Igniting a cancer care revolution – The Next 25

Feature Stories | 20 Oct 2022

This story is part of #TheNext25, an ongoing series exploring how Queen's Health Sciences is reimagining health education, research, and patient care.

Dr. Chris Booth’s calls for “a common-sense revolution in oncology” are about to get a larger soapbox.

The Queen’s Health Sciences researcher and professor was inducted as a Fellow in the Canadian Academy of Health Sciences (CAHS) on Thursday, October 20 in Ottawa.

CAHS brings together health and biomedical scientists and scholars from across Canada to evaluate the country’s most complex health challenges. Dr. Booth’s honour reflects the ground-breaking impact his efforts are already having at home and abroad.

“This platform will allow me to engage with policy-makers so that we can design and implement cancer care systems that are more equitable and more patient centred,” the Queen’s alumni says ahead of his induction.

The quality of cancer care – including access and patient outcome inequities – is fundamental to Dr. Booth’s research. That focus is grounded in his clinical work as a Medical Oncologist as well as his work overseas. He believes patients – regardless of where they live – should have access to care that makes a difference. As a member of the Queen’s Global Oncology Program and the Cancer Working Group for the World Health Organization’s (WHO) Essential Medicine List, his research is having a direct impact on the cancer medicines and treatments available to people around the world. Dr. Booth’s work also supports prioritizing treatments that meaningfully improve survival and quality of life. That was the essence of Dr. Booth’s call for an oncology revolution published in April 2022 with Queen’s colleague Dr. Bishal Gyawali.

Re-thinking the value of cancer care is another important part of that vision. Dr. Booth is a global leader in the movement to promote high-value care and reduce low-value unnecessary care. This work involves close collaboration with colleagues in India, Africa, and beyond.

“Our team works with patients, clinicians, and policy-makers to identify the most important cancer treatments that should be prioritized by ministries of health globally,” says Dr. Booth, Canada Research Chair in Population Cancer Care. “One challenge in cancer care is the perception among the public and policy makers that newer is always better. While some of our new medicines provide large benefits for patients, many have very small benefits – and these treatments cost tens of thousands of dollars per month.

"The reality is that many of our most effective medicines have been around for decades and are now generic. However, a recent study we did with colleagues from the WHO found that even these medicines remain unaffordable in most parts of the world. Our work is focused on ensuring that patients in all health systems get access to the treatments that provide large benefits. Treatment affordability is a huge barrier to equitable cancer care around the world.”

Another focus of Dr. Booth’s research involves quality of care – both in Canada and in a number of low and middle-income countries. His recent work has focused on cancer care delivered in the last year of life where he works closely with colleagues in palliative care. In his clinical practice he has learned from his patients that decisions in this context requires careful consideration of treatments benefits, side effects, quality of life, and how patients want to spend their time. These observations have informed new research initiatives in which Dr. Booth’s team is learning how oncologists can do a better job of communicating and helping patients make treatment decisions that match their own values and preferences.

Photos: Dr. Chris Booth with colleagues at Trivandrum Regional Cancer Centre in Kerala (main); Dr. Booth (above)

“Engaging patients in the research ecosystem is hugely important because otherwise there is a risk that oncologists will lose the forest for the trees and forget about what really matters,” says Dr. Booth. “Cancer doctors can sometimes get overly focused on tumor measurements on a CT scan. Our patients remind us to step back and see the big picture about what people want which is ultimately to live longer and better lives. We recently completed a study in which we directly asked patients how they balance survival, treatment benefit, side effects, and quality of life. The results were incredibly insightful and challenge many assumptions held by the oncology community. Most patients would not accept cancer treatment which will not help them live longer or better lives.”

One of the ways that Dr. Booth is helping improve end-of-life care is through the development of a new community program called the Kingston Kerala Project. The idea for the program stems from his time on sabbatical in South India, where he collaborated with physicians and nurses at Pallium India, an NGO delivering palliative care in a vastly different health system. With fewer resources and higher volumes of patients, Dr. Booth saw his colleagues using more creative ways to deliver care. The team in Kerala pioneered community-based volunteer delivery of palliative care. In this model, trained volunteers deliver much of the day-to-day visits, providing psychosocial support and assistance with domestic work that patients cannot do on their own – while visiting nurses and doctors attend to patients' medical needs.

“We’re in the process of launching a similar program that will engage trained volunteers in community-based palliative care here in Kingston. This project is directly informed by lessons learned from our partners in Kerala,” says Dr. Booth. “One of the major challenges in the current Canadian health system is the delivery of home care. There are many vulnerable patients living at home who need more support. The Kingston Kerala Project represents an incredibly low-cost innovation that could make a big difference for the quality of life for patients with terminal illness. There will also be tremendous benefits for the engaged community volunteers who can improve the lives of others.”

This program is just one example of Dr. Booth’s efforts to prioritize patients. He plans to utilize his new status with CAHS to continue his push to improve cancer care across Canada and the globe. A Queen’s alumni twice over (BSc’97, Meds 2001), Dr. Booth is honoured “to have the work we are doing be recognized by the Academy.

“More importantly,” he says, “it's a signal that work in global cancer care is becoming increasingly valued by the broader medical and scientific community.”

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Watch Dr. Booth’s Cinq à Sept Research Talk:

Igniting a cancer care revolution – The Next 25

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