In recognition of Breast Cancer Awareness Month 2024, we are highlighting a variety of initiatives at Women’s College Hospital and beyond, aimed at raising awareness and offering comprehensive information on breast cancer prevention, treatment and aftercare.
More Canadians than ever are surviving cancer thanks to groundbreaking discoveries made in cancer research, combined with better methods of detection and more effective treatments.
But they’re not necessarily getting the ongoing care they need to manage the late and long-term effects of cancer treatment. Put simply, a patient’s access to specialized care should not end once they enter remission.
Since 2012, the After Cancer Treatment Transition Clinic (ACTT) at Women’s College Hospital has been working to improve care delivery to this growing patient population. Its mandate: to treat the unique needs of cancer survivors – physical, psychological and social.
“The clinic addresses a huge need,” says Dr. Carol Townsley, Medical Director of the ACTT. “Patients can’t be seen in a tertiary care setting forever, but at the same time, they’re often reluctant to be sent directly back to primary care. Referral to the ACTT can help provide peace of mind during this transition.”
The ACTT Clinic boasts a small, yet highly effective team led by Dr. Townsley, a GP-Oncologist, complemented by an advanced practice nurse and a part-time nurse and doctor. Eligible patients are referred by their oncologist, and the length of time a patient attends the clinic depends on their individual needs, treatment, and surveillance plan.
“We see about 30 patients a day in our clinic; the majority are breast cancer survivors, but we also see patients recovering from thyroid cancer, gynecological cancer, melanoma, gastrointestinal and testicular cancers.
The multidisciplinary collaboration extends beyond the clinic walls to social work, physiotherapy, psychiatry, and the bone health team, ensuring comprehensive care for the diverse needs of cancer survivors.
“Most patients will have had surgery, chemotherapy and radiation, so they’re dealing with the effects these treatments had on their body, but also their minds, so we’re helping with that too.”
The issues Dr. Townsley sees in the clinic have helped her and her team serve a secondary need for cancer survivorship research. “The fear of cancer recurrence can be debilitating for some patients,” she says. “It can interfere with their ability to return to work and affect their relationship with family.”
She and her team, including researcher Patricia Nguyen and social worker Luana Pereira, have carried out several studies in this area and have successfully tapped into existing resources like Bounce Back to address anxiety and depression in cancer survivors.
An initiative led by Luana Pereira aimed at optimizing access to psychosocial support for patients in the ACTT experiencing moderate to high levels of fear of cancer recurrence saw the use of a fear of cancer recurrence screening tool. The use of this tool led to a 400 per cent increase in the number of referrals during that time, pointing to the acute need for such psychosocial support. All patients identified were offered a social work referral to further assess needs and provide appropriate support.
Additional areas of research include examining outcomes of transitioning survivors of thyroid cancer back to primary care, patient adherence to long-term medications and innovative approaches to managing the long-term effects of cancer treatments.
Education stands as another cornerstone of the ACTT clinic’s mission. Dr. Townsley’s commitment to training the next generation of healthcare professionals underscores the clinic’s dedication to knowledge dissemination and capacity building. Through structured rotations and hands-on experience, trainees gain invaluable insights into survivorship care, equipping them to address the evolving needs of cancer survivors.
The clinic’s impact extends beyond patient care, research and education, resonating deeply with healthcare providers who recognize the clinic’s role in filling a crucial gap in survivorship care.
“We’ve had a huge buy-in from oncologists and primary care providers,” Dr. Townsley says. “Oncologists can be confident their patients’ post-treatment concerns will be addressed, allowing them to concentrate on the newly diagnosed and those in active treatment.” Meanwhile, patient attendance at the ACTT also relieves the burden on primary care providers.”
As for the patients, “They really do feel very supported at Women’s College Hospital,” concludes Dr. Townsley. “From assessment to intervention and coordination of care, we ensure that their individual needs are met. WCH is a hospital designed to keep patients out of hospital. This can help.”