In 2018-19, the Rossy Cancer Network will fund $395,000 in Research Grants, enabling the completion of 4 projects. The grants will focus on improving the quality of care and quality of life for patients with colorectacl and head and neck cancer, while also evaluating tools to improve the patient experience.
The 2018 Rossy Cancer Network CQI Research Fund recipients are: (in alphabetical order, by principal investigator):
Impact of a Patient-Centered Program for Low Anterior Resection Syndrome: a Multicentre Randomized Controlled Trial
Low Anterior Resection Syndrome, or LARS, is a term used to describe changes in your bowels that occur after surgery for rectal cancer. These changes might include the need to empty your bowels often, the feeling of having the sudden urge to “go”, the accidental leakage of stool or gas, and more. These symptoms are common in patients who undergo surgery for rectal cancer, and negatively impact quality of life. Because every patient’s symptoms are slightly different, the treatment of LARS requires a bit of trial and error in order to find the best possible solution. This study will evaluate whether providing patients with education on LARS together with access to extra nursing support will help them better manage their symptoms. In addition to improving their quality of life, this supportive intervention may motivate patients to become more engaged in their LARS treatment and improve bowel symptoms.
Marylise Boutros will lead an MUHC-JGH-SMHC team including co-investigators Sender Liberman, Dawn Anderson, Carmen Loiselle, Nancy Posel, Te Vuong, Petr Kavan, Sahir Bhatnagar, Carol-Ann Vasilevsky, Nancy Morin and Julio Faria with collaborators Gerald Batist, Barry Stein, Patrick Charlebois, Lawrence Lee, Neil Kopek, Raghu Rajan, Sebastian Demyttenaere, Madeleine Poirier, Andrea Petrucci, Jason Park, Steven Wexner, Patricia Sylla, Liliana Bordeianou, Luca Stocchi from the RCN network as well as the University of Montreal, University of Manitoba, Cleveland Clinic Florida, Mount Sinai Hospital, NY; Massachusetts General Hospital, MA and the Cleveland Clinic Florida.
Head and neck cancer
Radiogenomic Models with Artificial Intelligence for Detection of Nodal Micrometastases to Reduce Unnecessary Neck Dissections in Head and Neck Cancer Patients
Medical imaging is at the heart of cancer diagnosis and therefore optimal cancer treatment and surveillance. There is a wealth of information in medical images, beyond what the human eye can see. Using sophisticated computer algorithms for fine image analysis -- known as texture or radiomic analysis -- combined with artificial intelligence, this information can be used to predict important tumour characteristics that can help improve the quality of patient care. In this investigation, we propose to use cutting-edge artificial intelligence-assisted radiomic analysis and high-end tumour molecular profiling to identify early spread of head and neck cancer tumours to lymph nodes more accurately. Improving diagnostic accuracy could result in less extensive surgery known as neck dissection or the elimination of some neck dissections, decreasing the potential for complications and morbidity and improving the quality of patient care and life after surgery.
Reza Forghani will lead a JGH-MUHC team including co-applicants Caroline Reinhold, Jaron Chong, Jeffrey Chankowsky, Behzad Forghani, Sahir Rai Bhatnagar, Michael Hier, Nader Sadeghi, Marcin Aleksander Mlynarek, Keith Richardson, Alan Spatz, Marc Pusztaszeri, Jan Seuntjens, and Khalil Sultanem.
Developing and Evaluating a Mobile Application for Caregivers
Opal is a phone and web app developed by a multidisciplinary team to allow cancer patients to have access to their own personalized health information and to better manage their cancer treatments. Opal allows patients to check-in to their appointments, see their clinical notes, view contextualized educational material and view their examination results. However, patients are not on their own through their cancer diagnosis and treatments. They usually have a team of caregivers ranging from neighbours, friends or volunteers who help them travel to their appointments or aid them with everyday tasks like shopping, to close family members such as partners, parents, or children, who may be intimately involved in the patient's day-to-day care. To respond to the needs of caregivers, our team proposes to develop a pilot version of a mobile app for caregivers based on Opal, called OpalCare and to conduct a feasibility study of OpalCare, for caregivers of patients undergoing treatment for breast cancer at both the MUHC and SMHC. The objectives of the study are to examine whether caregivers would use such an app to help them in taking care of their patient and to use feedback and suggestions from caregivers to improve the app and to identify new functions that can be integrated into future versions of OpalCare.
Laurie Hendren will lead a McGill-MUHC-SMHC team with co-investigators Tarek Hijal, John Kildea, Jamil Asselah, Rosana Faria, Sylvie Lambert and Ashley Davidson, as well as collaborators James Tsui, Nicholas Meti, Rebecca Hart and Omid Kiarash.
Implementation and testing of a sustainable support program as a complement to an ongoing RCN patient reported outcomes (PROs) initiative
A recent RCN initiative entitled “Responding to Expanded Outcomes-focused Screening (rEFOCUS)” is now set to collect patient-reported outcomes (PROs), a direct measurement of over 9000 patients’ cancer-related experiences at the three RCN sites (MUHC, JGH, and St-Mary’s). As part of the initiative, distress -- defined as uncomfortable emotions or symptoms reported by individuals as they cope with cancer -- is a central component. However, a systematic review shows a lack of appropriate follow-up on significant distress-related issues reported by patients (Mitchell, 2013). In fact, only 1 in 3 patients had a follow-up after reporting a significant level of distress. Factors put forward to account for these findings are lack of referral resources, training, costs, and gaps in following up. To address these issues, a team has already begun pilot testing sustainable means of responding to PROs using e-health and trained volunteers. Preliminary results of patients with low to moderate distress exposed to these costs contained interventions showed improvement on distress-related issues. This study will more broadly implement and test this sustainable program for cancer patients with unmet psychosocial needs alongside the RCN PROs initiative. Distress levels will be compared within and between participants to document changes over time between a group receiving informational e-handouts on commonly reported distress-related problems, phone calls from a trained Hope & Cope volunteer, or both and those patients receiving the usual care.
Carmen Loiselle will lead a JGH-MUHC-SMHC team with co-applicant Christine Maheu, and collaborators Erin Cook, Nathalie Aubin, Manon Allard, Linda House, Kevin Stein, Suzanne O’Brien and Linda Goodman.