The Emirates Oncology Conference (EOC), now in its 11th year, continues to highlight important developments in the fields of cancer prevention and treatment. The Abu Dhabi Health Services - SEHA, which is dedicated to offering the UAE top-tier healthcare and ongoing medical education to keep the public informed and ensure that medical experts remain up to date in their fields, is hosting the conference.

The EOC featured significant sessions covering a wide range of topics with globally renowned speakers who kept the audience interested with their illuminating lectures and visual presentations. Breast cancer, hematological malignancies, palliative care, lung cancer, radiation oncology, pediatric oncology, genitourinary, gastrointestinal, and neuro-oncology were some of the topics covered.

Over the course of the 3 days, there were about 2600 attendees including physicians, surgeons, researchers, healthcare professionals, and industry representatives from over 40 nations, of which 96% were from the UAE and 4% traveled from the USA, Europe, Middle East, and GCC. Approximately 150 speakers were hosted by EOC; speakers came from the USA, UK, Italy, Spain, France, Germany, Belgium, India, Pakistan, Philippines, Malaysia, Canada, and many regional nations such as Jordan, KSA, Oman, Bahrain, Lebanon, Egypt, and the UAE. In addition, more than 2 dozen abstracts were presented as oral and poster presentations, and the top 14 were chosen to be published in a medical journal as a result of EOC 2023. Selected abstracts are included herein.

We are grateful to all members of the scientific and medical community, our organizing team, speakers, delegates and sponsors for their time, efforts, and contributions to making EOC one of the most important scientific events of the year.

Nasir Ali1, Laraib Khan1, Maria Tariq1, Tooba Ali1, Agha Muhammad Hammad Khan2, Sheikh Muhammad Ebad Ali3, Ahmed Nadeem Abbasi1, Asim Hafiz1, Sehrish Abrar1, Bilal Mazhar Qureshi1

1Section of Radiation Oncology, Oncology Department, Aga Khan University Hospital, Karachi, Pakistan; 2McGill University, QC, Canada; 3Clinical Fellow in Surgery University Hospital Wishaw, UK

Introduction: Prostatic cancer (PCa) is the fifth leading cause of cancer related mortality. Radical prostatectomy (RP) or radiation therapy (RT) along with hormonal therapy are established as standard treatment in localized prostate cancer. Regardless of primary treatment, 20–30% of patients experience biochemical failure, which is defined as rising serum PSA levels after primary treatment for non-metastatic PCa. Important prognostic factors for patients developing biochemical recurrence include short interval to biochemical failure (IBF), high Gleason score and baseline PSA levels. In this study we aim to analyze the rate and factors associated with biochemical failure in patients who received for non-metastatic PCa at our university hospital. Methods: Data of 147 patients treated with radiotherapy with or without hormonal therapy for non-metastatic prostate cancer was collected retrospectively from the oncology department at our university hospital. Patient demographics, TNM stage and histopathology were recorded. Serum PSA levels were noted at diagnosis, before start and after the completion of radiation therapy. Patients with incomplete medical records were excluded from this analysis. Results: The mean age of patients was 75.8 years with follow-up duration of 186.9 ± 155.4 weeks after the last fraction of radiation. 48 (32.65%) patients reported for follow-up for more than 5 years, while 99 (67.34%) patients had follow-up for 3-5 years. The baseline PSA level among these patients was 32.3 ± 19.7 ng/ml at presentation which reduced to 4.4 ± 3.1 ng/ml 6 weeks after completion of radiotherapy. Biochemical failure was observed in 30 (20.4%) patients after a mean duration of 189.5 ± 155.3 weeks after the last radiotherapy fraction and was significantly associated with NCCN risk group (p = 0.001) and follow-up duration (p=0.002). Conclusions: With this study we concluded that biochemical recurrence rate was significantly associated with NCCN risk group stratification and duration of follow-up which can be further validated in prospective studies with larger sample size. However, stringent follow up strategies are still a major concern in LMIC.

Mawada Hussein1, Iman Tabash1, Yara Al Kanash1, Emad Dawoud1, Nouri Bennini1, Syed Rizwan2, Diaeddine Trad1, Saadia Ibrahim2, Majid Janabi2, Jamal AlKoteesh3, Jawaher Ansari1

1Medical Oncology Department, Tawam Hospital; 2Nuclear Medicine Department, Tawam Hospital; 3Interventional Radiology Department, Tawam Hospital, Abu Dhabi, UAE

Introduction: Prostate cancer ranks as the second most diagnosed cancer and a leading cause of death in men. Metastatic castrate-resistant prostate cancer (mCRPC) remains aggressive despite novel hormonal therapies. The US FDA-approved Lutetium-177 PSMA (177Lu-PSMA) shows promise in treating PSMA-positive mCRPC, evidencing survival benefits in Phase 3 trials. This study evaluates the efficacy, safety, and activity of 177Lu-PSMA Therapy in our tertiary Cancer Centre. Methods: In this retrospective single-centre study, we examined 38 mCRPC patients treated with 177Lu-PSMA from 2013 to 2021. PSA response was gauged by a decline of ≥50% during treatment. Adverse events were recorded using the Common Toxicity Criteria for Adverse Events (CTCAE). Data analysis utilized SPSS software, under approval from the hospital Research Ethics Board. Results: Patients' median age was 63 (44-84). At initial diagnosis, 76% were de novo metastatic, with Gleason score group 5 (5 + 4=9) being the most common subtype (48.7%). High-volume disease (the presence of visceral metastases, four or more bone metastases with at least one beyond the vertebral bodies and pelvis) was present in 71% of patients. Initially, 89% received Androgen deprivation therapy alone for mCSPC. The median time to progression to mCRPC was 20 months (range 1-123). In first line mCRPC treatment, 76% received novel hormonal therapy (Abiraterone acetate 42%, Enzalutamide 34%), and 21% underwent Docetaxel chemotherapy. 177Lu PSMA was the 2nd and 3rd line treatment for 42% and 26%, respectively. At second line mCRPC 36.8 % received PSMA Lutetium therapy while 31% received Novel hormonal therapy. At third line mCRPC 37% of patients received PSMA Lutetium therapy. Biochemical response to 177Lu-PSMA (≥50% PSA decline) was seen in 58%. Common adverse events included Grade 1 Nausea (60%) and Grade 2 Fatigue (39%). Thrombocytopenia occurred in 34%, with ≥ Grade 3 in 5 patients. Median survival with PSMA Lutetium therapy was five months (range 1-34). Conclusion: This first UAE study on LuPSMA in mCRPC demonstrates its effectiveness and tolerability in heavily pretreated patients. Approximately 57% showed a PSA decline of ≥50%, consistent with other studies. Patient receiving three or more cycles of lutetium therapy showed better median survival of 22 month.

Amna Al-Ajmi, Devisree Cheerathuvalappil, Abid Ali Mirza, Abishek Vidhyadharan, Nadeem Pervez, Zahid Al Mandhari

Sultan Qaboos Comprehensive cancer care and Research Centre (SQCCCRC), Muscat, Oman

Objectives: To assess and compare the potential variations between the Orfit knee and leg positioning cushion (Orfit KR) and the AIO indexable knee and foot frame, along with knee rest and footrest (AIO KR+FR) immobilization systems for pelvic radiotherapy treatment. Methods: Data was retrospectively collected from the ARIA involving 100 consecutive patients from (2nd of Jan to 21st of August 2023) who received pelvic External beam Radiotherapy using Varian Truebeam. Among these patients, 50 were positioned using an Orfit KR, while the remaining 50 patients were immobilized using an AIO KR+FR. The set-up corrections were performed offline based on the departmental protocol using anterior MV-lateral KV pairs, as well as CBCT images. Results: A total of 2463 CBCT images were analyzed. All data were carefully reviewed and recorded on an excel sheet, including translational and rotational shifts. Random errors were observed during the analysis process. The average standard deviation of random translational errors was found to be 0.446219mm for the Orfit KR cushion and 0.41526mm for the AIO KR + FR system. In terms of random rotational errors, the Orfit KR exhibited an average of 0.7705°, while the AIO KR + FR system showed an average of 0.838029°. Conclusions: The AIO KR+FR demonstrated slightly lower random translational errors compared to the Orfit KR in our study, while the Orfit KR demonstrates slightly lower random rotational errors. These findings suggest that both immobilization systems, the AIO KR+FR and Orfit KR, have similar performance in minimizing set-up errors during pelvic radiotherapy treatment. A prospective study including implementation of the SGRT system is being considered to confirm the findings and provide more comprehensive evidence on the effectiveness of these interventions.

Amna Al Ajmi, Abishek Vidhyadharan, Mohammad Al Gafri, Iqbal Al Amri, Agha Muhammed Hammad, Mohsina Vallengara , Nadeem Pervez, Zahid Al Mandhari

Sultan Qaboos Comprehensive cancer care and Research Centre (SQCCCRC), Muscat, Oman

Objectives: To establish a concise and reproducible protocol for maintaining bladder volume through hydration during radiation therapy in pelvic cancer patients. Methods: Twenty-four consecutive pelvic cancer patients treated at our institute were retrospectively analysed for bladder filling. Patients were divided into two groups based on preparation of bladder filling protocol. After emptying the bladder, Group one drank 750 ml of water and waited duration of 45 minutes before scan. Group two drank 250 ml of water for hydration, and then 15 minutes later, voided bladder. The patient next consumed 500 ml of water and waited 30 minutes before scan. In order to assess the consistency, bladder volume on daily CBCT images of the patient on treatment days was contoured by therapist, reviewed and modified by physician and then compared with CT-sim. Results: A total of 601 CBCT images were contoured and analysed retrospectively. All data were carefully reviewed and recorded on an Excel sheet. The average of the standard-deviation of bladder volume was found to be 83.81, 66.65 for Group1 & Group2 respectively. whereas the average of volume difference from the CT-sim to the CBCT was found to be -37.57 ml, 8.03 ml for Group1 & Group2 respectively. Conclusions: The hydration had a good impact on maintaining a consistent bladder volume as the result suggests that standard deviation is more in Group1 than the Group2 in our study which indicates that Group2 offers a bladder filling protocol that is better reproducible throughout the Treatment. A prospective study is being considered to confirm the findings and provide more comprehensive evidence on the effectiveness of these interventions.

Mohammad Hourani, Husam Marashi, Fatima Alkindi, Khaled Alqawasmeh, Iman Tabash, Yara Alkanash, Emad Dawoud, Nouri Bennini, Aydah Alawadhi, Diaeddine Trad, Jawaher Ansari

Department of Medical Oncology, Tawam Hospital, Al Ain, UAE

Background: Breast cancer is the most common cancer i n UAE with 883 cases reported in 2019 accounting for 20 % of all new annual cancer cases. Breast cancer was the leading cause of cancer deaths in 2019 in UAE with an estimated average of 11.6% cancer deaths per year. The breast cancer subtype HR (hormone receptor) +/HER2 (Human epidermal growth factor2) - is the most common subtype with an age-adjusted rate of 87.2 new cases per 100,000 women. The risk of recurrence for patients with node-positive, HR+, HER-2 negative breast cancer is up to 30% at 5 years despite combination chemotherapy, endocrine therapy and radiotherapy treatment advances. Abemaciclib, a CDK4/6 inhibitor, has emerged as a promising adjuvant therapy for hormone receptor-positive (HR+), HER2 -negative advanced breast cancer based on the results of the MonarchE, a phase 3 randomized trial which revealed significant disease free survival benefit with the addition of adjuvant Abemaciclib for 2 years in hormonal positive locally breast cancer with high risk features (involvement of ≥ 4 axillary lymph nodes or 1 to 3 axillary lymph nodes and either grade 3, tumor size ≥ 5 cm). Methods: We conducted a comprehensive retrospective chart review of 29 patients with high-risk HR positive breast cancer who commenced adjuvant therapy with Abemaciclib as per the licensed indication. The aim of this study is to assess the criteria for Abemaciclib usage, prevalence of risk-factors, and adverse events of treatment. Information was obtained from the Tawa m Cancer Registry and electronic health record. The data was analyzed using the SPSS software. The study was approved by the hospital Research Ethics Board. Results: Abemaciclib was initiated as an adjuvant treatment as per the licensed indication in 29 patients at our facility. The median age was 45 years (ranging from 31 to 68), and all were female patients. 20 patients (69%) were in premenopausal and 9 patients (31%) were post-menopausal. 65.5% of patients (n=19) had metastatic involvement of ≥ 4 axillary lymph nodes. 34% of patients (n=10) had 1-3 axillary lymph nodes positive for malignancy with either tumour size ≥ 5 cm or grade 3. The median time from surgical intervention to the initiation of Abemaciclib was 5 months (range 2 weeks to 23 months). The median treatment duration for Abemaciclib was 11 months (range 2 - 24 months). At the time of analysis, there were no recurrences to report. Adverse events observed with in our patient group predominantly included grade 1-3 diarrhea, affecting 65.5% (n=19). Abdominal pain was reported in 24.1% (n=7), primarily graded at 1. A minority, 17% (n=5) experienced grade 1 generalized skin rashes, while neutropenia of grades 1 and 2 was seen in two patients (6.9%). Additionally, another 6.9% of the cohort reported grade 1 fatigue, and one patient developed grade 2 transaminitis. These findings underscore the therapeutic promise of Abemaciclib in high-risk breast cancer patients, emphasizing its manageable safety profile and the importance of vigilant monitoring for adverse effects. Our re view revealed that dose reductions were necessitated in six cases, primarily due to gastrointestinal toxicity. Notably, this adverse reaction also led to the discontinuation of treatment for three patients. Conclusion: Adjuvant Abemaciclib was used as per the licensed indication for high-risk node positive breast cancer cases in all cases and demonstrated an acceptable tolerance profile. Close monitoring for toxicity and consideration for dose modification is essential to minimise discontinuation rates. The patients that discontinued treatment did so very early on in their treatment indicating the importance of counselling and close monitoring. Our recommendation is to use prophylactic supportive medications for better tolerability and efforts are being made for upfront enhanced patient education.

Javeria Khan1, Irtiza Ahmed Bhatti2, Nazish Jaffar3

1Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan; 2Nuffield Health, York, UK; 3Jinnah Sindh Medical University (JSMU), Karachi, Pakistan

Introduction: Gliomas form a heterogeneous group of tumors of central nervous system. It includes various histological types like astrocytic, oligodendrocytic, mixed oligoastroctyic. According to World Health Organization (WHO), they are classified into Grade I and II (low grade), Grade III (anaplastic) and Grade IV (Glioblastoma). The current study has been designed to observe the spectrum of gliomas according to the modified WHO 2016 central nervous system tumor classification, in the local population. Methods: A retrospective study was conducted in the department of Oncology, Jinnah Postgraduate Medical Centre (JPMC), Karachi. Medically diagnosed and registered glioma cases presented during 2017 to 2019 were included in the study. Patients who were younger than 15 years, incomplete reports and documentation and residents of other country were excluded. Data was collected through a self-structured validated Proforma. Data analysis was performed using SPSS Version 25.0. P-value of < 0.05 was considered significant. Results: A total of 115 gliomas cases were included. Males were 78 and females were 37. Age range was between 15 to 73 years, Mean=38.41, Standard deviation ±14.103. Most common presenting age group was in 4th decade of their life. Oligodendroglioma was the most common histological type 61 (53.5%) followed by glioblastoma 25 (21.9%). Other morphological types included astrocytoma, diffuse glioma, paraganglioma, brain stem glioma and gliosarcoma. Location of tumor was temporoparietal lobe in 47 (44.8%) followed by frontal lobe 34 (33.4%). Most common presenting symptom was headache in 46 (42.2%) followed by unilateral weakness in 19 (17.4%) cases respectively. Only 10% patients visited hospital within 2 weeks after the appearance of symptoms. Midline shift was present in 23/115 patients, of which 11 patients were of temporoparietal tumor. However, size of tumors did not show significant association with midline shift (p-value= 0.518). GFAP expression was positive in 55% (45/82) of cases followed by GFAP and ki67 in 19.5% (16/82) Table 1. According to WHO classification 2016, most common histological grade in current study was high-grade tumors (combined grade 2 and 3) at 54.2% followed by Grade Ⅱ, which was present in 40.2% cases. Conclusion: Glioma constitutes a less common malignancy in the local population. Oligodendroglioma was the most common histological type. Initial diagnosis of most of the patients was made at high grade. Immunohistochemistry reports showed GFAP expression for majority of tumors. 1p\19q co-deletion was an important finding in oligodendrogliomas.

Laraib Khan, Nasir Ali, Sehrish Abrar, Tooba Ali, Bilal Mazhar Qureshi, Asim Hafiz, Ahmed Nadeem Abbasi, Mariam Hina, Bilal Ahmed

Section Radiation Oncology, Department of Oncology, Aga Khan University Hospital, Karachi, Pakistan

Introduction: Role of HDR brachytherapy is well established in the management of cervical cancer management. Literature published on analgesia techniques in brachytherapy patients is scarce however, as per few prospective trials adequate regional analgesia decreases the need for systemic opioids post procedure. The American Society of Anesthesiologists Task Force on Acute Pain Management recommends the use of multimodal analgesia therefore addition of rectal suppository to parenteral analgesia resulted in lower pain perception. Methods: Cervical cancer patients treated on HDR brachytherapy over the past 3 years were reviewed for pain control after the procedure according to the pain medication used. In one group pain was managed by using intravenous (IV) pain medication (IV Ketorolac) and in other group IV pain medication and diclofenac sodium rectal suppository was used. Patient’s medical record was reviewed and pain control as per visual analog scale was recorded on a data form and analyzed for difference in pain relief. Results: From January 2019 to December 2022, 30 patients were treated on HDR brachytherapy for cervical cancer. Pain in 20 patients (60 procedures) was managed by IV ketorolac and in 10 patients (30 procedures) both IV ketorolac and diclofenac rectal suppository were used at the end of insertion of applicators. Relief in pain was scored on a scale of 0 – 10 of pain assessment scale in both groups and observations recorded on a data recording form. Mean patient reported pain score was 7 after IV medication alone and 3/10 after IV medication and rectal diclofenac suppository. There were no reported side effects in both groups. Conclusion: With this study we concluded that patient reported pain control was much better with rectal diclofenac suppository when with IV analgesia alone. However, this can be validated with further studies to be incorporated in routine clinical practice.

Hamza Afana, Aftab Bhatt, Muwafaq Salman, Khaled Askhaita, Amid Deyab, Mohammed H Khan

Department of Urology, Tawam Hospital, Al Ain UAE

Objective: To review the pattern of presentation, age distribution and the prevalence of various histological subtypes of testicular tumors and impact of delay on metastatic manifestations at presentation. Methods: After institutional board approval all consecutive cases of testicular tumors diagnosed in the Department of Urology at Tawam Hospital Al Ain UAE the during a period of 15 years were included in this study with a dataset of 100 patients. Relevant clinical details such as age, clinical presentation and side of involvement of the testis were also reviewed along with association with undescended testis and duration of delay to presentation. Results: Data revealed that the commonest histology accounting for 60% of cases was Testicular non seminomatous germ cell tumors (NSGCT). Of these NSGCT’s, 78% were metastatic at presentation. The second commonest histology was Seminoma, making up 33% of cases in the same 15-year period. Of these seminoma’s 39% were metastatic at presentation. Other less common histology types included Leydig cell tumor, Benign Leydig cell tumor, para testicular rhabdomyosarcoma, burnt out seminoma; with a prevalence of 2%, 1%, 1%, 1% and 1% respectively. The median age of cases ranged from 11 years of age to 62 years of age; with a median age of 39 years. Interestingly, the median age at admission was 29 years. Unfortunately, there was found to be a median 7.5 week delay to presentation amongst the 100 cases. With the latest presentation at 52 weeks delay. This is an important finding which inevitably impacts the management for the patient. With regard to whether the tumors were undescended, 43% of cases did not have this data recorded. But of all cases, 7% Were found to be undescended. Conclusion: Cancer is the third-leading cause of death in the United Arab Emirates (UAE); cancer care in the UAE has evolved dramatically over the last 40 years, from a single center in Al Ain in 1981 to more than 30 cancer centers and clinics across the UAE (1) Testicular cancer is the most common neoplasm among young men aged 15–40 years. Overall, it is a rare malignancy and represents about 1% of the adult neoplasms and 5% of urological tumors. In 2020, the International Agency for Research of Cancer (IARC) recorded 74,458 new cases worldwide. Incidences vary greatly across the globe, ranging from 3 to 12 new cases per 100,000 males/per year in Western societies. This retrospective study reviewed the pattern of presentation and prevalence of various histological subtypes of testicular tumors in a 15-year span at Tawam Hospital in Al-Ain, UAE. As well as quantifying delays in presentation. It found that the commonest histology subtype was NSGCT, and of these tumors more than 3 in 4 were metastatic at presentation. The second commonest histology was Seminoma, which had a lesser prevalence of metastases at presentation; at 33%. Overall, of the over 100 cases assessed there was a median delay to presentation of just under 2 months. This is an important finding which will help inform and guide future practice in order to best improve testicular tumor management as it is the most favorable prognostic solid cancer in men.

Muhsina Vellengara, Iqbal Al Amri, Mahmoud Alfishawy, Zahid AlMandhari, Jean-Philippe Pignol, Nadeem Pervez

Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Oman

Introduction: Prostate cancer is generally diagnosed at late stages in Oman. We prospectively treated low burden metastatic prostate adenocarcinoma patients with radical doses of radiotherapy and Androgen Deprivation Therapy (ADT). We report here the early PSA response and toxicity. Methods: Sixteen consecutive patients treated from August 2021 to April 2023 were reviewed. Patients were staged using MRI, CT and/or PSMA PET-CT. Patient characteristics, radiation doses/techniques, treatment tolerance and toxicities data were prospectively collected. Toxicities were recorded weekly during radiotherapy and every 3 months thereafter using CTCAE v5.0. Thirteen patients received moderately hypo-fractionated radiotherapy, 68 Gy in 25 fractions, and 3 received conventional radiotherapy, 78 Gy in 39 fractions to the gross pelvic disease. When para-aortic nodes were positive, they received 60 Gy in 25 fractions. Uninvolved nodes received 45 to 50 Gy in 25 fractions. Patients with bone metastases were treated with SBRT 30-40 Gy in 5 consecutive fractions. All patients were receiving ADT. Results: Median patient’s age was 70 years (range 48-97). Four patients had metastasis to regional nodes, and 12 had distant metastases. Median initial PSA was 22.5 ng/ml (range 14.8-153). Median follow up was 13.5 months (Range 5-23). All the patients were in biochemical remission at the last follow up. Fourteen patients had undetectable PSA below 0.006 ng/ml, and 2 patients had PSA of 0.5 ng/ml. Ten patients had grade 1 and one had grade 2 acute genitourinary (GU) toxicity. Two patients had grade 1 and one had grade 2 acute gastrointestinal (GI) toxicity. No other acute toxicities were observed. At the last follow up, 4 patients had grade 1 GU toxicity and none had GI toxicity. Conclusion: Radical doses of radiation therapy to the primary and metastatic sites in patients with low burden metastatic prostate cancer treated at our institution was well tolerated with very favourable early biochemical response. Contrary to focal radiotherapy to prostate gland in the metastatic setting, in our study, radiotherapy to all the gross disease including metastatic sites resulted in a pronounced PSA response. Longer follow up and prospective randomized trials will be required to confirm these findings, and are underway.

Rabia Javed1, Ayesha Ali2, Nishat Khan3

1Department of General Medicine, Riaz Specialist Medical Centre, Sharjah, UAE; 2Siddique Family Hospital, Gujranwala, Pakistan; 3Department of General Medicine, Gujranwala Medical College Teaching Hospital, Gujranwala, Pakistan

Introduction: Cancer is the second leading cause of death worldwide pertaining an imminent global health threat. There is relative paucity of oncologists throughout the world which is very alarming keeping in view the rising number of cancer cases globally. One of the prime reasons of less oncologists world-wide is that, amongst medical undergraduates, oncology is a low-ranked and not a favorable career field of choice. This research is therefore carried out to know the perception and opinion of medical undergraduates regarding oncology and determine the factors which influence their preferences in choosing oncology as a career. Methods: It was a one-week cross-sectional study conducted among 110 final year students of a public-sector medical college in Pakistan. A self-designed questionnaire was used which was sent online to the participants using Google forms. Data was collected after informed consent. Descriptive and univariate inferential statistics (p-value < 0.05) were applied on the data using SPSS version 22. Results: The overall response rate was 93.63% (103/110) of which 40.90% were females and 59.1% were males. Only 8.24% (7/103) wanted to pursue oncologist as a career. Oncology as a specialty choice was negatively influenced by death due to cancer in the family/friends (p=0.002), oncology being a depressing (p=0.034), less job opportunities (p=0.045) and poor patient prognosis(p=0.012); and positively influenced by stable working hours (p=0.02) and being a financially healthy specialty (p=0.044). 49(47.57%) said they would be unable to cope with the emotional challenges in this field and 58(56.31%) were overall pessimistic about cancer as a whole. 56(54.36%) of the respondents were unsatisfied with the oncology teaching hours in the college. Conclusion: There is a need to work on instilling the importance of oncology amongst medical undergraduates. An oncologist-workforce should be built sooner taking into consideration the escalating cancer cases world-wide and address this supply-demand mismatch. Proper steps should be taken to ensure appropriate oncology education at undergraduate level and address the shortcomings in the oncology teaching during the course.

Rabia Javed1, Sana Zahid2, Nishat Khan3

1Department of General Medicine, Riaz Specialist Medical Centre, Sharjah, UAE, 2Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore Pakistan; 3Department of General Medicine, Gujranwala Medical College Teaching Hospital, Gujranwala, Pakistan

Introduction: The quality of life (QoL) of Cancer survivors is an important concern in oncology. Overall, cancer survivors live a below average QoL which in turn is influenced by various factors. Amongst females, cervical cancer is the 4th most prevalent cancer globally. Early stage cases have a good 5-year relative survival rate of 91%. The QoL of cervical cancer survivors in particular is less researched upon. Methods: A cross-sectional study was conducted on 91 early-stage (stage IA, IB and IIA) cervical cancer survivors, 3 months after completion of treatment in a tertiary care hospital in Punjab district of Pakistan. The questionnaire consisted of various socio-demographic and clinical variables, and the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Mann-Whitney test was used for bivariate-analysis to investigate the association of QoL and its domains with other variables. Pearson's correlation-coefficient was used to ascertain correlation between overall QoL and the four domains individually. P-value was set at 0.05. Results: The age of the respondents ranged between 29and64 years (43.52±9.87 years). Cancer was diagnosed at an average age of 36.35±7.89 years. Majority of patients (47/91) were diagnosed with adenocarcinoma. Social relationship domain gave the highest mean score (62.31±13.97) while physical health domain gave the lowest (53.86±11.36). Treatment modality (p=0.032) and presence of co-morbidity (p=0.029) were associated with physical health domain, marital status (p=0.041), occupation (p=0.019) and educational status (p=0.031) with psychological domain, age (p=0.032) and marital status (p=0.012) with social relationship domain, and marital status (p=0.013), occupation (p=0.043) and educational status (p=0.033) with environment domain. Physical health (r=0.54) and psychological (r=0.61) domains were strongly associated with overall QoL. Conclusion: The social relationship domain showed the best average while physical health domain gave the least. The socio-demographics and clinical variables showed statistically significant correlation with different domains and also overall QoL. By identifying the areas where a patient’s life is most affected by the disease and making effective interventions, a comprehensive care can be provided to the cancer survivors and thus help them live a normal and healthy quality of life.

Ayman Allam1, Zeinab Idris1, Azza Hassan1,2, Shaikhah Mohsen1, Hodan Ibrahim1, Saad Jobran1, Mostafa Abdelmaksoud1, Amna Idris1, Salha Bujassoum1

1National Center for Cancer Care & Research, Hamad Medical Corporation, Doha, Qatar; 2Weill Cornell Medical College, Doha, Qatar

Introduction: Patients with cancer diagnosis suffer from a variety of distressing symptoms that affect their quality of life. Thus, comprehensive assessment of symptom prevalence especially in patients with advanced cancer who are referred to palliative care outpatient clinic is highly needed in order to properly address the most prevalent symptoms, leading to improved quality of life of those patients. The aim of the present study is to analyze symptom prevalence among patients with advanced cancer referred to palliative care outpatient clinics for the first time. Method: A descriptive cross-sectional study including 300 cancer patients assessed for symptom prevalence upon their first visit to the palliative care outpatient clinic. The ESAS-r tool was used for evaluation of symptom prevalence. Descriptive analysis was carried out, different variables such as age, gender, type of cancer, symptom severity were also studied. Results: The study consists of a total of 300 patients who visited the palliative care outpatient clinics for the first time between October 2021 to August 2023. The mean age was 54 years. The 4 most common prevalent symptoms were pain (86%), fatigue (75%), anxiety (59%), and anorexia (55%). The most common cancer types were breast cancer (21%), Gastrointestinal cancer (20%), hepatobiliary cancers (14%), and lung cancer (12%). Symptoms prevalence were higher in patients <65 years compared to those ≥65 years, however this difference was not statistically significant. When compared to a cohort of 400 palliative care inpatients, symptoms prevalence were higher for inpatients compared to outpatients. Conclusion: The present study showed that pain, fatigue, anxiety and anorexia are the most common prevalent symptoms among cancer patients seen in the palliative care outpatient clinics for the first time. Symptom prevalence for younger patients was higher compared to elderly patients.

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