Presidential Address IGCS 2023

Transcript of Presidential Address

Hello everyone. I am Keiichi Fujiwara, the current President of the IGCS and this is the Presidential Plenary.

Like many IGCS members in this hall, in my career as a gynecologic oncologist, I started my training by wanting to be a good surgeon and a good physician who can provide the best, most effective treatment options to CURE my patients and rid them of disease.

When my patients survived, I thought it was a great success, and if I lost my patients, I felt like I failed. You all understand how it feels to lose a patient. So I felt the need to be the best surgeon, to discover the best therapeutic treatments, to provide a cure.

On the other hand, you all know how it feels when you see your patient suffering, not only from their disease, but also from the side effects of your treatments, or from complications. Our patients are going through a very difficult time - physically, emotionally, and psychologically. We cannot and should not ignore their suffering.

When you first learned that this Presidential Plenary was about Palliative Care, I wonder how many of you thought that meant end of life care? How many of you thought that it was not very important for your practice? That it wouldn’t help you be a better doctor for your patients?

It’s ok. I used to think so too. I thought palliative care was only for end-of-life care, hospice care, a last resort.

When I thought of palliative care, I thought that meant that I had failed, and I felt guilty for having to talk about “palliative care”! But, after more than 30 years of experience, I know how important it is to understand what these terms really mean and the intentions behind them. Because words matter. Especially when we need to communicate complicated ideas and problems that need solutions.

Now I KNOW that palliative care is not just end of life care. Palliation means supportive care that relieves patients’ suffering. It is as simple as that. To relieve suffering.

As the IGCS President, I have use of this stage to speak to the largest most diverse gathering of gynecologic cancer specialists and caregivers in the entire world. When we were planning this session, my friend Michael Pearl said “We need to learn to love palliative care.”

So, if you are like me, let’s try to see things differently. Or maybe you are already aware, but you don’t know how to incorporate it into your practice. Or maybe you have challenges accessing the required services and medicines.

That’s why I think this topic is so important to talk about with all of you gathered here in the same room. We all come from different cultures, different settings with different resources, and different medical training. But you made the decision to journey to the IGCS Meeting, you came with an open mind to share ideas with your international peers. Together we can shape our own culture. The IGCS culture.

So when I tell you that the IGCS has declared our commitment to palliative and supportive care a couple of weeks ago, I hope you understand that we are calling on all of you to join us in that commitment. IGCS is only as powerful as the individuals within. Those of you in this very room. Whether you are a member or not, you are part of our community. We need you. Your colleagues need you. Your patients need you.

In our positions, we have the power to set the tone for the type of care our patients will receive. When we approach our patients with compassionate communication, take measures to alleviate their pain and symptom burden, refer them to services to address psychosocial and spiritual needs, this is holistic care. It is delivered by interdisciplinary care teams and should be based on a patient-centered approach, tailored to individual needs, preferences, and cultural backgrounds.

It should not be acceptable to sacrifice quality of life when we decide the best treatments.

Our patients deserve compassionate, dignified care, and it is our duty to do everything in our power to provide that.

I understand that there are very big challenges and barriers we must discuss and work to overcome, especially those in areas with limited resources. Lack of access to essential medicines like opioids is a major problem. When I visited Vietnam in February of this year, I learned that many young doctors were having difficulty controlling their patients’ pain, and it was a moment that awakened my sense of duty to do something about it.

I thought about how IGCS and our members have an important role to play in closing the gaps. One gap is the translation of the term palliative care. Understanding that it does not simply mean end of life care. The other gap is much bigger.

Many places do not have the environment or resources to provide appropriate care, even if they want to. Medicines and services are not available or not accessible. Not only at the national level, but also at the facility level. Filling these gaps will take more effort, more research, more training, more strategy, more advocacy, and more time. But with so many of us together, pledging our commitment to affect change, we can begin to fill in the gaps.

I invite everyone here today to take the pledge to support compassionate care. I’ll start.

1. I pledge to communicate with all patients under my care about their palliative and supportive care needs from the time of diagnosis onward, and not as a last resort.

2. I pledge to prioritize formal education in palliative and supportive care for myself and encourage education among my team members.

3. I pledge to integrate palliative and supportive care into the treatment plans for all patients with newly diagnosed, progressive, or recurrent gynecologic cancer under my care, through primary integration or specialist referral.

4. I pledge to advocate for patients’ rights to palliative and supportive care.

5. I pledge to advocate for the inclusion of health-related quality of life measures in the study of gynecologic cancer treatment.

6. I pledge to support global collaboration and IGCS’ efforts to maintain partnerships with international palliative care organizations to develop and implement policies and programs that prioritize palliative and supportive care in gynecologic oncology.

Please read the IGCS Declaration and find out more about these actions that you can take towards compassionate care.
• Go and read the IGCS pledge and share it proudly with your colleagues.
• Go home and have these important conversations with your care teams and patients.
• Go enroll in the IGCS Palliative Care Certificate Program and educate yourself further.

Thank you for your time and attention.

Pictured left to Right, Raimundo Correa, Noriko Fujiwara, Stephen Connor, Keiichi Fujiwara, Anisa Mburu, and Michael Pearl.