Attending the 5th Sapporo Conference for Palliative and Supportive Care in Cancer gave us the chance to step away from our usual roles and look at palliative care from a wider perspective. We came as clinicians and Cynthia Goh Fellows, but also as learners trying to understand how the field is changing and what that change should mean for the people we serve.
What struck us most was the seriousness with which the conference treated both science and human experience. The presentations were grounded in current research, yet they never lost sight of the person behind the illness. Palliative care is sometimes misunderstood as care that begins only when treatment ends. In reality, it is an approach that helps people live as well as possible while facing serious illness. It supports symptom control, decision-making, emotional well-being, family relationships, and the practical realities that illness brings.
The sessions on pain were a strong reminder that even the most familiar areas of care continue to evolve. Our understanding of pain, medicines, side effects, and individual response is still growing. At the same time, scientific knowledge has limits. Some of the most challenging discussions during the conference centered on suffering, choice, dignity, and the role of the clinician when there is no clear answer. These conversations pushed us to reflect on questions that sit at the heart of serious illness. Who decides what level of suffering is bearable? How do we respect a patient’s wishes while making sure that fear, untreated symptoms, poor access to care, or family pressure are not shaping decisions in harmful ways? How do we offer guidance without taking control away from the person whose life is being affected?
These are difficult questions because serious illness is never purely medical. It changes how people see themselves, their future, their relationships. Patients may worry about being a burden. Families may struggle with guilt, disagreement, or uncertainty. Some concerns can be treated. Others must first be heard. This is where palliative care has a distinct role. It creates space for honest conversations, especially when the path ahead is uncertain. It helps patients and families understand what is happening, consider what matters most, and make decisions that reflect their values. It also asks clinicians to recognize when there is no perfect response and to resist the urge to speak with certainty simply because uncertainty is uncomfortable.
Our conversations in Sapporo also turned toward the gap between research, models of care and everyday practice. Many advances are promising, but they may depend on resources that are not available in every country or community. This is where local research, adaptation, and collaboration become important. As members of the Asia Pacific Region, we are tasked to ask what can be learned, what can be tested, and what can be made accessible without losing quality.
We returned home with new ideas, but also with a clearer sense of what palliative care should continue to become. It must remain scientifically strong, deeply person-centred, and responsive to the realities of different communities. Death and dying are human experiences. Medicine cannot answer every question they raise. Palliative care does not claim otherwise. What it can offer is carefully tailored treatment, honest guidance, relief where relief is possible, and steady presence when the answers are incomplete.
Snapshots from SCPSC 2026 in Sapporo. Cynthia Goh Fellows came together to reflect on sessions that deepened our understanding of pain, suffering, and dignity, while reminding us that care is never only medical. Science met humanity, and fellowship grew!
Written by:
- Dr Maricar Sabeniano is Director for Training & Advocacy, The Ruth Foundation for Palliative and Hospice Care, Philippines
- Dr Ann Toh is Principal Resident Physician, HCA Hospice, Singapore
- Dr Aaron Wong is Clinical Director Supportive & Palliative Care service, Eastern Health, Australia
They are also fellows from Batch 2 of the Cynthia Goh Palliative Care Fellowship (CGF). The CGF is administered by the Asia Pacific Hospice Palliative Care Network (APHN), with support and guidance from the Lien Foundation.
