Sharon Watanabe graduated from McGill University in 1988. After training in Internal Medicine and Medical Oncology at the University of Toronto, she completed a fellowship in Palliative Care Medicine at the University of Alberta. She became a staff physician in the Tertiary Palliative Care Unit at the Grey Nuns Community Hospital, and later the Unit's Director. She is currently Director of the Department of Symptom Control and Palliative Care at the Cross Cancer Institute, and of the Division of Palliative Care Medicine.
ResearchOpioid administration by non-oral routes for treatment of cancer pain:
Opioids are the mainstay of treatment of cancer pain. Many patients are unable to take opioids by the oral route. Dr.
Watanabe contributed to studies on the administration of methadone by the rectal route, and fentanyl infusions and oxycodone by the subcutaneous route. She also conducted the first randomized controlled trial comparing subcutaneous opioid administration by continuous infusion versus intermittent injection. She was co-investigator on a feasibility study evaluating the use of sublingual methadone for treatment of breakthrough cancer pain, supported by a grant from the Alberta Breast Cancer Research Initiative. Symptom assessment:
The Edmonton Symptom Assessment System (ESAS) is a self-report tool for symptom intensity. It was introduced in 1991 and has since undergone widespread adoption nationally and internationally for clinical, research and administrative purposes. Dr.
Watanabe published a survey of palliative care nurses in Edmonton regarding their perceptions of the ESAS, which illustrated some limitations of the instrument. Then, in collaboration with Dr.
Cheryl Nekolaichuk, she contributed to a review of validation studies focusing on ESAS. Drs. Nekolaichuk and Watanabe received a grant from the CIHR New Emerging Team in Difficult Pain Problems to conduct a qualitative study of patient perspectives on the ESAS. Based on problematic areas identified by the qualitative study, a revised version of the ESAS (ESAS-r) was created. They received a further grant to compare the ESAS and ESAS-r in an international multicentre study, demonstrating that the revised instrument is preferred by patients. A survey has also shown that the ESAS-r is viewed favourably by palliative care providers who us
it in clinical practice. The ESAS-r is in the process of being implemented as part of routine screening for distress in all patients attending oncology clinics in Alberta. Further validation and translation work is
ongoing.Palliative care consultation by telehealth:
Palliative and supportive care services are readily accessible to cancer patients residing in urban areas, but not consistently available in rural and remote areas. Dr.
Watanabe led the Virtual Pain and Symptom Control/Palliative Radiotherapy Clinic pilot project, supported by a Clinical Telehealth Grant from Alberta Health and Wellness. The clinic provides specialist multidisciplinary consultation to cancer patients in rural Northern Alberta, by using videoconferencing
technology to link patients and specially-trained community nurses with the team at the Cross Cancer Institute. Patient and referring physician satisfaction with the service has been high, and significant savings have been realized in terms of travel and associated cost for patients and families. As the first clinic of its kind, the clinic has attracted interest nationally and internationally. Based on the success of the pilot project, the clinic is now funded as a core service.