New Cape Breton Cancer Centre thoracic clinic targets earlier diagnosis and treatment
SYDNEY, N.S. – A new thoracic clinic that opened last fall at the Cape Breton Cancer Centre is focused on improving outcomes for lung and related cancer patients through shorter wait times, faster diagnosis, and treatment options closer to home.
“When patients must travel to get the care they need, it’s hard on them and their families,” said Brian Comer, minister responsible for the Office of Addictions and Mental Health on behalf of Michelle Thompson, Minister of Health and Wellness. “They deserve to receive health care close to home and, in their community, whenever possible.
“The new clinic will improve access to care, diagnosis, outcomes and provide better, faster care for thoracic patients in Cape Breton,” Comer said.
The clinic is led by the provincial thoracic surgical team in Halifax, with coordination of care provided by a local registered nurse on site at the clinic in Sydney.
“We know that early diagnosis and timely treatment of lung disease are key to optimal patient outcomes,” said Dr. Daniel French, thoracic surgeon and medical lead for the new thoracic clinic. “This is particularly true for lung and esophageal cancers, which are too often diagnosed at a late stage when treatments are much less effective.
“Until this clinic was established last fall, Cape Breton patients with symptoms suspicious of lung and other related cancers had to make a number of trips to Halifax for various tests, surgery, and treatment. Now, patients travel to Halifax for surgery, but the majority of diagnostic tests and follow-up care is provided in Eastern Zone,” French said.
Not having to travel to Halifax for an EBUS (endobronchial ultrasound) bronchoscopy is making a difference for many patients. EBUS bronchoscopy is a specialized procedure used to diagnose different types of lung issues, including inflammation, infections, or cancer. Until March 2023, patients who needed this procedure had to travel to Halifax. Five surgeons and one respirologist in the province are trained to perform the procedure.
Today, because of this clinic, the purchase of two new EBUS scopes, and the commitment from thoracic surgeons, patients who need this procedure can have it at Cape Breton Regional Hospital.
“Patients are very pleased,” said Sarah Gillis, the registered nurse who coordinates clinic operations and works closely with the thoracic surgical team in Halifax to coordinate on-site patient care. “Having someone local who knows the area, is aware of local resources and is able to guide patients through the complexities of diagnosis and treatment alleviates some stress for them.”
Patients who have symptoms of possible lung cancer are referred by family doctors or nurse practitioners to the thoracic team in Halifax for a consultation. The surgeons review the patient’s history and related test results. Then they connect with Gillis to talk about other tests needed prior to consultation. Gillis reaches out to the patient, lets them know what other tests are needed and have been ordered, and schedules a consultation once the test results are available.
This is a joint, in person appointment with Gillis and one of the thoracic surgeons. Gillis and the patient are in clinic and the thoracic surgeon may be in the clinic or may join the appointment by video link. Clinics are held weekly, with surgeons regularly travelling to Sydney from Halifax.
“Having a nurse on the ground to coordinate care and be a local resource for patients and community health providers is absolutely essential to the success of this clinic,” Dr. French said. “The clinic would not be able to operate without this support.”
Dr. Elwood MacMullin, medical director of the Cape Breton Cancer Centre, said the clinic is the perfect example of the power of multidisciplinary collaboration.
“The provincial thoracic surgical team in Halifax reached out to cancer care, and Eastern Zone perioperative, lab, and diagnostic services and suggested we pull a team together to decide how we could improve things – for patients first – and perhaps in doing so, create efficiencies for our health system too,” said MacMullin.
“Over the course of a few months, working closely with the thoracic surgeons we developed new processes, identified available clinic space, hired a nurse, and just made it happen. In less than a year, the availability of this clinic has meant more than 200 Cape Bretoners [at present] have been able to have the majority of their care for lung and related cancers right here at home. The new clinic is also helping to alleviate wait times in other areas of the province and has simultaneously opened up clinic space in Halifax.”
The community thoracic clinic was approved for a Translating Research into Care (TRIC) grant to evaluate this model and its effectiveness. Early results are expected in winter 2024.