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After Cancer Treatment Transition Clinic (ACTT)

The ACTT Clinic provides comprehensive cancer survivorship care to women and men who have completed their cancer treatment at Princess Margaret Cancer Centre and/or Women’s College Hospital and are now cancer free. To be seen at the ACTT clinic, patients need to be referred by the doctors who treated their cancer.

These are the types of cancer that are seen at the ACTT clinic:

  • breast cancer
  • thyroid cancer
  • gynecological cancer (e.g. uterine, cervical, ovarian cancer)
  • melanoma
  • gastrointestinal (e.g. colon, rectal cancer)
  • testicular cancer

Patients are followed up in this clinic for a limited amount of time depending on their needs, treatment, and surveillance plan. Eventually, patients are transitioned from the ACTT team to their primary care practitioners when appropriate as per evidence-based guidelines and protocols. When a recurrence is detected, the ACTT team facilitates investigations and referrals back to the treating oncologists in a timely manner. 

ACTT Clinic Patient Eligibility Criteria:

To be seen in the ACTT clinic, you need to meet all the following criteria:

  • Previous diagnosis of breast cancer, thyroid cancer, gynecological cancer, gastrointestinal cancer, testicular cancer or melanoma
  • Completed cancer treatment at Princess Margaret Cancer Centre and/or Women’s College Hospital
  • Referred by treating Oncologist/GPO/WCH Endocrinologist or referred back by primary care practitioners after discharge from ACTT for a concern related to previous cancer

Patients Pre-visit Requirements:

At your first visit, you will need to complete a form regarding your health history, family history of cancer, medication, and latest health screening tests (e.g. colonoscopy, fecal occult blood test, bone mineral density, mammogram, PSA, PAP smear, and cholesterol) you may have had. Please complete this form in advance of your appointment when you have time to gather this information. It will help us get a better picture of your overall health.

To prepare for all your visits, we recommend that you gather a list of your current medication, review your health history including cancer history and treatment, and write down your cancer related concerns or questions.

What to Expect:

At every visit, we will review your health history and your current medications. You will have a physical examination and we will discuss your concerns related to cancer. You will be asked to fill out the Edmonton Symptom Assessment System (ESAS) form. This form helps us screen for potential cancer related effects in a consistent manner and better understand your concerns. An individual care plan will be developed and periodically reviewed based on your cancer history and your needs. Surveillance tests (e.g. blood work, imaging tests) will be organized based on your care plan and current guidelines. You may be referred to other health services at WCH or in the community as needed. A summary note of your first visit will be sent your family doctor after each clinic appointment. Your referring doctor will receive a letter after your first visit. In addition, we will liaise with your oncologists as needed.

Visits usually take between 30 to 45 minutes. You will see Dr. Townsley, but you may also meet the Advanced Practice Nurse or a medical fellow/resident during your appointment. As part of an academic teaching hospital, our clinical team may include students and trainees in various disciplines from nursing, allied health and medical residents and fellows. These individuals receive specialized and hands-on training with direct supervision and expertise from our team. 

The number of times you will be followed at the ACTT clinic may vary depending on your cancer diagnosis, any long-term effects from cancer treatment that you may experience, and treatment status. Patients are eventually discharged to their family care practitioners. If you need to go back to your treating oncologists while followed up at ACTT, we will facilitate timely referrals and organize the tests needed to plan treatments in consultation with your oncologist.

Dr Carol Townsley,
Medical Director

Dr. Townsley coordinates and oversees the care of all patients referring to the ACTT clinic. She provides medical management of long and persistent effects from cancer, coordinates ongoing therapy and surveillance tests according to current guidelines, and communicates to the patient’s primary care physician regarding the cancer survivorship plan and guidelines for follow up care. Moreover, she consults with the referring physician as needed and organizes referrals as appropriate. As the Medical Director, she is in charge of the ACTT team and the development of the clinic. 

Aronela Benea, RN, MScN
Advanced Practice Nurse

The advanced practice nurse (APN) collaborates with other health professionals to coordinate patient care, conducts physical assessments, reviews medical history, addresses patients’ concerns, engages in survivorship care planning, and offers telephone support when appropriate. 

Angela Duggan, RN, CON(c).

The RN provides specialized oncology care to patients. In addition to administrative duties, the RN connects with patients over the phone to address their concerns and coordinate their care.

Wilma Pesongco,
Administrative Assistant

The Administrative Assistant provides clerical support including telecommunications and customer service functions. The Administrative Assistant facilitates efficient and timely access to specialty services by receiving and processing referrals and scheduling and confirming of appointments.

The following tests may be organized for your ACTT appointment as part of your routine follow up. This will depend on your individual care plan:

  • Breast imaging tests (e.g. mammogram, breast MRI, breast US)
  • CT scans (chest/abdomen/pelvis)
  • Ultrasound (thyroid, abdomen, pelvis, etc.)
  • Blood work (tumor markers)

Patients being followed up for thyroid cancer will receive a letter with a blood test requisition for blood work to be done 2-3 weeks prior to their visit. You can have the blood work done at WCH or closer to your home. Remember that the results are needed at your visit and that it may take longer for blood work done close to your home to be sent to ACTT clinic.

Additional tests may be organized depending on your symptoms, concerns, and physical examination.

Preparing for Your Tests

 Please view the following pages for more information on the types of tests and how to prepare for these procedures

Lobby Lab – Specimen Collection Centre 

Breast Imaging/Mammography 

Computed Tomography (CT) Scans 

Magnetic Resonance Imaging (MRI) 

Nuclear Medicine 

General Support Service Information 



Symptom Management
You can learn how to manage short and long term effects from cancer by reviewing the Cancer Care Ontario Guide: How to Manage Your Symptoms

Lymphedema Resources
Lymphedema, Canadian Cancer Society
Lymphedema Association of Ontario
Canadian Lymphedema Framework
Find a therapist in Ontario
Ontario’ s Assistive Device Program

Breast Cancer Resources
What is Breast Cancer, Canadian Cancer Society
Breast Cancer Society of Canada
Canadian Breast Cancer Network
Rethink Breast Cancer
Dense Breasts Canada

Breast Reconstruction
Bra Day

Testicular Cancer Resources
Testicular Cancer, Canadian Cancer Society
Testicular Cancer Society
Testicular Cancer Canada

Thyroid Cancer Resources
Thyroid Cancer, Canadian Cancer Society
Thyroid Cancer Canada

GI Cancer Resources
Stomach Cancer, Canadian Cancer Society
Colorectal Cancer Canada

Gynecologic Cancer Resources
Ovarian Cancer, Canadian Cancer Society
Cervical Cancer, Canadian Cancer Society
Uterine Cancer, Canadian Cancer Society
Fallopian Tube
Ovarian Cancer Canada
Hereditary Breast Ovarian Cancer Society

Melanoma Resources
Melanoma, Canadian Cancer Society
Melanoma Network of Canada
Canadian Dermatology Association

Learn About Your Genetic Risk and OBSP program
Ontario Breast Screening Program (OBSP)

Community Supports
Canadian Cancer Society
Gilda’s Club

Mental Health Resources
Emotions and Cancer, Canadian Cancer Society
Coping with Cancer
Bounce Back Ontario
Canadian Association of Psychosocial Oncology

Fertility Resources
Fertile Future

Children and Families Resources
Coping Within a Family, Canadian Cancer Society
Start The Talk, Canadian Association of Psychosocial Oncology(CAPO)
Adult and Children Support Groups, Gilda’s Club
When A Parent Has Cancer, Wellsprings

Exercise Programs for Cancer Survivors
Wellspring Cancer Exercise Program
HEALTH Program, Toronto Rehabilitation Institute
CanWell Program (Hamilton/Burlington/Brantford) [
Toronto Physiotherapy

Nutrition Resources
Unlock Food.ca

Sexual Health Resources
Sexuality and Cancer, Canadian Cancer Society
BESTCO: Find a therapist

Work and Finance
Wellspring programs (Money Matters, Returning to Work, Back at Work)
Cancer and Work
Kelly Shires Breast Cancer Foundation

WCH Resources
Stella’s Playroom

Sutherland-Chan Clinic – Massage Therapy



The ACTT Clinic is currently operating as a special project in partnership with Princess Margaret Cancer Centre. For this reason, the program is only accepting patients from Princess Margaret Cancer Centre and Women’s College Hospital who have completed treatment for cancer, excepting hormonal therapy. Patients are transferred to this clinic based on specific criteria by their oncologists or treating endocrinologist for thyroid cancer. At this time, we are not accepting referrals from patients being followed at other cancer centres outside of Women’s College Hospital and Princess Margaret Hospital.

Patients discharged from ACTT clinic to their family practitioners can be referred back if there are any new concerns related to their previous cancer. The family care practitioners of patients discharged from ACTT are welcome to contact us with questions or concerns related to patients post discharge. 

If you have been referred to ACTT and have not been contacted with an appointment in 2-3 weeks, please call us at 416 323 6400 ext 3297. You may be contacted prior to your first visit to organize surveillance tests for your clinic appointment.

Patient Referral

Social Work Referral Form

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Location & Contact Information

After Cancer Treatment Transition Clinic
Women's College Hospital
76 Grenville Street
5th floor
Toronto, ON M5S 1B2

Phone: 416-323-6400 ext. 3297

Please note that phone messages are returned within 2-3 business days

If there is an emergency, please dial 911 or go to your nearest emergency department.

Fax: 416-323-6001

Hours of Service
Monday to Friday
9:00 a.m. – 5:00 p.m.

Our Publications

Peter Gilgan Centre For Women's Cancers logo
  • Fully affiliated with:
  • University of Toronto

  • A member of:
  • Council of Academic Hospitals of Ontario (CAHO)