McMaster University

McMaster University

Faculty of
Health Sciences



Nurses develop role to improve cancer care in Canada

Published: April 30, 2009
OAPN Opening photograph
From left: Esther Green, Provincial Head, Nursing and Psychosocial Oncology, Cancer Care Ontario, Nancy Fram, Vice President, Professional Affairs and Chief Nurse Executive, Hamilton Health Sciences, Jennifer Wiernikowski, Chief of Nursing Practice, Juravinski Cancer Program, Dr. Denise Bryant-Lukosius, Director OAPN, Dr. Bill Evans, President, Juravinski Cancer Centre, Dr. Catherine Tompkins, Association Dean, Nursing McMaster University, Leslie Patry, Manager, Certification Program, Canadian Nurses Association, Dr. Daniel Billen, Vice President and General Manager, Amgen Canada Inc., Anne Snider, Director of Education, Research and Quality Improvement, JCC.

Tom Regehr saw his oncology physician for the diagnosis and to learn about the treatment plan for his cancer of the tonsil last year. But it was advanced practice nurse Christine Zywine who worked with him to create a personal care plan, educated him and his family about the cancer treatment process and helped him handle the side effects and repercussions, including issues such as emotional care during the intense treatment process. 

"Christine made all the difference in the quality of my care," said Tom.  "Not only was she always there when I needed her, but as an APN, she really knew her stuff and was empowered to get things done herself rather than just ‘look into it’ for me.  Her warmth, compassion and professionalism truly gave me comfort and most importantly hope."

Christine Zywine is one of about 150 Canadian advanced practice nurses (APN) in oncology. These nurses have Masters or PhD training which allows them to take increased responsibility for managing the patient’s treatment, side effects and how it all affects the life of the patient and the family. APN is a growing area of specialty, which fits today’s need for efficient health care with the most appropriate health care professionals looking after relevant aspects of care.


This week Canada’s first research unit dedicated to improving the use of advanced nursing roles in cancer care opened at the Juravinski Cancer Centre at Hamilton Health Sciences. The Canadian Centre of Excellence in Oncology Advanced Practice Nursing (OAPN) held a grand rounds and ribbon cutting ceremony attended by provincial and national nursing leaders.

The centre will be lead by Denise Bryant-Lukosius, an APN and assistant professor in the School of Nursing at McMaster University who is cross appointed to the Juravinski Cancer Centre.

"While Canada has one of the best cancer systems in the world, we know that our current ways of providing cancer services are not sustainable and many patients continue to have unmet health needs related to their cancer," she said. "Over the next five years, Canada’s aging population will lead to significant increases in the number of people requiring cancer treatment. At the same time we have shortages of specialized cancer care providers and pressures to contain health care costs.

"APNs can play an important role in improving patient access to cancer services when they need it and for developing more cost-effective ways of providing care."

She said there are studies showing better outcomes for cancer patients, especially those with complex health care needs who receive APN care, with fewer complications, better continuity of care, higher patient satisfaction and lower acute care health costs.

Research is an important part of the APN role, particularly in developing better care. The Centre of Excellence’s research will focus on developing new models of patient care and delineating the APN role in cancer care. 

The first three years of the centre of excellence have been supported with a $500,000 grant from Amgen Canada Inc, a leading human therapeutics company in the biotechnology industry.

Dr. Bill Evans, president of the Juravinski Cancer Centre and a professor of oncology at McMaster University’s Michael G. DeGroote School of Medicine, said siting the new national centre of excellence in Hamilton was a natural step.

"The Juravinski Cancer Centre and McMaster’s School of Nursing are becoming well known across Canada for their innovation and leadership in the development of oncology nursing. This centre of excellence has already attracted top notch international researchers and will ensure a national perspective for the research and education being done there. We are grateful for the support of Amgen Canada Inc. to help us realize this vision."  
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