Alberta Cancer Foundation

The benefits of a coordinated province-wide diagnosis program

Illustration by Emily Chu.

News of a cancer diagnosis came to thirty-six-year-old mechanical engineer Corina Valencia on a sunny but chilly day in early December 2018. Three months earlier, Valencia had begun experiencing neck pain, but, as she was 24 weeks pregnant, she attributed it to her body changing. But, when her husband found a lump in her neck, Valencia went to see her family doctor. An ultrasound showed an inflamed lymph node, and the decision was made to investigate further once her baby was born.

At a routine prenatal checkup in late November, Valencia was rushed to hospital for an emergency C-section because her baby’s heart rate was low. While baby Oliver, who is healthy and happy today, lay in the neonatal intensive care unit, Valencia underwent a lymph node needle biopsy to her neck. The results of the biopsy showed suspicious cells indicative of Hodgkin’s lymphoma.

Valencia was exhibiting other symptoms consistent with Hodgkin’s but a biopsy to confirm the diagnosis came back negative, and without a positive cancer diagnosis, she was unable to access the services and support at Calgary’s Tom Baker Cancer Centre. Valencia was sent for an X-ray, which revealed a mass in her chest, but a bronchoscopy to take samples directly from her lungs also came back negative. Finally, following a CT-scan guided biopsy, Valencia was diagnosed with stage 4 Hodgkin’s lymphoma.

“It was a very stressful time,” says Valencia, who is now, thankfully, cancer-free.

Dr. Douglas Stewart is the senior medical director of the cancer strategic clinic at the Tom Baker. He believes a coordinated program is needed to better serve not only patients like Valencia, but also health-care professionals.

“With the current system, patients may experience distress caused by diagnostic delays, unnecessary tests and a lack of support. Likewise, the primary care providers experience variability in access to tests and specialists, referral processes and levels of communication,” he says.

Fortunately, things are changing. Stewart is one of the leads of the Alberta Health Services Cancer Strategic Clinical Network (SCN) team, which is developing a province-wide cancer diagnostic program called the provincial Accelerated Cancer Diagnosis program (ACD). The Cancer SCN team is made up of a variety of stakeholders including government agencies, universities, patients and more. The goal of the ACD program is to streamline, coordinate and standardize processes across all types of cancer, to lessen delays and provide education and support. Thanks to the generous support of Alberta Cancer Foundation donors, Phase 1 of development of the ACD program began in 2019.

There are existing province-wide coordinated cancer-specific diagnostic programs in Alberta, including programs to diagnose lung cancer and breast cancer, with colorectal and lymphoma programs in development. Eventually, these existing programs will continue to operate under the umbrella of the ACD program.

Stewart is hopeful the ACD program will also eliminate unnecessary tests. Family doctor referrals would go to the centralized program and patients would be triaged to the appropriate cancer pathway. Rather than tests and procedures happening in a linear sequence, multiple processes could happen at the same time to expedite diagnosis while also providing peer support.

Stewart hopes that the game-changing ACD program will be in place for all cancers within the next five years.