e22164 Background: Home hospice is relatively a new concept in Nepal. Up to 90% of approximately 30,000 cancer patients diagnosed in Nepal every year die within a year. We share our initial experience with home hospice program in Nepal. Methods: The home hospice (HH) program was established in January 2016. This program serves the patients in Kathmandu Valley in, Nepal. This is a joint collaborative program of Cancer Care Nepal (CCN) with technical support from National Hospital and Cancer Research Center, Jawalakhel. The HH services are provided free of cost to the patients at their homes. We evaluated the 126 enrolled patients from January 2016 to October 2017. Results: Among 126 patients, 78 were women and 56 men. Median age was 61 Years (27-85 years). Majority of the patients had lung cancer 28(22%) followed by gastrointestinal 24(19%), cervix 16(13%), hepatobiliary 16(13%), Breast 10(8%), haematological malignancy 7(9%), colo-rectal 7(6%) and 16(13%) were miscellaneous cancers. Commonest symptoms included nausea (85.71%), pain (76.19%), cough (66.69%) and constipation (57.14 %). Patients were treated with morphine and tramadol for pain management. 19 patients with moderate to severe pain responded well rendering pain score to mild. Average dose of morphine prescribed was 40 mg (range: 20 – 60 mg). 64 patients died at home and 6 in hospital and 56 are still under home hospice care. The average length of stay in hospice care from admission until death was one month. Conclusions: The home hospice program though in very early stage has helped many patients with terminal cancer, and their families. The essence of home hospice is to provide care that embraces not only physical needs but also emotional, social and spiritual support. Home hospice care is able to value the strong cultural bond that many patients during their end of life want to be at home surrounded with family members and die peacefully. We believe that HH is able to preserve this core cultural value of our society. Due to our socio- cultural and economic environment, free services like our program, may encourage the enrollment of many more patients to avail the service and help them have quality life and die with dignity.

Lung cancer is the leading cause of cancer related morbidity and mortality in both the sexes in Nepal. It accounts for 15.4 % of total cancer as per hospital based Cancer Registry in Nepal. Majority of patients are diagnosed and treated at advanced stage. This can be partly contributed to long lag period between the onset of symptoms and the initiation of cancer treatment. This study tries to evaluate the factor contributing delays in various steps in lung cancer diagnosis and treatment. This retrospective cross-sectional observational study was conducted at Department of Clinical Oncology, Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal. We reviewed the record of the all registered, histologically diagnosed lung cancer patient during the year 2012 and 2013. A total of 123 patients were diagnosed as Lung cancer and their records were evaluated. Out of these 123 patients, 60% of the cases were males. The mean age was 63.93 years with the youngest being 35 and the eldest was 83 years. Significant number of patient was in stage III (59%) and IV (33%). About 89% of the patients were smokers. Non-small cell lung cancer (NSCLC) accounted 83% and small cell lung cancer was (SCLC) 17%. A total of 17% (21) of patient were on empirical Anti-tubercular treatment (ATT) since the onset of current symptoms. While analyzing delay with independent T test showed mean delay of 25.01 days (-/+ SD 6.17) in patient without ATT and with ATT delay was 57.09 days (-/+ SD 8.05) (p=<0.01). Thirty five percentage (43) of patient received treatment within 1 month from the first hospital visit, 28% (34) within two months and 37%(46) within 3-4 months of the first hospital visit. The delay in specialist visit was shorter in advanced cancer and small cell cancer may be because of the acute presenting symptoms. Various factors contributing for the delays are lag time from symptom onset to first visit with primary physician, delay due to investigation and symptomatic treatment under primary physician care, delay further aggravated by empirical but inappropriate ATT, further delay due to diagnostic procedure to establish the cancer diagnosis. Thus proper and timely referral to the specialist from primary physician will reduce these delays and help to avoid situation where curable disease become incurable and significantly alters the prognosis.

e12572 Background: Nepal being one of the economically challenged developing countries has been lagging behind in all healthcare facilities. Cancer is now emerging as a major Non-communicable (NCD) disease accounting for 9% of all NCDs. Lack of preventive measures, screening and awareness programme is hindrance in the early diagnosis. Hence, we aimed to study the epidemiological variables of various cancers so that risk factors can be identified. Methods: A Prospective, observational, cross sectional study was conducted from July 2012 to December 2012 for a period of six months. All patients with histological diagnosis of cancer attending the National Hospital and Cancer Research Centre were enrolled. A Questionnaire was formed in English and patients were asked to answer the questionnaire. Results: Out of 142 patients diagnosed with cancer, 22 different types of cancer were noticed and the most common was lung cancer in both sex with 28% incidence followed by breast 18%, gynecological cancer 15%, colorectal 9%, hepatobillary 9%, gastrointestinal 8%, lymphoma 6%, Head and neck 4%. Out of them, 61% were females and 39% were males and 96% of patient were married. The most common age group at diagnosis was 41-60 years and comprised of 42% of total. About 37% of the patient earned their living by agriculture. About 44% of the patient has annual income of over USD 2500. The most common ethnic group with cancer was identified as Newar with 48% prevalence of cancer. About 36% of the patients were illiterate, 20% are literate. Total of 51% of the patient were smoker, 19% are taking alcohol till recently and 27% consume alcohol occasionally. Only 9% of the patient are vegetarian and the 91% non-vegetarian group mostly eat red meat. Significant number (64%) of the patient is consuming the commercial, canned food. Very few patients are aware of exercise (22%) and meditation (11%). Conclusions: This is a single institution study and with lots of limitation. However, this can be used to find risk factors associated with our ethnic and cultural variation and thus a multicentric study is advisable to formulate National level preventive and screening programme.