Bridging the distance Sunnybrook’s Odette Cancer Centre uses e-health technologies to support colorectal cancer patients in the community

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Peter Duffy turns 68 this year.  He and wife Rita will likely celebrate with a special bottle of champagne because the occasion marks more than his birthday. They will toast to the fact that Peter is living 10 years out from an advanced cancer diagnosis that many first thought was not treatable.

A retired technical trainer for Canadian Pacific Railway, Peter was diagnosed with colorectal cancer in 2002.  Shortly after a successful operation on the colorectal cancer, he was unfortunately found to have spread of the cancer to his liver. There were multiple tumours in his liver, and this was a complex situation. “He presented with a case with complexities that many in the cancer community would have said, based on older data, had no possible treatment,” says Dr. Calvin Law, a surgical oncologist who specializes in hepatobiliary cancers at Sunnybrook’s Odette Cancer Centre.

For patients living further away, and for the physicians caring for them, coordinated and rapid access to specialized cancer services is key to getting to the right treatment.  Faster access to a regional cancer centre like Sunnybrook’s Odette Cancer Centre means access to more specialized care and leading treatment technologies.

“Peter is one the early patients with a most challenging situation, who we were fortunate to see quickly – and were able to offer coordinated, multidisciplinary, specialized care. His case and others made us work harder to ask ourselves – How can we serve communities better? How can we build better bridges?” says Dr. Law, also the head of the Centre’s Surgical Oncology program, and an associate professor in the Department of Surgery at the University of Toronto. 

Sunnybrook’s Odette Cancer Centre is leading the way, bridging distances using the latest in e-health and information technologies.

A first-in-the-province initiative to support patients with metastatic colorectal cancer, Dr. Law and the Gastrointestinal Cancer Care team launched an all e-health referral portal for physicians in the community. This new system included a centralized e-contact address and e-imaging system which enabled digital scans from far away to be viewed within seconds at the Centre.  Physicians from Newmarket, Oshawa and Barrie have taken advantage of the system. Many patients have had their care optimized, and thus spared a few extra trips to Toronto, all the while receiving expert care for complex colorectal cancer.

Sunnybrook is linked to 38 community and teaching hospitals across Ontario through HDIRS (Hospital Diagnostic Imaging Repository Services), a Ministry of Health and Long-Term Care initiative of which Sunnybrook was a founding member.

The HDIRS network facilitates secure sharing of patient records and imaging such as CT scans and MRI examinations. Says Dr. Law, “This way, expertise can be shared between physicians in the community and Sunnybrook specialists – without the travel. These connections give patients and physicians new and faster access to more cancer expertise and leading diagnostic and treatment technologies.” 

“Part of building better community partnerships is about leading change in the way people access care in the virtual space and applying the latest tools to make those virtual connections happen faster,” says Dr. Andy Smith, chief, Sunnybrook’s Odette Cancer Centre.

Along with these newer e-health initiatives, Sunnybrook already hosts multidisciplinary cancer conferences. These regularly scheduled meetings or “tumour boards” are often held by videoconference between physicians from community hospitals and regional cancer centre specialists of disciplines, ranging for example, from pathology and radiology to medical and radiation oncology, and surgery. These confidential forums facilitate more input and collaboration on complex patient care issues.

“You sometimes hear about people falling through the cracks in the cancer system.  Well, I definitely didn’t,” says Peter Duffy. “The coordinated care I had – it’s good to see how my situation helped the process become more formalized for others out there.”

In 2003, Dr. Law’s team determined Peter was a candidate for a state-of-the-art treatment at Sunnybrook that teamed up chemotherapy followed by surgical liver resection using a revolutionary collagen-sealing device.  Peter was one of the first patients where these methods were combined which required constant communications between his medical oncologist, Dr. Georg Bjarnason, and Dr. Law, his surgeon.  When Peter needed another operation in 2006, Dr. Law and the team used the collagen-sealing device again successfully.

Peter returns to the Centre for his annual follow-up, often with gifts in hand, to express his gratitude to the doctors, nurses and other healthcare professionals who were part of his care team. 

As for celebrating life, Peter reflects on how far he’s come. “Every morning I get up and think it’s a great day to be alive,” he says.  He and Rita enjoy gourmet cooking, recently finessing an oxtail stew recipe, and keep busy outdoors being walked by their very large German Shepherd.