Opening doors in cancer care

Balbir Gill

Cancer research is often thought of as being synonymous with the search for cures, but the biological aspect of the disease is only one part of the challenge faced by the patient and their family. Dr. Zeev Rosberger, director of the Psychosocial Oncology Program at McGill says he and his colleagues are working to help stimulate research and interdisciplinary efforts to improve the quality of life for cancer patients.

The first Annual McGill Psychosocial Oncology Research Day at McGill is March 11, and Rosberger says the interaction of researchers that this conference will facilitate may lead to new collaborations. He says work across disciplines — such as nursing, psychology, medicine and sociology — is essential to finding ways to improve the quality of life for cancer patients.

"Nobody has the one approach that's going to find all the answers. Patient care and patient family care are not single silos — they do not belong to any one discipline. We need to be able to work together. The Psychosocial Oncology Program brings together all the academic activities in clinical research and training. We're holding our first annual meeting where academic staff and students will present their research in psychosocial oncology to begin to develop a network and support transdisciplinary research on a local level."

The program will feature presentations from researchers on their work, which ranges from how family caregivers manage the patient's pain at home, to the impact of infertility in young male cancer survivors, to a presentation from Hope and Cope, based at the Jewish General Hospital.

Rosberger says this year's Research Day is only the beginning. "My goal in the long term is to start locally, and ultimately connect with colleagues in Quebec City and other parts of the province, such as Laval and Sherbrooke, who are also doing similar research. We have already talked about possibly having a joint research day next year."

Dr. Robin Cohen, research director of the Division of Palliative Care at McGill, says there is still work to be done in the academic world in order to train researchers and clinicians in interdisciplinary approaches. For example, graduate courses are specialized in one program, and that means students may not be exposed to enough of a variety of ways to conduct research or analyze data.

"Universities are not set up in a way that supports study across disciplines. Since graduate students tend to have a heavy academic load in their own discipline, they simply do not have the time to take courses in other disciplines."

Cohen says the Canadian Institutes of Health Research (CIHR)-funded Palliative Care Strategic Training Initiative makes sure that students are exposed to a variety of approaches from different disciplines. She is the principal investigator of the training program and works with colleagues at the University of Ottawa and the UniversitÈ Laval to help develop professionals in palliative care. "We discuss the program from the point of view of different disciplines as the students are planning their research. Students have their supervisor, but in addition, they have a second mentor on the team from another discipline to help them as they develop their protocol and interpret their results."

She says one of the Research Day presenters is postdoctoral fellow Mary Ellen Macdonald who spent a year observing and learning about the culture of the intensive care unit (ICU) at the Montreal Children's Hospital. Cohen describes the study as medical anthropology because it examines the cultural context of the ICU and how it affects those parents whose children are at high risk of dying.

Some of the Research Day presenters will be from the Psychosocial Oncology Research Training Program (PORT), which brings together professionals from across Canada. "We tend to deal with cancer screening, diagnosis, treatment and follow up," explains principal investigator Dr. Carmen Loiselle. In addition to Loiselle's participation in McGill, PORT has leaders in nursing from the University of British Columbia, the University of Manitoba and Dalhousie University, and trains researchers to look at ways to improve the quality of life for cancer survivors.

Loiselle's current research is the impact of information technology on patients. She says that a group of patients were taught how to browse the internet, and were given the names of reputable websites as well as a checklist to help judge the credibility of a website.

"We wanted to see if people who have access to broader sources of information have better health outcomes than people who don't, so they're being compared to a control group that is getting the usual care. We also compare their use of services because another question is whether patients who are better informed use health services differently. We've finished a study of breast cancer, and there seems to be a positive impact of the intervention. We're analyzing the data right now, but it looks promising so far."

She says that information technology has led to changes in health-care professions. "It is much more democratic than it used to be. There is more of a partnership between doctors and patients. Health-care professionals are now coaches to patients. We help them navigate through the maze."