17th ECCO - 38th ESMO - 32nd ESTRO
European Cancer Congress 2013
The 17th ECCO - 38th ESMO - 32nd ESTRO European Cancer Congress was held in Amsterdam, 27 September - 1 October 2013. EONS is a founding member of ECCO so this was also your nursing congress in 2013 with a strong nursing programme.
It was the latest in a prestigious biennial series of meetings that have been growing in appeal and outreach across all disciplines and organisations since its inception in 1981. Involving ECCO, ESMO, ESTRO, ESSO, EACR, EONS and SIOPE, the European Cancer Congress forms a powerful combination for endorsing multidisciplinarity.
And the statistics report demonstrates that participation is consistently expanding so that the meeting has become the largest, truly multidisciplinary gathering in Europe. Delivering a pioneering programme, this Congress reinforced multidisciplinarity as optimal professional efficiency in practice.
The Winter 2013 edition of the EONS Magazine was dedicated to ECC 2013.
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For the first time, we had live reporting from the event.
Day 1 archive
Day 1 of the European Cancer Congress opened with the Oncology Nursing Opening and Award Session: the formal opening of the oncology nursing track and the recognition of outstanding work in nursing. Birgitte Grube and Erik van Muilekom, outgoing and incoming EONS Presidents, greeted a packed room as they welcomed oncology nurses to the conference - and to Amsterdam.
Keynote speech : Mark Johnson
The keynote speech was from Mark Johnson, who described awareness of diversity as a “critical safety issue” in nursing. Estee Lauder can advertise skin cream as “suitable for all ethnicities”. Can we say the same about oncology nursing? Professor Johnson believes that continuing professional development and policy-making must stay in step with the latest knowledge about diversity, or we risk excluding some patients from good-quality healthcare.
Lifetime Achievement Award 2013
Shelley Dolan wins the EONS Lifetime Achievement Award 2013
The EONS Lifetime Achievement Award was presented by Mary Wells. The deserving recipient was Shelley Dolan, described as “a true advocate” for oncology nurses.
Major Research Grant: report back
Vicky Cleary presented on her research topic at ECC 2013
Next we heard from Vicky Cleary of Ireland, who won the EONS Major Research Grant in 2010 and was reporting back on the work she did with that grant. She used the funding to develop an information intervention for women with gynaecological cancer.
Clinical Travel Grant: report back
Gianluca Catania presents work funded by the EONS Clinical Travel Grant 2012
Finally we heard from Gianluca Catania of Italy, winner of the EONS Clinical Travel Grant 2012. He used the funding to work on research into quality of life indicators for hospice patients.
Oncology Nursing Scientific Symposium
The opening session was followed by a scientific symposium on The Impact of Cancer - Exploring Complexity and Special Needs in Specific Cancers. EONS Board Members Francoise Charnay-Sonnek and Mary Wells chaired the session.
Proffered Papers Session: Nursing - Advanced Roles
At the same time there was a session on nursing roles, with eight short talks centring around the role of the nurse in cancer treatment. It began with a talk from M Bianchi of Switzerland about Peripherally Inserted Central Catheters (PICCs) : a nurse innovation implemented by a multidisciplinary team. Three of the talks were about an exciting new piece of medical technology: the telephone. M Rihuete showed research indicating that telephone follow-ups increase patient adherence to cancer patients. Charlotte Pihlmann of Denmark discussed her findings that a telephone hotline for women newly diagnosed with breast cancer can improve the patient experience. Suzanne Moiniche, also of Denmark, discussed her experiment in replacing outpatient visits before chemotherapy with a telephone call.
All three presentations about telephones made similar findings: that phone contact can reduce patient anxiety and actually save healthcare resources by reducing the number of unnecessary face-to-face consultations. Moiniche also found that phone consultations tended to be shorter - an average of 20 minutes rather than the 100 minutes for a face-to-face pre-chemotherapy consultation. Perhaps this is because if a patient doesn’t have to travel, they don’t feel the need to make a consultation “worth the journey” by asking a lot of questions. Patients in all three studies reported satisfaction with the telephone contact.
We also heard from Alessandra Milani about a pilot scheme using mobile tablets for nurse e-learning in the workplace, from E Elfrink about oncology nursing research and from Rob Kuin about the use of a phase model clinical pathway.
Carol Farrell of the UK spoke about nurses’ roles in nurse-led chemotherapy clinics, and said that nurses should focus on nursing-specific skills rather than just replacing doctors: “When you duplicate doctors’ work, you lose the nursing approach.” She pointed out that communications training is still not seen as an essential skill on the level of prescribing and ended with advice: “We need to do what’s best for the patient, not just fit in with or copy the doctor. Nurses need to lead, not just follow.” That need for nursing leadership and innovation is bound to be a theme for the sessions to come.
Day 2 archive
As EONS approaches its 30th anniversary, it is time to celebrate how far we’ve come - and plan for the future. This morning’s Anniversary Session was entitled Multidisciplinary Collaboration - Reflections on the Past, Thinking Ahead for the Future. Birgitte Grube, outgoing EONS President, began by reflecting on the society’s history and changes in the oncology nursing profession.
Then we heard from various different organisations who have worked with EONS over the years. Cornelius van de Velde of ECCO talked about how EONS has pushed forward multidisciplinary collaboration as a Founding Member of ECCO. He praised EONS Board Member Anita Margulies for being the first ever nurse to win the Pezcoller-ECCO award for contributions to oncology.
Martin Piccart of ESMO said that she believes “here is not sufficient recognition of oncology nursing as a discipline.” She argued for increasing collaboration between ESMO and EONS in the future and commented: “I don’t know how we could do research without oncology nurses.”
Peter Naredi of ESSO made a similar comment about his own profession: “Surgeons would be nothing without the opportunity to collaborate with nurses.” But he raised a concern: why do so many nurses leave clinical care when they get a PhD? And how can we stop them leaving? Naredi also shared concerns about patient perceptions of oncology professionals. Will the rise of robot surgery and computer algorithms lead patients to think that the oncologist plays “a minor role”? In the future, will they be more inclined to trust computers than humans? We don’t yet know.
After a contribution from Vincenzo Valentini of ESTRO, we heard from Gilles Vassal of SIOPE. He said that now 80% of young cancer patients in Europe can be cured - great news, but it means that there are many young adult cancer survivors living with the after-effects of their illness and treatment. Who helps them manage those after-effects? It is more a role for nurses than any other clinician. Professor Vassal also believes that these higher survival rates are in themselves due to multidisciplinary collaboration in European oncology - with nurses a key part of the mix. “We need to improve collaboration with nurses.”
The final speaker was Fatima Cardoso of ESO, who said: “We couldn’t perform any clinical research without the crucial role of nurses.” She pointed out that doctors often don’t learn techniques such as drawing blood in medical school. When they need to do something simple like make an injection, they learn these techniques from nurses. All ESO events for nurses are done in collaboration with EONS, an arrangement made long ago that has worked very well.
Chair Erik van Muilekom wrapped up the session by asking for audience questions. EONS Board Member Mary Wells spoke from the floor. Her point: all the speakers have spoken about the need for further multidisciplinary collaboration, but they need to back that up with action. More inclusion and recognition of nurses is the way to keep PhD nurses in clinical care: “The more you ask us to be at the table, the less we will leave the profession.” She also spoke about the need to help eastern European oncology nurses who are not being recognised in their country.
A delighted Anita Margulies receives the Pezcoller-ECCO Award
Anita Margulies, EONS Board Member, is one nurse who has done a huge amount to increase recognition of oncology nurses. Today she delivered a lecture in honour of having received the Pezcoller-ECCO Award for her contribution to oncology. She is the first ever nurse to receive this prestigious award. She has been working in continuing professional education for over 30 years and won the award for her development of educational resources and her mentoring of nurses.
The Award lecture was about the importance of nurses within multidisciplinary teams: “Science without care does not work any better than care without science”. She also called for regulators to give nurses full open access to drug information so that they remain up to date with the latest developments.
Anita also praised EONS for its work with oncology nurses, calling it a “fantastic society” and praising the CARE (Communication, Advocacy, Research and Education) strategy.
The EONS General Meeting was preceded by a Networking Reception, held jointly with the Dutch Oncology Nursing Society, where members took the chance to catch up over a glass of wine.
The evening’s business began with the approval of the 2012 meeting minutes and a speech from outgoing EONS President Birgitte Grube, who reflected on the past two years. She said that the EONS CARE strategy - Communication, Advocacy, Research, Education - remains key to our work.
Executive Director Clair Watts led the voting, which was to confirm the results of the elections in which all EONS Members were eligible to vote. There were no surprises; all results were confirmed.
Maria Cristina Pires de Lacerda of Portugal was elected EONS Treasurer. Andreas Charalambous of Cyprus) was elected Board Member for Education. Patrick Crombez of Belgium was elected Board Member for Advocacy. Daniel Kelly (United Kingdom) was elected President-Elect.
The new EONS Board Members
We then took some time to thank some of the outgoing Board Members. Sultan Kav, Françoise Charnay-Sonnek and Anita Margulies received a token of thanks from the Board and prolonged, foot-stamping applause from the assembled members.
Outgoing President Birgitte Grube then formally handed over the Presidency to Erik van Muilekom, who spoke about plans for the future: “Build bridges. And if you can’t build a bridge, dig a tunnel.”
Erik van Muilekon receives the Presidency of EONS from Birgitte Grube
Then it was the turn of the Working Group Chairs to update members on the work of their groups over the past couple of years. Paul Trevatt, Communication Working Group co-chair, told us about the new website design and the successful social media trial. Françoise Charnay-Sonnek of the Advocacy group told us about their efforts to increase minimum educational requirements for oncology nurses in the EU and gain recognition of oncology nursing as a speciality. Mary Wells of the Research group shared various achievements and invited people to apply for the spring workshop. Finally, Anita Margulies reported from the Education Working Group about the success of the first Putting Evidence into Practice (PEP) workshop.
We then heard a financial report from Daniel Kelly as outgoing Treasurer, an update on grants and awards from Sultan Kav and a report on the 2013 Masterclass from Lena Sharp.
The EONS General Meeting ended on a note of optimism - but with a feeling that there is lots of work for us to do before the next one!
Day 3 archive
EONS-ESO Joint Session - Cancer Surgery and Nursing
Both nursing roles and surgery techniques are evolving, which is why we need to keep updating our perception of the nurse’s role in surgery. EONS and the European School of Oncology (ESO) jointly organised a session on cancer surgery and nursing.
Dr M Cardoso of Portugal discussed oncoplastic surgery, specifically in relation to breast cancer treatment. She explained that the range of options for reconstructive surgery has broadened, which is great news but does mean more difficult choices for patients, with no outcomes guaranteed. She said that the key is to give patients the information they need to make a choice, such as telling them about the possibility of scarring. She also emphasised that you can’t expect a patient to make those choices at the same time as receiving the initial diagnosis - they need time to think things over.
Danuta Lichosik of Italy discussed the nurse’s role in robotic surgery. This involves a surgeon manipulating a computer console while robot arms carry out the operation. The nurse’s role is complex, requiring both technical and leadership skills as well as concern for patient outcomes. Key quote: “Nurses are the owners of the operating theatre. Doctors are only the guests.”
Finally we heard from Riccardo Audisio of the UK about surgical oncology in the elderly. He reminded that elderly patients vary wildly, not just in terms of the cancer but also in terms of cognitive function, general health, mental outlook and many other factors. Assessment is essential for the right treatment.
Dr Audisio’s most surprising point: frailty is not necessarily associated with old age. So instead of assuming that all geriatric patients will be frail, we should look at frailty as something to be treated. He also introduced the concept of “pre-habilitation”: why not work on other health problems in the patient, such as malnourishment, before surgery? More than half of elderly hospital patients, in both the US and the EU, are malnourished, and this is associated with poorer outcomes.
Scientific Symposium: The Elderly Cancer Patient
The theme of diversity in elderly patients was continued in today’s scientific symposium. Lucien Noens spoke about diverse reasons for non-adherence to treatment, including side-effects, cost of treatment, life disruptions such as travel and many other reasons. Non-adherence is actually the rule rather than the exception, and non-adherent patients cost healthcare systems much more than treatment-adherent patients. Oral treatment has many advantages, but these are lost without adherence.
The bad news? “There is no perfect method for monitoring treatment adherence, no gold standard”. There is also no perfect method for increasing adherence, but lots of things can play a part: telephone follow-ups, electronic reminders, more openness when prescribing. But in the end, “It all comes down to one thing: we need more time.”
One comment from the floor raised the point that it is the content rather than the channel that matters. What you actually say on the telephone is more important than using the telephone.
Dr van den Berkmortel of the Netherlands spoke at the same session about polypharmacy in the elderly. More patients need interventions where their multiple drugs are assessed and stopped if necessary. These interventions tend to result in the patient being on fewer drugs and self-reporting as more healthy. We also heard from B Esbensen of Denmark on geriatric assessment.
Debate on personalised medicine
The final EONS event of the day was a debate with the motion This House Believes that the Term ‘Personalised Medicine’ is too narrow and should be renamed ‘Personalised Treatment and Care’.
Birgitte Grube, EONS Board Member, spoke in favour of the motion, seconded by patient advocate Jana Pelouchova. Speaking against were Angelo Paradiso of Italy and Didier Jacqmin of France. The debate was chaired by EONS Board Secretary Mary Wells. Birgitte made the point that when patients hear the term ‘personalised medicine’, they think of the personal touch rather than of biomarkers.
Although participants were in strong disagreement about the use of the term in question, there was a lot of agreement across both sides of the debating floor on many issues, such as the importance of multidisciplinarity. The final result was in favour of the motion.
How to endure life during treatment for colorectal
cancer. Created by: Birgitte Pedersen, B. Winther, T. Bladt, B.K.
Hansen, A. Norlyk, from Denmark.
+ Download the winning poster
In second place was Clinical nurse specialist: a key link to manage patients using targeted therapies - experience of Centre Eugene Marquis. Created by: A. M’Sadek, M. Duval, J. Edeline, C. Lefeuvre, T. Lesimple, E. Vauléon, S. Sizun, B. Laguerre, E. Boucher, from Rennes (France).
In third place was The importance of combination therapy in patients with lymphoedema by L Buzea and C Ancuta, from Romania.
For a flavour of EONS at ECC 2013, see the pictures below.
Paul Trevatt reports on the achievements of the Communication Working Group
EONS members had a chance to catch up over a glass of wine before the EONS General Meeting
Board Secretary Professor Mary Wells with Gianluca Catania, 2012 winner of the Clinical Travel Grant
Outgoing EONS President Birgitte Grube with incoming President Erik van Muilekom
The EONS lounge was the place for informal meetings
Voting at the EONS General Meeting
L-R: Daniel Kelly, Anita Margulies, Paul Trevatt and Francoise Charnay-Sonnek