beingwell magazine Summer 2007
The inescapable fact, as confirmed by Cancer Care Ontario, is that by 2012 almost half of us will be diagnosed with cancer in our lifetime.
As cancer begins to surpass heart disease as the leading cause of death in Canada, everyone should all be interested and highly motivated to understanding and working on improving how cancer treatment is delivered across the province.
“The growth of the disease and the increasing complexity of care compels us to seek better methods of delivery,” said Dr. Terrance Sullivan, president and CEO of Cancer Care Ontario (CCO). “The scale of treatment will have a substantial effect on the evolution of health care and on hospitals.”
Witness the construction of the Regional Cancer Centre at Southlake.
More than bricks and mortar, this building and associated regional program are part of a province-wide plan to improve the quality, accessibility and efficiency of cancer care and is integrated with an entire network of facilities and resources throughout Ontario.
By approving and establishing the Regional Cancer Centre at Southlake and other regional centres, the Ontario Ministry of Health and CCO are easing the heavy travel burden on patients who have had to endure lengthy and time consuming trips to downtown academic centres. At the same time, it is raising the bar on the quality of care and the access to specialized services in each region.
“It has been a long journey,” said Dr. Sullivan of this massive undertaking. “The good news is that we are making progress. The challenges: there are many of these, the biggest being the growth of the disease.”
The disease: cancer. The prognosis: almost half of us. A sobering statistic under any circumstances but, picturing that division of haves and have-nots in any gathering of your friends, co-workers or family emphasizes the fact that cancer really does affect all of us, even if we are personally fortunate enough to avoid the disease ourselves.
There are many possible causes for the increasing prevalence of cancer, but perhaps some of the most important factors are the absolute increase in population numbers,
the baby-boomer population where cancer incidence is higher and and our ever-changing environment.
Other factors affecting the incidence of cancer include the increased proportion of the population classed as overweight or obese, the level of physical activity, dietary habits and persistence by some for tobacco use.
The diagnosis or term cancer refers to more than 200 specific diseases, each with a variety of causes, treatment plans and projected outcomes. The disease is seen in all age groups, with some cancers having a predilection for children as young as only a few months old. While research and clinical studies have led to better prognosis for many patients, coordinating the clinical knowledge and complex treatments ensures the best possible outcome for the greatest number of patients.
“It really is a very big picture,” said Dr. Sullivan. “It is not simply a doctor and a patient. Previously, care was very narrowly focused on having skilled and knowledgeable doctors with access to therapies.”
The future is very much in coordinating the full continuum of care, from prevention, to screening, to rapid accurate diagnosis, to treatment and symptom management. Obviously as more cancers are prevented or detected in an early stage, fewer patients will need to face the challenges of long treatment protocols.
Prevention and screening are key components of comprehensive cancer care management and this responsibility must be embraced by every member of society, not just health care providers or government.
We now know people who take preventative steps by eating plenty of fruits and vegetables, exercising regularly, maintaining a healthy weight and not smoking are at a lower risk of cancer. Regular screening for prostate, breast and cervical cancers provide the opportunity for earlier diagnosis, greatly increasing a patient’s odds for successful treatment.
Raising public awareness and ensuring people have access to cancer screening programs is part of the Cancer Care Ontario strategy.
With initiatives such as Smoke-free Ontario and the emerging Healthy Eating Active Living (HEAL) program, the province is educating the public and directing policy toward preventative health care measures, specifically cancer prevention. As well, regional cancer centres will be able to increase their capacity for screening.
According to Cancer Care Ontario, not enough individuals are taking advantage of existing breast and cervical cancer screening programs and even fewer are screened for colorectal cancers. By putting the people and facilities that support these programs into the communities, together with increased emphasis on the importance of early diagnosis, the province would like to boost screening to more than 90 per cent participation for those at risk.
Despite the best prevention and screening programs, some patients will have to face the diagnosis of cancer, which may be at any level of progression. At that point in time, patients will be reassured by the knowledge one of the best, state-of-the-art cancer treatment facility, soon to include radiation treatment is available right in their own community at the Regional Cancer Centre at Southlake.
“Consistency of care is a core component of the Local Health Integration Network (LHIN),” said Dr. Sullivan, explaining the need for high quality care is universal. Regional centres, such as the one at Southlake, will be “centres of excellence” that work at the highest provincial standard for cancer care.
For patients this means treatment will be provided by a variety of skilled specialists: Doctors and staff who are at the forefront of their fields but who also know the resources of their own communities. Further, with the recently announced partnership with Princess Margaret Hospital, Southlake staff and physicians — and ultimately their patients — will have access to the innovations and research of the Princess Margaret’s renowned expertise and knowledge.
As part of the enhanced level of care that will be available at Southlake, patients will benefit from state-of-the-art technology as well. Digital mammography and radiation treatment top the list of advanced procedures that will be available close to home.
Surgical oncology at Southlake already includes thoracic (lung and esophagus) procedures, laparoscopic prostatctomy, laparoscopic bowel surgery as well as breast cancer surgery, including breast reconstruction, which may be possible at the same time as the initial surgery.
For the ultimate benefit of patients, all cancer centres participate in clinical trials and share non-identifying data on patients with CCO, contributing to province-wide health studies and increasing the pool of information to advance the quality of care for all patients.
“Research is useless if we can’t implement this in our community,” said Dr. Mary Gospodarowicz of Princess Margaret Hospital, a key participant in the integration model of cancer care. With half of us expected to be diagnosed with cancer in our lifetime, and the other half knowing, supporting or loving a patient at least once, all of us benefit from the improvements in service delivery for cancer care.