Grant: Operating Grant: PHSI for Cancer Control - LOI

Gastrointestinal (GI) cancers (esophageal, gastric, pancreatic, hepatobiliary, colorectal) represent over 20% of cancers diagnosed annually. GI cancers are often a fatal diagnosis, as a large percentage of patients are diagnosed with incurable disease at time of presentation. GI cancer patients suffer significant symptom burdens, such as pain, nausea, and anorexia. In addition, treatment for advanced GI cancer is very resource-intensive, accounting for 5 of the 10 most expensive cancers to treat. This study proposes an innovative way to combine existing provincial data to inform hospital and regional cancer policy makers in the provision of evidence-based care in order to improve outcomes in a population of patients with advanced GI malignancies. We will determine the effect of alternate treatment regimes or best supportive care on patient symptom burden, healthcare costs, and overall survival. Data from the initial phase of this project will form the basis for a patient engagement workshop, which will be used to inform methods of information dissemination targeting patients and providers, as well as strategies to incorporate considerations relating to symptom burden and quality of life into patient-centered medical decision making. This project carries potential to broadly impact cancer care through systematic assessment of the efficacy, cost-effectiveness, and patient symptom burden at the palliative phase of GI cancers. Through partnerships with key knowledge users, data derived from this study will be leveraged to answer critical questions concerning the outcomes of cost-effectiveness, symptom burden, and overall survival effectiveness of palliative chemotherapy in GI cancers. These findings are of particular importance given that GI cancers are among the most poorly funded and studied, despite the high burden on society in terms of mortality, symptoms and treatment costs.