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With the generous support of The Hong Kong Jockey Club Charities Trust, the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) has established the Jockey Club Institute of Cancer Care (HKU JCICC) – the very first purpose-built cancer-specific research and service centre in Hong Kong, which has served 15,313 patients since 2018.

Background
By 2030, cancer incidence is expected to reach 21.7 million globally. While early detection and treatment have progressively improved cancer patients’ survival, the psychological impact of cancer remains substantial and underattended. The Centre for Psycho-Oncology Research and Training team (CePort) at the School of Public Health of HKUMed reported that about one in every five patients had experienced chronic distress during the first year of cancer diagnosis.

Cancer and related treatments frequently generate physical symptoms, many of which may persist for several or more years. Unrelieved physical symptoms are distressing and are a key predictor of psychological distress on cancer patients, leading to poor health-related quality of life and prevent regaining normal life.

In 2020, HKU JCICC established the first community-based multidisciplinary cancer survivorship clinic to (1) provide support in managing post-treatment symptoms and (2) offer personalised diet and physical activity advice. Since then, a total of 512 cancer survivors have attended the cancer survivorship clinic. Through the assessment, we identified that nearly half (48%) reported sub-clinical symptom distress (scored 4-6 on a scale of 0-10) according to the Edmonton Symptom Assessment System (ESAS), while another 29% had clinical symptom distress (scored 7 or above). In the group with clinical symptom distress, the most common symptoms included sleep disturbance (52%), neuropathy (38%), anxiety (36%) and depressive symptom (26%). For those with severe anxiety or depressive symptoms, 90% showed grave concerns about cancer recurrence. Patients with clinical symptom distress are managed and regularly followed up for five years by our nurses who serve as the case manager.

In the survivorship clinic, we also assessed participants’ health status and lifestyle behaviours. All of the 512 patients who attended the cancer survivorship clinic failed in at least one of the 13 health indicators, such as body mass index (BMI), central obesity, intake of red meats, whole grains, fruit and vegetables, as well as muscle strength and cardio-fitness. About two-thirds of them even failed in four or more categories. Despite cancer survivors being at increased risk for secondary cancer and other co-morbidities, our data showed few cancer survivors meet lifestyle recommendations, indicating the urgent need for professional advice and support on health promotion. This is currently lacking in routine cancer care. HKU JCICC, therefore, develops life-style modification programmes (such as weight loss programme) to fill the service gap.  

Preliminary evaluation
In fact, of the 512 cancer patients and survivors who attended the cancer survivorship clinic, over 80% said the advice they received from the fitness trainers, dietitians and nurses could adequately address their concerns. They also believe that survivorship clinic is worth participating, with 94% of them said they would recommend other patients to join.

‘As we can see, physical and psychological symptoms have a profound impact on the well-being of cancer patients and survivors, which may ultimately undermine the effectiveness of their treatment and recovery,’ said Dr Wendy Lam Wing-tak, Director of HKU JCICC; Associate Professor and Division Head, Division of Behavioural Sciences, School of Public Health, HKUMed. ‘It is time to change our concept about cancer, its patients and their recovery. Cancer should be seen as a chronic disease, while cancer patients and survivors should be given long-term and sustained support for a more robust outlook of health.’

Significance of HKU JCICC Service
First of its kind in Hong Kong, HKU JCICC is committed to filling a long-due service gap in cancer care, and the cancer survivorship clinic is only one of its initiatives. HKU JCICC is HKUMed’s lynchpin in research and knowledge exchange to advance evidence-based tertiary cancer care strategies, and a pioneering platform to provide supportive care to cancer patients, as well as their families and caregivers. The findings gathered through HKU JCICC projects will enable HKUMed to identify and optimise cancer survivorship programmes that are locally relevant and effective in supporting affected individuals to regain normal life and establish a healthy lifestyle.

The Hong Kong Jockey Club Head of Charities (Special Projects) Ms Imelda Chan said: ‘Promoting a healthy community is one of the strategic charitable focus areas of the Club. We encourage the adoption of healthy lifestyle habits to mitigate the risk of chronic diseases and are helping to enhance medical-social collaboration to better address different needs in the community. Among the organisations we support is HKUMed. We have joined hands to establish The University of Hong Kong Jockey Club Institute of Cancer Care to build a healthier Hong Kong.’

‘As HKUMed’s “cancer moonshot”, HKU JCICC provides a pioneering platform for translating scientific innovation into care models that incorporate prevention, diagnosis, treatment, rehabilitation and palliation, in order to address the physical and psychological needs of cancer patients,’ said Professor Gabriel Leung, Dean of Medicine, The University of Hong Kong; Helen and Francis Zimmern Professor in Population Health and Chair Professor of Public Health Medicine, School of Public Health, HKUMed. ‘We are most grateful to The Hong Kong Jockey Club Charities Trust for its tremendous support that has made this endeavour possible.’

Please visit jcicc.med.hku.hk for more details on HKU JCICC.

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Media Enquiries
Please contact LKS Faculty of Medicine of The University of Hong Kong by email (medmedia@hku.hk).