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Dr. Eva Grunfeld at the Maplesoft Centre

On June 21, 2012 the Ottawa Regional Cancer Foundation was honoured to welcome Dr. Eva Grunfeld to the Maplesoft Centre. Dr. Grunfeld is a leading Canadian expert on cancer survivorship care and was on hand to give two lectures. She is the Giblon Professor and Director, Research Program at the University of Toronto’s Department of Family and Community Medicine.

Dr. Grunfeld’s research focuses on evaluation and knowledge translation of cancer health services, covering the entire spectrum of cancer control activities. She is internationally recognized for making important contributions to the literature on cancer follow-up and cancer survivorship.

We had an opportunity to speak with her in between lectures:

How has cancer care evolved in the last 20 years?

I remember being one of the first researchers interested in survivorship over 20 years ago. No one was studying this aspect of cancer. The first study on survivorship care came out in 1991 and the research has grown exponentially since. I would say that before 2006 there was little interest or research in survivorship, but with early diagnosis and as treatment protocols continued to evolve and be successful, the medical and research community realized that more people were living with cancer then dying from it.

Why do you see the research you do as being relevant to overall cancer care?

My research and that of several of my colleagues has helped define very clear follow-up recommendations, for breast cancer particularly, that is geared not only towards oncologists but more importantly toward family physicians. These are the physicians who will keep following a patient after cancer treatment and they need the proper tools to help them care for their patients effectively.

What are some of the most surprising findings you have come across in your research?

Two studies come to mind. One involved family caregivers whose spouses succumbed to cancer. They were interviewed and the astounding revelation was that caregivers rarely saw the death of their loved one coming, regardless of clear signs such as the initiation of palliative care.  This indicated to me a lack of communication between health care professionals, patients and family caretakers.   The second study was a survivorship care plan study that clearly demonstrated the need to be much more mindful of resources. For example, with regards to health human resources, there is evidence to suggest that most patients (for example, those with breast, colorectal or prostate cancer) do not need to see an oncologist for a follow up appointment, but can see their family doctor instead. The residual effect could be oncologists who now have more time to see newly diagnosed or in-treatment patients, potentially reducing wait times.

Where do you see cancer care going in the future?

The trend towards personalized medicine is certainly interesting and makes sense in the context of the individual course the disease takes. However, I think we also need to ensure this type of personalized medicine is sustainable. And that requires resources and oversight. Drug and test development are long processes so there needs to be a move toward developing tests that are affordable and, therefore, benefit a greater number of patients.

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