Five projects totaling $434,083 were awarded funding in the 2022 edition of the Rossy Cancer Network's CQI Research Fund competition.
Quality of Life - Lymphoma
Lymfit cardio-oncology exercise program: Optimizing fitness, health care and quality of life for lymphoma survivors
Lymphoma is the most common cancer in young adults. Despite curing 80% of patients, lymphoma treatment affects young adults' quality of life, psychosocial well-being, and health. Lymphoma treatment typically involves chemotherapy and radiation, which can cause fatigue, anxiety, and cardiovascular diseases. Recent guidelines recommend that cancer patients participate in regular and adapted exercise programs during and after treatment to reduce the risk of developing these side effects. However, lymphoma patients rarely follow these guidelines, citing fatigue and a lack of motivation as the main barriers. Our study aims to help young adults with lymphoma stay active by providing an individualized cardio-oncology exercise program and professional support. We will also examine how exercise reduces anxiety, improves QoL and physical and mental fitness to return to work or school, and lowers cardiovascular disease risk. The study has significant implications for preventing short and long-term treatment complications in young adult lymphoma survivors.
Christine Maheu and Nathalie Johnson will lead an MUHC-JGH team including co-investigators, Ross Anderson, Kelly Davidson and Wing Lam Tock.
Surgical Oncology - Colorectal Cancer
Strengthening candidacy for same day discharge colorectal surgery: A multi-centered mixed methods study
Colorectal surgery is commonly performed in Canada to treat bowel cancers and other bowel diseases. After surgery, patients are usually admitted to hospital for several days. However, it is difficult to begin the recovery process in hospital. Patients don’t tend to sleep or eat well in hospital, and they feel this delays their recovery. Instead of staying in hospital, surgeons have started allowing patients to recover at home. This means that patients are discharged on the same day as their operation. Since this is a new process, we do not yet know who will recover well at home and who needs to stay in hospital longer. We also need to ask patients about their day surgery needs and experiences so that we can build a program that meets patient expectations. Our study will determine which patients benefit from day surgery and what are the needs of patients recovering at home. We will use this information to build a surgical care pathway that improves patient outcomes and experiences.
Chelsia Gillis will lead an MUHC-JGH team including co-investigators, Lawrence Lee, Sender Liberman and Marylise Boutros.
Psychosocial Oncology - Health Inequalities
A research quality improvement program to address cancer health inequalities
COVID-19 has created a fertile terrain for the intensification of health inequalities, with its corollary impacts on cancer care outcomes such as psychological distress (acute stress, depression), quality of life (QoL), physical symptom burden, and healthcare utilization. Objectives: Our research quality improvement program aims to improve cancer outcomes through addressing cancer health disparities. Methodology: Phase I will be a longitudinal study to identify trajectories of psychological distress, quality of life (QoL), and physical symptom burden among 280 cancer patients, with an emphasis on health inequalities. Phase I analyses will lead to the identification of early social determinants of compromised cancer trajectories. These early determinants will inform Phases II and III. Phase II will comprise of end-of-grant stakeholder and patient engagement meetings to adapt an equity screening tool, integrating variables of Phase I, as well as to identify promising early palliative and psychosocial interventions to address inequities. Phases III and IV will involve testing the identified equity tool and interventions in a trial or program evaluation framework. Significance: This initiative will allow for early detection and implementation of key resources for underserved vulnerable cancer patients to improve health inequalities in oncology at the Rossy Cancer Network. Effective strategies could eventually be scaled-up to a provincial, national, and international level.
Melissa Henry will lead a JGH-MUHC team including co-investigators, Mark Basik, Michael Hier, Karen Kost, Marco Mascarella, Alex Mlynarek, Nader Sadeghi and Anthony Zeitouni.
Breast Cancer and Genetic Testing
Breast oncology Initiated Genetic Testing (BRIGHT) Program for women with newly diagnosed or recurrent stage I-IV breast cancer
Patients with a new diagnosis of breast cancer benefit from testing certain genes (“genetic testing”) for a change (“pathogenic variant”) that may have predisposed them to developing cancer. The most common pathogenic variants are found in the genes BRCA1, BRCA2 and PALB2. When someone has a pathogenic variant in BRCA1, BRCA2, PALB2 or other genes, they and their blood-relatives have an up to 70% lifetime risk of developing breast cancer, as well as ovarian cancer and other types of cancers. For the patient, genetic testing results can influence their choice of breast surgery, access to specific treatments, and other preventive surgeries. Testing relatives (referred to as “cascade testing”) can also change recommendations for screening or prevention in family members without cancer. We have designed a new program called “breast oncology initiated genetic testing” (BRIGHT) to streamline testing so results are available to patients, families, and their doctors faster. We will also study the impact on cost and patient satisfaction with how genetics information and results are conveyed to patients in this program.
Stephanie Wong and William Foulkes will lead an MUHC-JGH-SMH team including co-investigators, Sarkis Meterissian, David Fleiszer, Mark Basik, Jean-François Boileau, Ipshita Prakash, Dawn Anderson, Jean-Baptiste Rivière, Zoulikha Rezoug and Evan Weber.
Psychosocial Oncology - Patient Reported Outcomes
Beyond RCTs, what is the real-world evidence for patient-reported outcomes (PROs) screening in routine cancer care? Patients’ perspectives and impact on emergency room visits and survival
Cancer treatments can lead to severe side effects, which are not always identified and treated. This has a significant impact on how well individuals can carry on with their lives. Untreated side effects can also be costly for the health care system, as patients might then require more expensive care (e.g., emergency department visit). One solution is to ask all patients to report their side effects by completing a questionnaire every time they see their health care professional. We know from research that this strategy can improve patient-clinician communication, symptom management, and even survival. With this evidence, it is not surprising that screening for the side effects patient experience using questionnaires they complete is a cornerstone of high-quality care. However, the issue is that once screening is taken out of the very rigid research context, and applied to complex and unpredictable real world cancer care, we do not know if the benefits are the same. The goal of this study is to document whether two real-world screening programs for treatment side effects have the expected benefits on health services use and patient survival, as well as to ask patients what they thought about completing questionnaires about their side effects as part of usual care.
Sylvie Lambert will lead a SMH-JGH-MUHC team including co-investigators, Erica Moodie, Zeev Rosberger, Marc Hamel, Christine Bouchard, Fabienne Germeil and Jennifer Wilson.
MUHC - Ď㽶ĘÓƵ Health Centre; JGH - Jewish General Hospital; SMH: St. Mary's Hospital