Cancer care: An integrated approach – COSA 31st Annual Scientific Meeting

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The 31st COSA Annual Scientific Meeting was held at the National Convention Centre in Canberra from 27-30 November 2004. The theme of the meeting “Cancer Care: An Integrated Approach” was chosen to emphasis the modern multidisciplinary and multimodality approach to coordinated cancer care. COSA is in a unique position of being a national body that represents all health professionals involved in cancer care with an annual meeting that caters for all of these groups.

As with previous conferences, a consumer forum was hosted by The Cancer Council ACT and Cancer Alliance Network on the day preceding the main conference and featured national and international guest speakers on the topics of colorectal cancer, breast cancer, ovarian cancer, prostate cancer, psychosocial issues, palliative care and spirituality. The forum was opened by Lady Marlena Jeffrey and 150 consumers attended.

At the opening session, Martin Tattersall Professor of Cancer Medicine at the University of Sydney spoke on the Development of Integrated Care in Cancer with the evolution of multidisciplinary treatment teams and the recognition of the importance of screening programmes, clinical trials and maintenance of quality of life. Laurie Grealish from University of Canberra presented a paper on Integrated Patient Support in looking at philosophical assumptions of how current health systems are divided into treatment and support and how a shift away from medically driven health care may work in cancer care. Peter Harper from Guy’s Hospital London described the formation of a model of Coordinated Oncology Research in the United Kingdom with a National Cancer Research Network to provide centralised support and management of oncology trials. This presentation was especially timely as the Australian Federal Government had just prior to the elections committed to the formation of a National Cancer Centre as well as to infrastructure funding for cooperative group clinical trials.

A strong international faculty contributed to a number of symposia and sessions. Peter Harper discussed the issues of cancer in the elderly in a breakfast session and symposium and also participated in ovarian and lung cancer sessions. Martin Gore from the Royal Marsden presented on ovarian cancer, gene therapy and biological therapies in melanoma. Pierre Hainaut from the IARC in Lyon discussed the role of p53 in the Genetics of Cancer Symposium. In the Palliative Care symposium Nicholas Christakis from Harvard Medical School talked on the impact of healthcare on surviving family members of cancer patients and Christina Mason from St Joseph’s Hospice London on the impact on carers. James Zabora from the Catholic University of America presented on psychosocial screening and programme development as well as participated in the inaugural Oncology Social Work Australia Conference following on from COSA. Sheila Rankin, a consultant radiologist from Guy’s Hospital, described the use of CT/PET fusion imaging in lung cancer and contributed to two multidisciplinary sessions.

Multidisciplinary case presentations and hypothetical sessions were used to good effect  to illustrate integrated cancer care throughout the meeting. A innovative hypothetical coordinated by Fran Boyle from Royal North Shore Hospital was titled Multidisciplinary Care in Lung Care-The Fellowship of the Ring used the story of the Lord of the Rings (LOTR) as a model for management of lung cancer. The audience was treated to slides of various panel members wearing wigs and wielding props from LOTR characters. Noel Tait from Canberra Hospital chaired a Multidisciplinary Rectal Cancer Care Case study. Issues including genetics, fertility, radical surgery, chemotherapy and radiation were covered. Maurice Eisenbruch from the Centre for Culture and Health examined the often overlooked area of Cultural Competence in Cancer Care with a panel using video vignettes. The role and controversy surrounding complementary and alternative therapy in management of cancer was explored in a hypothetical chaired by Stephen Clarke from Concord Hospital. The background of participants in these sessions were wide and included the specialties of radiology, pathology, surgery, radiation therapy, respiratory medicine, gastroenterology, palliative care, medical oncology, radiation therapy, pharmacy, social work, nursing, clinical trials, genetics and psychology.

In addition to the Consumer Forum there was participation of consumers in the main scientific programme. Raelene Boyle discussed her cancer journey in battling breast cancer in the Psychooncology Symposium. Consumer speakers lent their unique perspectives to the Cancer Genetics, Psychosocial Care, Rectal Cancer Case Study, Neurooncology and Complementary Therapy Sessions.

Clinical trials again had a prominence during the meeting. The ANZ Gynaecological Oncology Group, The ANZ Melanoma Group and the newly formed Australian Lung Trials Group all had their annual meetings concurrent with the conference. The Data Managers Group held a breakfast session examining imaging assessments in clinical trials and also a workshop in standard operating procedures. Nik Zeps coordinated a pharmaceutical industry symposium titled “What Can We Achieve Right Now to Enhance Clinical Trial Participation and Running in Australia”. Participants included representatives from the Therapeutic Goods Administration, the NSW Department of Health and the gold sponsor pharmaceutical companies. Clinical Trials in the Elderly was also one of the topics in the special symposium on geriatric oncology.

Joint sessions were held in conjunction with the Lung Cancer Consultative Group of the Australian Lung Foundation and also with the Royal Australasian College of Surgeons Surgical Oncology Group.

Communication workshops were conducted by the Pam McLean Centre in Discussing Prognosis in Lung Cancer. Other workshops included a Look Good Feel Good workshop sponsored by Mayne Pharma, a  Patient/Consumer Education workshop run by The Cancer Council Victoria and a National Initiatives in Supportive Care for rural Women with Breast Cancer by the National Breast Cancer Centre.  A well attended Melanoma Diagnostic Workshop was conducted by the Sydney Melanoma Unit in conjunction with the Royal Australian College of General Practitioners.

Other special sessions during the conference included New Drugs in Oncology from Pharmacy Group, Supportive Therapies covering mucositis, emesis and cytokines, Let’s Talk about Sex (sexuality in cancer) and Melanoma. Radiation Oncology Group conducted a two part multidisciplinary educational programme in radiotherapy.

Over 120 abstracts describing original research were received for presentation at the conference. These were incorporated into poster presentations and a number of Free Communication sessions under each of the COSA Groups. Social Work Group and Psychooncology Group abstracts were grouped together in two sessions because of their common themes. Radiation Oncology and Medical Oncology Group also had a joint session. This year there was again a Quality in Cancer Services Free Communication session chaired by Anne Lloyd although there is not as yet a Quality group of COSA. Neurooncology is now formally a group of COSA and had an inaugural AGM following its Free Communication breakfast session.

All abstracts were assessed and selected for presentation by group chairs and organising committee members. The posters and oral presentations were again scored and ranked for merit and presentation at the meeting by independent judges. The prize winners this year are as follows:

Student/Trainee Award (Eli Lilly)
Dr Ray Ashgari, Liverpool Hosptial
Estimation of an optimal chemotherapy utilisation rate in newly diagnosed colon cancer

Best Oral Presentation Prize (Sanofi)
Ms Alison Boyes, University of Newcastle
It’s not all doom and gloom: Well being of cancer survivors 5 years after diagnosis.

Best Poster Prize (Novartis)
Ms Tracey Doherty, Flinders Medical Centre
Utilisation of Clinical Practice Improvement Methodology to decrease the incidence of chemotherapy induced nausea and vomiting in a haematology/oncology day unit

Best Overall Abstract Prize (COSA)
Ms Natasha Sekelja, University of Sydney
Early and later referral to palliative care: a randomised controlled trial of patients with metastatic cancer.

Two award lectures were given this year. The first was by Professor Richard Fox from the Royal Melbourne Hospital, the recipient of the Pierre Fabre Achievement Award, and the second by Anna Nowak from the NHMRC Clinical Trials Centre who is the Medical Oncology Group/Novartis Fellowship recipient.

The two social functions were well attended with the Canberra regional wine tasting welcoming reception and the Conference Dinner in the Great Hall of New Parliament House.

I would like to acknowledge the enthusiasm and assistance of my organising committee. The helpful advice from Nik Zeps and David Goldstein the convenors of the two previous ASMs was greatly appreciated.  Thanks also to Bernard Stewart chair of the Cancer Research Group for organising two COSA symposia at the Australian Health and Medical Research Congress (AHMRC) in Sydney and also helping to smooth the sharing of Pierre Hainaut and Martin Gore between the meetings, which were running concurrently in the two cities. Special thanks also to Margaret McJannett, Executive Officer of COSA, and Ruth Lilian from Pharmaevents for their tireless logistical support with the meeting. COSA is also most grateful for the support of the industry sponsors some of whom were exhibiting for the first time. The 2005 meeting will be in Brisbane and my best wishes go out to Sandro Porceddu and his organising committee.

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