JEDDAH, 14 May 2003 — With the incidence of cancer on the rise around the world and the number of older patients increasing, the deadly disease will be a major health challenge in the future.
It is good news when specific treatments are developed, leading to more cures and to longer survival for patients who are not cured. As patients and their families are becoming more informed about cancer they will become more and more involved in decisions relating to their care and their quality of life. Therefore, it is necessary for the clinicians to acquire the skills for the management of symptoms caused by local and systemic effects of the malignancy. It is also important for patients and families to receive appropriate follow-up and to have access to multiple settings for optimal care.
Timely referral to a palliative medicine service and hospice is also important and can have significant impact on the total care of the patient and on home caregiver. King Faisal Specialist Hospital in Jeddah and Riyadh recognized the importance of providing an integrated approach to palliative care in the treatment of patients with cancer and organized the first international symposium in the region last month to boost awareness of the issue among various health care professionals.
“The main objective of the symposium was to bring about the support needed for the cancer patient from the day they are diagnosed, throughout their therapy and most importantly at the end-of-life sort of care,” Dr. Adnan Ezzat, chairman of oncology department at KFSH in Riyadh, told Arab News. This is a new branch of medicine that we don’t have a lot of Saudi specialists in, according to Dr. Ezzat. “In Riyadh, we have the largest and first department of palliative care medicine which belongs to the cancer department and have the first Saudi consultant specialized in this field,” he said.
A comprehensive cancer care program consists of state-of-art patients care, prevention, education, research, and attending to the patient’s emotional, physical, psychological and social needs. While much has been achieved in this field in the Kingdom, responsibility toward addressing patients’ needs has received less attention.
The symposium invited distinguished international, regional and local experts to share their knowledge and experience with many health care workers and caregivers of different professional background. “We have looked at another important aspect and that is the issue of the disclosure of the diagnosis,” said Dr. Ezzat. “This is a very difficult and delicate subject that needs not only ethical but also social and religious aspects of it to look at and handled.” As regards the religious aspects, Dr. Abdulaziz Al-Homaidhi, director of academic and training program and senior hematologist at KFSH, Jeddah interviewed Sheikh Abdul Aziz Al-Al-Sheikh, the Grand Mufti of Saudi Arabia about disclosing diagnosis, withholding information, refusal of treatment, consent form, etc.; the interview is available on videotape and will be distributed throughout the hospitals of the Kingdom.
“We need multi-institutional participation because KFSH in Riyadh is a referral center, patients are sent to us after being diagnosed with cancer and treatment of cancer starts from the day a physician suspects the diagnosis,” said Dr. Ezzat. He had just completed a study on 400 cancer patients about how they were told about the diagnosis, whether they would like to be told, how, when and by whom; the results of this study will be published soon.
As part of KFSH approach to palliative care for cancer patients it launched an oncology nurses training program. Nurses with a bachelor’s degree are enrolled in a one-year training program after which they are given a diploma as specialized oncology nurses. “The training focuses on building our basic knowledge of oncology and the science of oncology combined with extensive clinical practice,” Noor Al-Attas, one of the oncology nursing students, told Arab News. “I think patients feel comfortable with us because we speak Arabic,” said Al-Attas.
The program covers training in six areas: radiation therapy, bone-marrow transplantation, palliative care, chemotherapy, treating patients and the pediatric oncology unit. “I think it’s a very important program because we need to be specialized,” said Ranyah Gommosani. “I wish we can have more programs for nurses to be specialized,” she added.