Learning from our patients, providing care in the community

Joan reached out her hand to me today, “Thank you Dr. Trinkaus, for all you’ve done.”

It’s a bitter sweet accolade for the many discussions we’ve had about her terminal illness, for the trials of chemotherapy that prolonged her life by several weeks, and for the genuine care that the team in our cancer clinic offered her. Joan is one of my patients who is currently, at the time of writing this article, in the final stages of her life. She has an inspiring story, like every one of my other patients that I see in our cancer clinic. Our visit today reminded me of why I became a cancer specialist in the first place. If you asked an oncologist or a nurse who specializes in oncology why we have chosen our professions, we inevitably describe the tremendous privilege of treating our patients during what are often the most frightening, physically taxing, and vulnerable stages of their lives.

We have the opportunity to treat, and sometimes cure cancer in addition to helping our patients fulfill their legacy for the remaining time that they have to live. The challenge in cancer care has always been, and in my opinion will always be, having the capacity to balance this “art of medicine” with the technical aspects of providing cancer care.

Many people think that only the downtown hospitals or regional cancer centres provide a full chemotherapy clinic. When I first meet a new patient, often one of the first things they ask is, “Where will I get my chemotherapy treatment?”

As a community hospital in York Region, we are lucky to be able to provide our community with cancer care, close to home.

Our hospital works closely with regional cancer centres in Newmarket, Oshawa and Toronto to provide radiation treatment or other surgical expertise not offered at our hospital. However, we are able to provide a significant portion of cancer care right here in the community. I believe that our partnerships are what make our approach so successful and truly allow patients to have the best of both worlds – being treated locally and, when necessary, having access to a regional cancer centre.

Markham Stouffville Hospital is a small hospital, compared to GTA standards, which is its strength and also which can be its challenge. The advantages of working in a tight community include having face-to-face interactions on a daily basis with other specialists to discuss patient care, the capacity to request urgent radiologic investigations that can often be accommodated in a fraction of the time compared to a tertiary centre, and the ability to provide chemotherapy in a centre where everyone, from the volunteers to nurses, physicians and support staff, knows my patients by their names and their stories. And this is truly the strength of our hospital in my opinion; we strive to provide a standard of excellence in cancer care, all the while providing the continuity of care needed for our patients and families at a time when our patients need us most.

While I emphasize the strengths of our centre, there are also some challenges due to our current size and scope of practice. We sometimes struggle with scheduling chemotherapy with the limited number of chemotherapy chairs in our small space and are not able to provide all cancer treatments, including radiation therapy, onsite. We also treat most tumour sites, and therefore we work very hard to ensure we stay up-to-date with new discoveries and research.

Despite these challenges, there has never been a better time to be an oncologist.  New targeted treatments and better attention to cancer prevention and survivorship have led us to improve the quality of our patients’ lives, and ultimately increased the chance of a cure.

This is also an exciting time to be an oncologist at Markham Stouffville Hospital. The hospital is in the midst of an expansion project that will double its size and greatly expand the programs and services we offer. Our new chemotherapy suite has a great blueprint created with our patients in mind that offers more chemotherapy chairs, treatment and counseling areas, expansive windows, and access to a tranquility garden.  As well, our team of three oncologists is committed to growing our educational, palliative, and clinical trial programs.

As a physician, we have the opportunity to help shape cancer care and palliative care in this growing community. The leading inspiration for all of these advances is patients like Joan; I owe her, and all of our patients, a heartfelt “thank you” as well.

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