals. The contribution of ESO MCOs to trainees' career development in different oncology disciplines around the world is discussed.
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Tomiak A, Braund H, Egan R, Dalgarno N, Emack J, Reid MA, Hammad N. Exploring How the New Entrustable Professional Activity Assessment Tools Affect the Quality of Feedback Given to Medical Oncology Residents. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:165-177. [PMID: 30604387 DOI: 10.1007/s13187-018-1456-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The post-graduate medical programs at Queen's University transitioned to a competency-based medical education framework on July 1, 2017. In advance of this transition, the Medical Oncology program participated in a pilot of six Entrustable Professional Activities (EPAs) focused workplace-based assessment (WBA) tools with faculty and residents. The purpose of this sequential explanatory mixed method study was to determine the extent to which these WBAs provided quality feedback for residents. The WBAs were introduced into daily clinical practice and, once completed, were collected by the research team. A resident focus group (n = 4) and faculty interviews (n = 5) were also conducted. Focus group and interview data were analyzed using an emergent thematic analysis. Data from the completed assessment tools were analyzed using both descriptive statistics and a literature-informed framework developed to assess the quality of feedback. Six main findings emerged: Verbal feedback is preferred over written; providing both written and verbal feedback is important; effective feedback was seen as timely, specific, and actionable; the process was conceptualized as coaching rather than high stakes; there were logistical concerns about the WBAs, and additional clarification about the WBA tools is needed. This study provides insight into faculty and resident perceptions of quality feedback and the potential for WBA tools to assist in providing effective feedback to residents as we shift to competency-based medical education in Canada. Our results suggest the need for additional faculty development around the use of the tools, and their intended role, and the elements of quality feedback.
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Affiliation(s)
- Anna Tomiak
- Department of Oncology, Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, Queen's University, 25 King Street W, Kingston, Ontario, K7L 5P9, Canada
| | - Heather Braund
- Faculty of Education, Office of Professional Development and Educational Scholarship, Botterell Hall, Queen's University, Room 217, 18 Stuart Street, Kingston, Ontario, K7L 3N6, Canada
| | - Rylan Egan
- Health Quality Programs, Queen's University, 82-84 Barrie Street, Kingston, Ontario, K7L 3N, Canada
| | - Nancy Dalgarno
- Office of Professional Development and Education Scholarship, Botterell Hall, Queen's University, Room 217, 18 Stuart Street, Kingston, Ontario, K7L 3N6, Canada
| | - Jeffrey Emack
- Department of Oncology, Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, 25 King Street W, Kingston, Ontario, K7L 5P9, Canada
| | - Mary-Anne Reid
- Department of Kinesiology - College of Education, Michigan State University, IM Sports Circle Building - 308 W. Circle Drive, East Lansing, MI, 48824, USA
| | - Nazik Hammad
- Medical Oncology Residency Training Program, Department of Oncology, Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, Queen's University, 25 King Street W, Kingston, Ontario, K7L 5P9, Canada.
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12
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O'Higgins N, Eriksen JG, Wyld L, Benstead K. Interdisciplinary training for cancer specialists: The time has come. Radiother Oncol 2018; 129:415-416. [DOI: 10.1016/j.radonc.2018.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 08/07/2018] [Indexed: 11/16/2022]
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13
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Hui D, Cherny N, Latino N, Strasser F. The 'critical mass' survey of palliative care programme at ESMO designated centres of integrated oncology and palliative care. Ann Oncol 2018; 28:2057-2066. [PMID: 28911084 DOI: 10.1093/annonc/mdx280] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The ESMO Designated Centres (ESMO-DCs) of Integrated Oncology and Palliative Care (PC) Incentive Programme has grown steadily. We aimed to characterise the level of PC clinical services, education and research at ESMO-DCs. Methods We sent all 184 ESMO-DCs an electronic survey consisting of 78 questions examining the DC characteristics, palliative care clinical programme (structure, processes, and outcomes), primary PC delivery by oncologists, education, research and attitudes and beliefs towards the ESMO-DC programme. Results The response rate was 83% (152/184). 115 (76%) ESMO-DCs were from Europe, 87 (57%) were tertiary care centres. 136 (90%) had inpatient consultation teams, 135 (89%) had outpatient PC clinics, 107 (71%) had dedicated acute care beds, and 75 (50%) offered community-based PC. An estimated 70% (interquartile range [IQR] 28-80%) of patients with advanced cancer had a PC consultation before death, occurring 90 days before death (median, IQR 40-150 days) for outpatients and 21 days (IQR 14-45 days) for inpatients. 59 (39%) offered PC fellowship programme; 47 (32%) had mandatory PC rotations for oncology fellows. Ninety-nine (65%) had double-boarded palliative oncologists. 118 (78%) of the ESMO-DCs reported that routine symptom screening was offered in the oncology clinic and 30% of patients had documented end-of-life discussions by their oncologists. Most centres (>80%) perceived the ESMO-DC programme to increase their status. Conclusions The ESMO-DCs had a high level of PC infrastructure and provided access to a large proportion of patients with advanced cancer. The survey supports that the 13 criteria required for ESMO designation set a robust framework for integration, stimulated investment of resources into some palliative care programmes prior to accreditation, and raised the interest about palliative care among clinicians, trainees and patients.
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Affiliation(s)
- D Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - N Cherny
- Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - N Latino
- European Society for Medical Oncology Head Office, Viganello-Lugano
| | - F Strasser
- Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital, St. Gallen, Switzerland
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14
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Multidisciplinary training of cancer specialists in Europe. Eur J Cancer 2017; 83:1-8. [PMID: 28704643 DOI: 10.1016/j.ejca.2017.05.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 11/21/2022]
Abstract
The best care for patients with cancer is most likely to be achieved when decisions about diagnosis, staging and treatment are made at multidisciplinary and multiprofessional meetings, preferably when all the professional expertise relevant to the patient's condition is gathered together. Questionnaires were sent to National Societies of Radiation Oncology and Medical Oncology concerning similarities and differences in training programs and multidisciplinary care in member states in Europe. Results indicated wide variation in training systems and practice. Data were lacking for Surgery because Surgical Oncology is not recognised as a speciality in the EU and most specialist training in cancer surgery is organ based. A period of time in cross-disciplinary training in each of the other two disciplines for all trainees in Medical Oncology, Radiation Oncology and Surgical Oncology (including all surgeons training in cancer surgery) is recommended. This is likely to improve the value of multidisciplinary meetings and may result in improved patient care. The Expert Group on Cancer Control of the European Commission has endorsed this recommendation.
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Dittrich C, Stiefel F, Kiss A, Dizon DS. Reply to the letter to the editor 'Integrating communication as a core skill in the global curriculum for medical oncology' by Horlait et al. Ann Oncol 2017; 28:905-906. [PMID: 28049138 DOI: 10.1093/annonc/mdw679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Dittrich
- Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, and Applied Cancer Research - Institution for Translational Research, Vienna, Austria
| | - F Stiefel
- Psychiatric Liaison Service, Department of Psychiatry, University Hospital of Lausanne-CHUV, Lausanne, Switzerland
| | - A Kiss
- Psychosomatic Division, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - D S Dizon
- Gynecologic Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
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Fadhil I, Lyons G, Payne S. Barriers to, and opportunities for, palliative care development in the Eastern Mediterranean Region. Lancet Oncol 2017; 18:e176-e184. [PMID: 28271872 DOI: 10.1016/s1470-2045(17)30101-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 12/31/2022]
Abstract
The 22 countries of WHO's Eastern Mediterranean Region are experiencing an increase in the burden of non-communicable diseases (NCDs), including cancer. Of the six WHO regions, the Eastern Mediterranean Region is projected to have the greatest increase in cancer incidence in the next 15 years. Furthermore, most cancers are diagnosed at a late stage, resulting in a lower cancer survival rate than in the European Region and the Region of the Americas. With increasing numbers of deaths from cancer, palliative care should be available to relieve suffering in patients with advanced disease and at the end of life. However, in the Eastern Mediterranean Region, the palliative care available is variable and inconsistent. Several barriers exist to the development and expansion of palliative care delivery in this region, including the absence of palliative care in national policies, little partnership working, insufficient palliative care education for health-care professionals and volunteers, poor public awareness, and gaps in access to essential pain-relief medicines. In this Review, we explore data and evidence from published literature, WHO meeting reports, cancer control mission reports, and the WHO global NCD country capacity survey to identify the status of palliative care in the Eastern Mediterranean Region, including the challenges and opportunities for development.
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Affiliation(s)
- Ibtihal Fadhil
- WHO, Eastern Mediterranean Regional Office, Cairo, Egypt.
| | - Gemma Lyons
- WHO, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Sheila Payne
- International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Horlait M, Leys M, De Grève J, Van Belle S. Integrating communication as a core skill in the global curriculum for medical oncology. Ann Oncol 2017; 28:670-671. [PMID: 27993807 DOI: 10.1093/annonc/mdw650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Horlait
- Department of Health Sciences, Organisation Policy and Social Inequalities in Health Care (OPIH), Vrije Universiteit Brussel (VUB), Brussels
| | - M Leys
- Department of Health Sciences, Organisation Policy and Social Inequalities in Health Care (OPIH), Vrije Universiteit Brussel (VUB), Brussels
| | - J De Grève
- Department of Medical Oncology, Oncologisch Centrum, UZ Brussel, Brussels
| | - S Van Belle
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
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