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Pacific Island Child Cancer Regional Conference AN UPDATE FROM SAMOA OVERVIEW – INTRODUCTION – PAEDIATRIC STAFF – SAMOA CANCER SOCIETY – CANCER PATIENTS – update INTRODUCTION – Samoa - is a Polynesian Pacific county northeast of Fiji. – – - consists of 4 inhabited and 5 uninhabited islands - capital is Apia and is located on Upolu (most populous island & developed) – - population is approximately 200,000. – - 1962 independence (1st pacific island to achieve independence) – The chief hospital of Samoa is the Tupua Tamasese Meaole Hospital at Motootua – - provides primary, secondary and tertiary healthcare facilities in addition to offering a range of specialist medical services, surgery and outpatient clinic. – - bed capacity of 200 Who are in the paeds unit? STAFF – Acting HOU – Dr. Kirtimalini Anand – Snr registrar – Ulugia Dr. Tito Kamu – Snr registrar – Dr. Litara Esera – Snr registrar – Dr. Fiona Hunt (Fiji) – Jnr registrar – Dr. Kuinita Margraff – Jnr registrar – Dr. Maluapapa Siaosi Nursing staff – Clinical Nurse Consultant – Nurse Manager – 13 registered nurses (5 trained for oncology) – 2 full time enrolled nurses + 1 part timer – 1 auxiliary nurse SAMOA CANCER SOCIETY An independent, not-for-profit organization deeply committed to reducing the number of people impacted by cancer, as well as ensuring the best possible outcomes for those affected by it. Established in 1998, and is governed by a voluntary board Partners 1. Child cancer foundation NZ 2. Starship Children's Hospital 3. Cancer society of NZ 4. USO Bike Riders NZ 5. American Samoa Community Cancer Coalition Cancer patients in Samoa Patient name Diagnosis Protocol DOB Age Completed treatment Progress Female Wilm’s tumour Left kidney Stage III FH Pl Wilm’s #1 29/10/05 11 May 2014 Likely cured from Wilms. Off treatment 3 years. Surgery in Samoa- nephrectomy and splenectomy SSH- radiotherapy and commencement chemotherapy. Completed chemotherapy in Samoa May 2012. Remains well. Follow-up every 3 months review with Paediatric Male Wilm’s tumour Right kidney Stage II FH PI Wilm’s #1 28/05/12 4 Jan 2014 Well. Off treatment 2 years Male Burkitts Lymphoma Malawi 2000 18/01/05 11 April 2012 Cured of Burkitts for 4 years Male Histiocytosis Family disorder LCH 4 06/10/11 5 Ongoing Responding well to treatment. 9 cycles left to complete. Follow-up every three weeks in Paediatric ward. Next chemotherapy due December 12 Male ALL PI – ALL 1 07/11/11 5 Under investigation Currently in New Zealand Male ? ALL 19/08/08 8 Under investigation Currently in America (US national) UPDATE – Currently we are only seeing approximately 5 cases/year – There is a lack of national awareness on childhood cancers – Traditional and cultural mind-set that cancer is an ‘adult only disease’ – Late presentation to the hospital due to ancient beliefs. Traditional healers over modern medicine. – 2016: 1. Ekeroma Sauloa Tulaimalo (Histiocytosis – non Langerhans cell) 2. Jayden Roebeck (currently in NZ) 3. Zarahya Moors (currently in USA) Update – We currently do not have anyone on palliative care – Following chemotherapy criteria, only two cases from 2015-2016 period were referred to NZ for treatment. – In the past, two paediatric doctors & five nursing staff were trained to administer chemotherapy drugs – Ongoing partnership with the Samoa cancer society. They provide support for the families of those affected as well as financial assistance for patients coming in for chemotherapy. – “Project Paeds” founded by Dr. Salote Vaai. Project also assists in meeting financial needs of low income families, who are struggling to come into the main hospital for treatment. Update – Complicated cases are referred overseas for investigation – We can manage febrile neutropenia (Ceftazidime, Gentamicin, Ceftriaxone, Vancomycin) – Our ICU team are equipped to assist with central lines (for chemotherapy patients) – Limitations: Availability/cost of drugs Staff shortage Lab – all tests sent to NZ (takes 2-3weeks for the results) Family situations (e.g. financial, cultural/traditional beliefs, isolation) Awareness – we need more especially for our children age group Update – July 2016 Dr. Jane Skeen and Oncology team visited Samoa to review children who were undergoing chemotherapy – Samoa is very fortunate that we have a good relationship with the Starship team in assisting us in diagnosing our cases and ongoing consultation on difficult patients. – Samoa currently has a overseas treatment scheme that allows patients to go over to NZ for investigations as well as treatment. FA’AFETAI