Researchers optimising cancer survivors’ outcomes

Brisbane cancer nurse scientists are working alongside clinicians and scientists to develop better healthcare models for cancer survivors.

• QUT & PA Hospital’s Professor Raymond Chan is leading a large team involved in 35 research projects, all aimed at helping improve the quantity and/or quality of life for cancer survivors

• Professor Chan has secured two NHMRC research grants totalling $4.5 million+ to develop and implement new models of follow-up care for cancer survivors across the nation

Queensland University of Technology (QUT) and Princess Alexandra Hospital’s Chair of Cancer Nursing, Professor Raymond ‘Ray’ Chan, says cancer is increasingly recognised as a chronic condition, with mortality rates decreasing by one per cent worldwide each year.

“We’re seeing much longer survival times for cancer patients, but at the same time we’re also seeing more and more long-term health issues arising from the toxic nature of cancer treatments,” said Professor Chan.

“The reality is that cancer survivorship today comes with an increased risk of a range of chronic conditions and health issues,” he said.

“It’s important that we give cancer patients both an increased quantity of life along with a quality life. To do this, we need new ways to care for cancer survivors and a deeper understanding of how cancer treatments work.”

Professor Chan leads a large research team, which is working on more than 35 research projects.

He was recently awarded two NHMRC research grants totalling more than $4.5 million. One of these grants will allow him to develop a model of care to enhance the role of general practitioners (GPs) in caring for cancer survivors.

Using a shared-care approach between cancer specialists and GPs, the program has the potential to transform follow-up care for cancer survivors.

“By sharing the care of cancer patients between their specialist and GP, and shifting the focus of follow-up care away from the hospital, we believe we can increase the quality and efficiency of care, plus make more it more cost effective and satisfactory for patients,” said Professor Chan.

“Our team is trying to think out of the box in developing approaches that will lead to big changes in the healthcare system, and make it more patient-centric and sustainable.”

For this project and others, Professor Chan and his team are collecting patients’ clinical data and blood samples to help identify the biological mechanisms underlying treatment toxicities.

“There are a lot of biological mechanisms which we want to understand from cancer treatments, such as what causes distressing symptoms? Why do some patient get them and some don’t?” said Professor Chan.

“By collecting this information, it will make it easier to now understand what is going on. We’re working with QUT scientists, including some based at the Translational Research Institute, and with a group in San Francisco to get some of these answers. I’d really like to be involved in more collaborative projects in this area.”

Many of Professor Chan’s research projects involve new models of survivor care for specific cancers, such as breast and lymphoma, while others are looking at whole-of-system models of care designed to increase the efficiency and effectiveness of the healthcare system for cancer patients.

His team uses an implementation science approach in their research program, ensuring all research knowledge and new development of interventions will be translated into patient care.

“A lot of my research is about implementation—how research can be applied within the healthcare system. I am hoping that our group can contribute our implementation science expertise to the Translation Research Institute community.”

“It gives me a lot of satisfaction because I know my research is changing patient care and changing patient outcomes. It’s what drives me.”

He says his team can add value to cancer research by working alongside scientists to help ensure their cancer research is applicable in the healthcare system.

“If you’re developing a new technology or diagnostics and you want to consider patients’ perspectives or experiences or the clinical setting in which your new technology will be used, get in touch with us! As nurse scientists, we pride ourselves as experts in patient experiences and implementation science.”

About Professor Raymond Chan RN, BN, MAppSc, PhD, GAICD

Professor Chan holds a Professorial Chair - Cancer Nursing in a joint appointment between Metro South Health and the Queensland University of Technology. He is an NHMRC Investigator, with a focus on optimising models of care and outcomes for cancer survivors. He has a special interest in how health services respond to the needs of people affected by cancer across the cancer trajectory especially in the survivorship phase. He is active in promoting evidence-based practice by implementing best available evidence in care, and conducting Cochrane systematic reviews, RCTs, and other research.

Professor Chan has attracted more than $20 million in research grants to undertake research in supportive cancer care. He is a chief investigator for five NHMRC grants and two NHMRC Fellowships. He has published 116 peer-reviewed articles. He is a Past President of the Cancer Nurses Society of Australia, the Founding Chair/Co-Chair for the Queensland Collaborative for Cancer Survivorship, and Vice-Chair for the Survivorship Group of the Clinical Oncology Society of Australia. Internationally, he serves as Chair for the Survivorship Study Group within the Multinational Association for Supportive Care in Cancer and as a Board Director for the International Society of Nurses in Cancer Care.

Professor Chan began his career as an oncology nurse with the Mater. Prior to joining the Princess Alexandra Hospital, he worked at the Royal Brisbane and Women’s Hospital.

Research projects

• (2021-2025): Optimising Primary Care for Cancer Survivorship. NHMRC

• (2020-2024): Implementation of a nurse-enabled, shared-care follow-up model for early Breast cancer survIvorS (The IBIS-Survivorship study). NHMRC

• (2020-2023): PROMISE: Patient-Reported Outcome Measures in cancer care: a hybrid effectiveness-Implementation trial to optimise Symptom control and health service Experience. Cancer Council Queensland

• (2020-2022): Partnering with General practitioners to Optimise Survivorship for PatiEnts with Lymphoma: A Phase II randomised controlled trial (The GOSPEL Trial). HIIRO Queensland Health

• (2020-2021): Telehealth Cancer-Related Fatigue Clinic Model for Cancer Survivors: A Pilot Randomised Controlled Trial (The TCRF Trial). PA Research Foundation

• (2019-2020): ImplEMenting a nurse-coordinated, INtegrated, shared-care model involving specialists and general practitioners in breast cancer post-treatmENT follow-up: a Phase II randomised controlled trial (The EMINENT Trial). Metro South Health

• (2017-2020): A sequential multiple assignment randomised trial (SMART) of nursing interventions to reduce pain associated with chemotherapy induced peripheral neuropathy. NHMRC

Recent journal publications (selected)

• Howell D, Mayer D, Fielding R, Eicher M, Verdon ck-de Leeuw, Johansen C, Soto PE, Foster C, Jefford M, Alfano C, Chan R, Lam W, Pravettoni G. Shapiro L, Stein K, Koczwara B, & members of the Global Project on Self-Management in Cancer (GPS-Cancer) (2020). What happens to patients after the clinic visit?  A call to action for self-management in cancer care. Journal of National Cancer Institute.
• Chan R, Teleni L, MacDonald S, Kelly J, Mahony J, Ernst K, Patford K, Townsend J, Singh M, Yates P (2020) Breast cancer nursing interventions and clinical effectiveness: a systematic review. BMJ Supportive and Palliative Care.
• Chan R, Howell D, Lustberg M, Mustain K, Koczwara B, Ng CC, Kim Y, Napoles AM, Dixit N, Yu K, Toh YL, Fitch M, Crichton M, Agarawal S, Chan A (2020). Advances and Future Directions in the use of mobile health in supportive cancer care: Proceedings of the 2019 MASCC Annual Meeting Symposium. Support Care in Cancer (Q2). 28: 4059-4067.
• Green T, Bonner A, Teleni L, Bradford N, Purtell L, Douglas C, Yates P, MacAndrew M, Dao HY, Chan R (2020) Use and Reporting of Experience-Based Co-Design Studies in the Healthcare Setting: A Systematic Review. BMJ Quality & Safety (Q1). 29: 64-76.
• Vardy J, Chan R, Koczwara B, Lisy K, Cohn R, Joske D, Dhillon H, Jefford M (2020) Clinical Oncology Society of Australia position statement on cancer survivorship care. Australian Journal of General Practice. 48 (12): 833-836
• Chan R, Blades R, Jones L, Downer T, Peet S, Button E, Wyld D, McPhail S, Doolan M, Yates P (2019). A single-blind, randomized controlled trial of StrataXRT® - a silicone-based film-forming gel dressing for prophylaxis and management of radiation dermatitis in patient with head and neck cancer. Radiotherapy and Oncology. 139: 72-78.  
• Chan R, Marx W, Bradford N, Gordon L, Bonner A, Douglas C, Schmalkuche D, Yates P. (2018) Clinical and economic outcomes of nurse-led services in the ambulatory care setting: a systematic review. International Journal of Nursing Studies. 81: 61-80.
• Chan R, Northfield N, Larsen E, Mihala G, Ullman A, Marsh N, Hancock P, Webster J, Wyld D, Allworth A, Russell E, Rickard C (2017). The effectiveness of dressing and securement devices for peripherally inserted central catheters (CASCADE): a pilot multi-arm randomised controlled trial. Trials. 18: Article 458
• Molassiotis A, Yates P, Li Q, So WKW, Pongthavornkamol K, Pittayapan P, Komatsu H, Thandar M, Yi MS, Titus Chacko S, Lopez V, Butcon J, Wyld W, Chan R (2017). Mapping unmet supportive care needs in cancer survivors across the Asia-Pacific region: Results from the international STEP study. Annals of Oncology. 28: 2552-2558
• Chan R, Yates P, Li Q, Komatsu H, Lopez V, Thandar M, Chacko ST, So WKW, Pongthavornkamol K, Yi MS, Pittayapan P, Butcon J, Wyld W, Molassiotis A (2017). Oncology practitioners’ perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: whose job is it anyway? Results from the STEP study. BMC Cancer. 17: Article 715

Photo: Professor Ray Chan, courtesy Queensland University of Queensland