Due to the COVID-19 pandemic and the military invasion of Ukraine by Russia, this Sapporo Conference for Palliative and Supportive Care in Cancer has been changed to a joint 3rd and 4th conference. The first two days are based on the original program for the 3rd conference, of which I was in charge. For the third day, a special program has been planned by Satoshi Miyake, the Chairman of the 4th conference. Through the addition of new input from the two of us, we believe that the joint international conference offers a meaningful program. Below is a brief introduction to the first two days of the program. Each day consists of a single paradigm.

Day 1: Palliative Oncology
Symposium: Opioids and Cancer Pain: Evolving Science and Practice
The recent advances in basic opioid research have been remarkable. By understanding the results of the basic research and applying them to clinical practice, more effective management of cancer pain is expected. Further, opioids are said to be deeply involved in the mechanisms underlying other symptoms. This symposium will discuss the latest science and practice related to opioids. We have asked Dr. Russell Portenoy to arrange the speakers.
Luncheon Seminar: “Integration of Oncology and Palliative Care, a review of its history and directions for the future” by Prof. Stein Kaasa, a pioneer in cancer palliative care. This seminar aims to remind us of the sustainable and disruptive innovation of Clayton M. Christensen.
Plenary Session: Recent progress in the integration of standard oncology and palliative care
New research is being developed in each of these fields and lectures by leading experts have been prepared.

Day 2: Psycho-oncology or the Humanities
Symposium: Making the Case for Integration of Spiritual Issues in Palliative care
With the importance being placed on spiritual care, there is a desire among non-religious people who do not believe in a specific religion to understand it. An essential discussion of spirituality is expected.
Luncheon Seminar: Prof. Sheldon Solomon will give a lecture on the “Palliative Care in Medicine and in Life: An Existential Account”.
Plenary Session: Determinants and effects of existential suffering in the clinics of palliative care
The differentiation of existential suffering from spiritual suffering is an important issue, and this is the first time that this point of view will been discussed in a public forum. Also, the essence of existential pain and the means of providing care for it will be explained from the perspective of psycho-oncology.

In addition, two evening seminars has been planned through discussion with Satoshi Miyake, the Chairman of the 4th conference. Prof. Philip Larkin, the former president of the European Palliative Care Association and a nurse will present on the first evening. And on the second evening, Dr Joseph Clark, a young expert in palliative care health policy research will present.

We pray that everyone who participates in the joint 3rd/4th SCPSC will come into contact with the world's most advanced palliative oncology and psycho-oncology, and that the new encounters in Sapporo will be meaningful.

Takeshi Terui
Chair, The 3rd Sapporo Conference for Palliative and Supportive Care in Cancer
Higashi Sapporo Hospital
November 24th, 2022

The name of the organization was changed to the International Research Society for Palliative Cancer Care (IRS-SCPSC), and this is the third time that the Sapporo Conference for Palliative and Supportive Care in Cancer (SCPSC) will be held. The organization has been restructured as an international research society centered on the Asian region, with future activities expected to be centered round Palliative Oncology and Psycho-oncology. The reasoning behind this focus is that due to current advances in cancer treatment, the number of patients who continue with their daily lives while receiving cancer treatment (including those who cannot proceed with treatment unless they continue to work) is increasing. Moreover, there is no doubt that future cancer treatment and research will require greater collaboration with technology and the humanities, as well as medicine and biology, toward successfully dealing with cancer symptoms, adverse events associated with cancer treatment, psychosocial problems, interpersonal relationships including those involving family members family, social systems, and so on.
The 3rd conference was originally scheduled for 2020 and the 4th for 2023, but due to the COVID-19 pandemic and the military invasion of Ukraine by Russia, the two events will be held jointly. Furthermore rescheduled, the event will finally be held in April 2023. As the Chairman of the 4th SCPSC, I will be in charge the program for the 3rd day. For the morning, we have organized a Plenary Session on the theme of Technology-enabled palliative care in Palliative Oncology, and Dr. David Hui will be the chair. Many of us also experienced telemedicine and patient interviews using tablets during the COVID-19 pandemic; however, this session covers the possibilities of medical treatment using technology and ethical issues arising from that. At the luncheon seminar, Prof. Declan Walsh, Editor-in-chief of BMJ Supportive and Palliative Care, will give a lecture on the " Supportive oncology: a novel department in a major US cancer institute"
For the afternoon, we have planned a Symposium on the theme of euthanasia physician assisted suicide. Prof. Harvey Max Chochinov will be the chair and Prof. Friedrich Stiefel will be the co-chair of this symposium. In Japan, we have had few opportunities to discuss this theme head-on, but I hope that we can have a wide-reaching discussion of the issues, including the current situations in other countries.

This SCPSC has been extended to 3 days, which are closely packed with interesting content. Along with Takeshi Terui, the Chairman of the 3rd conference, I hope that this conference will afford an opportunity for us contemplate together medical care and research in relation to post-COVID-19 pandemic Palliative Oncology and Psycho-oncology.

Satoshi Miyake
Chair, The 4th Sapporo Conference for Palliative and Supportive Care in Cancer
Tsuchiura Kyodo General Hospital / Tokyo Medical and Dental University
November 24th, 2022