For Vivian Hall “survivorship” means staying as positive as you can, even when dealing with very difficult circumstances. At 75 she was diagnosed with colorectal cancer and was admittedly naïve about the disease, like the majority of Canadians.
Colon cancer is the second leading cause of both male and female cancer-related deaths in Canada, but if caught early over 90% of cases should result in a full recovery.
Fortunately, Vivian's cancer was diagnosed and treated quickly at North York General Hospital (NYGH), which has the best cancer surgery wait times in Ontario and the most surgical oncologists in the region. Learn more about NYGH's Colorectal Cancer Program.
Today, Vivian is part of the North York Family Health Team (NYFHT) Colorectal Cancer Survivorship Program. The program, offered by the NYFHT in collaboration with North York General Hospital, ensures her health is monitored every six months for a five-year follow-up period and that any new signs of cancer are detected quickly.
In good hands
“I think the whole program is wonderful and I have been in such good hands,” says Vivian. “During my appointments I have to talk about some very personal things that are happening to my body; the nurses and doctors are such good listeners and very easy to talk to.”
In 2012, the North York Family Health Team and North York General Hospital developed this new nurse practitioner-led (NP) model of care to deliver all of the follow-up care for colorectal cancer patients. To date, it is the only colorectal cancer survivorship program in the GTA and the only NP-led one in Canada.
The Colorectal Cancer Survivorship Program has two NPs, Heather Whalen and Helen Frederickson, who care for patients who have completed active treatment. Helen Frederickson has been with the program for the past two years and describes herself as wearing two hats for this role, one is oncology and the other is primary care.
“I provide medical surveillance for cancer recurrence by reviewing CT scans, blood work, colonoscopies, as well as performing physical examinations,” says Helen. “I help my patients by addressing the various short- and long-term side effects of cancer treatment, such as pain, bowel changes, or other issues like high blood pressure that require a referral back to their family doctor.”
In the case of a recurrence of cancer, Helen is able to consult with the colorectal cancer team quickly to provide patients with a smooth reentry into oncology care at NYGH.
“Cancer can impact every aspect of person's life, including their family, so it's important to also assess the person's psychosocial needs through a distress scale,” says Helen. “This is where my primary care hat plays in — I screen for depression, hypertension, smoking, financial restraints — and provide health teaching and refer to community resources.”
Research shows that cancer survivors can feel a sense of abandonment after treatment, which underscores the importance of having timely, patient-centred care.
Helen's decision to specialize in cancer survivorship care was influenced by her experience with cancer from a caregiver perspective. Her mother died of stomach cancer and her father died of colon cancer.
"I've lived through it in a way, so I know how important it is to also connect with the caregivers of my patients and inquire how they are coping,” says Helen. “I find my work very meaningful; I know that my mom would have loved to be a ‘survivor.' "
For Helen, survivorship means that her patients continue to be productive, healthy individuals who return back to their family and community as whole as possible.
By that definition, Vivian is a perfect example.
“I try to keep up a normal routine by walking every day and keeping as active as I can — I think sometimes my friends don't even remember I had cancer,” says Vivian. “Plus I have a very supportive husband, two sons, their wives and children, all of whom I want to keep healthy for.”