Sid Tabak
“Things are very, very exciting
at Southlake. It is the new model for a cancer centre where you take a very well-managed, high functioning community hospital and you put it in a coaching and support relationship with one of the best cancer canters in the world (Princess Margaret) and you build in a cancer program that delivers care in the best way on the planet.”
— Terry Sullivan, President and CEO
of Cancer Care Ontario
Health
June 23, 2008 02:41 PM
beingwell magazine Summer 2008
By: Robin Harvey
Terry Sullivan is proud of the momentum that’s rippling reform through cancer care in this province, creating what he calls a “world-class model” based on expansion, efficient use of existing resources and a model of state-of-the-art care.
“We’ve identified four priorities: expanding and improving our screening activity; improving the diagnostic phase of care; improving the quality of care on a regional level; then planning for individualized treatments,” Mr. Sullivan told beingwell, when summarizing the 2008-2011 Ontario Cancer Plan, at a forum at Southlake Regional Health Centre this spring. It is the province’s second phase of an overall cancer reform policy strategy, which began in 2005.
Mr. Sullivan, President and CEO of Cancer Care Ontario, says the foundations of this next three-year road map are based on solid progress made during the first phase. One building block of this next phase will be to continue to boost cancer-screening rates, he says.
“Expanding and improving our screening activity is up at the top of the list of our priorities and that means breast cancer screening, cervical and of course, our latest efforts in colorectal screening,” Mr. Sullivan says.
Under the plan, cancer-screening targets for 2010 are:
• A total of 70 per cent of Ontario women ages 50 to 69 will be screened for breast cancer, compared to the current rate of 60 per cent.
• A total of 85 per cent of eligible women will be screened for cervical cancer, compared to 70 per cent in 2007.
• A total of 40 per cent of eligible Ontarians — generally considered those over age 50 or those with a strong family history of the disease — will be screened for colorectal cancer, an increase from 17 per cent in 2007.
Another key element will be reducing the time period from when a patient first sees their family doctor about a suspected cancer, through subsequent visits to specialists, follow up tests and diagnostic services to an eventual positive or negative diagnosis.
Eventually, the province hopes to establish cancer diagnostic assessment centres for many cancers, starting with breast cancer, lung cancer and colorectal cancer, in each of the province’s 14 Local Health Integration Networks (LHINs), Mr. Sullivan says.
These facilities will centralize the diagnostic and assessment services needed to detect cancers, such as radiology and imaging technology, laboratory and pathology services, as well as surgical services and expertise, Mr. Sullivan says. And they will aim to reach a treatment decision for each patient within uniform and consistent time frames.
“There is a deliberate intent to compress down the sequence of events so that in a short window of time you will know whether you are dealing with a diagnosis of cancer and require treatment and you are not left worrying about this,” he says.
As screening for and diagnosis of the major cancers improves, Ontario will also improve the quality of regional cancer-care services, so patients will have access to better cancer surgery and specialized chemotherapy treatment, Mr. Sullivan says.
One way this will happen is by creating more regional thoracic surgical centres to treat lung and esophageal cancer patients, he says.
Right now, about 30 hospitals across the province do thoracic surgery, but over time that will be reduced to 14, or one per LHIN.
As a result, the remaining facilities doing thoracic surgery will increase their volume, hence, their expertise, creating better treatment outcomes, he says.
“For very complex surgical procedures you need highly skilled people who are doing them day in and day out,” Mr. Sullivan says.
The plan also aims to increase access across the province to the “gold standard” in radiation therapy technology — known as intense modulated radiation therapy.
It lets doctors more accurately treat irregularly shaped tumors, sparing healthy cells and surrounding tissue.
There will also be more emphasis on the orderly introduction of new technologies and research techniques, especially in molecular oncology, Mr. Sullivan says.
Molecular oncology targets a cancer’s molecular and genetic pathways, employing the newest cancer-fighting drugs and treatments.
“In breast cancer, we now have a panel of 10 different receptors you can test for that can help target the best chemo and treatment management,” he says. “But we’d like to close the gap between research and best practice.”
However, this involves evaluating the proven medical benefits versus the costs of any drug or treatment and that is always hard to do, he says.
Mr. Sullivan says cancer care reform is a crucial priority, considering the province’s grim cancer statistics. As the boomers age in the next 10 years, he says, Ontario will see a 40 per cent hike in those living with cancer. In 2007, 172 Ontarians were diagnosed with cancer each day, but by 2117, the figure could hit 228 per day, unless we continue to make big strides in cancer prevention, he cautions.
Getting the cancer prevention message to the public is crucial because 50 per cent of all cancers can be prevented, he says. “Regular exercise, having a healthy body weight and a healthy diet with more plant food and less red meat … these are important for cancer and important for all chronic disease,” he says. “And of course not smoking is at the top of the list.”
Creative public education programs, such as the provincial health ministry’s recent television ad showing an “invisible man” who can see he has colon cancer, are all examples of what is needed, Mr. Sullivan says.
But despite the grim cancer statistics, he says, Ontario has made good progress under phase one of the plan. He cites reduced treatment wait times (radiation treatment wait times went down 31 per cent from 2003/04 to 2006/07), and the introduction of colorectal cancer screening (begun in 2007) as major achievements in the last three years.
Banning public smoking by enacting the Smoke-Free Ontario Act in May 2006 and the introduction of HPV vaccinations for Grade 8 Ontario girls in 2007 were also milestones in Ontario’s war against cancer, he says.
And facilities such as Southlake Regional Health Centre are playing a big role and will continue to do so, Mr. Sullivan says. “Things are very, very exciting at Southlake,” he says. “It is the new model for a cancer centre where you take a very well-managed, high functioning community hospital and you put it in a coaching and support relationship with one of the best cancer centres in the world (Princess Margaret) and you build in a cancer program that delivers care in the best way on the planet.”
For information on cancer screening guidelines, visit the Canadian Cancer Society website at www.cancer.ca or call 1-888-939-3333.
For information on the Ontario Cancer Care Plan, visit www.cancercare.on.ca