Workshop for Cancer Nurses

Concurrent with the Lymphoma Symposium held at the NCI, Cairo, a three-day training course entitled "New Developments in Cancer Nursing" was held for Egyptian and Palestinian nurses (supported by OIA, NCI, USA, the pharmaceutical industry and the Charitable Foundation of St. Bartholomew's Hospital (SBH), London).

Sabine Perrier-Bonnet from INCTR's French branch, called Alliance Mondiale Contre le Cancer, has held several courses for oncology nurses in Africa, including a one-day meeting in Cameroon in March 2003, a similar course in Setif, Algeria in March 2004, and a three-day training course for oncology nurses, including a segment on the psychological support of terminally ill patients in Ouagadougou, Burkina Faso, in November 2004.

INCTR Designated Training Centers

In the last year, with support from NCI's OIA and the NCI Liaison Office in Brussels, INCTR has established a program in which training is provided in selected centers in developing countries. This not only costs less, but provides an environment closer to that in the trainees' own country. The first candidate, a Nigerian gynecologist from Ile Ife, is completing a year of specialist training in gynecological oncology at the Tata Memorial Hospital in Mumbai, India.

In recent months he has been joined by two senior nurses and a social worker, and all four will complete training in direct visualization screening techniques for pre-invasive cervical cancer prior to returning to Ile Ife to develop a comprehensive program in cervical cancer control in Nigeria. A second group of health professionals, including a gynecologist and several nurses from Lagos, will undergo short-term training in direct visualization techniques in the early part of 2005 prior to establishing a second cervical cancer screening program in southern Nigeria.

INCTR is also coordinating the training of several health professionals from Kabul, Afghanistan, with the ultimate goal of initiating a cancer control program in Kabul. At present, a pathology technician is undergoing training at the Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, and a physician is undergoing specialist training in medical oncology at the Tata Memorial Hospital.

A third element of this program was recently initiated and will continue in the course of 2005. Bolivian health care workers will be trained in direct visualization cervical cancer screening techniques at the Instituto Nacional de Enfermedades Neoplasicas, in Lima, Peru.

Training Cancer Nurses Nursing workshops and meetings like this one in Burkina Faso enhance the quality of health care in developing countries. From communicating with patients and families to administering chemotherapy and pain management therapies, nurses around the world bear the brunt of patient care. Their focus is on the needs of the patient rather than the specific disease, yet cancer nurses must be highly skilled, well-trained and knowledgeable about treatment. Such nurses are able to undertake many tasks previously performed only by doctors – thus increasing capacity and influencing patient access to care. They help to improve patients’ support by providing more information and counseling to patients – critical to improving follow-up — and have an important role in patient care, including the administration of chemotherapy, care of patients undergoing radiation therapy or surgery, and the management of treatment complications. Research nurses participate in the collection of information needed to evaluate treatment efficacy and side effects, and specialized palliative care nurses help manage symptoms, particularly pain, in the terminally ill, whether in a hospice or community setting. By training cancer nurses in developing countries, INCTR seeks to strengthen the quality and quantity of health care. To date, training courses for cancer nurses have been held, under INCTR’s Visiting Expert program, in Algeria, Burkina Faso, Cameroon, Egypt, Nepal and Pakistan. Sabine Perrier-Bonnet of INCTR’s French Branch, AMCC–Alliance Mondiale contre le Cancer - initiated the program with a one-day course for oncology nurses in Cameroon in March 2003. This was a basic course in chemotherapy and palliative care and was intended as a first step in promoting the education of cancer nurses. To assure that as many health professionals as possible could attend, the workshop was held at the same time as the second Euro-African Cancer Congress in Yaounde. Sabine held a similar course in Setif, Algeria, during the first International Forum on Cancer, held in March 2004. Last November, a three-day training course was organized in Ouagadougou, the capital of Burkina Faso, for both doctors and nurses. This course included a workshop on the psychological support of terminally ill patients. Cancer nurses from St. Bartholomew’s Hospital and the Royal Marsden Hospital in London organized a three-day meeting in Cairo, Egypt, for both Egyptian and Palestinian cancer nurses in November 2003. The English nurses, working together with those from the School of Nursing at the National Cancer Institute, Cairo, conducted classes focused on recent developments in cancer nursing. They paid special attention to the nurse’s role in caring for the immuno-compromised patient (generally caused by chemotherapy) and the development of cancer nursing protocols. This meeting, which ran concurrently with a Lymphoma Workshop, was funded jointly by the OIA (NCI Bethesda), and the Special Trustees of St. Bart’s. Melanie Ridge, an oncology nurse who works for the MacMillan Fund in London, spent two weeks at the Shaukat Khanum Hospital in Lahore, Pakistan, as an INCTR Visiting Expert. INCTR plans to develop coordinated efforts in the education of cancer nurses through additional short courses of this kind, and arrange longer term exchange programs with centers where cancer nursing is more developed. Nurses in developing countries are often undervalued, and it is important to ensure their participation in local and national medical cancer meetings and conferences of all types. This will also permit the exchange of views on needs and the best approaches to meeting them. A planning session of this kind will be held in Turkey in April 2005.

Visiting Expert Program 2003 & 2004 Lynn Murphree, a Los Angeles-based ophthalmologist specializing in the care of retinoblastoma, spent a week at the Instituto Nacional de Pediatria in Mexico City, discussing with local colleagues various aspects of the early detection and treatment of retinoblastoma in Mexico. Marty Malowar, an orthopedic surgeon from the Lombardi Cancer Center and Washington Cancer Institute, spent time in Shanghai in November, after the Pediatric Oncology update in China, discussing limb-sparing procedures. Melanie Ridge, an oncology nurse who works for the MacMillan Fund in London, spent two weeks at the Shaukut Khanum Hospital in Lahore, working on the wards and in the Day Unit. Ama Rohatiner, a medical oncologist and Director of INCTR’s Education Program, worked with physicians in the Dept. of Medical Oncology at the NCI, Cairo, prior to the meetings there in October, attending multidisciplinary meetings and ward rounds. Ama also spent a week at Jinnah Hospital, in Lahore, seeing patients with Dr Zeba Aziz, and teaching medical students and young physicians at Allama Iqbal Medical College. Most recently, she and two senior nurses visited the Shaukat Khanum Memorial Cancer and Research Center in Lahore, to advise on the establishment of a program for stem cell rescue after high-dose therapy. Judith Kingston, a pediatric oncologist from St Bartholomew’s Hospital in London, also visited Mexico, where she attended the first meeting of the Mexican Retinoblastoma Group and participated in activities at the Instituto Nacional de Pediatria. Stuart Brown and several colleagues (three palliative care physicians, two nurses and a psychosocial worker) have visited Nepal on several occasions over the last two years in the context of developing a coordinated program in palliative care in the Kathmandu valley, which will eventually provide training locations for other parts of Nepal. As part of the visit of a team of seven INCTR experts, several Nepalese institutions and organizations - including INCTR’s Nepalese Branch NNCTR (which organized the meeting) and the Nepalese Cancer Relief Organization - participated in a one-day meeting on “Improving Cancer Care through National and International Collaboration” in January 2005. The experts visited various institutions, including Hospice Nepal, the Kathmandu Maternity Hospital, Scheer Memorial Hospital and the Kanti Children’s Hospital.