Sheikh Sabah Al-Ahmad Al-Jaber Al

Sheikh Sabah Al-Ahmad Al-Jaber Al-Sabah –
Sabah
Sheikh Nawaf Al-Ahmad Al-Jaber Al-
Dr. Ali Saad Al-Obaidi
Chairman Opening Speech
Dr. Khalid Al-Saleh
The concept of palliative care has been promoted as early as the 1950s but it was only
recently that palliative medicine has been accepted as a specialty in the field of medicine.
In Kuwait, the idea of establishing a palliative center was spearheaded by the Kuwait Society
for Smoking and Cancer Prevention (KSSCP) way back in 2002. With the support of the Ministry of
Health of Kuwait and International Islamic Charitable Organization (IICO), the construction and
establishment of the 92-bed Palliative Healthcare Center was finally completed in 2009. The
management of the Center was turned over to the Ministry of Health and the Center started
admitting the first palliative patients in January 2011. On May 4, 2011, the Center was inaugurated
by no less than His Highness the Amir, Sheikh Sabah Al-Ahmad Al-Jaber Al Sabah of Kuwait in
simple ceremonies to celebrate the successful establishment and opening of the Center.
The Palliative Healthcare Center is the first of its kind in Kuwait and the Middle East. It can
accommodate 92 patient-beds and equipped with modern facilities for a small theatre, a pain clinic,
alternative clinic, nutrition clinic and a room for conducting an international peer-to-peer
collaboration meeting. It provides patient services for a) acute palliative b) Symptomatic treatment
and follow-up c) consultation for symptom management d) 1-day visits. A dedicated health care
team of palliative professionals comprising of doctors, staff nurses, physiotherapists, nutritionists,
social workers, psychologists, spiritual counselors and other specialists on-call are employed by the
Center to provide regular and urgent services to patients around the clock.
Now on its 3rd year of operation, the Palliative Healthcare Center of Kuwait continues to serve
its maiden purpose of improving the quality of life of many patients and their families who may have
otherwise been left alone without help in their most desperate moments of grief, pain and
sufferings from life-threatening diseases like cancer. With this thought in mind, all of us at the
Palliative Healthcare Center value our mission and will continue to dedicate our services to help the
sick and the less fortunate among us.
Dr. Khalid Ahmad Al- Saleh
Consultant Oncologist ,
Head of the Palliative Team, Palliative care Center,
Chairman, Palliative Medical Society.
State of Kuwait.
CONFERENCE COMMITTEES
The Higher Committee:
-Dr. Ahmad Al -Awadi, Dr. Khalid Al -Saleh, Mr. Faisal Al -Dousari
The Organizing Committee:
- Dr. Khalid Al Saleh
- Dr. Saleh Al Abad
- Dr. Najla Al Sayed
- Dr. Mohamed Mostafa
-Dr. Maha Abdullah
- Dr. Ahmad Rahal
- Metron Fadela Dashti
Chairman
Member
Member
Member
Member
Member
Member
The Scientific Committee:
- Dr. Khalid Al Saleh
- Dr. Najla Al Sayed
- Dr. Eman Al Diri
- Dr. Mohamed Mostafa
-Dr. Sobhy Mostafa
- Dr. Wafaa Mostafa
- Mrs. Thuraya Al-Bloushy
Chairman
Member
Member
Member
Member
Member
Member
The Media Committee:
- Dr. Najla Al Sayed
- Dr. Maha Abdullah
- Dr. Wafaa Mostafa
- Dr. Fatma Abd El Shakor
-Mrs. Wafaa Al-Barqawi
-Mr . Abdullah Gohar
Chairman
Member
Member
Member
Member
Member
Public Relation & Secretariat Committee
-Dr. Ameena Al-Ansari
-Dr.Fatma Abd El Shakor
- Mrs. Huda Al-Shehab
-Mrs.Noura Al-Enezi
-Mrs.Anaheed Al-Faquan
- Mrs. Wafaa Al-Barqawi
- Mr. Zakeer Ali Khan
CONFERENCE MODERATORS
 Dr. Salem Al-Shemmari Consultant of Hematology , Head of Medical
Oncology department, Kuwait Cancer Control Center ,Kuwait.
 Dr. Amina Al-Ansari Senior Specialist Palliative medicine , Palliative Care
Center, Kuwait.
 Dr. Khalid Al-Khaldy Consultant of surgical oncology , Kuwait Cancer Control
Center, Kuwait.
 Dr. Abdul-Rahman Abdul-Aziz Specialist Palliative Medicine, Palliative Care
Center, Kuwait.
 Dr. Salah Fayaz Consultant of Radiation Oncology, Head of Unit B, Radiation
Oncology department, Kuwait Cancer Control Center, Kuwait.
 Dr. Najla Al-Sayed Internal Medicine specialist , Palliative Care Center, Kuwait.
 Dr. Shafiqa Al-Awadi Consultant of Medical Oncology, Head of Breast Unit,
Kuwait Cancer Control Center , Kuwait.
 Dr. Abbraham Varghese Consultant of Radiation oncology, Head of Unit A,
Radiation Oncology department, Kuwait Cancer Control Center, Kuwait.
ABSTRACT
Dr. Mohammad Zafir Al-Shahri
 Associate Professor, College of Medicine, Al faisal University, Riyadh, KSA.
 Consultant, Palliative Medicine, Oncology Centre, King Faisal Specialist Hospital and
Research Center, Riyadh
 Director, Palliative Medicine Fellowship Program, King Faisal Specialist Hospital and
Research Center, Riyadh.
 President, Saudi Society of Palliative Care.
 Fellowship in palliative care, university of Alberta, Edmonton, Alberta,
Canada.
 American board of hospice and palliative medicine, USA.
1-Lecture Title: Palliative Care models.
Time Offered: Sunday, 13thApril, 2014 , Session I , 10:00 – 10:30 am
Abstract: Palliative care aims at relieving suffering and improving quality of life for patients
and their families facing life-threatening illnesses. In order to achieve that aim, various
palliative care models have been adopted. Hospital-based palliative care programs may take
the form of a dedicated palliative care in-patient unit, a consultation service and/or an
ambulatory service. While palliative care can be offered to patients at any stage along the
trajectory of their disease, hospice model usually refers to a program that delivers palliative
care towards the end of life. Hospice care can be provided at patients’ homes, hospitals or
nursing homes, as well as in freestanding hospice inpatient facilities. The choice of one
palliative care model or another or the combination of more than one model in a given
program depends on various factors. Such factors may include the characteristics of the
target population, the available resources, and the health system format. This paper
discusses the various palliative care models and the characteristic features of each.
2-Lecture Title: Implementing palliative care within the community.
Time Offered: Sunday, 13thApril, 2014, Session I, 10:50 – 11:10 am
Abstract: A well-established home health care program may be the optimal model for the
provision of palliative care for patients with life-limiting conditions who wish to remain at
home for as long as possible. Palliative care in the home setting entails an interdisciplinary
approach for comprehensively addressing patients' physical, psycho-social and spiritual
needs. In-home palliative care may be associated with a greater level of patient satisfaction
and reduced use and cost of health services. For patients with advanced progressive lifelimiting diseases who wish to die at home, palliative home care may have the greatest
potential for making such a goal achievable. The religious and cultural background of a
Muslim community places great emphasis on the strong familial bonds between extended
family members. This shapes the readiness of Muslim families to care for terminally ill
patients at home and is likely to facilitate progress in home palliative care programs in our
region.
Dr. Najla Al-Sayed Mohamed
 Internal medicine specialist in Al-Sabah hospital& palliative care center, Kuwait.
 Palliative Medical Society Member ,Kuwait.
 Membership of the Royal College of Physicians (MRCP).
Lecture Title: Experience of Kuwait Palliative Care Center
Time Offered: Sunday, 13thApril, 2014, Session I, 10:30 – 10:50 am
Abstract: Palliative Medicine is a recent field in medicine, and it is growing very rapidly.
Palliative care focuses on patients and families with a holistic view delivered by
multidisciplinary team.
The importance of palliative care in patients with advanced cancer is well
established. Reports on the experience with palliative care in the Middle East region are
Limited. Regarding our palliative care experience, palliative care center was opened
officialy on May 2011 in Kuwait. We identified the profile of patients required palliative
care till december 2013.
We admitted 219 patients as inpatients, from them 97males and 122 females. The mean
length of stay of our patients were 56 days.
Most of our patients are diagnosed as advanced cancer (99.10%) with only two patients with
end stage medical diseases (0.9%).
The commonest symptom was pain that was reported in 72.6% as assessed by the Edmonton
Symptom Assessment System.
The inpatients are admitted to us either through our outpatients clinic or through referrals
from other hospitals through consultations.
We received more than 400 consultation mainly from Kuwait cancer control center (253
consultations, 61.70%). Most of patients with were transferred for controlling symptoms
and to improve quality of life.
Regarding our outpatients clinic, the total number of visits are 274 visits representing 87
patients.
There is a growing need to have more hospitals to provide support for palliative care,
and more physicians to practice in this field.
Dr. K. Suresh Kumar
 Director Institute of Palliative Medicine.
 Director, WHO Collaborating Center for Community Participation in Palliative Care
and Long Term Care.
 Adjunct Associate Professor, Edith Cowen University, Perth, Western Australia .
 Member, Panel of Experts, International Atomic Energy Agency, Vienna.
 Ashoka Global fellow.
 W.H.O/CRMF Overseas Fellowship in Palliative Care.
Lecture Title: Palliative Care Service Overview in India.
Time Offered: Sunday, 13thApril, 2014, Session I, 11:10 – 11:30 am
Abstract: Though Palliative care got introduced to India three decades ago, only 2% of the
needy have access to care in the country today. Except in the South Indian state of Kerala,
palliative care is restricted to limited services in some of the cities. But the concept has been
gaining steady acceptability and some of the recent developments in the area have the
potential to take palliative care forward faster in future. These are:
1-Recent amendment of Narcotic Law by the Indian Parliament to ensure better availability
of oral morphine for medical use
2-Generation of a National Palliative Care Program document by Government of India
3-Development of a community based model for palliative care in the south Indian state of
Kerala.
Details of these developments and their relevance to India and also the rest of the world are
discussed in the lecture.
Dr. Iman Al-Diri




Anesthesia & intensive care specialist in Kuwait cancer centre , Kuwait.
pain &palliative care specialist KCCC, NBK children's hospital, Kuwait .
pediatric pain &palliative home care specialist ,Kuwait .
diploma in palliative medicine Cardiff university.
 MD Aleppo university .
Lecture Title : Break through pain
Time Offered: Sunday, 13thApril, 2014 , Session II, 12:35 – 12:55 pm
Abstract: Breakthrough pain is one of the most distressing types of pain in cancer patients.
It’s defined as a transient exacerbation of pain that occurs either spontaneously, or in
relation to a specific predictable or unpredictable trigger, despite relatively stable and
adequately controlled background pain. 40-80% of patients with cancer pain suffer from
breakthrough pain. Causes include direct effect or indirect effect of cancer, effect of cancer
treatment or Effect of concurrent disease. It could be Nociceptive, Neuropathic or Mixed
pain. It’s classified as Spontaneous pain, and Incident pain. Mean number of episodes - 4 /
day, with a range of 1- 14 / day with and with Median duration of 30 min. Assessment
should include: History (pain, general), Examination (area of pain, general), Investigations
and use of (Assessment tools). Patients with breakthrough pain should have this pain
specifically re-assessed. Management of breakthrough pain needs to be individualised, and it
includes treatment of cause of pain, symptomatic treatment of pain and treatment of
complications of pain. A rescue medication used to treat breakthrough pain should has,
Good efficacy, Rapid onset of action, Short duration of effect and Good tolerability. Titration
of the rescue dose should be viewed as a key principle in the management of breakthrough
pain.
Dr. Humam H. Akbik




Mercy health physician.
Medical director, pain management specialists.
FIPP certification (fellow in interventional pain).
Board Certified American Board of Anesthesia Pain.
1-Lecture Title: New modalities in managing neuropathic pain:
Time Offered: Sunday, 13thApril, 2014, Session II, 12:15 – 12:25 pm
Abstract:
2-Lecture Title : Interventional pain management:
Time Offered: Sunday, 13thApril, 2014 , Session II ,12:55 – 01:15 pm
Abstract: Cancer Pain, A 360 evaluation, the prevalence of cancer-related pain is high
despite available guidelines for the effective assessment and management of that pain.
Barriers to the use of opioid analgesics partially cause under treatment of cancer pain
especially in the Middle East area where such use of medications is highly and negatively
stigmatized. The aim of this talk is to compare pain management outcomes and patientrelated barriers to cancer pain management which is bounded (culture, place, time, etc.).
Whether or not a treatment technique is indicated or contra-indicated, and its selection
underpinnings (theory-based, empirically based, “principle of faith-based, tradition-based,
budget-based, etc.) continues to be a generic and key treatment issue. In the West, with the
relatively new ideology of “harm reduction” and the even newer quality of life (QOL) and
“wellness” treatment concepts presented for the treatment of cancer patients.
Emotional distress and patient attitudes toward opioid analgesics in cancer patient, pain
relief and pain medication adherence is much better in the Western countries. Interventions
towards those issues may result in better pain management outcomes generally, whereas
poor adherence to pain medication and poor pain relief appear to be more country-specific
problems.
Health Care Professionals should have heightened awareness of the causes and treatment of
pain with the aim of anticipating and managing pain most appropriately for each individual
patient. This is clearly an important component of holistic patient care before, during, and
after oncological treatment.
Dr. Abdul-Rahman Abdul-Aziz
 Specialist Palliative Medicine, Palliative Care Center, Kuwait.
 fellowship in Palliative Medicine at King Faisal Specialized hospital and Research
Centre (KFSHRC).
 board in family medicine from the Royal College of General Practitioners MRCGP int.
(UK).
1-Lecture Title: Management of Constipation.
Time Offered: Day 2: Monday, 14th April, 2014, Session III , 02:30 – 02:50 pm
Abstract: Discusses important issues that face palliative medicine, patients and doctors
including definition, prevalence, causes, diagnosis, impact, and most common management
plan. Presented with case scenarios.
2-Lecture Title: Dyspnea in Palliative Care.
Time Offered: Day 2: Monday, 14th April, 2014, Session III, 03:10 – 03:30 pm
Abstract: Dyspnea is a common subjective feeling associated with wide variety of illnesses.
How is it looked at in palliative medicine? Do we routinely use Oxygen, diuretics,
brochodialators, monitoring devices ...etc. Explore palliative care dyspnea uniqueness.
3-Lecture Title: Palliative care debates.
Time Offered: Day 3: Tuesday, 15th April, Session VI, 04:20 – 04:40 pm
Abstract: Discover some of the common areas of dilemma and debates in palliative
medicine ,Chemotherapy near the end of life. Nutrition of palliative patients, how should it
be? Is it merely patient or carer choice for the plan of care. Is what we think better for
the benefit of patients is always right. What about futility Vs. benefits and risks equation?
This lecture discusses variety of controversial issues in palliative medicine.
Dr. Ameena Mohammed Al-Ansari
 Senior Specialist Palliative Medicine, Palliative Care Center, Kuwait.
 fellowship in Palliative Medicine at King Faisal Specialised hospital and Research
Centre (KFSHRC).
 Kuwait board in family medicine.
1-Lecture Title: Nausea and Vomiting.
Time Offered: Day 2: Monday, 14th April, 2014, Session III, 02:50 – 03:10 pm
Abstract: Definitions of nausea and vomiting enable us to remember that the two are
separate symptoms and do not always co-exist. Nausea is an unpleasant feeling of the need
to vomit, often accompanied by autonomic Symptoms (such as pallor, sweating, salivation,
tachycardia).Vomiting (emesis) is the forceful expulsion of gastric contents through the
mouth.
It is important to understand the cause of symptoms to address the problem as effectively as
possible. Causes of nausea and Vomiting can be broadly divided into six Categories
chemicals, gastrointestinal stretch or irritation, gastric stasis, raise intracranial pressure,
movement related and anxiety related factors. (National Institute for Health and Clinical
Excellence, 2012); sometimes causes are multifactorial, especially in palliative care, and
several approaches may be needed.
The standard palliative care approach to the assessment and treatment of nausea and
vomiting is based on determining the cause and then relating this back to the “emetic
pathway” before prescribing drugs such as dopamine antagonists, antihistamines, and anticholinergic agents which block neurotransmitters at different sites along the pathway.
2-Lecture Title: Delirium.
Time Offered: Day 2: Monday, 14th April, 2014,Session III ,03:30 – 03:50 pm
Abstract: Delirium (sometimes called 'acute confusional state') is a common clinical
syndrome frequently experienced by palliative care inpatients, Characterized by disturbed
consciousness, cognitive function or perception, which has an acute onset and fluctuating
course. Delirium can be hypoactive or hyperactive but some people show signs of both
(mixed).
Diagnosis depends mainly on careful clinical assessment; consider using Mini-Mental
State Examination or Abbreviated Mental Test.
Identifying the precipitating factors like drugs (including: opioids, anti-cholinergics,
steroids, benzodiazepines, antidepressants, sedatives), Drug withdrawal (alcohol, sedatives,
antidepressants, nicotine), dehydration, constipation, urinary retention, uncontrolled pain,
Liver or renal impairment, electrolyte disturbance (Na, Ca, glucose), infection, hypoxia,
cerebral tumor or cerebro-vascular disease, Visual impairment and deafness are risk factors.
Delirium treatment is multidimensional and includes the identification of precipitating
and aggravating factors, family support and drugs. For symptomatic management,
haloperidol remains the practice standard. Further research investigating the appropriate
treatment of this complex syndrome is needed.
3-Lecture Title: Admission criteria of Kuwait Palliative Care Center.
Time Offered: Day 3: Tuesday, 15thApril, 2014 Session VI, 04:40 – 05:00 pm
Abstract: Palliative care centre in Kuwait is the first adult palliative care center in the
region, designed and constructed to introduce specialist palliative care services to health
care system in Kuwait .
Inpatient unit is the core essential element of the specialist palliative care service. It
provides a wide range of specialist service to the patients and families, addressing their
medical, nursing, psychosocial and spiritual needs.
Admission to palliative care unit must fulfill the criteria of admission. Patient should have
advanced disease, with goals of care that emphasis symptom control, quality of life, and
support for the patient and family.
All patients must be assessed by a physician from the palliative care center team and
confirmed that he/she meets the admission criteria.
Dr. Joanne Hands :





Clinical Director and Therapist , Kuwait Counceling Center, Jabriya, Kuwait.
Association of Psychologists of Venezuela, Member.
American Psychological Association, Member .
American Counceling Association, Member.
PhD in psychology.
Lecture Title: Role of Palliative Care in family support:
Time Offered: Day 2: Monday, 14th April, 2014 Session IV ,04:30 – 04:50 pm
Abstract: When a patient is suffering from a chronic illness unfortunately he/ she is not
the only one going through the difficulty, the entire family gets affected as well. Palliative
care is a team approach to care. Palliative care provides support to the patient and the
family by helping them understanding the treatment options and the goals to follow. this
session is designed to bring awareness on the importance of the role that palliative care
plays in family support, as well as to provide ideas on how to execute this support in the
best possible manner.
Dr. Hazim Abdul-Karim
 Psychiatrist in the Consultation Liaison Team in the Kuwait Center For Mental Health
(KCMH).
 Part of the psycho-social oncology unit in the KCCC and PCC , Kuwait.
 Former general director of the technical offices in the mental health secretariat.
 Master’s degree in psychiatry from Ain Shams University in Cairo , Eygpt.
Lecture Title: Psychiatry protocol in Palliative care.
Time Offered: Day 2: Monday, 14th April, 2014 ,Session IV , 04:50 – 05:10 pm
Abstract: As part of a fully integrated service model, psychiatry has become one of the
essential disciplines in palliative care centers around the world. The growing number of
patients in palliative care centers with mental health issues has become very evident, and
undeniable. Also the role of psychiatry in such centers has transformed provided care into a
more patient oriented service.
Despite the fact that it is difficult to assess the incidence of some mental health issues in
palliative care patients. Depression is highly prevalent in hospice and palliative care
settings—especially among cancer patients, in whom the prevalence of depression may be 4
times that of the general population. Furthermore; suicide is a relatively common,
unwanted consequence of depression among cancer patients. whereas the risk of suicide
among advanced cancer patients may be twice that of the general population.
Recent meta-analyses have confirmed that at least 25-30% of cancer patients, in different
clinical settings, including oncology and hematology, meet the criteria for a psychiatric
diagnosis, mainly depressive disorders, anxiety, adjustment and stress-related disorders,
across the trajectory of their disease. These figures tend to increase in the advanced phases
of illness in which delirium and confusional states, depression and anxiety have shown to
affect even a higher percentage of patients.
Dr. Marcia Dunn
 Physiotherapist with the Ontario College of Physiotherapists.
 Specialized in Oncology care at the Princess Margaret Cancer Centre in Toronto,
Canada.
 Clinical project manager with the University Health Network International Program
at the Kuwait Cancer Control Centre, Kuwait.
Lecture Title: Role of physiotherapy in Psychological Support.
Time Offered: Day 2: Monday, 14th April, 2014, Session IV, 05:10 – 05:30 pm
Abstract: Role of Rehabilitation Services in Relaxation Therapy – Objectives




What professionals can provide relaxation therapy to patients?
What cancer symptoms can relaxation therapy effectively target?
What patient factors should be considered before developing a relaxation therapy
program?
What therapeutic tools can we use to assist in relaxation therapy for our patients?
Dr. Nouf Mohammed Al-Dhwayan
 Senior Physical Therapist, Lymphedema Specialist , King Faisal Specialist Hospital &
Research Centre, Riyadh, Saudi Arabia.
 T.L.C. International, Centro de Estudios T.L.C., Inc.USA. Lymphedema therapy trainer
certification.
 MSc in Healthcare Management from the Royal College of Surgeons in Ireland.
Lecture Title: Management of Lymphedema.
Time Offered: Day 3: Tuesday, 15thApril ,Session V , 02:00 – 02:20pm
Abstract: lymphedema is an external (or internal) manifestation of lymphatic system
insufficiency and deranged lymph transport.
In the treatment of “classical” lymphedema of the limbs, improvement in swelling can
usually be achieved by non-operative therapy.
A specialized Physical Therapist is a prerequisite for a successful Lymphedema treatment.
Managing Lymphedema conservatively is referred to, as complete decongestive Therapy.
CDT is a program supported by a long history of experience and research.CDT may also be of
use for palliation as, for example, to control secondary lymphedema from tumor-blocked
lymphatic’s.
Lymphedema can produce distressing and debilitating symptoms that affect lifestyle and
function. Lymphedema in Palliative patient will have even more symptoms that affect the
patient daily activities and quality of life.
Patients with advanced disease may not be able to tolerate a full program of assessment
and treatment, but require a palliative approach in which assessment techniques are
modified and individual treatments are selected to ease specific symptoms.
Dr. Wafaa Helmi Ayesh
 Director of Clinical Nutrition Department ,Clinical Support Services Sector ,Dubai
Health Authority (DHA).
 A part time lecturer in the Faculty of Allied Health Sciences, University of Sharjah,
UAE.
 Adjunct and Advisory Board Member for Clinical Nutrition Department in University
of Sharjah.
 European ESPEN Diploma from European Society for Clinical Nutrition and
Metabolism – France.
Lecture Title: Role Of Nutritional Support in Bed sores.
Time Offered: Day 3: Tuesday, 15th April, Session V, 02:20 – 02:40pm
Abstract: When it comes to preventing pressure sores that means paying careful attention
to nutrition.
Recovering from surgery or illness, or confined to a bed or wheelchair?
When it comes to preventing pressure sores, maintaining the health of your skin is crucial.
And, yes, that means paying careful attention to nutrition.
The development of pressure sores is often linked to poor appetite, difficulty eating, and the
inadequate intake of nutrients – factors that are all often present in bed-resting people.
In addition, weight loss, inadequate protein intake, a diet poor in protective vitamins and
minerals, and either a very low or very high body mass index, could slow down the woundhealing process where pressure sores already exist.
A deficiency in vital nutrients may delay wound healing. Research supports the importance
of protein, vitamin C and zinc in wound healing. Chronic wound healing requires a
multidisciplinary and holistic approach. Early identification of at-risk patients is vital for the
prevention and exacerbation of pressure sore development.
Wound healing involves complex physico-chemical interactions that require various micro
and macronutrients at every stage. The prevalence of pressure ulcers among hospitalized
patients ranges from 3%-11% and 18% among bedridden hospitalized patients.
The relationship between malnutrition and pressure sore development is well documented.
Clinical manifestations of malnutrition include weight loss and compromised immune
function. Both underweight and obese individuals can be malnourished.
A high incidence of weight loss, low body mass index, malnutrition and poor visceral protein
status are reported nutritional factors associated with pressure ulcer development in longterm care patients.
A primary objective for healthcare professionals should be to recognize the risk factors for
under nutrition in such patients and to try to maximize their nutritional status if possible.
The good news is that nutrition intervention can have a very direct effect on pressure sores,
significantly reducing their size in a relatively short space of time.
Dr. Tasleem Zafar
 Assistant Professor, Dept. of Food Science and Nutrition , College of Life Sciences ,
Kuwait University, Kuwait.
 PhD , Department of Food and Nutrition, Purdue University, West Lafayette, Indiana,
USA.
Lecture Title: Nutritional concept in palliative care.
Time Offered: Day 3: Tuesday, 15thApril, Session V, 02:40 – 03:00pm
Abstract: According to WHO, “Palliative Care is defined as the active total care of patients
whose disease is not responsive to curative treatment. Control of pain, of other symptoms,
and of psychological, social and spiritual problems, is paramount. The goal of palliative care
is achievement of the best quality of life for patients and their families. Many aspects of
palliative care are also applicable earlier in the course of the illness in conjunction with anticancer treatment.”
PC needs an interdisciplinary team approach. Feeding a balanced diet is a challenge in
gravely ill patients. As many terminally ill patients are unable to eat, swallow, digest, absorb
or utilize enough food to maintain body weight and health. Artificial feeding methods as well
as various strategies for oral feeding used for meeting the nutritional challenges of these
patients. The end goal of nutritional support is to palliate which means to improve quality of
life and enhance comfort.
Dr. Lemia Shaban
 Assistant Professor at Kuwait University, College for Women ,Department of Food
Science and Nutrition, Kuwait.
 Doctor of Philosophy in Dietetics and Nutrition , Florida International University .
Lecture Title: Cancer cachexia.
Time Offered: Day 3: Tuesday, 15th April, Session V, 03:00 – 03:20pm
Abstract: Weight loss in cancer cachexia is different from the weight loss as a result of
starvation or anorexia. The main difference is the accelerated loss of both skeletal muscles
and fat. The majority of cancer patients experience weight loss as their disease progresses
and, in general, weight loss is a major prognostic indicator of poor survival and impaired
response to cancer treatment.
Factors that affect food intake are GI symptoms such as nausea, loss of appetite and taste
changes, presence of pain, and depression, all of which may play an additional role in the
patient’s ability and tolerability of food. Nutrition intervention may lead to a variety of
outcomes including changes in dietary intake, symptoms, biochemistry, anthropometric
measures or nutritional status. These changes then impact morbidity and mortality, length
of hospital stay, functional capacity and/or the quality of life.
It is, therefore, essential that dietitians early on are able to screen for cachexia, identify
those at risk, and have evidence-based tools to help them control the cancer cachexia at any
given stage. Each patient should be also viewed as an individual and dietetic care should be
focused on understanding patients’ needs and level/degree of cachexia. Therefore, the aim
of this talk is to address cancer cachexia and nutritional management of this aggressive
complex syndrome.
Dr. Khaled Al-Saleh
 consultant Radiation Oncology & Head of Radiation Oncology Department, Kuwait
Cancer Control Center, Kuwait.
 Head of the Palliative Team, Palliative care Center ,Kuwait.
 Chairman, Palliative Medical Society, Kuwait.
 General Secretary, The Gulf Federation for Cancer Control.
 Chairman, Kuwait Society of Oncology.
 Board Certificate in Radiotherapy & Oncology, Maria Skłodowska-Curie Institute of
Oncology, Warsaw, Poland.
Lecture Title: Palliative radiotherapy.
Time Offered: Day 3: Tuesday, 15th April ,Session VI , 04:00 – 04:20pm
Abstract:
Palliative medicine is an approach that aim to affirm and promote quality of life through a
multidisciplinary team ,patients and their family are concerned by palliative medicine .
Palliative radiotherapy (RT) is use of megavoltage (Mv) radiation to palliate symptoms due
to advanced malignancy such as pain, bone metastasis & impending fracture, airway
obstruction (superior vena cava syndrome),brain metastasis, spinal cord compression due to
vertebral metastasis, bleeding and treatment of cutaneous metastatic disease.
Palliative radiotherapy is best utilized by some form of hypo fractionation.
Majority of advanced cancer presents with pain because of disease involving to tissue or
direct nerve affection.
Radiotherapy effectively palliates pain and other symptoms that interfere with good quality
of life on the other hand palliative RT may reduce opoids and other analgesics medications .
Palliative radiotherapy can be an emergency used in spinal cord compression ,SVC
obstruction and bleeding.
This lecture will discuss different radiotherapy protocols used in palliation of various
symptoms.