Igniting a cancer care revolution
November 11, 2022
Allowing cancer patients in Canada and beyond to achieve the best possible outcomes has been a priority in the research and clinical work of medical oncologist Christopher Booth, a professor at Queen's School of Medicine. In October, he was inducted as a Fellow in the Canadian Academy of Health Sciences (CAHS), which brings together health and biomedical scientists and scholars from across Canada to evaluate the country’s most complex health challenges.
“This platform will allow me to engage with policy-makers so that we can design and implement cancer care systems that are more equitable and more patient centred,” says Dr. Booth, who is also the Canada Research Chair in Population Cancer Care.
The quality of cancer care – including access and patient outcome inequities – is fundamental to Dr. Booth’s research. As a member of the Queen’s Global Oncology Program and the Cancer Working Group for the World Health Organization’s (WHO) Essential Medicine List, his research is having a direct impact on the cancer medicines and treatments available to people around the world. Dr. Booth’s work also supports prioritizing treatments that meaningfully improve survival and quality of life.
“One challenge in cancer care is the perception among the public and policy makers that newer is always better. While some of our new medicines provide large benefits for patients, many have very small benefits – and these treatments cost tens of thousands of dollars per month,” he highlights.
On the other hand, several effective medicines have been around for decades and are now generic. But this does not guarantee access: a study by WHO in which Dr. Booth participated suggest even these medicines remain unaffordable for many patients around the world.
Palliative care for cancer patients
In collaboration with colleagues in palliative care, Dr. Booth has been looking at cancer care delivered in the last year of life. In his clinical practice, he has learned from his patients that decisions in this context require careful consideration of treatments’ benefits, side effects, and patients’ quality of life and how they want to spend their time. These observations have informed new research initiatives to learn how oncologists can do a better job of communicating and helping patients make treatment decisions that match their own values and preferences.
“We recently completed a study in which we directly asked patients how they balance survival, treatment benefit, side effects, and quality of life. The results were incredibly insightful and challenge many assumptions held by the oncology community. Most patients would not accept cancer treatment which will not help them live longer or better lives,” explains Dr. Booth.
One of the ways that Dr. Booth is helping improve end-of-life care is through the development of a new community program called the Kingston Kerala Project. The idea for the program stems from his time on sabbatical in South India, where he collaborated with physicians and nurses at Pallium India, an NGO delivering palliative care in a vastly different health system. With fewer resources and higher volumes of patients, Dr. Booth saw his colleagues using more creative ways to deliver care.
The team in Kerala pioneered community-based volunteer delivery of palliative care. In this model, trained volunteers deliver much of the day-to-day visits, providing psychosocial support and assistance with domestic work that patients cannot do on their own – while visiting nurses and doctors attend to patients' medical needs.
“We’re in the process of launching a similar program that will engage trained volunteers in community-based palliative care here in Kingston. This project is directly informed by lessons learned from our partners in Kerala,” says Dr. Booth. “One of the major challenges in the current Canadian health system is the delivery of home care. There are many vulnerable patients living at home who need more support. The Kingston Kerala Project represents an incredibly low-cost innovation that could make a big difference for the quality of life for patients with terminal illness. There will also be tremendous benefits for the engaged community volunteers who can improve the lives of others.”
This program is just one example of Dr. Booth’s efforts to prioritize patients. He plans to utilize his new status with CAHS to continue his push to improve cancer care across Canada and the globe. A Queen’s alumni twice over (BSc’97, Meds 2001), Dr. Booth is honoured “to have the work we are doing be recognized by the Academy. “More importantly,” he says, “it's a signal that work in global cancer care is becoming increasingly valued by the broader medical and scientific community.”
This story was originally published by Queen’s Health Sciences.