The Canadian Partnership for Quality Radiotherapy is a Canadian radiation therapy community alliance that brings together representatives from three disciplines delivering radiation treatment in Canada – radiation oncology, medical physics and radiation therapy. The alliance is sponsored by the Canadian Partnership Against Cancer.

In 2010, the group began an extensive review of existing technical quality standards. The structured process involved expert review and revision as well as broad community consultation. The guidelines were validated in a real-world clinical environment and developed with a sustainability plan to assure continued relevance over time. The guidelines are currently available in English and French versions are expected to be released later in 2013. Additional guidelines are currently in development.

Radiation therapy is used to save and prolong the lives of people with cancer. About 50 per cent of individuals diagnosed with cancer receive this treatment it at some point during their care ^[1].

Find out more:

• New technical quality guidelines
• About the Canadian Partnership for Quality Radiotherapy

[1] Quality Assurance Guidance for Canadian Radiation Treatment Programs

On May 8-10, the 11^th Behavioural Research in Cancer Control Conference will convene over 150 international cancer researchers and health professionals to share their latest research on how behaviours are connected to cancer.  The conference will also provide an opportunity for Canada’s significant progress in cancer screening to be profiled internationally.

During the conference, participants will hear keynote presentations from three internationally recognised behavioural cancer researchers, including the Partnership’s VP of Cancer Control, Dr. Heather Bryant who will open the conference with a presentation, Screening: Can Old Wisdom Inform Implementation of New Screening Tests?   Dr. Bryant will highlight Canadian experiences in screening for breast and cervical cancers and how these lessons can have a positive impact on colorectal and lung cancer screening.

“There has been great progress in cancer screening over the past couple of decades and we’ve seen changes in mortality from breast and cervical cancers as a result,” said Dr. Bryant. “However, this progress hasn’t been without controversy and we need to address the controversies and the lessons learned as we consider the future potential for screening for colorectal and lung cancers.  The conference will allow the participants an opportunity to discuss these issues and to consider how best to move forward to ensure the best health impacts from our current efforts.”

Other conference topics will include:

• alcohol and cancer
• tobacco
• physical activity
• nutrition
• sun protection; and
• supportive cancer care

The conference is being hosted by the Cancer Council South Australia in Adelaide and the theme is Taking action: translating research into practice for improved cancer outcomes.   Learn more about the conference program here.

Data from the recently released study End-of-Life Hospital Care for Cancer Patients  by the Canadian Institute for Health Information (CIHI) examines the use of hospital services by cancer patients who died in acute care hospitals across Canada (excluding Quebec).  The study notes that differences in the availability and location of palliative care beds in some provinces, as well as access to home care and hospice services, may be contributing to variations in in-hospital deaths.

The new CIHI study indicates that more than 25,000 people died in hospital from cancer in 2011–2012, representing 45% of all estimated cancer deaths that year.  It provides additional data to help inform our work with partners to support cancer patients, caregivers and families in improving the patient journey for Canadians and better aligning end-of-life care with the choices of patients, their families and caregivers.

End-of-life care continues to be an emerging area of research and interest and the Partnership is exploring ways to collect and track more pan-Canadian data through its annual system performance reports.   In addition, the Canadian Partnership Against Cancer recently launched a program of work to better support patients, caregivers, families in making important choices on where care is provided, and to improve the palliative and end-of-life care journey for Canadians.

Working with the health-care community to translate data, evidence and best practices into action, the Partnership is enabling the advancement of consistent approaches to diagnosing and caring for cancer patients. Background information about the upcoming opportunity is available in the Procurement section of the Partnership’s website. The Request for Proposals or Request for Quotes will be posted in the summer of 2013.

Dr. Janet Dancey, Program Director of the High Impact Clinical Trials Program at OICR will lead the Coordinating Centre for the Canadian Cancer Clinical Trials Network.

The Canadian Partnership Against Cancer is investing in a pan-Canadian approach to strengthen Canada’s ability to conduct practice-changing clinical trials and improve cancer outcomes for Canadians. With funding from the Partnership, the Ontario Institute for Cancer Research (OICR) has been selected to develop the Coordinating Centre for the Canadian Cancer Clinical Trials Network, the leadership and administrative hub of the still-to-be-created pan-Canadian clinical trials network. Dr. Janet Dancey, Program Director of the High Impact Clinical Trials Program at OICR will lead the Coordinating Centre. The NCIC-Clinical Trials Group and N2 (Network of Networks) are collaborating with OICR on the project.

“The Coordinating Centre will link to and build upon the strengths of Canada’s existing clinical trials groups,” says Dr. Heather Bryant, Vice-President of Cancer Control at the Partnership. “Supporting existing clinical trial centres in a coordinated network would provide the opportunity for more patients to take part in leading edge research studies.”

Clinical trials are an important component of improving and advancing medical care. They are a key step in evaluating new approaches to cancer treatment, palliation and support that lead to improved patient outcomes, including increased survival and improved quality of life.

The need for a pan-Canadian cooperative program to facilitate the initiation and conduct of academic cancer clinical trials in Canada was identified in the Canadian Cancer Research Alliance’s 2011 Report on the State of Cancer Clinical Trials in Canada. Following a competitive application process adjudicated by an international panel, OICR is the successful candidate to lead the development of this program.

“We are thrilled to be leading the creation of a pan-Canadian clinical trials network,” says Dr. Dancey. “The Coordinating Centre will increase Canada’s capacity and capability to undertake clinical trials being developed by investigators from the academic sector, leading to improved outcomes for people affected by cancer.”

“Unique to this report is our analysis of researcher capacity,” says Dr. Elizabeth Eisenhauer, Head, Department of Oncology at Queen’s University, Program Medical Director for Oncology at Kingston General Hospital, and Expert Lead for Research at the Partnership.

“We did find evidence that there were more principal investigators receiving funding for cancer research in the 2009‒2010 period when compared with the 2005‒2006 period and this growth in capacity bodes well for future cancer research activity.”

Annual survey

The survey captures information from 40 organizations or programs across the country involved in cancer research^[1]. It is designed to help optimize research investment by addressing gaps, reducing duplication and fostering opportunities for collaboration. “The investment survey is a valuable source of information for cancer research funders and an integral part of the pan-Canadian cancer research strategy,” says Dr. Eisenhauer.

This year’s report also describes shifts in the distribution of research funding by cancer type including a significant growth in investment in pancreatic cancer, a cancer with a very poor survivor outlook. As well, investment in bladder, lung and esophageal cancer research has more than doubled since 2005.

Find out more

To order copies of the 2010 report, download it in PDF or PowerPoint form, or get detailed information about the survey methodology please visit the CCRA website (http://www.ccra-acrc.ca/).

The CCRA is an alliance of more than 30 organizations involved in funding cancer research. The Executive Office of the CCRA is supported by the Partnership.

[1] The Canadian Cancer Research Survey captures most of the peer-reviewed research from the voluntary and government sectors. It does not include all sources of funding. See the report for additional information.

“We know that up to 60 percent of patients will experience a sleep disturbance,” says Dr. Doris Howell of Toronto’s Princess Margaret Hospital, who led the development team for the Partnership-sponsored project.

“Sleep disturbances are often underestimated and overlooked in cancer populations. Patients report the need for greater attention to sleep disturbance early in the cancer journey and access to effective interventions. Unfortunately, patients may suffer silently with this problem assuming it to be a normal and untreatable side-effect of cancer treatment.”

The evidence-based guideline, A Pan-Canadian Practice Guideline: Prevention, Screening, Assessment and Treatment of Sleep Disturbances in Adults with Cancer, offers healthcare providers information about strategies and interventions across a broad range of sleep related issues. It recommends routine screening for sleep issues, provides information on assessment as well as insight into what has been shown to be effective in helping patients.

The guideline was produced through a collaborative partnership between the Canadian Association of Psychosocial Oncology and the Partnership. It benefited from the expertise of wide range of contributors throughout the development process.

Sleep disturbance is considered a separate issue from cancer related fatigue. A practice guideline for fatigue was created in 2011 and is also available online.

Evidence-based guidelines

The Partnership supports the development of pan-Canadian evidence-based guidelines in several ways. A Guidelines Resource Centre is available on the cancer resource portal, cancerview.ca, as well as the SAGE Directory of Clinical Practice Guidelines.

To find out more about clinical practice guidelines, watch the video What makes a high quality guideline?

April 16, 2013 – The Canadian Partnership Against Cancer is pleased to join with voices from across the healthcare community to mark National Advance Care Planning Day and encourage Canadians, including those in good health, to reflect on their end-of-life wishes.

The Speak Up campaign, led by the Canadian Hospice Palliative Care Association and supported by the Partnership, provides resources for individuals, family members and healthcare professionals start conversations about an individual’s wishes for end-of-life care.

These include wallet-sized fact cards, webinars and resources such as the new video “Conversations”: it’s how we care for each other:

CREDIT: The Advance Care Planning in Canada Initiative, facilitated by the Canadian Hospice Palliative Care Association with support from the Partnership, Canadian Researchers at the End of Life Network (CARENET) and the GlaxoSmithKline Foundation.

Dr. Lawrence Librach, the Partnership’s Senior Scientific Lead for the Person-Centred Perspective portfolio, has designed and implemented education programs on advance care planning for local, national and international groups.  In addition, Dr. Librach is a member of the Advance Care Planning National Task Group, a committee responsible for raising awareness on this important topic.

“While more Canadians are surviving cancer, it continues to be a leading cause of death, with an estimated 75,700 Canadians who died of the disease in 2012,” says Dr. Librach.  “That’s why advance care planning is so important – these discussions can give people peace of mind and help them to let others know how they want to be cared for, and ultimately help reduce added stress on the family during a difficult time.”

For more information on advance care planning and the Speak Up campaign, visit advancecareplanning.ca.   For information on palliative and end-of-life-care see the palliative care resources section of cancerview.ca.

 “In recent years, understanding of the need for both of these core elements of person-centred care has expanded rapidly,” says Dr. Margaret Fitch, Expert Lead of the patient experience and survivorship initiatives of the Person-Centred Perspective at the Partnership.

“These guides exist because of the collective will of practitioners to share expertise and learn from each other. We all strive to get the best possible programs in place for patients as quickly as possible and by working together we can improve our own programs as well as help those in the early stages of initiating programs for their patients.”

Navigation: A Guide to Implementing Best Practices in Person-Centred Care

The new navigation guide, which builds on a working document released in 2010, describes the different types of navigation programs as well as highlighting promising practices, quality and change management initiatives and providing an evaluation framework. Navigation refers to a structured approach to helping patients access the most appropriate care and resources offered by the cancer system.

Chris Power, Division Manager with Eastern Health’s provincial Cancer Care Program (Newfoundland and Labrador), says the original guide, entitled, Guide To Implementing Navigation, was invaluable in establishing the province’s professional patient navigation program, which began with nurse navigators in 2011. She is looking forward to putting the expanded guide to use. “I see the new guide being instrumental as we complete our evaluation and plan our next steps. It will be very helpful in guiding the future developments of our program.”

“For jurisdictions who are just starting out, this is a very good, in-depth and comprehensive guide to use when planning your program. It provides information on the development of patient navigation within Canada, as well as detailed information around professional navigation versus peer navigation, and also virtual navigation. It is also helpful when looking at the change management, an essential component with any new program implementation.”

Screening for Distress, the 6th Vital Sign: A Guide to Implementing Best Practices in Person-Centred Care

Cancer patients often report distress that is severe enough to affect their ability to cope effectively with their diagnosis, as documented in the expanded guide to implementing screening for distress. This has led to growing efforts to systematically identify and measure levels of distress. Cancer program accreditation standards in Canada now include screening for distress as an element in accreditation.

The revised implementation guide builds on a working draft released in 2009. The guide offers a series of modules providing the steps and considerations necessary to implement a screening for distress program and includes strategies and techniques based on insights from nine jurisdictions that were monitored while implementing screening for distress, as well as links to useful tools and resources.

“The guide was remarkable,” says Deb Bulych, Provincial Leader, Supportive Care with the Saskatchewan Cancer Agency. She credits it with kick-starting the program when they began screening for distress in 2010. “It was really the roadmap and the toolkit we needed to just get going.”

Saskatchewan now offers nurse-implemented screening for distress to new patients.  “The revised guide is wonderful because it shares information about maintaining momentum and sustainability which is another very practical piece of work that we are all involved in right now,” says Bulych. 

“It is so well laid out, providing you with the evidence base, the steps for implementation, and it shows you the potential outcome. One of the exciting aspects of the original tool was that two key areas were identified by our patients as significant and at times unmet needs – one was fatigue and one was sexuality. We trained staff in both of those areas and have developed provincial programs.  It informed a practice change for us.”

Find them on cancerview.ca

Both guides are available, in English and French, in the Person-Centred Care Toolkit  accessed through the Partnership’s cancer information portal, cancerview.ca.

The Partnership joins with partners across the country urging Canadians to talk to friends and family about the importance of colon cancer screening during March – Colon Cancer Awareness Month – and all year round.

“Colon cancer is the second leading cause of cancer death in Canada. In 2012, 5,000 men and 4,200 women were expected to die from it,^[1]” says Dr. Heather Bryant, the Partnership’s Vice-President of Cancer Control. “But through screening colorectal cancer can often be found early, while it can still be treated successfully. Screening saves lives.”

The website www.colonversation.ca provides resources to help spread the word. Produced in partnership with the National Colorectal Cancer Screening Network, it explains who should consider being screened and how the tests are done, and gives tips on how to start a “colonversation” with your doctor, friends or family. It also has multimedia resources such as Five Feet of Fabulous: 

Pan-Canadian Cancer Strategy

Cancer screening is a priority area of the Partnership’s strategic plan. In addition to the National Colorectal Cancer Screening Network and other colorectal screening-related initiatives, the Partnership supports population-based screening initiatives related to breast and cervical cancer.

For more information please see:

• Colonversation.ca
• Cancerview.ca: Prevention and Screening

[1] Canadian Cancer Society’s Steering Committee on Cancer Statistics. Canadian Cancer Statistics 2012. Toronto, ON: Canadian Cancer Society; 2012. Table 1.2.