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Significant reduction in wait time for diagnosis, treatment of patients who may have lung cancer

Posted Oct 11th, 2011

Niagara patients with a suspicion of lung cancer are being diagnosed and treated much faster since a new program, the largest and busiest of its kind in the province, began a year ago.

The wait time for a diagnosis has dropped dramatically – from an average of 95 days to an average of 27 days – with the launch in September 2010 of the Lung Diagnostic Assessment Program (LDAP), a partnership between the Niagara Health System (NHS), Juravinski Cancer Centre, Cancer Care Ontario and St. Joseph’s Healthcare Hamilton.

In Niagara, the assessment clinic is located at the Outpatient Oncology Clinic at St. Catharines General Site and is integrated with oncology services provided by the NHS.

“We are extremely pleased with the success we have had in improving our patients’ experience from the suspicion of lung cancer to diagnosis and the beginning of treatment,” says Dr. Mark Jany, respirologist and lead physician for the regional program at NHS.

Key to the success of this program is the role of the Nurse Navigator. Registered Nurse Colleen Stang coordinates all aspects of care from the time a patient is referred, including making arrangements for diagnostic tests, providing information and guidance on what to expect each step of the way and arranging the consultation with a respirologist or surgeon. If a patient is diagnosed with lung cancer, the team collaborates with oncologists, surgeons and other specialists to determine the best course of treatment. Thoracic surgeons travel to Niagara every two weeks to see patients and meet with the team of local care providers. Once diagnosis is made and a treatment plan established, patients may go outside the region for care depending on their needs. For example, patients requiring radiation therapy or surgery would receive their care in Hamilton, while patients requiring chemotherapy could receive their care in Niagara.

Through the program’s coordinated approach, respirologists and surgeons at St. Joseph’s and NHS adopted a common approach to lung cancer diagnosis based on newly published guidelines. Since the program began, Niagara’s care providers have been taking part in multidisciplinary case conferences with medical colleagues in Hamilton to discuss a patient’s case as a group and determine the patient’s best course of treatment.

Niagara’s cancer program has increased about 30 per cent in the last five years. A new prostate cancer clinic recently opened at the St. Catharines General Site and the chemotherapy treatment space was expanded. In 2013, the Walker Family Cancer Centre will open at the new health complex in St. Catharines, bringing comprehensive cancer care, including radiation services, to Niagara for the first time.


Prior to coming into this role 1.5 years ago, I had never heard of navigation as a nurse before. However there were compelling studies showing that 60 to 70 per cent of patients with lung cancer stated that they had a lot of anxiety because they had no idea what was happening next in the diagnostic phase. Although a stressful role, I am thankful to be involved in this program working with this outstanding committed team to serve these phenomenal patients and their families, helping them to navigate the healthcare system at one of the most anxiety-provoking times in their lives. This is an essential role in cancer care.”

Registered Nurse Colleen Stang, Nurse Navigator for the LDAP

The NHS Oncology Program is expanding as we prepare for the new Walker Family Cancer Centre. In alignment with Cancer Care Ontario’s Cancer Plan, we are looking to improve the patient experience. This includes the diagnostic process through assessment programs, the first being the Lung Diagnostic Assessment Program or LDAP. We want patients facing a cancer situation to experience excellent, compassionate and patient-centred care as they enter the cancer system throughout our region.

- Dr. Janice Giesbrecht, NHS Medical Director of Oncology

By reducing wait times, we have been successful in reducing anxiety for our patients and their families at this extremely difficult time. The feedback we are receiving is overwhelmingly positive about the impact of this program in reducing wait times, providing better coordinated care and providing ongoing support to patients and families as they navigate the healthcare system.

Dr. Mark Jany, respirologist and lead physician for the program at NHS

The Lung Diagnostic Assessment Program is an excellent example of a win-win partnership for patients and care providers. This marks a successful development in bringing specialized services and resources to Niagara so that patients may be better served in their own community rather than having to travel outside the region for assessment and diagnosis.

Carol Potvin, NHS Director of Oncology Program Development

The Lung Diagnostic Assessment Program at St. Joseph’s Healthcare Hamilton and the Niagara Health System has been a tremendous success with our patients and staff members. The extensive and collegial collaboration between the oncology, respirology and thoracic surgery teams has been exemplary and unique, leading to the formation of the largest and busiest program of its kind in the province. The Lung Diagnostic Program has played a vital role in ensuring that patients with thoracic (chest) malignancies receive the very best and specialized care in the community.

Dr. Yaron Shargall, Head of Thoracic Surgery, St. Joseph’s Healthcare Hamilton and McMaster University

Niagara Health System