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MBO team
Some members of the Malignant Bowel Obstruction Program who led the development of the Educational Series videos. (L to R) Tanya Chawla, Naa Kwarley Quartey, Nazlin Jivraj, Dr. Stephanie Lheureux, Sarah Buchanan. (Photo: UHN)

Gynecological cancer is one of the most difficult cancers to battle. On top of that, approximately 30 per cent of women with advanced gynecological cancer may develop bowel obstruction during their treatment.

Bowel obstruction is an incredibly distressing event where part of the intestinal track is blocked by cancer and normal function is delayed or stopped, causing a range of uncomfortable symptoms such as pain, vomiting, constipation and cramping. For those with severe bowel obstruction, even the simple pleasure of eating in conventional ways is off the table.

The problem is that it's incredibly challenging to recognize the symptoms and understand how to manage it. That is in addition to the fact that it's not a comfortable topic to broach, even with your closest confidants.

A multidisciplinary team at the Princess Margaret Cancer Centre came together to crack these conversations open to improve quality of life for their patients, launching a dedicated program to empower women to recognize their symptoms before they become serious.

One of their most recent ventures: five educational videos on bowel obstruction that patients could have easy access to anywhere.

  1. Know What to Do if You Have Bowel Obstruction
  2. Know if You Are at Risk for Bowel Obstruction
  3. Know How to Maintain Good Bowel Function
  4. Know About Medicines to Maintain Bowel Obstruction, and;
  5. Know How Diet Can Help to Manage Bowel Function

The videos were created by a team of doctors, nurses, dietitians, patient education, cancer survivorship and hospital administration. Together they form the Malignant Bowel Obstruction (MBO) group.

"We launched this program to help women understand what's happening in their bodies," says Dr. Stephanie Lheureux, medical oncologist at the Princess Margaret and MBO member. "Most importantly, it's empowering healthcare teams, patients and their families with information that has helped detect symptoms earlier on so our patients can be as comfortable as possible."

One of the team's initial projects, a triage tool used for patients and proactive assessments conducted by specialized oncology nurses for early intervention and support, won the 2018 Quality Improvement Award from Cancer Care Ontario for reducing the length of the hospital stay. Some of their work has also been published in the Journal of Oncology Practice.

"In helping our patients detect and manage bowel obstruction, we, in turn, have helped decrease visits to the ER, helped patients manage symptoms at home, extended treatment options, and reduce the overall time our patients are in hospital," says Dr. Lheureux.

Presented at the 19th Annual Continuing Professional Development Meeting for the Society of Gynecologic Oncology of Canada earlier in 2019, the videos serve as a part of their vision to reach past the borders of the Princess Margaret – so every cancer patient has the information they need to understand their bodies and their symptoms.

"We know our patients want to have reliable information at their fingertips," says Nazlin Jivraj, registered nurse in gynecological oncology and member of MBO.

"These videos are helping to accomplish just that, and we're excited to share them with women and their families at the Princess Margaret and beyond."


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