Mar 05, 2020
By Sarah Bachmann, ASCO International Affairs, and Katherine H. Crawford, MA, PMP, ASCO Communications
ASCO, in collaboration with international oncology societies, hosts International Palliative Care Workshops (IPCWs) designed to teach participants practical skills in communication and management of symptoms and pain. The IPCWs are led by ASCO member volunteers and local experts who serve as faculty. Sessions include communication strategies, such as how to deliver bad news; methods for pain assessment and medication management; comprehensive care and symptom management practices; and strategies for implementing palliative care services in various practice setting (hospitals, community clinics, etc.).
In September 2019, ASCO partnered with the Russian Society of Clinical Oncology (RUSSCO) to hold the first IPCW in Russia. More than 40 oncologists, general physicians, and other health care workers from around Russia attended the workshop, which was held in Vladivostok.
The workshop featured case-based presentations and interactive sessions on different aspects of palliative care, including the value of early palliative care, communicating prognosis, pain pathophysiology, negotiating goals of care, advance care planning, and managing side effects.
According to a survey given to attendees, nearly 60% reported never having attended a palliative care course before, and 60% spent more than a quarter of their time with patients delivering palliative care. At the end of the workshop, 98% of respondents stated they planned to make practice changes based on what they learned at the workshop.
Jessica Geiger, PharmD, MS, BCPS, CPE, one of the faculty who led the Russian IPCW, said, “The physicians we interacted with were so receptive to our teaching and were highly engaged. I could feel the enthusiasm for palliative care and cannot wait to see the growth of palliative care in Russia. It was an honor to be included in this educational activity.”
The attendee feedback from the event was overwhelmingly positive:
- 92% of participants reported improvement in their ability to conduct a family meeting.
- 90% reported improvement in their ability to manage patents’ abdominal, bone, and neuropathic pain.
- 88% reported improvement in their ability to use different medications to control pain effectively and safely.
- 87% reported improvement in their understanding of the concepts and principles of palliative and end-of-life care.
- 85% reported improvement in their ability to manage patients’ symptoms.
- 84% reported improvement in their ability to communicate with patients and their families.
This was the third workshop that ASCO has collaborated on with RUSSCO. Previously, ASCO has held two International Clinical Trial Workshops with the Russian society, as well as joint sessions at RUSSCO’s annual meeting, the Russian National Cancer Congress, in Moscow.
At the time of publication, an ASCO-RUSSCO joint session is planned at the Russian National Cancer Congress in 2020, at which ASCO president-elect Lori J. Pierce, MD, FASTRO, FASCO, will be a speaker.
ASCO is currently accepting applications for IPCWs in 2021. If your organization is interested in applying to host a workshop, please contact ASCO International at email@example.com.
Comments From IPCW Russia Attendees
“Participation in the International Palliative Care Workshop helped me realize the importance of early palliative care and get practical instruments to provide better care to my patients. We were trained intensively to communicate with patients and family [and] to treat pain and other symptoms of disease. The most inspirational thing was the interaction and the willingness of the organizers to give the best knowledge. I am very grateful for the opportunity to be there and improve my knowledge in such relevant issue[s].”
—Ivan Gerk, MD, oncology resident, North-Western Mechnikov State Medical University, St. Petersburg
“This course [was] perfectly organized and extremely useful. Three days of close collaboration… gave me not only a modern understanding of palliative care, but also the tools to implement it in my work. I have already heard that some positive changes in palliative care have been made at the regional level since this course. I am very pleased that there are initiatives such as the ASCO IPCW that have a real impact on the quality of care around the world.”
—Ruslan Absalyamov, MD, medical oncologist and surgeon, Rassvet Clinic, Moscow
“Palliative medicine is a huge field of medical science, covering many related specialties. For three days we received a lot of information. It is difficult to single out the most important, the most memorable; all the lectures were extremely important, all were very bright. I personally really liked the lecture on delirium. [The session on] ‘Planning the Last Days of My Life’ made everyone look differently at their own lives and the lives of our patients. The main thing, as it seems to me, [is that] everyone saw the prospect of where we need to move, to what goals, to what heights.”
—Alexey Ilyukhov, MD, head of the Oncology Center, Chaika Clinics, Moscow
From a Single Course, a Far-Reaching Impact Impact Across the Region
By Ilya Tsimafeyeu, MD, CEO (2011-2019), Russian Society of Clinical Oncology
It was a great honor for the Russian Society of Clinical Oncology (RUSSCO) and for me to be a co-organizer from the Russian side of the ASCO IPCW in Russia.
RUSSCO is a professional cancer society with the mission to advance cancer treatment and cures. The organization represents the leading authority within the Russian Federation and Commonwealth of Independent States on education and research. Over 4,000 medical professionals have joined RUSSCO’s ranks and help to create forward-looking solutions for continuous improvement, professional growth, and knowledge sharing.
RUSSCO held 89 events around Russia last year. Undoubtedly, one of the most striking and significant events of the past year was the IPCW.
The IPCW was held in Vladivostok, the capital of Primorye and the Far East region. The distance between this region and Moscow is 9,165 kilometers, or 9 hours by flight. It is very difficult for doctors and health care providers from the Far East region to get to the central part of Russia and gain new knowledge that will be put into practice. Moreover, there was not a single palliative care department in this region. Therefore, ASCO and RUSSCO had a primary endpoint to provide new knowledge in palliative care and a secondary endpoint to stimulate the regional Ministry of Health to move forward in the organization of palliative care services.
Professor Frank Ferris, MD, and his team, including Shannon Moore, MD, MPH, and Jessica Geiger, PharmD, MS, BCPS, CPE, arrived in Vladivostok with great enthusiasm and lots of bags with IPCW materials and information. For three days, they transferred their enthusiasm to all IPCW participants, as well as to the Minister of Health and head of the Primorye Regional Cancer Center, who were invited as special guests. The largest Russian television channel “Rossija” released a special program about the event, the need for palliative care for the people in the region, and the current possibilities of palliative care approach.
The Palliative Care Program has now been approved in the Vladivostok region, including the foundation of a palliative care department with 115 beds (105 for adult patients and 10 for children). Sixty-five nurses also will be involved in outpatient palliative service.
RUSSCO is very grateful to ASCO and personally to staff members Vanessa Eaton and Sarah Bachmann for their continued support.
Dr. Tsimafeyeu is the recipient of several ASCO grants and awards, including the International Development and Education Award in 2008 and a Merit Award in 2016.
The Impossible Becomes Possible
By Marina Chernykh, MD, PhD, IPCW Russian faculty member; director, Radiological Center of the Moscow region, Podolsk, Moscow region
The IPCW was extremely unexpected for me. Despite the fact that I had the great honor to be on the scientific committee of this event, I received incredibly important information every day and every minute for all three days, which subsequently, in a very short time, became absolutely necessary in my daily practice.
There are many patients who need palliative care in my center; however, oncologists do not always have the working skills to provide it quickly and correctly. In the case of bone pain, we have developed the emergency fraction therapy program “Fraction of Hope,” which is carried out on the day of treatment in order to stop the pain syndrome as quickly as possible. The program has been functioning for 1.5 years; more than 200 patients have been treated. However, we have very little knowledge of systemic pain treatment, which is an extremely important aspect of treatment for this very difficult category of patients. It is even more important to receive treatment in a short time in the clinic where the anticancer therapy is taking place. It always seemed very difficult to organize.
Thanks to the knowledge gained in Vladivostok and the support of colleagues, the impossible becomes possible and turns into a very close perspective. A new center, “Against Pain,” will be opened in our clinic very soon, where patients will be able to meet a palliative care specialist and, more importantly, to receive pain management according to international guidelines. Dreams come true after this wonderful workshop. We appreciate the opportunity for us and our patients.