SASMO / SASCRO Oncology conference unpacks quality care

One of the biggest themes at the recent SASMO/SASCRO oncology conference was how to balance cost and quality of treatments to ensure that cancer patients receive the best possible medical care.

The South African Society of Medical Oncology (SASMO) and the South African Society of Clinical and Radiation Oncology (SASCRO) in conjunction with the National Oncology Nursing Society of South Africa (NONSA), the South African Oncology Social Workers’ Forum (SAOSWF) and the South African Society of Gynaecologic Oncology (SASGO) and Radiation Therapists held their 17th national congress in Cape Town from 7 to 9 August 2015.

“We are delighted by this year’s turn-out, which has made it our biggest conference to date,” said Professor Raymond Abratt, who co-chaired the conference with Dr Georgia Demetriou from SASMO.

This year’s conference theme was Partnerships and Progress and featured internationally distinguished speakers like Professor Sandro Porceddu, acting deputy director of the Radiation Oncology Department at the Princess Alexandra Hospital in Australia and Professor Clifford Hudis of the Memorial Sloan Kettering Cancer Centre in New York in the US.

Professor Abratt, who is also the head of clinical governance at the Independent Clinical Oncology Network (ICON), delivered the Sealy/Falkson Honorary Lecture during the opening sessions of the conference on the CARE Vision, which he developed during his time as head of the Department of Radiation Medicine at Groote Schuur Hospital and which can be used as a guide to ensure best practice in various fields of oncology. It is based on the themes of clinical excellence, academic leadership, relationships and the environment.

“The most important of these is clinical excellence, because it has to do with patients and the care that is delivered,” he said, adding that to achieve clinical excellence, there also needs to be an open and sympathetic relationship between patients and doctors.

“All patients, no matter what their income group, deserve good medical quality care,” he said, adding that one of the biggest challenges facing oncology worldwide is to improve outcomes and to control costs, ideally looking at a situation where high outcomes are partnered with low costs.

He said this could be achieved through good protocols, quality treatments and in healthcare providers who matched their intentions with their actions. Despite a lack of resources and the divide between the private and public healthcare sector in South Africa, the ultimate goal was good quality care.

“We can always give patients good quality care with our available resources,” he said. “At the same time, we work collaboratively with our funders to increase resources,” added Professor Abratt.

Other speakers spoke about their experiences at clinics and hospitals in South Africa and the experiences of patients with cancer. Professor Lize Maree from the University of the Witwatersrand spoke about cervical cancer, currently the most common cancer among black women in South Africa and sub-Saharan Africa.

Professor Maree said that once patients experienced symptoms of cervical cancer or were even given a diagnosis, it could take up to five years before they began treatment. She highlighted the many misunderstandings that existed around cervical cancer, the stigmatisation of patients in their communities and need for more education and support of cancer patients in developing areas.

In another presentation on palliative chemotherapy, Professor Maree also touched on the complexity around the issue of treating or not treating patients who had no hope of recovery – a thorny issue for funders as well as healthcare providers due to the rising cost of oncological therapies worldwide. “It becomes an issue of to treat or not to treat,” she said. “For many patients, palliative chemotherapy represents hope.”

Theola Potgieter in her presentation on palliative chemotherapy revealed, however, that some nurses felt this was false hope and that family members pressured many patients into treatment. Despite the rising costs of treatment, patients and their dignity and especially, their quality of life towards the end, had to be prioritised. “Human beings want to live,” she said. “Nobody wants to die. Everybody wants as much time to live as possible.”