New Canadian Guidelines Set To Standardize The Treatment Of Follicular Lymphoma
Prevention and Treatment Busy schedules and heavy workloads can often prevent physicians from keeping pace with new protocols in surgery, drug treatments, and best practices.
However, Lymphoma Canada, in collaboration with its scientific committee, has successfully developed Canadian guidelines on the management of newly diagnosed follicular lymphoma (FL). These guidelines were recently accepted in a peer-reviewed oncology journal (Clinical Lymphoma, Myeloma & Leukemia).These guidelines will allow healthcare professionals to be updated on the most recent evidence for the management of this disease and will ensure that Canadian patients are offered the highest standards of care.
"The new guidelines mark a departure from this model, and offer a variety of benefits for both healthcare professionals and patients."
Follicular lymphoma is the most common form of indolent (slow growing) non-Hodgkin’s lymphoma (NHL) — a disease that can, in many cases, grow to a more aggressive form of cancer. Up until now, there were no national guidelines for the treatment of this disease. Physicians and oncology centres across the country had dealt with FL on a purely provincial basis — evolving their own sets of best practices as they went. They faced many challenges, such as the question of when to start therapy, how to navigate through treatment options, and the end point to which success of the individual treatment should be measured.
The new guidelines mark a departure from this model, and offer a variety of benefits for both healthcare professionals and patients. Robin Markowitz, CEO of Lymphoma Canada, is excited by the benefits that the new guidelines will bring. “We are extremely excited — they [the guidelines] have been a year in the works and were spearheaded by our scientific advisory board. So for doctors and particularly those who aren’t in centres of excellence — or for hematologists who may not see FL very often in their practice, this provides a place where they can look to offer their patients the newest and most efficacious therapies,” says Robin. “The board wanted to do this because they’d heard from their colleagues that they weren’t familiar [with newer treatments] and were going with what they knew — so patients weren’t always getting the most current therapies.”
Equity in treatment
The practical effect of the guidelines is that care for FL nationwide will be up-to-date, consistent and will ensure that patients with FL have equitable access to the best available care. Dr. John Kuruvilla is Staff Physician of Medical Oncology and Haematology at Princess Margaret Hospital in Toronto and sees the new guidelines as essential in ensuring effective, equitable treatment. “When clinicians met across the country we noticed that there were similarities in how Canadians wanted to manage these diseases but there were limitations from provincial approvals and funding — particularly novel drugs et cetera. In a universal healthcare system, where healthcare is transportable we wanted to ensure some basic standard across the country, so that equity would be achievable,” says Dr. Kuruvilla.
For example, not all provinces have approved the reimbursement of some of these new therapies for iNHL patients — with Quebec a peculiar exception. “I don’t know why they’ve chosen not to,” says Dr. Kuruvilla “but the efficacy is clear across the rest of Canada and considered a primary treatment in the rest of the world.” It remains unclear if the Quebec Ministry of Health will change their minds any time soon.
Lymphoma Canada are to introduce new patient-targeted guidelines and are working to create guidelines for other forms of lymphoma — guidelines that Robin Markowitz believes will set a “new standard of care for lymphoma” in Canada. “We are undertaking new guidelines for Chronic Lymphocytic Leukemia for first and second line treatment. As a patient group and charity, this is why we raise money — and one of the ways we spend it [is]…for optimal and equitable patient care,” says Robin.