Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
339 (10%) had hematologic malignancies, 312 (10%) had esophageal or gastric
cancer, 311 (10%) had colorectal cancer, 105 (3%) had a cancer of the CNS, 101
(3%) had lymphoma, 93 (3%) had renal cancer, 87 patients (3%) had ovarian
cancer, 81 (2%) had lung cancer, 54 patients (2%) had prostate cancer and 50
(2%) had pancreatic cancer. The other 40% of the cancer patients had either
less frequent cancers or their exact cancer site was not recorded. In most
countries, the gap between death and specific therapies is considered as an
indicator of the quality of physician services and more length of time will
be a better indicator for physician services, while cancer patients in health
system of Iran receive specific treatment and chemotherapy even to moment
of death. To consider countless benefits of home care and the patients’ desire
to receive services at home, if we can provide the conditions that at least 20%
of end stage cancer patients receive home based palliative care, 1000 deaths
will occur at home yearly, and 1000 ICU beds will be released for use for other
patients with better prognosis for survival (5). For this reason, the Ala charity
has also started free of charge home care services in Isfahan and Tehran. Iran,
like many other countries, needs many more palliative care units as well as
an expansion of home based palliative care services to advanced and very
advanced cancer patients. As palliative medicine is not financially lucrative,
charities play a major role in setting up, maintaining and expanding these
units.References:
Salins N, Ramanjulu R, Patra L, Deodhar J, Muckaden MA. Integration of Early
Specialist Palliative Care in Cancer Care and Patient Related Outcomes: A
Critical Review of Evidence. Indian J Palliat Care. (2016) 22:252-7
McNamara BA, Rosenwax LK, Murray K, Currow DC. Early admission to
community-based palliative care reduces use of emergency departments in
the ninety days before death. J Palliat Med. (2013) ;16:774-9
Mousavi SM, Gouya MM, Ramazani R, et al. Cancer incidence and mortality in
Iran. Annals of Oncology. (2009) ;20:556–63.
in the region, took on the challenge of fighting tobacco across the region in
collaboration with regional and international partners. KHCC became the
regional host for Global Bridges (an international TDT healthcare alliance
co-founded by the Mayo Clinic, the American Cancer Society, and the
University of Arizona). The main mission of this collaboration is to address the
implementation of article 14 of the FCTC agreement and design and
implement effective programmes to promote the cessation of tobacco use
and provide adequate treatment for tobacco dependence (TDT). This will also
serve to address one of the six strategies recommended by the WHO; Offer
help to quit tobacco use. Tobacco dependence in the region is severe. The high
number of cigarettes smoked per capita and the significant exposure to SHS
make people less capable of quitting on their own. Availing TDT across the
region would respond to the high demand for such service (more than 65% of
smokers are interested in quitting) and help curb the expected epidemic of
NCDs. Long term, quitting tobacco generally reduces the risk of disease and
premature death by 90% for those who quit before the age of 30 and by 50%
for those who quit before the age of 50. In addition, TDT will optimize the
management of certain NCDs such as cancer resulting in better treatment
outcomes and long-term survivals. Over the past 5 years, KHCC developed
partnership with countries across the Middle East and worked on training
healthcare providers (HCPs) on how to treat tobacco dependence (figure 1).
More than 2000 HCPS were trained to date (figure 2). Furthermore, 4 hubs
designated for TDT training were established in Oman, Egypt, Tunisia and
Morocco. In addition, an evidence-based TDT training curriculum specifically
designed for the Middle East was developed and in the process of being made
available in 3 languages; Arabic, English and French. In conclusion, tobacco
dependence represents a major threat to the health and wellbeing of the
people in the Middle East. Significant rise in NCDs including cancer is
expected over the next few years. Many collaborative initiatives are underway
to address this sever epidemic.
World Health Organization. Cancer country profiles in Iran 2014. Geneva:
WHO; 2014. [cited 29 August 2015]. Avilable from: http://www.who.int/cancer/
country-profiles/en/
Heydari H. Home-based Palliative Care: A Strategy for Keeping Intensive Care
Unit Beds Vacant. Int J Community Based Nurs Midwifery. (2016);4:186-7.
Keywords: Palliative medicine, cancer, Iran
SESSION ED03: GLOBAL TOBACCO CONTROL POLICIES:
ADVANCES & CHALLENGES
MONDAY, DECEMBER 5, 2016 - 14:30-15:45
ED03.01 TOBACCO CONTROL IN THE MIDDLE EAST
Feras Hawari
The King Hussein Cancer Foundation, Amman/Jordan
Despite many countries signing and ratifying the Framework Convention on
Tobacco Control (FCTC), the prevalence of tobacco continues to be on the rise
in the Middle East. For example, in countries like Jordan and Tunisia, tobacco
prevalence among males is close to 5o% and in Jordan specifically it is
estimated to increase to 88% over the next 5 years according to the World
Health Organization (WHO). In 2008 it was estimated that five million people
died due to tobacco related illnesses. This number is expected to increase to
eight million in the year 2030 with individuals from low- and middle-income
countries making up approximately 80% of these deaths. Tobacco is a risk
factor for all major non-communicable diseases (NCDs) such as cardiovascular
diseases, cancer, pulmonary diseases and diabetes mellitus. The developing
countries and the Middle East in particular is bracing for at least a 25%
increase in such diseases over the next few years. The world economic forum
estimates that the cost for such chronic disabling diseases will exceed USD 15
trillion with cancer costs specifically reaching close to USD 3 trillion. The WHO
outlined six strategies that, when implemented simultaneously, will result in
significant reduction in tobacco prevalence and its related morbidity and
mortality. Those strategies known as MPOWER (Monitor tobacco use and
prevention policies, Protect people from tobacco smoke, Offer help to quit
tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco
advertising, promotion and sponsorship, Raise taxes on tobacco) when
implemented in a country like Jordan, for example, close to 180,000 deaths can
be prevented over 5 years. Despite the documented benefits of these six
strategies, compliance with implementing them across the Middle East
remains low. Only few countries have pictorial warnings, exposure to second
hand smoke (SHS) is high, tobacco prices remain low and smoking cessation
services are scarce. As the population in the Middle East age and with the
ongoing rise in tobacco prevalence and obesity, cancer is expected to be on
top of the list of diseases causing death and disability in the region. For that
reason, King Hussein Cancer Center (KHCC), one of the leading cancer centers
Keywords: Middle East, Training, tobacco, treatment
ED03: GLOBAL TOBACCO CONTROL POLICIES: ADVANCES & CHALLENGES
MONDAY, DECEMBER 5, 2016 - 14:30-15:45
ED03.02 THE AUSTRALIAN TOBACCO CONTROL STRATEGY:
LESSONS LEARNED
Mike Daube
Faculty of Health Sciences, Curtin University, Perth/WA/Australia
S12 Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017