BC Cancer Agency technology may revolutionize radiation therapy delivery

The BC Cancer Agency has developed a revolutionary technology that could provide faster and more precise radiation therapy for patients. Gordon Wright, a 72 year old retired commercial fisherman diagnosed with prostate cancer this July, is the first patient in the world treated with this technology.

“I obviously wanted the best treatment possible,” says Wright, whose first treatment lasted just over a minute and a half, “and it’s comforting to know that I’m benefiting from the latest technology while contributing to research that can help many people in the future.”

The technology, Volumetric Modulated Arc Therapy (VMAT), allows a patient to receive radiation treatment with a single 360º rotation of the radiation beam around the body. VMAT can be delivered from a standard linear accelerator.

For more information, please visit http://www.bccancer.bc.ca/ABCCA/NewsCentre/2007/vmat.htm

Advancing Strategic Direction #1
Sustain and advance our system of cancer control.

Premier announces new cancer centre for Prince George

The province’s Northern Cancer Control Strategy took a step forward in September when Premier Gordon Campbell announced plans to establish the sixth BC Cancer Agency regional centre in Prince George.

“Cancer is a terrible disease that will affect one in three British Columbians some time in their life,” said Campbell. “The new cancer centre planned for Prince George is part of our Northern cancer control strategy to further improve care and access for all Northern communities.”

Scheduled for completion in 2012 and situated at the Prince George Regional Hospital, the centre will be part of a larger strategy to provide equity of cancer services and improve outcomes in the North. Other initiatives include:

• Increased training and support for northern physicians on cancer control including access to BC Cancer Agency resources through outreach and telehealth services
• Greater focus on cancer screening services and early diagnosis across the North and enhancing the marketing of screening and availability of diagnostic services;
• Patient centred care where navigational supports are provided to ensure that northerners receive timely and the same quality of care;
• Enhancements to the system of cancer care in the North by strengthening the network of care that extends from smaller communities to the largest centres through the community oncology network;
• Recruitment and training initiatives to attract and retain the required professionals in the North;
• Enhanced cancer prevention initiatives including public education on lifestyle changes to prevent incidence of cancer especially around reducing tobacco use.

Advancing Strategic Direction #3
Support the regional centres, regions and communities with the implementation of provincial cancer control programs and integration of knowledge.

Quality and Safety is our business

Quality and safety in health care are becoming hot topics in the news recently - even the New England Journal of Medicine’s recent (August 2007) lead editorial focused on quality and safety as a key concern in care today.

As it surfaces as a major issue in health care, the BC Cancer Agency recognizes the need to continuously build quality and safety into our strategic priorities, ensuring that services are delivered safely while maintaining provincial and national standards. Leading up this critical portfolio at the BC Cancer Agency is Rosmin Esmail, who comes to us after a cross-Canada search as the director of Quality, Safety & Risk Management.

The BC Cancer Agency recognizes the need to continuously build quality and safety into our strategic priorities, ensuring that services are delivered safely while maintaining provincial and national standards.
“I am delighted to be part of the BC Cancer Agency and to lead its quality and safety initiatives," says Rosmin. "I truly believe to make meaningful and sustainable change, quality and safety is not just the responsibility of one individual, but of everyone in the organization, so that people at every level feel a shared desire to make processes and outcomes better every day.”

Her expertise spans both research and healthcare administration, having worked with London Health Sciences Centre as an epidemiologist; the Toronto Institute for Work & Health and the Cochrane Collaboration as a researcher; and the Program in Evidence Based Care at Cancer Care Ontario. For the past five years, Rosmin has been working as the Quality Improvement and Patient Safety Leader for the Department of Critical Care Medicine, Calgary Health Region.

“Rosmin will work closely with the Agency executive, regional leadership teams, program leaders, professional practice leaders and staff in further developing the Agency's Quality and Safety Program,” says Karim Karmali, vice president of Management and Operations. “She will provide guidance and leadership on quality improvement and patient safety, coordinate the Canadian Council on Health Services Accreditation occurring in June 2009 and facilitate the implementation of imPROVE projects throughout the Agency.”

Rosmin will be based at BC Cancer Agency’s Vancouver Centre in the Administration office, and she can be reached via e-mail at resmail@bccancer.bc.ca or at local 6198.

Advancing Strategic Direction #1
Sustain and advance our system of cancer control.

Centre for Health Economics: helping set priorities for cancer care

PBMA will be applied in three areas:

• Herceptin and breast cancer. For example, does treating women with Herceptin sooner rather than later improve patient outcomes and free up resources for other patients?
• Breast density and the frequency of screening mammography (some studies show that more frequent screening may prevent or catch cancer earlier for women with higher breast density).
• Use of PET Scans in determining operability of lung cancer (i.e. can PET scans help surgeons determine whether or not a surgical intervention will be successful?)

Allocating limited healthcare resources to best meet patient needs is a challenge faced by healthcare providers across the globe.

Established last year, the BC Cancer Agency’s Centre for Health Economics is developing strategies to help Agency leaders make evidence-based decisions about funding programs and services.

The Centre recently received a $310,000 CIHR grant to evaluate how Program Budgeting and Marginal Analysis (PBMA) – a priority-setting tool – can help decision-makers determine how to best distribute resources to improve patient outcomes in an ethical manner.

“On the one hand financial resources are limited, and on the other hand technological advances and discoveries of targeted therapies are putting more pressure on those finite budgets,” says Dr. Stuart Peacock, senior scientist, Centre for Health Economics, BC Cancer Agency.

“Leaders are faced with some difficult decisions about what services to provide, how to provide them, who to provide them to, and where to provide them,” says Stuart.

“But, if you have a rigorous and sound priority-setting method to determine which programs and services ultimately are the most effective and efficient in improving health outcomes, you can make those decisions with greater confidence."

The PBMA tool will be applied to three Agency projects (see sidebar). For each project, eight to 10 advisory panel members – comprised of Agency Executive and Tumour Groups – will meet for six workshops over the next 12 months. They will learn the PBMA process and work through a variety of research questions in order to provide recommendations on how best to allocate funds.

For more information about the research project, please contact Stuart at speacock@bccrc.ca

Advancing Strategic Direction #4
Ensure we have the resources to achieve maximal organizational effectiveness

Discovery explains why lung cancer remains prevalent among former smokers

BC Cancer Agency researchers, led by Drs. Stephen Lam and Wan Lam, have discovered new evidence that explains why former smokers are still susceptible to lung cancer after they have stopped smoking for many years.

Published in the online journal BMC Genomics, the study shows that in former smokers, some genes associated with tobacco smoking return to levels similar to people who never smoked, while other genes appear to be permanently damaged.

“The study is important because it helps to explain why heavy smokers who have stopped smoking are still at risk of lung cancer,” says Dr. Stephen Lam, one of the principal investigators and chair of the BC Cancer Agency’s lung tumour group. “Fifty percent of patients with newly diagnosed lung cancer are now former smokers.”

For a copy of the full press release, please visit www.bcancer.bc.ca/ABCCA/NewsCentre/2007/smokingdamage.htm

Advancing Strategic Direction #2
Establish the knowledge generation and application model within the provincial cancer control platform.

Study looks at on-line support for young breast cancer patients

This summer, the BC Cancer Agency launched a new pilot study, the first of its kind in Canada, to test the value of providing online emotional support to improve the quality of life of young women with breast cancer.

“The internet is a powerful tool with the potential to reduce geographical and other barriers; and by comparing the two trial groups in this study, we can test whether an online resource is an effective way of providing counseling support for cancer patients,” says Dr. Joanne Stephen, a researcher who is leading this study.

“While there are existing support groups and educational resources for young women, these are often limited to those living in major cities,” explains Joanne. “With an online resource, young women regardless of where they live will be able to benefit from accessing companionship and information.”

For more information about the study, please visit www.bccancer.bc.ca/ABCCA/NewsCentre/2007/emotionalsupport.htm

Advancing Strategic Direction #2
Establish the knowledge-generation and application model within the provincial cancer control platform.

Screening Mammography Program of BC: understanding the barriers

A screening mammogram is an effective way to detect breast cancer, but it is only effective if women use the program. It is particularly challenging to recruit ethnic women: language differences, cultural differences and/or lack of understanding the facts can be barriers.

This is the focus of a small research project being conducted by two Langara nursing students. Rhena Magtibay and Josephine Castillo of Langara College have been attending South-Asian events talking to women and administering a short survey to gather some quantitative data about what influences women to seek screening.

The survey results will help SMP identify compelling ways to raise awareness and encourage South-Asian women to join the Program. SMP will use the lessons learned from this research to develop ways to reach other diverse groups.

Newsmakers

Susan Walisser (VIC, Provincial Pharmacy) was awarded the Distinguished Service Award by the Canadian Association of Pharmacy in Oncology (CAPhO), at the National Oncology Pharmacy Symposium, held in Halifax, Nova Scotia, this October.

The Distinguished Service Award recognizes outstanding contributions to CAPhO and the oncology practice in Canada. Throughout her career, Susan has contributed to CAPhO on the National Oncology Pharmacy Symposium Organizing Committee and on the Executive Committee. She was the Co-Chair of the National Cancer Institute of Canada Pharmacists Network Steering Group and has led and participated on many provincial and national committees, including the BC Cancer Agency GI Tumour Group, Canadian Association of Provincial Cancer Agencies Systemic Therapy Working Group, International Society of Oncology Pharmacy Practice Organizing Committee, and the BC Cancer Agency Joint Oncology Drug Review.

In their nomination letter, the Vancouver pharmacy staff wrote:

"But what this list (of accomplishments) does not capture is who Susan is. It does not describe the exceptional level of commitment and leadership, nor the limitless vision, wisdom, and insight she brings to all she does. It does not describe the consistently high standards she holds herself to, and the way in which this rubs off on everyone she works with. And it does not capture the high esteem in which she is held by her staff with whom she is abundantly willing to share her wisdom, and to whom she shows enormous generosity, care and trust."

The entire pharmacy family and Susan’s colleagues at the Agency are pleased and delighted to congratulate her on this well-deserved recognition from her peers.

Vancouver Canucks and BC Cancer Agency Team Up For Cancer Awareness

The BC Cancer Agency teamed up with the Vancouver Canucks, in support of the NHL’s “Hockey Fights Cancer” initiative, to host an interactive booth at the Canucks/Edmonton Oilers game on Saturday, October 13, 2007. Canucks fans had the opportunity to learn about the BC Cancer Agency screening programs for early detection - including the screening mammography program – and about making healthy lifestyle choices to prevent cancer.

More than 20,000 British Columbians will be diagnosed with cancer this year - more than enough people to fill every seat in General Motors Place, bringing the message closer to home for fans.

Tour of Courage raises $1.8 million for blood cancer research

Congratulations to Dr. Clay Smith and his Agency colleagues who cycled in the first BC Cancer Foundation Tour of Courage featuring Lance Armstrong, on a sunny September weekend. The Agency team raised $18,875.

Foundation development officer Heather Jones’ Vancouver Island team raised another $8,000. Agency oncology nutrition researcher Cheri Van Patten rode in both the Vancouver Community Ride and the Kelowna Challenge Ride and generated $3,445. The grand total, well over $1.8 million, will fund several exciting blood cancer research initiatives led by Dr. Smith in the Agency’s Terry Fox Lab.

Neil Berman, the Agency’s Business Development director, summed up his ride this way: "The Tour of Courage was such an exciting experience: panting alongside my colleagues who are world-leading researchers; knowing my panting will help enhance their capacity and speed in translating research into improved outcomes for blood cancer patients; and cycling next to Lance, that world-famous cancer survivor with such an extremely high VO2max. I definitely look forward to panting for another 95km next year.”

Dr. Smith’s fellow researcher Dr. Donna Hogge said, “I was proud to be one of these riders. This fundraising effort is a wonderful contribution to the war against leukemia and other blood cancers. I am inspired by the determination of the many Tour of Courage participants and deeply touched by their faith in the research which I and many others in B.C. are performing to improve cancer treatment. My heartfelt thanks to everyone involved!!”

Tour of Courage event chair Sindi Hawkins fighting cancer again

MLA Sindi Hawkins, who chaired the BC Cancer Foundation Tour of Courage event, has begun treatment for a recurrence of leukemia.

She has requested that in lieu of gifts or flowers, donations be made to the BC Cancer Foundation to support blood cancer and stem cell research in Dr. Clay Smith’s Terry Fox laboratory at the Agency.

Your BC Cancer Foundation regional contacts:
Fraser Valley: Kate Ludlam, 604.930.4083, kludlam@bccancer.bc.ca.
Southern Interior: Cynthia Waldek-Peters, 250.712.3910, cwaldekpeters@bccancer.bc.ca
Vancouver: Sharon Kennedy, 604.877.6160, skennedy@bccancer.bc.ca
Vancouver Island: Laura Walsh, 250.519.5554, lwalsh@bccancer.bc.ca
BC Cancer Foundation website: www.bccancerfoundation.com

Advancing Strategic Direction #1
Sustain and advance our system of cancer control

Terry Fox Research Institute Headquarters at BC Cancer Agency

The BC Cancer Agency has been named the headquarters of the newly established Terry Fox Research Institute (TFRI). Dr. Victor Ling is the founding scientific director of the new institute which will have nodes across the country.

The institute will focus on translating research discoveries quickly into practical solutions to benefit cancer patients within three to five years.

The provincial government is providing $30 million to fund the institute and The Terry Fox Foundation (TFF) will invest a minimum of $50 million over the next five years in this initiative. Initially, there will be centres in Montreal, Toronto, Edmonton, and Calgary, and headquarters in Vancouver.