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Komal Patel, an advanced practice nurse educator with the de Souza Institute, poses for a photograph outside of her office in Toronto on Friday, May 16, 2014.Matthew Sherwood/The Globe and Mail

Two in five Canadians will develop cancer in their lifetimes and one out of four will die from it, according to the latest data from Canadian Cancer Statistics.

In 2000, cancer was the fourth-most-expensive disease in Canada, costing the health-care system $2.6-billion to treat.

Emotional costs also take a toll on patients as they deal with the fear and anxiety of trying to understand their disease and treatments.

Involving nurses more deeply in patient care can help patients who have questions about the details and side effects of therapy or about prognosis, as well as provide reassurance and take some of the pressure off specialists. To practise in cancer and palliative care, however, most cancer centres require nurses to undergo advanced and specialized training.

Komal Patel said she was motivated to upgrade her qualifications because she felt she would be better prepared to address patients' questions. "Patients are constantly asking questions," she said. "If I hadn't been taking courses, I'd have to [tell them] 'Okay, I'll come back to you.'"

Ms. Patel, a nurse at Brampton Civic Hospital, was one of three nurses who became designated as a de Souza certified advanced-practice registered nurse in Brampton on Thursday night during the province's Nursing Week.

The de Souza model, offered at the de Souza Institute, started in 2008 and involves coursework and workshops that include evidence-based treatments, professional development, and patient coaching, and has a heavy focus on teaching nurses how to listen and talk to their patients about their emotional concerns.

Ontario has seen a rise in specialty training programs dedicated to enhancing nurses' skills in oncology and palliative care including courses through the Princess Margaret Cancer Centre, where 500 cancer nurses have undertaken a 14-week orientation plus two years of specialized oncology course work during their residency.

"It allows for the most appropriate care for the patient that they're looking after," said Simonne Simon, the advanced practice nurse educator at Princess Margaret.

The Canadian Nurses Association gives a specialty certification for oncology nurses through a series of tests, but they don't provide any training.

Wen Huang graduated from nursing school in 1990 and said she felt she didn't know enough to give her patients the answers they needed.

"I've been out of school for so long," she said. "The patient would ask me what's going to happen to me now, like after surgery, and I [found] that I [didn't] know a lot about what's happening."

Mary Jane Esplen, the executive director of the de Souza Institute and a professor at the University of Toronto, says she sometimes uses the word "super nurse" to designate these professionals.

Tracey DasGupta, the director of interprofessional practice at Sunnybrook Health Sciences Centre and a specialized oncology nurse, said that she's seen a trend toward patients being more aware and knowledgeable of their conditions because of easy access to information on the Internet.

"There is an expectation that patients and the health-care team will be equal partners," she said. "So we all need to be up to date with the most information and to be able to answer those questions and to know where to go for answers if we don't have [them]," she said.

Nursing week is May 12 to 18 in Ontario.