Napanee’s rapid lung cancer assessment clinic reduces barriers to care

Patients in Napanee and the surrounding communities with suspected lung cancer used to rely on a trip (or many) down Highway 401 to Kingston for testing and proper diagnosis, sometimes causing delays in treatment that could mean the difference between life and death. Now, thanks to the first-place winners of the Merck Canada Lung Cancer Innovation Challenge, Dr. Genevieve Digby and Dr. Christopher Parker, Kingston Health Sciences Centre (KHSC) has opened a new rapid assessment clinic for patients in the Napanee region.

According to Clinical Lead and Respirologist, Dr. Genevieve Digby, lung cancer is one of the most common cancer types in Canada. Unfortunately, symptoms of lung cancer tend to appear only after the disease has progressed, with approximately 50 per cent of all lung cancer patients diagnosed with stage IV of the disease. This late-stage diagnosis can make lung cancer more difficult to treat, resulting in a poor prognosis and one of the lowest survival rates of all types of cancer.

In rural populations, she continued, this can be even more complicated, with distance being just one of the barriers to face when seeking diagnosis and treatment.

“We’ve done some work to look at those barriers in our clinic and there’s also some research that we’re doing looking at these barriers provincially. And, well, those reasons are multifactorial; there are lots of reasons why people experienced barriers. Some of the most common ones tend to be the distance from a treatment facility — the geographic barrier,” Digby said.

“There are socio-economic barriers to care as well,” she went on. “It’s been well documented that individuals and groups of lower socioeconomic status don’t have the same access to care, whether it be a transportation barrier or not knowing how to access care, or simply a different problem… And then there are sometimes cultural barriers to care that exist, as well, whether it be hesitancy towards Western medicine, whether it be fearfulness around certain types of diagnostic or treatment options that are out there, or maybe not being aware fully of what’s available. And what we’re trying to do is to break down those barriers to really try and bring care closer to patients to eliminate as many of these geographic and cultural barriers that we can.”

Dr. Christopher Parker, also a respirologist, pointed out that bringing a rapid assessment care where it is needed instead of having patients travel to such centres is a very new concept.

“This is a very innovative model. As far as we know, we’re not aware of any other rapid assessment lung cancer programs in the province or perhaps even the country,” he expressed. “We’re taking the centralized model of care and putting it back in the community to try to better address the population we’re trying to serve.”

Through the new outreach clinic, patients referred to the program will have the opportunity to have their initial consultation with the Lung Diagnostic Assessment Program (LDAP) clinic at the Lennox and Addington General Hospital (LACGH), at which initial lung cancer diagnostics and investigations will be coordinated, as well as subsequent referral appointments with the multidisciplinary team specializing in lung cancer at KHSC, including respirologists, thoracic surgeons, and oncologists.

“A big challenge faced by patients in rural Ontario is access to care, and we’re proud to be part of the solution by expanding the LDAP clinic, made possible through the prize funds we won from the challenge,” said Dr. Digby. “Our hope is to reduce wait times, travel, and expenses for patients, while increasing family and caregiver presence at appointments. Ultimately, we want to reduce the barriers patients face and make it easier for patients to receive the specialty cancer care they need, right in their own community.”

“What we’ve tried to do is make this process as streamlined as you can, not only for people who are coming through as patients but also for family physicians, or other healthcare practitioners, referring patients into the model,” she explained.

And, there is very little wait time, Dr. Parker said, noting, “when we can, we try to do that [assessment] on the same day. There are some tests, for example, that, even in Kingston, we have to, unfortunately, send people out of the region for and that’s something that we’re working on future resources [to address].”

Digby pointed out that this can also allow for more family support during assessment because family and friends won’t also have to travel to be with the patient at what can be a stressful time, and will be more readily able to attend appointments.

“The other big opportunity to be had in Napanee, obviously, is our sub-regional partnership with LACGH, who’ve been very keen on this idea and supporting it. And it’s also an opportunity in the sense [of] the proximity to Tyendinaga and the large Indigenous community there. We very much hope to be able to identify and break down some barriers that historically impact the Indigenous population in terms of accessing care around lung cancer.”

With their idea to launch a rapid assessment clinic for patients with suspected lung cancer in the LACGH, KHSC won first place in the competition held earlier this year: Merck Canada’s Lung Cancer Innovation Challenge in partnership with MaRS, which called on Ontario-based innovators to identify, implement, and scale solutions that could help enhance the lung cancer patient journey. The first prize came with a $100,000 contribution to making the project a reality.

In a press release for the opening of the clinic, Alex Ryan, Senior Vice President at MaRS Discovery District wrote, “MaRS congratulates KHSC on the successful launch of the outreach clinic. This demonstrates the power of innovation challenges to unearth solutions that already exist in Ontario and build new partnerships between innovators and adopters.”

“It’s very exciting to see this next stage of their idea in the field,” agreed Marwan Akar, President and Managing Director, Merck Canada, “and how they will be delivering a solution that can help patients receive optimal care as quickly as possible. At Merck Canada, our vision has always been to make a difference in patients’ lives through cutting-edge research and innovation, and we’re excited to continue to support Ontario-based innovators to ensure that patients everywhere have access to quality care that could help improve their health outcomes.”

You can watch the Merck Lung Cancer Innovation Challenge Finalist Showcase and award presentation here.