RUIS McGill and the Department of Oncology
Description
RUIS
RUIS (Réseau universitaire intégré de santé) is the
designation for the university-based networks of each of
the four faculties of medicine in Québec: McGill
University, Université de Montréal, Université
Sherbrooke, and Université Laval. It is designed to give
the faculties of medicine a more prominent role in the
organization and delivery of tertiary level health care
in Québec. The goal of the plan is to improve access to
health care by streamlining exchanges between primary
care providers and upper level care providers of
specialized procedures. RUIS Map (PDF)
RUIS McGill
Each university RUIS serves a geographic region and is
responsible for coordinating the tertiary health care
services, research and teaching provided by its faculty
of medicine and affiliated teaching hospitals in that
area. For McGill, these include the McGill University
Health Centre (MUHC), the Jewish General, St. Mary’s
and the Douglas hospitals.
The Department of Oncology is the focus of the oncology activities of RUIS McGill and is critical to the integration of activities in all of the McGill-affiliated institutions. It integrates cancer treatments and research and it is organized along tumour-specific lines in multidisciplinary committees that encourage clinical research efforts. At the same time, the Department promotes programs that cut across disease sites and focuses on fields of research and treatment that are not confined to one tumour type. McGill Network for Cancer Care
In all of the McGill hospitals, multidisciplinary teams treat cancer patients. Each hospital has developed approaches for the medical and nursing management of specific cancers with the aim of providing patient-focused best care. Concern for the psychosocial and spiritual needs of the patients and their families is a feature of this approach. Patient care includes the expertise of a wide range of professionals—doctors, nurses, social workers, psychologists, dieticians, physiotherapists, etc.—as well as volunteers (Hope and Cope) and clergy. The patient is viewed in the context of his/her family and living environment and early interventions are made using this range of services.
Last year we established the “table d’oncologie” with representatives from all McGill institutions and all disciplines of cancer care, in addition to epidemiologists, a tumour registrar, health care administrators and patient representatives.
The mandate of the table d’oncologie includes extending academic leadership to guide treatments in the primary care regional hospitals in a community hospital outreach program. To achieve conformity in clinical approaches for each type of tumour, we are developing common treatment approaches which are being articulated with the Québec-wide practice guidelines developed by the Conseil Québécois pour la lutte contre le cancer, as well as with the clinical research efforts of Le Groupe d’Études en Oncologie du Québec.
RUIS McGill also addresses the role of the family doctor in cancer care. There is a significant benefit to the patient in being treated close to home and family doctors can perform many aspects of cancer control, from treatment and symptom management to psychosocial support. A coordinated effort to include community doctors in educational programs, practice guidelines preparation and clinical trials could advance this vision as well as potentially aid in recruitment to outlying regions. This concept is consistent with discussions underway at the Comité regional de lutte contre le cancer, à l’Agence de santé et des services sociaux de Montréal.
Another major focus of RUIS McGill is manpower resources for cancer care. The recent crises in radiation therapy reflects increased cancer diagnosis and resulting higher patient numbers; however, it is also the result of an increased use of radiation therapy, to replace or minimize surgery for example, as well as enhanced complexity of treatment planning to improve efficacy and reduce toxicity. This requires more time and personnel resources.
A potentially even greater manpower challenge is occurring with regard to systemic therapy of cancer—chemotherapy and biological therapies—which is now part of the treatment of the majority of cancer patients. As a result of pioneering clinical research—including some performed by Québec oncologists—adjuvant chemotherapy administered after initial surgery has been proven to increase the cure rate of a number of cancers.
New treatments—such as biologic agents aimed at molecular targets on the tumours or their necessary blood vessels—have important clinical benefits to a significant number of patients; however, these treatments are complex and require highly specialized medical oncologists to administer them.
These new treatments are also enormously expensive. In the absence of designated budgets for centres with expertise in their administration, the costs will quickly expand beyond control. Participation in state-of-the-art trials, in which access to novel agents can be obtained at no, or reduced, cost, is one approach to this problem. Our aim is to be in a position to have scientific impact in the development plans of pharmaceutical and biotech companies. Access to trials will benefit all Québecers, not only with regard to cancer therapeutics, but also for prevention.
RUIS McGill Table d'Oncologie Committee Membership
Dr. Gerald Batist -
Committee Chair - Medical Oncology, Research, McGill, JGH
Ms. Winie Celestin - Liaison/Administration,
Department of Oncology, McGill
Ms. Cathy Ammendolea - Patient Representative
Dr. Armen Aprikan - Interim Director, Department of
Oncology - MUHC
Dr. Mark Basik - Tumor Registry, JGH
TBA - Tumor Registry, MUHC
Dr. Sonia Brisson - Medical Oncology, Gatineau
Dr. Carolyn Freeman - Radiation Oncology, Pediatric
Oncology, MUHC
Dr. Mark Goldberg - Epidemiology
Dr. Walter Gotlieb - Surgical Gyn-Oncology, JGH
Dr. Paul Jacquemin - Director, Professional Services, CSSS
Verdun
Mr. Joseph Jospé - Patient Representative
Dr. Bernard Lapointe - Palliative Care, JGH
Dr. Bruno Lemieux - Director, Professional Services, CSSS
Vieux Lachine/LaSalle
Dr. Bernard Lesperance - Agence de Montréal
Dr. Richard Margolese - Surgical Oncology, JGH
Ms. Lynne McVey - Nursing Oncology, JGH
Dr. François Patenaude - Hematology-Oncology, Rouyn
Noranda
Dr. Jaroslav Prchal - Hematology-Oncology, St.
Mary's Hospital
Dr. Zeev Rosberger - Psychosocial Oncology
Ms. Adréanne Saucier - Nursing Oncology, MUHC
Dr. Gayle Shinder - Research Grants Coordinator,
Department of Oncology
Ms. Lucie Suprenant - Pharmacy
Dr. Jeremy Sturgeon - RVH