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HEALTH
Wednesday, January 23, 2013
THE CHRONICLE-JOURNAL
Kenora’s Cancer Care Unit Over 25 Years Old
By Graham Strong
Regional Cancer Care Northwest
(RCC) partners closely with 13
satellite sites throughout Northwestern
Ontario to provide closer-to-home
chemotherapy and other cancer care
services. In this ongoing series about
regional cancer services, we find out
about Kenora’s Cancer Care Unit.
Of all the chemotherapy
programs in Northwestern
Ontario, Kenora has the
largest outside of
Thunder Bay. And, it
turns out, the oldest.
Dr. James Beveridge,
who has been practicing in Kenora for
40 years, played a large part in
bringing chemotherapy to Kenora. It
started in December 1985 when a
patient of his who was being treated
for breast cancer in Winnipeg asked if
she could get her chemotherapy in
Thunder Bay so she could go home to
Red Rock for Christmas.
“I looked at her chemo protocol
and said, ‘By golly, this is a pretty
simple protocol.’ I phoned her and
said I could probably give it to her
right in Kenora. So that was the start
of our chemo program,” Dr.
Beveridge said.
Today, the Cancer Care Unit at the
Lake of the Woods District Hospital
has about 3,000 patient visits per year,
including 1,000 chemotherapy
treatments. Initially, most of the
patients – about 90% – were being
treated out of Winnipeg but today
90% of the patients are treated
through Thunder Bay. The Unit is
open Monday to Thursday, though
Dr. Beveridge said they would like to
find funding that would allow them
to operate five days per week.
The unit is staffed with two
physicians
(Dr.
Beveridge and Dr.
Sandra Sas), and three
nurses. The program has
access to a palliative care nurse
and a social worker, and has several
other patient support programs
including access to programs via
Telemedicine. The Unit also has a 24hour phone answering service for
cancer patients should they need
urgent assistance – an alternative to
the Emergency Department.
“The Emergency Department is a
bad place to be… we want to keep
them away from germs,” Dr.
Beveridge said. The team can
troubleshoot for them and direct
them to the right care, whether that is
with their Family Physician,
oncologist, or at the Unit itself.
There are many advantages to
having a local cancer care program.
Holly Rose, who has worked at the
unit as a nurse for the last seven years,
“Beveridge’s Babes”, the 2006 event team made up of nurses and physicians from the Cancer Care Unit and others in
Kenora. From left to right: Kim Halverson, Dr. Jim Beveridge, Donna Burkhart, Dr. Sandra Sas, Carolyn Hamlyn,
Holly Rose, Joelle Thompson, and Brigitte Tellier.
said that chemotherapy is hard
enough without travel.
“It’s necessary to have something
so close to home,” Rose said. “For
people to have to drive three hours or
six hours… it would take such a toll
on them when they are already feeling
sick.”
She added that it’s also convenient
for patients with questions and
concerns to call or drop in at the
Unit.
All three of the nurses working at
the Cancer Care Unit had special
training to get their oncology nursing
certification. Rose said she’s glad that
they are able to offer cancer care
services, and takes pride in creating a
welcoming, trusting environment.
“Whenever people ask me where I
work they say, ‘Oh, it must be so
hard,’ but really we all love it here,”
Rose said. “We do see a lot of sadness,
but we also see a lot of great stories.
The biggest compliment we get from
patients is that they’re sad to leave
when they finish their chemotherapy.”
Live, work, play...even better smoke-free
"Live, work, play... even better
smoke-free." That is the theme of
this year’s National Non-Smoking
Week (NNSW), which runs from
January 20 to 26, 2013.
As part of its NNSW celebrations,
the cafeteria at Thunder Bay
Regional Health Sciences Centre
(TBRHSC) will be serving cold
turkey sandwiches. But quitting cold
turkey is certainly not the only way
to quit smoking and less than 5 %
successful, according to Jim Morris,
Quit Coach at the Cancer Centre’s
Nicotine Dependence Centre.
“The most successful way to quit
is to combine planning, approved
medications and counselling,” says
Morris, who will be joining
representatives from Smokers’
Helpline, Cancer Care Ontario and
Thunder Bay District Health Unit in
the ‘Even Better Smoke-Free’
displays in the TBRHSC cafeteria on
Wednesday, January 23, also known
as Weedless Wednesday.
Weedless Wednesday has been a
highlight of National Non-Smoking
Week almost from the start, focusing
media and public attention on the
benefits of cessation and the
community resources available to
help smokers quit. The idea behind
Weedless Wednesday is to promote a
"one day at a time" approach to
quitting smoking, a concept
appealing to many smokers who may
be discouraged at the thought of an
entire week, or lifetime, without
cigarettes, but who may be able to
cope with one smoke-free day.
Morris recognizes how difficult it
can be for people to cease tobacco
use and has even coined nicotine the
“King of Drugs.” “It’s an upper and
a downer; it’s legal, available 24/7,
instant, doesn’t intoxicate, not that
expensive and, until recently, you
could do it everywhere,” he says.
“But, there’s nothing wrong with
nicotine – it’s the delivery device
called the cigarette that’s the
problem.”
Morris advocates the ‘one day at a
time’ approach to quitting and
encourages smokers to try quitting
for Weedless Wednesday and see how
comfortable they are without
smoking. “It gives people a chance
to try to quit for one day,” says
Morris. “The medical definition of a
non-smoker is a person who has not
Jim Morris uses a bottle of Ketchup and Gatorade to illustrate the difference between a smoker’s blood, made thicker by
carbon monoxide, and a non-smoker’s blood that is thin, similar to Gatorade.
smoked for 24 hours, so if you get
through the day, you can call yourself
a non-smoker.”
National Non-Smoking Week has
been observed for more than 30
years. It is one of the longest
running and most important events
in Canada’s ongoing public health
education efforts. Established in
1977 by the Canadian Council for
Tobacco Control (CCTC), its goals
are to educate Canadians about the
dangers of smoking; prevent people
who do not smoke from beginning
to smoke and becoming addicted to
tobacco; to help people quit
smoking; promote the right of
individuals to breathe air unpolluted
by tobacco smoke; denormalize the
tobacco industry, tobacco industry
marketing
practices,
tobacco
products, and tobacco use; and assist
in the attainment of a smoke-free
society in Canada.
Dr. Heather McLean Takes on New Regional Primary Care Lead Role
“Bringing the voice of primary care
into the cancer system and the voice
of cancer to primary care.” – Cancer
Care Ontario Primary Care Motto
Cancer Care Ontario (CCO)
believes that a strong primary care
system is the foundation of a strong
healthcare system. In 2008, CCO
looked for a way to meaningfully
engage primary care in the cancer
system and recruited a family
physician from each region in Ontario
to become a Regional Primary Care
Lead (RPCL). These thirteen PCLs,
together with a Provincial Lead,
formed the first Provincial Primary
Care and Cancer Network (PPCCN)
in Ontario.
Initially, the PPCCN focused on
colorectal cancer screening, and Dr.
Heather McLean, a busy Thunder
Bay family physician, became the first
Northwest Regional Primary Care
Lead. As time passed, Regional
Primary Care Leads found that their
input and expertise was being sought
for various cancer program initiatives
including
developing
and
implementing diagnostic assessment
programs, survivorship models for
care, and integrating palliative care.
CCO realized the value of primary
care input and engagement across the
cancer care continuum and made
funding available to expand the
Regional Primary Care Lead
positions.
The Network has grown to include
18 RPCLs who, together, reach out
to engage with 13,000 primary care
providers across the province. Now,
Regional Cancer Care Northwest has
two RPCLs – each one working the
equivalent of one day per week. Dr.
Margaret Woods brings a fresh
primary care perspective to the
Prevention and Screening Lead role
while Dr. McLean takes on a newly
funded role that encompasses the
whole cancer journey.
As she became involved in
challenges beyond Prevention and
Screening, such as helping to improve
the process of discharging patients
from the Regional Cancer Program
back to their primary care provider or
helping to improve breast assessment
in the region, Dr. McLean wanted to
do more.
When asked what she would like
to achieve in her new position, Dr.
McLean feels that her overarching
goal is “to help bring the voice of
primary care into the cancer program
and to continually improve existing
initiatives
and
those
under
development.” She hopes to engage
the public around these initiatives
too.
A big part of her plans for the next
few years is to see more primary care
involvement in palliative care to help
improve symptom management for
patients. “Anyone with a chronic
condition or illness, such as late stage
liver or lung disease, as well as cancer,
may be in a position to receive
palliative care to improve their quality
of life,” says Dr. McLean. “I will work
with our Palliative Care Lead, Dr.
Kevin Miller, to achieve this.”
Regional Cancer Care Northwest
already has a number of Diagnostic
Assessment Programs (DAPs) –
including lung and colorectal – that
have helped to improve wait times
and patient navigation of the cancer
system. Dr. McLean will help to
develop new cervical and prostate
DAPs to streamline processes and
ensure that people being investigated
for cervical and prostate cancers
receive the best care possible.
The Provincial Primary Care in
Cancer Network has been a positive
addition to regional cancer programs.
“Often,” Dr. McLean points out,
“primary care has been left out in the
development and implementation of
programs that directly impact how
care is provided in the community
and hospital. The Network builds on
primary care skills and capitalizes on
perhaps the most vital thing about
our role – the continuity of care with
our patients,” says Dr. McLean. “We
see our patients when they are well,
when they are ill, and through every
life phase – birth, pregnancy, death,
and other life transitions.”
The PPCCN has served as a model
for primary care leadership in areas
other than cancer. Regional primary
care leadership positions have been
developed for diabetes and in each
Local Health Integration Network
(LHIN). It has opened opportunities
for primary care to be involved at the
provincial level, such as guideline
development and review, or assessing
new models of care.
“It is rewarding to bring a primary
care perspective to the regional cancer
program and help find solutions for
the daily problems that patients and
primary care providers face,” says Dr.
McLean. “But as my patients would
tell you, I am never far from
Prevention and Screening – it is an
integral part of my family practice.”
Material has been provided by Thunder Bay Regional Health Sciences Foundation and its partners.
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