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Estimation of HER2 membranous expression is routinely used in breast and gastric cancers, as both a prognostic and a predictive factor. To date there is no evidence for similar application of HER2 expression in colorectal cancer (CRC) cells. In CRC, HER2 is sometimes overexpressed in the cell membrane and very often in the cytoplasm. This study was conducted to determine possible correlations between both membranous and cytoplasmatic expression of HER2 in CRC cells and the outcome of the disease. The prognostic significance of combined staining intensity in the cell membrane and cytoplasm in the entire CRC cell was also investigated. HER2 expression in resectable colorectal adenocarcinoma cells was evaluated by immunohistochemistry in specimens taken from 202 patients. The percentage of cancer cells with membranous or cytoplasmatic reactions and the staining intensity of the reaction in the whole cell were recorded. A membranous reaction was present in 27% of cases, and cytoplasmatic reaction in 66% of cases. The total staining intensity in the entire cell was evaluated as moderate (2+) in 32% of cases and strong (3+) staining in 15%. There was no correlation found between either membranous or cytoplasmatic HER2 expression and survival. Furthermore combined staining intensity did not provide any prognostic information. We conclude that HER2 expression in CRC does not correlate with prognosis.

11 Background: Real life observations suggest hospice caregiving may result in physical health deterioration of family caregivers; they are less likely to participate in health-related initiatives and frequently don’t benefit from the most optimal medical care. Data reporting caregivers’ medical needs are rather scarce. Methods: The estimation of needs for specialist medical care aimed at family caregivers was carried out based on the activity called Open Day of Health Prophylaxis (ODHP – free consultations with specialists, ultrasound examinations and mammography) held annually at Rev. Eugeniusz Dutkiewicz SAC Hospice, Gdańsk, Poland during three consecutive years (2014 - 2018). In total, 715 medical consultations (median: 3 per caregiver, range: 1 - 6), 172 ultrasound, and 31 mammogram examinations were provided). The level of satisfaction expressed by the ODHP participants was also analyzed. Demographic, medical data, and involvement in the caregiving were analyzed based on consultation cards and questionnaires presented to all ODHP participants (307 total participants). Results: In total, 186 persons replied (60.59%), 103 of them fulfilled study inclusion criteria (currently or within the last 6 months providing personal care of a chronically ill person for minimum 12 hours per week), 82 (79.61%) of responders were women, most of advanced age (median: 67 years; range: 29 - 91). The vast majority (95.31%) estimated ODHP as valuable initiative. According to 52.23% ODHP completely fulfilled caregivers’ needs and expectations, 45.57% were partly satisfied, and for 2.13% the activity did not meet their expectations. The most common reason for dissatisfaction in the response was both lack of communication and access to specialists, as well inability to initiate other diagnostic tests. All responders indicated the expedient nature of ODHP activity. Conclusions: Facilitated access to medical specialists care in is well received form of support for family hospice caregivers. There is indication of a need for systemic solutions to the problems of medical care for long-term caregivers.

178 Background: Real life observations suggest CAM is frequently used by cancer patients. The profound knowledge of CAM use details is crucial for both efficacy and safety of anticancer and supportive therapy. Methods: Semi-structured pilot questionnaire about details of CAM use was presented to all 202 consecutive patients of Palliative Care Outpatient Clinic, E. Dutkiewicz SAC Hospice, Gdańsk, Poland (April-22 and September-30/2016). After excluding 112 patients (no-responders group = N-RES) due to low performance status (N = 64), lack of written agreement (n = 10), diagnosis of non-malignant disease (N = 26), others (N = 12), the final analysis included 90 patients (female: 72,0%, median age: 63,5, range: 24-94 yrs) with advanced cancer (responders = RES). Demographic and clinical data were collected at the same time, then statistically related to CAM use details. Results: RES patients were significantly younger (p = 0,0045) and in better performance status (p < 0,05) as compared to N-RES group (no difference with regard to gender, education level, primary cancer location, duration of malignant disease, marital status). Since the primary cancer diagnosis, CAM was used by 56 (62,2%) RES patients and mostly included vitamin/mineral formulations (36,7%), herbs (32,2%), alternative nutrition (24,4%), music therapy (11,1%) and Chinese medicine (5,6%). The main reasons for CAM use were: to enhance the effects of anticancer therapy (48,9%), to treat its side-effects (15,6%) or the lack of conventional therapy possibilities (5,6%). CAM was used more frequently by patients who experienced weight loss since diagnosis of cancer (p = 0,0028) or those who used CAM methods to control symptoms not related to cancer (p = 0,0109); age, gender, education level, marital status, religious practices frequency were not significantly related to CAM use. Conclusions: 1) CAM use is common among patients with advanced cancer under palliative care; 2) some factors might be in relation to higher CAM use (weight loss, CAM use to control symptoms not related to cancer); 3) further research is required to investigate better different aspects of CAM use such as safety, efficacy and outcomes in this population.

e265 Background: Voluntary activities are essential in many different aspects of hospice and palliative care. The interest in becoming a volunteer lowers in many communities. Better knowledge of volunteers’ characteristics and wider understanding of their motivations seem to be crucial for more sufficient volunteers’ recruitment and retain. Methods: Self-reported demographic details and data on motives for hospice / palliative care volunteering were collected from initial questionnaire forms fulfilled by all consecutive participants of the teaching course for medical voluntary cancer patients caregivers (16 editions; April-2006-November-2014; no data for 2009) at Rev. Eugeniusz Dutkiewicz Hospice SAC, Gdańsk, Poland. Results: all 562 records were analyzed: 1) mean volunteers age was 35,73+14,69 years and significant trend (p < 0.001) for increasing age was observed (e.g.: mean age values + SD were: 2007: 28.41+11.82; 2011: 37.19+14.93; 2014: 41.31+12.16); 2) the vast majority of volunteers were females (82.03%), who already completed education; 3) 67 of study participants declared professional connections with medicine (19.47%), 42 (12.21%) - pedagogy or 38 (11.05%) – psychology; 4) 241 (42.88%) volunteers declared full current professional activity, 174 (30.96%) were unemployed, 50 (8.89%) - retired; 5) participants mostly reported motives for volunteering which might be categorized as altruistic (67.08%: “I want to help others”) – the percentage increased significantly during the study period (p < 0.012); 6) the next two most frequently indicated motives represented category of personal gain (29.36%: “I want to improve my skills”; 26.87%: “volunteering is the way of my personal development” – not significant trend for time). Conclusions: 1) Results showed that some demographic features as well motives for hospice / palliative care volunteering changed over the time in our community - it warrants some individualization in recruitment process recognition for volunteers coordinators; 2) the study will continue to identify the volunteers’ subgroup with the greatest probability to retain at service for longer period of time.

204 Background: In spite of the fact that cancer patients under palliative care represent the group of high risk for vitamin D deficiency (e.g. changed nutritional patterns and UV exposure), data reporting vitamin D levels in palliative care setting are rather scarce. Methods: Between Jan-02/2014 and June-20/2015 circulating 25-hydroxyvitamin-D (25-OH-D) levels were analyzed in 76% consecutive patients’ samples of a single individual cancer practice located in Gdansk, Poland. Three hundred forty seven patients (female: 72.5%, median age 64, range: 23-89 years; breast cancer: 57.8%, colon cancer 27.7%) were admitted for palliative care due to: disseminated cancer (18%), side effects of anticancer therapy (56.6%) or symptom control in non-cancer diseases (24.5%). Results of fast 25-OH-D blood tests were correlated with selected clinical factors. Results: The median 25-OH-D level of all our cohort patients was 15.85 ng/mL (range: 0.40 – 62.00 ng/mL); 65.0% of subjects were vitamin D deficient (25-OH-D < 20 ng/mL) and 23.5% insufficient (20-30 ng/mL); only 3.30% patients were taking vitamin D supplements before they entered the study. The univariate analysis identified the following risk factors for inadequate 25-OH-D levels: active cancer disease (median 25-OH-D: 12.50 ng/mL versus 17.86 ng/mL in patients without evidence of disease, p < 0.001) and current glucocorticoids use (at least 14 days within the last month: 11.58 ng/mL versus 17.12 ng/mL in glucocorticoids nonusers; p < 0.01). Age, gender, body mass index values, primary cancer location, dominant metastatic site and higher antibiotics use did not influence 25-OH-D levels. Conclusions: 1) Low (deficient or insufficient) 25-OH-D serum levels were highly prevalent in palliative cancer care outpatients, mostly in those with clinically active disease and using glucocorticoids; 2) the study will continue to address the correlation between 25-OH-D concentrations and symptom burden as well as the potential feasibility of vitamin D supplementation to improve symptoms management of patients in palliative care setting.