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EPICC - The Early symPtom Indicators for Cancer Care Screening Program

EPICC provides repeat symptom screening to better manage your quality of life during cancer care.

Early Symptom Management in Cancer Care

During your cancer care, you may experience symptoms and side effects. Each person is different.

Regular screening improves your care and gives you a better quality of life by showing your symptom patterns over time. This alerts your care team to symptoms and issues that are starting or that are getting worse. This helps the team better plan for your care. It also helps them better care for any mental, emotional and spiritual distress you are having.

How does EPICC work?

In participating clinics, you may be asked to participate in EPICC. When you take part in EPICC, you will be asked to answer a few sets of questions about your symptoms and issues. These are called screens. You may fill out these screens on an iPad, online or by answering questions on the phone.

  • Screens happen before consult visits where you review your cancer care progress or symptoms (up to 24 hours before, or Friday for Monday visits).
    • A nurse will review the screen results with you before the consult.
  • The questions are grouped into four sets. Your first screen will have all the sets. One set is asked at every screen, the rest are asked only every month or two.
  • The screens help your care team learn about your care and symptom issues of interest in a quick and standardized way. To learn more about these screens, watch the Canadian Partnership Against Cancer video.
  • The Symptom Management Resources section below provides information and resource links and guidance for each of the items in the EPICC Screening Tool (PDF).
  • The EPICC Brochure - Vancouver is a printable version of this page including the symptom management resources section.

If offered, how do I take part?

  • If you have questions, please ask any member of your health care team.
  • For in-person consult visits, you may be offered an iPad to do the screening in the clinic. Or, you may be asked to do the screen online or by phone the day before.
  • For the online screens, please try to complete the questions by midnight the day you get them.
  • If you feel able, complete the screen when it is offered. We can track your symptoms better if you complete more screens.
  • Answer each question as best you can. 
  • A nurse or other member of your cancer care team will review your results with you.
  • Talk with the nurse about how you are feeling, including your worries and fears.
  • You may have one or more symptoms and side effects. Each person is different. If you do have symptoms, let the nurse know which ones are most important to you.
  • For some symptoms, the nurse may suggest some things you can do to help yourself. For other symptoms, you may need more support (such as medications or services).
  • When possible, you will receive a printout that shows your results over time. If you want, you can share your results with other health care providers and with family members and friends. 

Symptom Management Resources

This section contains links to the self-support options, education, and services available for each symptom and issue asked in the EPICC Screening Tool. 

For symptom scores of 0 to 6 on the Screening Tool look at the Self-care resources, which have practical, easy tips for cancer-related symptoms. Most issues also have information guides.

If you have been encouraged to use symptom self-management strategies, and at any time these are not working or your symptoms are getting worse, contact your BC Cancer Vancouver care team at 604.877.6025.
  • For immediate help with intense symptoms, call 911. 
  • First Nations, Métis, and Inuit patients & their families: Connect with the Prince George Indigenous Patient Navigator by emailing icc@bccancer.bc.ca
BC Cancer Library Pathfinders are lists of some of the library's books and e-books, available pamphlets and support services, and recommended websites.


Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

  • Talk to your BC Cancer care team (or with your community health care team, or HealthLink BC phone line: 811)
  • Telephone Line Care Nurse: 604.877.6025
  • Pain and symptom clinic: 604.877.6000 ext. 672752 

Tiredness = lack of energy.   Drowsiness = sleepy.


Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

  • Talk to your BC Cancer care team (or with your community health care team or HealthLink BC phone line: 811)
  • Telephone Line Care Nurse: 604.877.6025

Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

  • Talk to your BC Cancer care team (or with your community health care team or HealthLink BC phone line: 811)
  • Dietitian: discuss a referral with your care team or call 604.877.6000 ext. 672013
 

Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

  • Talk to your BC Cancer care team (or with your community health care team or HealthLink BC phone line: 811)
  • Telephone Line Care Nurse: 604.877.6025
 

Scores of 0 to 6: no, low, or moderate symptom severity

Patient & Family Counselling: 604.877.6000 ext. 672194

The Emotional Facts of Life with Cancer (external link)


Scores of 4 or more: moderate to high symptom severity

  • Talk to your BC Cancer care team (or with your community health care team or HealthLink BC phone line: 811)
  • Telephone Line Care Nurse: 604.877.6025
  • Dietitian: discuss a referral with your care team or call 604.877.6000 ext. 672013
  • BC Cancer website: Constipation caused by your medications

Scores of 0 to 6: no, low, or moderate symptom severity

Scores of 4 or more: moderate to high symptom severity

 

Canadian Problem Checklist items:

  • Memory & Attention
  • Diarrhea
  • Swallowing
  • Communication difficulties
  • Falling / Loss of balance
  • Tingling / Numbness
BC Cancer website resources
Other resources
  • Talk to your BC Cancer care team (or with your community health care team, or HealthLink BC phone line: 811)
  • Telephone Line Care Nurse: 604.877.6025
      • Pain and symptom clinic: 604.877.6000 ext. 672752  
      • Dietitian: discuss a referral with your care team or call 604.877.6000 ext. 672013
       
       

      Canadian Problem Checklist items:

      • Returning to (staying in) Work and School
      • Affording costs / loss of income
      • Getting to and from appointments
      • Where to stay during treatment
      • Child / Family / Elder care

      BC Cancer website resources

      External website resources

      Other resources

      Canadian Problem Checklist items:

      • Understanding my illness / treatment
      • Talking with the health care team
      • Making treatment decisions
      • Knowing about available resources
      • Quitting smoking
      • Medications

      BC Cancer website resources

      External website resources

      Other resources

       

      Canadian Problem Checklist items:

      • Fears / worries
      • Depression / Sadness
      • Frustration / Anger
      • Changes in appearance
      • Intimacy / Sexuality
      • Coping
      • Change in sense of self
      • Loss of interest in everyday things

      BC Cancer website resources

      External website resources

      Other resources

      Canadian Problem Checklist items:

      • Feeling a burden to others
      • Worry about family / friends
      • Feeling alone
      • Relationship difficulties
      • Support for family / friends caring for me
      BC Cancer website resources
      Other resources

      Canadian Problem Checklist item

      • Meaning / Purpose in life
      • Faith
      BC Cancer website resources
      Other resources

      Many people with cancer think about suicide.


      If you are currently thinking about suicide, please call and connect:

      You can contact any of the above teams or your community health care team at any time with questions or concerns about suicide or finding further support.
      BC Cancer website resources
      External website resources
      Advance care planning is when you think about what matters to you, what a good day looks like, how your personal beliefs and wishes fit into your future healthcare and personal care, and then sharing your wishes and preferences with others. It also means deciding who will speak for you if you cannot speak for yourself. 

      Your BC Cancer health care team can help you start or update your planning documents at any time.

      BC Cancer webpages
      External website resources

      Are you a family member or friend providing care and support for someone with cancer? Remember to take care of yourself while you are caring for others.


      BC Cancer website and support services
      External website resources
       

       External website resources

      SOURCE: EPICC - The Early symPtom Indicators for Cancer Care Screening Program ( )
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