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The second international symposium on "Supportive Care in Cancer
Patients" took place March 1-3, 1990-again in St. Gallen in eastern
Switzerland. It was an honor once more to welcome dozens of
internationally recognized experts in the field and more than 800
participants from over 30 countries around the world: Australia,
Canada, China, USSR, USA and many countries in Europe. The
international nature of the grade facilitated lively and exciting
contributions and critical discussions, aimed at fostering
professional knowledge and skills and rethinking our personal
attitudes toward cancer patients in all stages of their disease.
Cancer patients need various types of tailored support, whether
during active initial (curative) therapies, in phases of worrying
relapsing disease, or during the demanding terminal stage of their
illness. The symposium tried to bridge the strange "gap" between
"curative" and "palliative" cancer care: it must be our aim to be
and remain "supportive" for our patients during both curative and
palliative treatment strategies This requires extended knowledge
and even more and flexible professional skills. The symposium was
designed to promote improved approaches that are helpful and
supportive for all our oncology patients, not just for a selected
disease-or stage dependent minority."
The symposium on supportive care in cancer patients, which took
place in St. Gallen, Switzerland, on February 18-21, 1987, wel
comed renowned experts in the field and more than 600 partici pants
from 25 countries with the aim of stimulating discussion on how to
improve our professional skills and personal attitudes to ward
cancer patients in all stages of their disease. Why did we or
ganize such a symposium on supportive care in cancer patients?
Recent decades have witnessed remarkable success in cancer treat
ment, and we have learned how to cure a finite number of neoplas
tic diseases. Some malignant tumors that previously entailed high
fatality rates, such as leukemias, lymphomas, and testicular can
cers, can now be cured, even when at an advanced stage. Yet it
seems to many that our struggle to improve results and to fight
death from cancer has also imposed greater toxicity on patients.
Conventional scientifically based oncology has only recently made
adequate efforts to improve the subjective quality of life of
cancer patients, for example through prophylaxis against emesis,
nausea, and scalp hypothermia, pain control and the development of
psy chosocial support structures. The search for less toxic and yet
equally effective treatment measures has not been one of our pri
mary goals in the past. Supportive care has always been part of
nurses' professional aim, even though many have not known how best
to offer it.
Current literature shows that there is a gap in our knowledge about
how tired ness/fatigue in cancer patients should be defined and
measured. Existing fa tigue-related research in cancer patients
shows conceptual and measurement differences (Piper 1993). There is
no continuum of tiredness/fatigue in univer sal use. What do
patients mean if they fill in a visual analogue scale indicating
that they feel "very tired"? Is it an indicator of general
well-being, and thus an 1993)? Most articles estimate of general
quality of life (Hiirny and Bernhard written by English authors use
the word fatigue to identify extreme tired ness. It could be said
that in the English language, tiredness that is perceived as
unusual, continuing distress is fatigue rather than tiredness. In
the German language, tiredness (Mudigkeit) is not primarily a term
for distress attributed to disease or unusual effort. But tiredness
becomes a distressing phenomenon when it no longer regulates a
healthy balance between rest and activity but represents unusual,
abnormal or excessive whole-body tiredness that is dis
proportionate to or unrelated to activity or excessive exertion
(Piper 1993). As there is no word for fatigue in the German
language, the definition "extreme, unusual tiredness" (in German:
extreme, unubliche Mudigkeit), is used to explain the term
"fatigue: ' This clarification is needed to ensure that future
fatigue research conducted in German-speaking countries can be com
pared with such research carried out elsewhere."
Abhandlung der psychischen, sozialen, rehabilitativen sowie
pflegerischen Aspekte der Betreuung Krebskranker, die an- l{ lich
des Kongresses "Supportive Care in Cancer Patients" 1987 in St.
Gallen von Krankenschwestern und -pflegern vor- getragen wurden.
Fortbildungsgrundlage f}r das onkologische Assistenzpersonal.
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