Grant: Operating Grant: PHSI for Cancer Control

Living with worsening cancer creates significant distress for patients and their families, especially when care transitions abruptly from a focus on the life-prolonging cancer therapies to a focus on palliative care (supportive care for enhancing quality of life). Patients and their families have told us that to improve these transitions they need: (1) a sense of continuity in their care, (2) opportunities to discuss preferences for future care, and (3) prompt access to specialized palliative care when needed. We know that patients who receive palliative care supports earlier, e.g. while also being treated with chemotherapy, tend to spend less time in hospital, with less invasive treatments when at the end of their lives. This is associated with improved quality of life, reduced family distress and decreased healthcare system costs. Currently, our cancer systems struggle to provide that "early palliative care." Our proposal aims to demonstrate the effectiveness of routinely offering early, community-based palliative care to support people with non-curable colorectal (lower gut) cancer. We will do this by closing current gaps in care by using: (1) A "Pathway" or roadmap to guide clinicians on when and how to identify and address suffering associated with colorectal cancer, developed together by patient and families, family doctor, cancer and palliative clinicians; and (2) Routinely ensuring all patients and families are supported in five key palliative needs. We will measure the impact on patients, their families and healthcare system costs. We will start in one city and compare results with another similar city. Senior health services leaders are involved with the research to ensure that this innovative pathway of care continues after the project. What we learn will be adaptable and spreadable to help people living in rural and other areas across Canada and people with other cancers.