VANDERHOOF - The brand new B.C. Cancer Agency Centre for the North in Prince George has brought cancer care to the region to a new level, but many patients still choose to access treatment even closer to home.
Vanderhoof is home to one of 10 community cancer clinics in Northern Health, where patients can receive chemotherapy from specially trained general practice oncologists (GPO).
"Essentially it means more people can access [cancer treatment]," Vanderhoof GPO Dr. Suzanne Campbell said. "There are people who otherwise would not to because of travel, it also decreases financial costs, emotional costs, it allows people to be more comfortable, it allows their families to be involved more and basically just increases their access to good oncology care."
Campbell gave the example of a First Nations elder who was diagnosed with a incurable form of cancer and offered palliative chemotherapy to manage the disease. She said if he had to travel to Prince George, he likely would have chosen not to take the medicine and his life expectancy would have been six months. With treatment available in Vanderhoof, he's been receiving care for 2 1/2 years.
The local clinic also cuts down on the number of trips needed to the Lower Mainland.
"Travelling to Vancouver for some people is like travelling to Mars," Campbell said.
Northern Health CEO Cathy Ulrich said the community cancer clinics were a foundation of the Northern Cancer Control Strategy and have done a great job providing prevention, treatment and follow-up care.
"We know that access to treatment is important in terms of outcomes," she said.
The GPOs don't diagnose cancer nor do they prescribe a treatment plan, that work is done by a medical oncologist at a B.C. Cancer Agency site - like the one in Prince George. Once the treatment plan is in place, a patient can be referred to a GPO to carry out that treatment and provide after care.
"From that point on we have lots of communication with the medical oncologist, via phone or email," Campbell said, noting some of the work can be via teleconference with patients and the specialist.
The Vanderhoof clinic is also committed to providing patients with follow up care for five years after their treatment. Campbell said by having GPOs handle that aspect, it takes a lot of pressure off family doctors who don't have the extra specialized training.
"Cancer care is more and more complex," she said. "I can be pretty overwhelming for a family physician to stay on top of that."
The GPOs can also make sure people don't fall through the cracks after their chemotherapy by offering a convenient place to have screenings.
The number of chemotherapy doses the Vanderhoof clinic has dispensed annually since it opened in 2008 has more than doubled, but Campbell doesn't expect that rate of growth will continue.
"I think that well level off," she said. "Sometimes people will start chemotherpy and remain on it for three years, so we're seeing that accumulation build up."
So far the clinic has served 144 cancer patients, 45 of whom required more than one course of treatment.
Vanderhoof has three GPOs working out of its clinic, in addition to one full-time and one-part time registered nurse. There's also a part-time unit clerk and support from the lab and pharmacy. For the doctors, the oncology work represents a little over 20 per cent of their practice, with the rest of their time dedicated to their general practice duties.
The GPOs are trained through the B.C. Cancer Agency, which allows them to learn about the intracases of oncology and make connections with the specialists they'll be dealing with.
The Vanderhoof clinic is unique in Northern Health in that it provides outreach to other nearby communities. General practice oncologists regularly travel to Fraser Lake and Burns Lake to meet with patients, provide pre-treatment assessments and do follow up care. Campbell said the clinic would also like to expand its reach to Fort St. James, if it can secure funding.
Ulrich said the outreach model is interesting because not every community will have enough cancer cases to justify a GPO on staff.
"You do want to make sure that when you're delivering chemotherapy, you're delivering it in a quality way," she said. "That means that the nurses and the physicians need to have enough volume, so to speak, so that they are able to retain their skills."
Although chemotherapy has been available in Vanderhoof for more than four years, Campbell said the community will still see a significant benefit with the opening of the cancer centre in Prince George.
"It's huge having radiation services in Prince George," she said. "There are so many people in the north who did not have access to that and would not travel, particularly for palliative radiation which can be key for pain control and symptom control."