As a tertiary level teaching hospital, the McGill University Health Centre (MUHC) delivers care to over 1500 newly diagnosed cancer patients each year. Most people diagnosed with cancer will experience pain as a result of their disease or its treatment. While the majority of cancer pain problems can be effectively treated using guidelines provided by the World Health Organization, 10-20% of them, the highly complex cases, will show failure to respond to conventional management.
Description of the Program
In keeping with the mandate of the MUHC Cancer Care Mission to address the needs of this highly complex population, the Supportive and Palliative Care Service and the Alan Edwards Pain Management Unit (AEPMU) partnered to create a comprehensive Cancer Pain Program launched in March 2011. The MUHC Cancer Pain Program strives to meet the needs of patients with cancer pain by providing a single point of entry to services within an interdisciplinary clinic.
Among the goals of our Program we aim to 1) offer early palliative care management for cancer pain patients throughout their disease, 2) manage pain and other cancer-related symptoms in those particular cases where the WHO ladder approach has failed and 3) offer a combined conventional medical management with non-pharmacological approach which has proven to be effective to manage challenging cases by providing better pain relief, less opioid consumption, less drug toxicity and improved survival.
The Cancer Pain team sees patients three half days per week, and an average of 6-8 patients are seen during those clinic hours. The core team is composed of palliative care physicians, anaesthesiologists, a radiation oncologist, and a nurse clinician. Under the Allied Health Service umbrella, a designated social worker, physiotherapist, and occupational therapist as well as a Psychosocial Oncology Program offer additional support upon referral.
This program is proudly supported by the Louise and Alan Edwards Foundation
Dr. Jordi Perez, Director of MUHC Cancer Pain Program
The Cancer Pain Program team:
Christelle Rémy (B.Sc.N.)
Nurse clinician in oncology who works full time for the Ambulatory Cancer Pain Program. Christelle is responsible for the coordination of the clinic and the triage of all referrals. She acts as resource person for the patients, their family members and their caregivers with regards to pain treatment, symptoms management and teaching.A contact person that is easily accessible by phone for them during the week. Therefore, is able to provide close monitoring of the patient. Assures continuity and coordination of care between the pain program and allied health services. Based at the supportive care clinics of MUHC-Cedar Cancer Center.
Nathalie Aubin (N, MSc), CHPCN(C). Nathalie works as an Advanced Practice Nurse at the McGill University Health Centre. She is an Adjunct Faculty, Assistant Professor in the School of Nursing at McGill and is a Clinical Nurse Specialist in Palliative Care who has been involved with clinical practice, nursing education, consultation and research.
Interventional Pain Physicians
Palliative Care Physicians
Allied Health Services
Physiotherapy: Marta Jelowicki (BSc, Pt) obtained a Bachelor of Science degree in Physical Therapy from McGill University. Her interest in working in the Cancer Nutrition-Rehabilitation Program stems from her work with hematology and bone marrow transplant patients for the last 3 years. She has taken courses in cancer rehabilitation in order to best address the needs of this patient group. The ultimate goal of her interventions is to optimize patient’s mobility and physical functioning and improve quality of life. She is based at the MUHC-Royal Victoria Hospital clinic site.
Occupational Therapy: Rabiaa Laroui, (OT). Individuals with cancer may experience varying activity limitations. An occupational therapist can evaluate the impact of physical and cognitive changes such as cancer-related fatigue, fluctuating energy levels, cancer pain, difficulty sleeping and chemo “fog”, on activity participation in order to recommend modifications and strategies to maintain or increase activity. The role of a n occupational therapist is to enable individuals to optimize their level of functioning in relevant meaningful activities. This may include activities of daily living, work, leisure or social pursuits.In the of cancer pain patients, interventions may include correcting posture, teaching joint protection techniques as well as pain management strategies, teaching energy conservation and restoration techniques, helping with neuropathies management and providing technical aids in order to help with pain and activity performance. An occupational therapist also provides support and refers patient to other specialties if there is a need to.