Recapping Day 7 of the 2021 ESMO Congress

The European Society for Medical Oncology (ESMO) 2021 Congress concluded its annual conference with a wide selection of educational sessions geared towards nurses. Below are some of the highlights from day 7 of ESMO’s 2021 Congress.

EONS14: Opening session

Kicking off the seventh and final day of the ESMO Congress was the EONS14: Opening Session. Led by the European Oncology Nursing Society (EONS) President Johan de Munter from Belgium, the session gave attendees an overview of the educational sessions held on September 22 that covered the latest evidence in cancer nursing.

Since a central part of EONS’ mission is to ensure all patients with cancer have access to high-quality nursing care, President de Munter also stressed the importance of policymakers and other stakeholders engaging with the cancer nursing community through initiatives like the EU Beating Cancer Plan.

This led to the next part of the session featuring the European Commissioner for Health and Food Safety Ms. Stella Kyriakides from Belgium, who explained The EU Beating Cancer Plan. The Plan is an inter-specialty program committed to implementing strategies to help prevent cancer and curve its impact.

As Ms. Kyriakides stated, nurses play a key role in each patient’s pathway, which is why she believes strong and collective commitment to the Plan is central to its success and the oncology community’s ability to fight for better quality of life and survivorship for patients.

Up next to discuss patient involvement in cancer nursing research was Ms. Theresa Wiseman, Clinical Chair in Applied Health Research in Cancer Care at the Royal Marsden NHS Foundation Fund. She argued that patients always need to be front and center, whether it’s in relation to policy, services, research, or interventions. However, a recent article in The Lancet drew attention to the mismatch between what clinical researchers do and what patients need.

This paper provided a new realization that patients have the right to provide input into research on their condition, which is why Ms. Wiseman provided the following principles for patient engagement in research:

• Respect
• Support
• Transparency
• Responsiveness
• Fairness of opportunity
• Accountability

While there’s an ongoing debate surrounding the best way to assess the quality and impact of patient engagement, this approach can still help increase the accountability and transparency of research, which is why Ms. Wiseman supports patient involvement in cancer nursing research.

Rounding out the Opening Session was the presentation of the Lifetime Achievement and RECaN awards and a live Q&A. With that, the final day of the ESMO Congress was off to the races.

Health Promotion, Prevention, & Screening

The “Health Promotion, Screening, And Prevention” session kicked off with a presentation from the Coalition of Nurses and Health Professionals Against Tobacco and Nicotine Products.

Christa Rustler, from the German Network for Tobacco Free Healthcare Services, took listeners through the development of this organization, made up of healthcare professionals from around the globe.

The Coalition of Nurses and Health Professionals Against Tobacco and Nicotine Products has worked together to form an online network, develop concept notes with ideas from participants, and provide an international symposium in the German Conference on Tobacco Control, taking place this upcoming December.

Rustler and the organization participate in national and international events to inform about the coalition and other good practices, with a mission of stopping the consumption of all products containing tobacco and nicotine in Europe. She also shared a few of the organization’s key objectives:

• To support HCPs to stop using tobacco and nicotine products
• Support population approaches to tobacco control by sharing information and benchmarking best practices across Europe of tobacco control initiatives that involved nurses and other healthcare professionals.

Dr. Andri Christou from the Cyprus University of Technology then introduced a new scale for the routine assessment of sialadenitis in the radioiodine treatment context and demonstrated the capability of this new scale through the Cohen’s kappa test: the Sialadenitis Assessment Tool.

According to the results, this tool has proven to be reliable and effective when testing for sialadenitis. And according to Dr. Christou, the uniqueness of this tool comes from the fact that it provides a specific grading system that is correlated to the symptoms induced by sialadenitis.

To conclude, she sums up her assessment by determining that, based on preliminary evidence, the Sialadenitis Assessment Tool is reliable for radioiodine-induced sialadenitis.

Following Dr. Christou, Mandy van Rosmalen, a nurse practitioner from Rotterdam, Netherlands, then argued for the need for nurse-led clinics for cancer treatment, highlighting the current burden of care on traditional clinics and the need for advanced nursing practices that can only be found in a nurse-led clinic.

These outpatient clinics have been shown to have tremendous benefits for patients with hereditary breast cancer. A nurse-led breast clinic, according to Rosmalen, can help implement new data, develop targeted research groups, and improve the overall quality of care.

While challenges remain in funding nurse-led clinics, Rosmalen believes that the benefits in quality of care outweigh the costs and that these clinics could benefit the oncology community as a whole.

Dr. Isabelle Fromantin from Paris then explored the impact of cancer screening and detection with dogs, explaining how the human body emits Volatile Organic Compounds (VOCs) through absorption of external components, bacterial metabolism, or human disease, and that disease-related VOCs, specifically for patients with breast cancer, can be identified by detection dogs.

The KDOG concept, explained by Dr. Fromantin, would make this possible. A volunteer would sleep with a cotton gauze on their breast to collect sweat and would be shown to the dog.

Dr. Fromantin walked us through a variety of strategies to train a dog to perform such a task, such as:

• Developing a link between the smell and a reward
• Work in a room with cones to help educate
• Use a conditioning or positive method to reward initiatives
• After training, the dog must do exercises every week

She concluded by saying that research with a living being cannot be considered with the same lens as a machine, but that if we go about training and assessing the correct way, detection with dogs can lead to access outcomes.

And finally, Selma Musters shared the impact of a surgical ward breakfast buffet on nutritional intake in postoperative patients.

In a prospective pilot cohort study, Musters and her team aimed to assess the impact o the breakfast buffet on protein and energy intake.

Based on the results of the study, she found that the breakfast buffet contributed to higher protein and energy intake, that it was a low-cost intervention, and that it led to positive responses from the patients involved.

SARS-Cov-2 & Cancer (EONS-ECPC)

To shed light on the far-reaching impacts of the COVID-19 pandemic on cancer patients, the “SARS-Cov-2 & Cancer (EONS-ECPC)” was led by Amanda Drury and featured five presentations given by nurse Manuela Eicher from Switzerland, post-doctoral research fellow at Concordia University Urska Kosir from Oxford, patient expert and advocate Alina Comanescu from Romania, pharmacist Dr. Richard O-Dwyer from Dublin, and registered general nurse Maura Dowling from Galway.

Here are three key takeaways from the session.

There Are 3 Main Themes Regarding Patient Experiences During the Pandemic

Ms. Eicher and Ms. Dowling shared data from a longitudinal, qualitative study that conducted telephone interviews with adults receiving systemic anti-cancer treatment or follow-up care to assess their psychological distress, resilience, and overall experiences amid the COVID-19 pandemic.

The study identified three main themes among patients’ responses:

1. Patients are being careful, keeping safe, and feeling safe. Participants value and accept efforts like masking that can help minimize their infection risk, and they generally feel safe.

2. Patients are feeling isolated and worry that their support system is shrinking. Not only are they missing the support of family and friends, but some also reported that healthcare professionals were preoccupied with COVID-19 during visits.

3. Patients don’t feel like they’re missing out. This is mainly because everyone is living with the same restrictions.

While these three themes were prevalent among study participants, both Ms. Eicher and Ms. Dowling noted that there can be a great variability of experiences, which is why targeted and tailored supportive care is key for these patients.

The Pandemic Has Greatly Impacted Young Patients

Ms. Kosir shared a study looking at young cancer patients’ mental health amid the COVID-19 pandemic. There were over 170 participants from North America and Europe, and 45 percent reported changes in care, including delays in treatment and follow-up.

When it came to the pandemic’s impact on patients’ mental health, the study found that:

• 62 percent reported feeling more anxious now than before the pandemic
• 52 percent reported feeling more isolated now than before the pandemic
• 10 percent reported feeling less anxious and isolated than before the pandemic

The study also asked participants where they got information about COVID-19 and found that 24 percent received direct communication from healthcare professionals and 56 percent reported wanting more tailored information.

Based on these findings, Ms. Kosir stressed the importance of attending to young people and those who experience psychological distress.

SACT Delivery Has Been Maintained Throughout the Pandemic

Since the onset of the COVID-19 pandemic, the delivery of systemic anti-cancer therapies (SACT) has faced many challenges, such as the uncertainty of when to treat patients and when to delay. So to analyze the delivery of SACT to cancer patients during the pandemic, Dr. O-Dwyer shared a study that examined records from electronic dispensing systems.

The study found that the volume of SACT dispensed from March 2019 to February 2020 was similar to the volume dispensed from March 2020 to February 2021. In fact, the total number of items dispensed decreased by just 5 percent.

This shows that the oncology day ward observed in the study was able to continue administering comparable numbers of treatments despite ongoing challenges. And while this highlights the adaptability and resilience of the staff, Dr. O-Dwyer noted that more resources are needed to improve and sustain these approaches.

As the COVID-19 pandemic continues to rage on, research efforts like the ones discussed in this session will become even more important to ensure that cancer patients get the treatment they need.