Dr. Darren Brenner

Dr. Darren Brenner has done the math. He knows the chances of him walking through the Calgary Cancer Centre doors are high. Not as a doctor, but as a patient one day. He wants to make sure when he—or any other Albertan—is treated for cancer, his health-care team has the best possible data at their fingertips to predict the best outcomes.

Brenner, Dr. Winson Cheung and a team of clinicians and data scientists at the University of Calgary have positioned the city as a major hub for health outcomes research and real-world evidence generation. At its simplest, they are trying to improve patient care by understanding the gaps in screening and treatment as well as in the health-care system. To accomplish this, big data research that intersects with healthcare policy and industry becomes important.

“Data are only useful if they are used to answer the right questions and if they are analyzed in the right way. Because of this, we have developed a team of clinicians interested in outcomes research and big data in the province. This level of clinician engagement is unique yet essential to ensure that our data are leveraged to address the most high priority clinical issues.” says Dr. Winson Cheung.

Dr. Winson Cheung

Using data coupled with artificial intelligence and machine learning is important to improving patient outcomes across many types of cancer. For instance, in Brenner’s ACCORD project, they used a risk prediction model to determine who will continue treatment for early stage cancer, which can be used to identify who to focus on in terms follow-up or who to approach about different treatment options. 

The goal of the future Calgary Cancer Centre is to build a learning cancer care system with the proper tools, teams, and systems so that the data being collected can immediately change the treatment for the next person to ensure it’s the right treatment, for the right person, at the right time.

“If you’re collecting the right data, it can be used to make better predictions and improve care,” says Brenner. “It improves treatment and care for the next patient, because the system learns from every patient who came before them.”

The Calgary Cancer Centre campaign is a once-in-a-generation opportunity. To excel at data-driven cancer care, you need good infrastructure, talented staff to ensure data integrity, and the right data to be collected. “To be successful, you need a learning care system like the one we will set up,” says Brenner, adding it can be done in pieces but this would take longer and won’t achieve the same impact. “If we want to think big, we can only do that because of that building going up right now that will allow us to have the right people in the right place.”

Funding, including philanthropic dollars, is key to setting up Alberta as leader in using high quality data to drive outcomes. “A learning health system is visionary and transformational,” says Brenner. “We need philanthropy to make this successful and that requires an investment. For instance, Alberta is a leader in cancer prevention because we have traditionally invested in that area. Investing in health outcomes research in the proper way will let us do it faster and with greater impact.”

Dr. Joe Dort knows head and neck cancer inside and out. A University of Calgary educator and surgeon by trade, he’s dedicated his career to saving patients – not just treating them, but improving the care they receive and restoring quality of life for them and their families.

But it’s his work as a researcher, examining and improving processes in the hospital, where Dr. Joe Dort is making his latest career mark. He is passionate about improving the health care system itself – designing and delivering health care that is more efficient and more effective.

Designing better health care

One of the ways he’s doing this is through a head and neck pathway program he developed in 2010 and continues to be used and refined to this day.

“Back in 2009, if you were a head and neck cancer patient and you were having a surgery, you’d end up in the hospital for an average of 22 days. Over three weeks, you’d have about a one in three chance of having pneumonia and high risk of other complications.”

Deciding that wasn’t good enough, Dr. Dort and the team developed a new care pathway. Today, the current length of stay for head and neck surgery patients is on average is nine to ten days and the pneumonia rate is less than four per cent. Dr. Dort says the difference is standardized care, with a precision medicine focus.

“It’s much less variable because all of the members of the team do the same thing. And if we vary from the protocol, we vary because of something the patient needs.”

Not only is this better for the individual patient; it’s saving the health care system time and money.

“It’s been millions of dollars and thousands of complications avoided because of applying the science of clinical effectiveness to this group of patients, and taking it to broader cohorts of surgical patients.”

This is a powerful example of the way University of Calgary research is informing care and improving outcomes for cancer patients – in Southern Alberta and around the world.

Technologies

Another way Dr. Dort is leading the way in improving treatment and outcomes is by harnessing the power of new technologies.

He and his team are developing a virtual reality (VR) program to practice surgery outside of the human body. Students and doctors will be able to put on VR goggles and go into the operating room to practice operations in a simulated environment. This training and opportunity to practice will benefit countless patients – improving expertise and reducing risk for error.

Alberta-led innovations like these contribute to better patient outcomes, bringing research from the lab to the bedside to advance treatment and care.

Changing the culture of how care is delivered

Dr. Joe Dort sees the Calgary Cancer Centre as an opportunity to get it right for patients and families. He says that the path forward is an improved health care system – something that seems simple but is not easy. But if anyone can do it, he says it’s Alberta, which is set up with the one health care system.

The outcomes of this work are real and life-changing.

“What we’re really trying to do is get closer and closer to a world where more cancers are cured, but also detected earlier and treated better, and treated in a way that allow people to get back to whatever level of function they defined as being meaningful and have a life that they define as a life worth living.”

Through the Calgary Cancer Centre, Dr. Dort says we can change the culture of how care is delivered. “We have a historic opportunity to create something that will really be impactful at the centre level, as well as at the individual level.”

Arrow Big Smoke, a proud member of the Piikani Nation, supports Indigenous people in Alberta impacted by cancer.

Finding yourself in the medical world, juggling appointments, therapies and treatments is intimidating. It’s even more complicated if you speak another language or have unique personal needs. With the support of enhanced navigation for certain patient populations, these patients and their families are better able to focus on healing and less on figuring out a complex health care system. One of these navigation services includes the current Indigenous Cancer Navigation Program.

Over the last few decades, cancer rates in Indigenous people have increased rapidly, with patients typically being diagnosed in the later stages (stages 3 and 4). Due to barriers to screening programs, long distances between home and cancer centres, and a lack of culturally-appropriate care and understanding, Indigenous patients are more likely to experience reduced quality of life and poorer outcomes.

Arrow Big Smoke, a proud member of the Piikani Nation, is passionate about providing quality health care for Indigenous people. Having worked in health care for over 10 years, she has personally and professionally witnessed the barriers that many Indigenous patients face when entering the health care system. “Throughout my journey, I have worked with and have seen Indigenous clients in emergency and cancer care, and I continually find that there are still gaps in understanding,” she says. “I have personally seen and experienced biases in health care, and that’s part of what fuels my passion to do better.”

In her role, Arrow, a registered nurse with specialized training in cancer care, helps patients understand their treatment pathway and manage some of the barriers and challenges they may face. This includes acting as an advocate and voice for patients and helping health-care professionals to better understand Indigenous peoples and their cultural ways, as well as the historical trauma that can affect a patient’s ability to access health services.

Arrow believes that providing this level of compassionate and personalized care to people that might otherwise fall through the cracks is an integral aspect of the navigation service. Not only does Arrow support patients through the healthcare system, she also focuses on closing the gaps by working with other professionals to develop and connect Indigenous patients to programs and community resources that support and advocate for them through their cancer journey. “I’m working closely with other providers to contribute to a system change,” shares Arrow. “But there’s still a lot of work that needs to be done to acknowledge bias and stereotypes within the health system. It deters people from wanting to come and see us.”

With an increased commitment to services for certain patient populations, including Indigenous patients and their families, Arrow is optimistic that the new Calgary Cancer Centre will work towards being an inclusive space where all can feel safe visiting and accessing treatment and care.  

This is our moment. Our once-in-a-generation opportunity to transform the landscape of cancer research, care and treatment. We’re ready to OWN.CANCER. Are you with us?

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Alberta has all the right ingredients to be leaders in prevention and screening. Talent. Data. Technical Know-How. Machine Learning. Passion. Bringing all of those pieces together in the Calgary Cancer Centre will allow us to change the way we prevent and detect cancer. Dr. Huiming Yang explains the benefits of this system.

“I like to think of precision screening as ensuring we’re giving the right test, the right service to the right people,” says Dr. Huiming Yang, Medical Director, Screening and the Provincial Medical Officer of Health, Healthy Living at Alberta Health Services. “If we do this well, we will spend the right resources on the right people and it means much more precise intervention when it’s needed and no interventions when it’s not.”

“Alberta has true leaders in Artificial Intelligence and Machine Learning and we have great data in this province. We could wait for others to do this work or start it now and really be leaders around the world. The Calgary Cancer Centre will help us generate those patterns that will affect outcomes. The earlier we identify and detect cancers, the better chance of a cure and survival.”

We’re on the precipice of big changes in prevention and screening. Until now, we’ve taken an “average risk” approach instead of focusing on identifying which individuals are at higher risk and when. At the clinical level, when someone had an abnormal result, there would be diagnostic follow-up. It was that simple. Now, technology and a better understanding of disease progression should allow us to be much better when it comes to screening.

The use of Artificial Intelligence and Machine Learning brings a whole new level of sophistication to screening and surveillance. Humans can only take in so much information, says Yang. Machines are capable of massive learning and can give precise recommendations, allowing health-care teams to target the population in most urgent need and take the services to where they are. 

For example, in Alberta there are about 1.3 million people in the target population for cervical cancer screening and we currently screen close to 70 per cent of that population. Many don’t need to be screened for a variety of reasons while others who are being missed, should be. It’s a huge benefit to the health-care system—and to individuals–if we can determine who needs it most. 

With the Pap test, for instance, pathologists look at cells on a slide to determine if what they’re seeing might lead to cancer. “There’s some human subjectivity involved with what is being seen and what the recommendation is,” says Dr. Huiming Yang. Now machines can determine which cell combinations and other risk factors are indicative of a higher risk of developing cervical cancer and compile all the data to identify who should continue to be screened or screened more often. Machine learning can also apply to breast cancer screening to determine who needs a supplemental ultrasound, for instance, and who doesn’t. 

“Machine learning can help us pinpoint the pattern human eyes can’t see,” says Yang. “The computer can tell you all kinds of things and identify patterns of concern. It reduces possible harm with every test done by giving a very precise recommendation. It will say ‘this person should have this test and this one should not.’”

Alberta is a leader in Artificial Intelligence and Machine Learning and has unique capabilities when it comes to big data access and analysis. The Calgary Cancer Centre will provide an opportunity to consolidate some of that knowledge and work with colleagues across the province to be pioneers in this field. “This feels like the perfect opportunity to me,” says Dr. Huiming Yang. “Rather than wait for others to do this work, we can start it now and be leaders. I’m convinced that in five to 10 years from now, most people who do not require screening will not have it done and those who do need it will get the right test(s) at the right time.”  

This is our moment. Our once-in-a-generation opportunity to transform the landscape of cancer research, care and treatment. We’re ready to OWN.CANCER. Are you with us?

Donate Today