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Creating Collaboration & Synergy: Surgery, Palliative Medicine & Oncology, Cummings School of Medicine, University of Calgary

Author: Srini Chary, University of Calgary, Calgary
13 December 2017

Thanks to Dr. Balfour Mount, Urological Surgeon at McGill University, following his visit and working with Dame Cicely Saunders at St. Christopher’s Hospice in London, England, he coined the term “Palliative Care” and he is valued as the “father of Palliative Care” in Canada.

Similarly, Dr. Geoffrey Dunn, a Trauma & Burns, Pediatric Surgeon in the United States has led the way in Palliative Medicine.

The Senate of Canada has passed the Private Members Bill C277 unanimously, sponsored by The Hon. Marilyn Gladu (Member of Parliament, Sarnia-Lambton), now Royal Ascent leads to a new era in education, research and service for Palliative Care in Canada.

Hosted by the Division of Palliative Medicine, Department of Oncology, Cummings School of Medicine, University of Calgary @UCalgary  www.ucalgary.ca - @UcalgaryMed  an Inaugural Visiting Professor Lecture Series was conducted over two days with the purpose to create awareness, knowledge dissemination, collaboration and integration of services amongst Surgery, Oncology and Palliative Medicine to improve patient and family care.

Dr. Jessica Simon, Division of Palliative Medicine academic lead and Dr. Ayn Sinnarajah. Division clinical lead agreed to invite Dr. Alexandra Easson, a General Surgical Oncologist at Mount Sinai Hospital an`d Princess Margaret Hospital, Toronto. The surgical group Dr. Lloyd Mack, Dr. Chad Ball and Dr. Elijah Dixon were collaborating along with Dr. Suni Verma and Dr. Vincent Tam, from the Oncology Department, Tom Baker Cancer Centre.

Dr. Easson was able to spend November 16 & 17, 2017 in Calgary was to engage surgical, oncological and palliative care trainees & faculty.

Dr. Easson, is an Assistant Professor in the Department of Surgery at the University of Toronto. She graduated from medical school at Queen’s University in Kingston, Ontario and completed her General Surgery Residency at the University of Ottawa.  She was a Research Fellow at the Massachusetts General Hospital in Boston and completed a Clinical Fellowship in Surgical Oncology at the University of Toronto, in Toronto. She received an MSc in Clinical Epidemiology at the University of Toronto, where she completed a thesis in patient outcome measures after palliative surgical interventions. Her major clinical and research interests are in the management of breast, melanoma, and colorectal malignancies, as well as surgical palliative care. Dr. Easson is a founding member of Committee of Surgical Palliative Care at the American College of Surgeons www.facs.org; @AmCollSurgeons (ACS), since its beginning in 2001 and has been focusing on creating and disseminating palliative care education for surgeons and surgical trainees.  

On the morning of November 16th Dr. Easson, presented “Care when there is no cure – what surgeons can give palliative care”. Surgeons have been doing palliative surgery for centuries and as the anesthesia improved, “curative” surgery was a possibility. Despite the improvements still palliative surgery is needed, as curative intent not always results in a cure.

“Early, integrated, Collaborative Palliative Approach to care, Palliative Care & End of Life care” is becoming a very important “Spectrum of care”. “Palliative Care is Everybody’s Business”.

 Alexandra, was able to have a conversation with three palliative care fellows who are in training from internal medicine, family medicine and hematological oncology. They felt it was important and insightful to hear the perspective from a surgical oncologist. In the afternoon, Dr. Easson spent two hours with surgical residents and fellows. The audience was very appreciative, as this was the first time they have heard of the contribution by a surgical team and palliative care team in the best interest of the patient, families and community.

The next morning, Alexandra was able to engage gynecologic oncology faculty, trainees and other health care providers and she was impressed with the “model of care” in gynecologic oncology in the Calgary Zone. Dr. Prafull Ghatage may work with Dr. Easson at the American College of Surgeons.

Dr. Leonie Herx, president elect, Canadian Society of Palliative Care Physicians @cspcp_scmsp  www.cspcp.ca (CSPCP),  was able to further the discussion at national level, while Dr. Easson volunteered to be on an educational committee relating to the Royal College of Physicians and Surgeons of Canada www.royalcollege.ca  @Royal_College (RCPSC), Subspecialty in Palliative Medicine, which is part of Internal Medicine. At present, the subspecialty does not extend to surgeons and there seem to be an opportunity for a joint college like RCPSC to consider in the future for a surgical stream.

At lunch time Dr. Easson made a presentation entitled “Palliative care is everybody’s business – what palliative care can give to surgeons”. The audience included surgical oncology, palliative and oncology faculty and fellows. It was well received and a good discussion ensued.

The Division of Palliative Medicine is grateful to Dr. Easson for spending time in Calgary and presenting her thoughts from her practice of surgical oncology, interwoven with palliative care and work at the American College of Surgeons in relation to education, and change of practice in the surgical field in North America.

Incidentally, Dr. Easson will be presenting a similar lecture at the American College of Surgeons, “Surgical Congress 2018” entitled “Creating Synergy: Early Integration of Palliative Care with Complex Surgical Care”. Calgary has been blessed with this encounter with Dr. Easson. As we move forwards, more joint rounds, resident & fellow educational endeavors, along with electives to trainees, are being planned.

The Pallium Foundation of Canada, www.pallium.ca  @palliumcanada a national not for profit organization, has taken the lead to create frontline caregiver educational material and is currently is working on “Learning Essentials Approaches to Palliative Care (LEAP) Surgery”. Pallium Canada, has been involved in caregiver and interprofessional education & capacity building in provinces, through local facilitators for more than 15 years in Canada. Plan is afoot, to include public education relating to palliative care and end of life care, as we move forwards.

 

Srini Chary, University of Calgary, Calgary

12 December 2017

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