The Cancer Journey. Bringing the patient home. Dr. Jan Owen, Primary Care Lead, SW Regional Cancer Program

Transcription

1 The Cancer Journey Bringing the patient home Dr. Jan Owen, Primary Care Lead, SW Regional Cancer Program

2 Proportion of deaths due to cancer and other causes, Canada, 2007 Other, 23.1% Cancer, 29.6% Kidney disease, 1.6% Suicide, 1.5% Alzheimer's disease, 2.5% Influenza and pneumonia, 2.3% Diabetes, 3.1% Accidents, 4.2% Chronic lower respiratory diseases, 4.5% Cerebrovascular diseases, 5.9% Diseases of the heart, 21.5% Adapted from: Ten leading causes of death, Canada, 2007, Statistics Canada Why we need to know about the cancer journey 2

3 Most common cancer diagnoses, Ontario, 2009 Males N = 33,212 Females N = 32,126 3

4

5 Letting the Light In The Family The Patient Pat Community Care Specialty Care PPrimary Care

6 6

7 Cancer Care Ontario provincial government s cancer advisory agency overseeing $700 million dollars for cancer services Regional Cancer Programs responsible for implementing programs for cancer care customized to regional issues Regional Primary Care Leads Strengthening connection between primary care and the cancer system Janice.owen@lhsc.on.ca

8 Family physicians play a crucial role throughout the cancer journey Key Findings: 4 In a practice of 2,000 people, an average family physician may care for 50 patients with cancer Ontario N = 12,861, ,097 to 1,157,575 unattached patients in Ontario 3 Family Physicians (w/ Longitudinal Practices) N = 8,789 1 Family physicians reported that cancer care makes up 23.6% of their professional activity The contact rate with family physicians among breast, prostate and colorectal cancer patients is increased across all stages of the cancer journey compared to pre-cancer diagnosis. During the peri-diagnostic, posttreatment (follow-up) and palliative periods, patients with lung, colorectal, breast and prostate cancer had higher contact rates with their family physician than with any oncology specialist or other physician. Family physicians undervalue their role in cancer care 8

9 9

10 Prevention Smoking Cessation SW Regional Cancer Program adopted the Ottawa Model for Smoking Cessation in January 2014 Identifies, provides treatment and follow up to all smokers seen in clinical visits The Ottawa Model has demonstrated at least double the success rate for quitting long term

11 11

12 Ontario s Screening Programs Ontario Breast Screening Program Common/pages/UserFile.aspx?fileId= Colon Cancer Check Average risk age 50-74: mammogram every 2 years High risk age 30-69: annual mammogram & MRI Average risk age 50-74: FOBT every 2 years for both men and women Increased risk due to family history: colonoscopy beginning at age 50 or 10 years younger than earliest age of diagnosis of relative, whichever comes first Ontario Cervical Screening Program Age 21-70: pap test every 3 years 12

13 The Ugly Truth about CRC Screening When caught early, there is a 90% chance that people with colorectal cancer will be cured Half of CRC in Ontario diagnosed at a late stage (III and IV) with poorer survival Provincial average for CRC screening of rostered patients is 63% SW LHIN average is 58% We can do better!

14 Screening Activity Report - the SAR

15 Screening Activity Report SAR Dashboard provides an easy to read quick overview and comparison with other practices Gives you details on your patients screening status and follow-up procedure dates How to access your SAR online: Register for oneid we can help you do it x54926 Melissa Stott You can authorize a delegate to access your report Updated biannually Next release early May now includes Cervical, Breast and Colorectal screening

16 16

17 Expediting Diagnosis Diagnostic Assessment Programs (DAPS) for Colorectal and Lung Single point of access for all diagnostic services!!! Navigators to coordinate and streamline process Colorectal DAP in SW for pos FOBT, high risk screening Tel: Ext Fax: Thoracic DAP LHSC for suspicion of lung cancer abn Xray or CT Sue Stein Nurse Navigator Tel: (519) x Grey Bruce Thoracic DAP in Owen Sound Grey Bruce Prostate DAP in Owen Sound Stay Tuned - Prostate DAP LHSC under construction

18 18

19 Survivorship Pink and Blue Breast and Colorectal Cancer survivors are being formally discharged back to their primary care providers Evidence shows family docs willing and able to provide this care Resource guides available on-line and in print Guidelines for surveillance Management of common problems survivors may encounter

20

21

22 22

23 Palliative Care ESAS - Edmonton Symptom Assessment Scale Used at the Cancer Center at ISAAC Kiosks for each patient visit Can be used in your office to help you manage your patient in combination with the Symptom Management APP Symptom Management CCO APP radiation for symptom management lots of uses and lots of capacity LEAP course Learning Essentials Approach to Palliative and End of Life Care 2 day

24

25

26 The Ask for the Southwest Primary Care Network 1. Improve colorectal cancer screening rates Get everyone registered with oneid and SAR friendly Regional Cancer Program can provide help with registration clerical for assistance contacting underscreened patients 2. Introduce the use of ESAS as an assessment tool in primary care offices 3. Encourage the use of the CCO Symptom Management APP for use in home and office visits