Toshiro Kusakabe reflects on the highlights of The 2023 Sapporo Conference for Palliative and Supportive Care in Cancer (SCPSC) in Japan that was due to happen in 2020, and was then postponed on three separate occasions
The 3rd/4th joint SCPSC
The 3rd SCPSC was scheduled for 2020, but due to the COVID-19 pandemic and the Russian invasion of Ukraine, it was postponed three times. It was eventually held as the 3rd/4th joint SCPSC over three days in April 2023.
The program consisted of 3 symposiums, 3 plenary sessions, 3 luncheon seminars, and 2 evening seminars. There 30 lectures by world-renowned speakers and 100 general presentations were registered. Overall, 1,000 people from 22 countries participated, which was regarded as a great response.
Day 1:
Symposium 1 in the morning focused on recent developments in Opioids, which are central to the biology of palliative care. Moderated by Dr. Russell Portenoy, discussions were held under the theme of “Opioids and cancer pain: Evolving science and practice.”
At the Luncheon seminar, Prof. Stein Kaasa, a pioneer in cancer palliative care, gave a lecture on “Integration of oncology and palliative care: A review of its history and directions for the future”.
In recent years, the need for integration of standard oncology and palliative care has been recognized, and we planned to provoke discussion on how this should proceed. In Plenary Session 1, under the theme of “Recent progress in the integration of standard oncology and palliative care,” leading speakers in each area of palliative care gave lectures on the latest research results. At the evening seminar, Prof. Philip Larkin, a nurse and former president of EAPC, gave a lecture on “Palliative nursing – an essential component for the future of palliative care”.
Day 2:
Many people who seek euthanasia are not necessarily cancer patients. The pain experienced by such people appears mainly to be psychological pain, including spiritual and existential suffering. The main themes of the 2nd and 3rd days were planned to cover these two types of suffering.
Symposium 2 in the morning was chaired by Prof. Christina Puchalski, and consisted of an essential discussion on spirituality under the theme of “Making the case for integration of spiritual issues in palliative care.”
Prof. Sheldon Solomon gave a lecture on “Palliative care in medicine and in life: An existential account” for the Luncheon seminar.
In Plenary Session 2 in the afternoon, under the theme of “Determinants and effects of existential suffering in the clinics of palliative care,” discussions were held on the essence of existential pain and how to care for it from the standpoint of psycho-oncology.
In the evening seminar, Dr. Joseph Clark, a young researcher focusing on palliative care medical policy, gave a lecture on “Global palliative care development: Promoting access to services and essential medicines, through understanding of international policy and processes.”
Day 3:
As Technology Enabled Care (TEC) continues to evolve through the Covid-19 pandemic, we planned to ask a group of experts to speak about the latest developments. In Plenary Session 3 in the morning, Dr. David Hui chaired a discussion on the current status and future direction of TEC under the theme of “TEC in Palliative care”.
Prof. Declan Walsh, Editor-in-chief of BMJ SP Care, gave a lecture on “Supportive oncology: A novel department in a major US cancer institute” at the Luncheon seminar.
Symposium 3 in the afternoon was planned in anticipation of essential discussions on Euthanasia. Chaired by Dr. Harvey Max Chochinov and Dr. Friedrich Stiefel, the theme was “Euthanasia, physician assisted suicide and their connection to palliative care,” and a wide-ranging discussion was held, including coverage of the current situation in other countries.
At the 3rd/4th joint SCPSC, discussions were held at a very high level, and the content and quality of each lecture was quite overwhelming. Thus, the SCPSC has become Asia’s leading academic conference on palliative cancer care.
Common understanding of Cancer Palliative Care Researchers and Experts and the Future of Palliative Care
At present, researchers and specialists in cancer palliative care around the world seem to share a common view of the following four points.
- Alleviation of physical pain is believed to be largely manageable through [i] development of symptom assessment, [ii] development of drugs, and [iii] advances in technology.
- It is also argued that it is possible to deal with psychological pain (existential pain, spiritual pain).
(3) The integration of clinical oncology and cancer palliative care has been discussed, converging on the concept of palliative oncology, and the importance of basic research has been highlighted.
(4) Establishment of palliative care that does not require physician-assisted suicide, euthanasia.
In addition, it is assumed that palliative care in the future will develop as follows:
- Disease-specific palliative care (cancer, intractable neurological disease, heart failure, respiratory failure, etc.)
- Palliative care, including care for the elderly, collectively referred to as End-of-Life Care
Our IRS-SCPSC, which is particular focused on oncology and based on palliative oncology and psycho-oncology, we will develop academic research and contribute to the world.
Toward the 5th SCPSC
We are planning to hold the 5th SCPSC three years from now in 2026, and we are currently preparing the structure of the program. I would like to introduce some of the ideas. (1) A focus on Opioids, which are symbols of cancer palliative care, and discussing their relationships with the nervous, immune, and endocrine systems, (2) more detailed discussions in each area of palliative oncology, (3) psycho-oncology, (4) recent developments in light of the essential arguments for euthanasia’, and (5) the role of artificial intelligence in palliative care, a very rapidly progressing area.
Details will be posted on the SCPSC website as soon as they are decided, so please refer there for more information.
Author
Toshiro Kusakabe
SCPSC Executive Committee Chair,
Vice President, Higashi Sapporo Hospital, Japan.
ORCID: 0000-0002-0106-7958