Radiation treatment offered close to home

Most Algoma District cancer patients requiring radiation treatment can forget about packing a suitcase to make the long, three and a half hour drive to Sudbury. With radiation treatment services and a state-of-the-art linear accelerator at the new Sault Area Hospital, the vast majority of cancer patients are finally able to receive radiation treatment without leaving home.

Sault Ste. Marie becomes the only city in Ontario and one of the first in Canada to be approved for a single radiation treatment unit, according to Brenda Lynn, director of oncology and renal programs. “Until now, radiation services were only offered by regional cancer programs in larger centres. The Algoma District Cancer Program will now provide a comprehensive cancer care service including radiation treatment.”

The Sault Area Hospital radiation service will be a satellite of the Regional Cancer Program in Sudbury. In a collaborative partnership model, they will share an identical clinical information system and resources to provide safe, quality radiation services at SAH. The seven radiation oncologists in Sudbury will take turns spending two days per week seeing patients in Sault Ste. Marie. They will also be available for follow-up visits by videoconference.

“Since the late 1990s, Cancer Care Ontario has been working with Sault Area Hospital for planning and developing radiation treatment services to serve the Algoma District population,” said Lynn. “In January 2005, the Ministry of Health and Long-Term Care approved a single radiation treatment unit for SAH as an affiliate of Sudbury Regional Hospital’s Northeast Regional Cancer Program.”

The decision in favour of a district service took into consideration the inconvenience to Algoma District cancer patients who had to travel to Sudbury every week for the duration of a course of treatment, which can be up to seven and a half weeks.  Patients were able to stay for free at the Daffodil Terrace, a lodge attached to the Cancer Centre in Sudbury, but were separated from their families and only returned home on weekends.

Disruption

“It was definitely a disruption to their lives,” said Dr. Julie Bowen, a radiation oncologist with the Regional Cancer Program in Sudbury.

The majority of Algoma District patients will be able to receive radiation treatment in Sault Ste. Marie, but patients with some forms of cancer – head and neck tumors, for example – will still have to be treated in Sudbury.

The availability of radiation services in Sault Ste. Marie will be especially convenient for palliative care patients from the Algoma District, who often turned down radiation treatment and the relief it offered because they didn’t want to spend part of the last few months of their lives travelling back and forth to Sudbury, said Bowen.

“Palliative radiation is an important part of what we do. Now, these patients can take advantage of radiation treatment without having to leave home.”

Communication technologies such as teleconferencing and radiation planning software have made it much more feasible to offer a district service, said Bowen.

“It wouldn’t have been possible 10 years ago. Now, we can look at diagnostic images from Sault Ste. Marie and do our planning remotely. We’re completely paperless in terms of our radiation prescriptions and our imaging, so it doesn’t matter if I’m in Sault Ste. Marie or Sudbury. I can still see the same things electronically as if I were on site.”

Identical linear accelerators in the two sites will ensure backup in the event that the unit in Sault Ste. Marie is out of service. The Varian Clinac iX linear accelerator “has all the bells and whistles, including cone beam imaging, which allows us to image the tumors daily to make sure we’re treating what we think we are,” said Bowen. “It’s a very technologically advanced machine.”

If the linear accelerator in Sault Ste. Marie is out of service, patients can be treated in Sudbury. Treating 30 patients on a different linear accelerator in midcourse would be a lot more work, said Bowen.

Cancer patients receiving chemotherapy at the new Sault Area Hospital will also see big changes. Located on Level 2 of the new hospital, one floor above the radiation program, the new chemotherapy suite is a spacious, open-concept area with a wall of windows overlooking a forested landscape.

There is a waiting room with a fireplace for patients and their families, a dedicated resource room with computers and books for patients to do research and a classroom where nurse educators, dietitians and social workers will conduct classes on subjects ranging from nutrition to the side effects patients can expect from chemotherapy treatments.

However, one thing that won’t change is the quality of care from the cancer program’s dedicated staff, volunteers and two medical oncologists, Dr. Silvana Spadafora and Dr. Malcolm Brigden.
“It’s nice to have a modern new facility, but it’s the quality of care that really counts and we’re bringing that with us,” said Lynn.

The Algoma District Cancer Program predicts 340 new radiation treatment cases next year, increasing to 430 in 2014-2015.