‘Forgotten’ cancer patients have long faced treatment delays

Opinion: COVID-19 has only exacerbated and amplified the problem of urgent cancer surgeries being delayed due to too few surgeons and beds.

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On January 26, Kelly Ennis underwent desperately needed ovarian cancer surgery. But that’s only after a second trip to the ER in 12 days.

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Her gynecologist had deemed the operation urgent six weeks earlier. But the earliest available date was February 28. Her mother, Dianne Davis, believed – rightly or wrongly – that her daughter would be dead by then.

Nearly six liters of fluid drained from Ennis’ abdomen during his first trip to the emergency room in mid-January. Twelve days later, she went back because her stomach was so distended that she looked eight months pregnant and could barely breathe or walk.

The gynecological oncologist removed the tumor which had grown two inches while Ennis waited. The surgeon also removed two lymph nodes and nearly six more liters of fluid.

The 48-year-old Surrey woman had surgery at Vancouver General Hospital because there are no gynecological oncologists in the Fraser Health Region. There are only seven in the entire province – five in Vancouver at BC Cancer and two in Victoria.

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BC Cancer receives between 30 and 40 referrals a week from across the province, according to Dr. Sarah Finlayson, who works there and is also co-director of gynecology and obstetrics at the University of British Columbia. To meet this demand, she says, there would need to be at least seven full-time gynecological oncologists.

Newfoundland, for example, has four with a total population smaller than that of Vancouver, while Saskatchewan, with less than a quarter of the total population of British Columbia, has six gynecological oncologists.

Some of the delays Ennis and hundreds of other cancer patients are experiencing are related to COVID-19 which has led to staffing and bed shortages. Between March and December 2020, the Canadian Institute for Health Information reported a 12% reduction in cancer surgeries compared to the same period in 2019.

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“People facing cancer and their caregivers need reassurance that their care will be prioritized and that a plan is in place to expedite care once this latest wave of the pandemic is behind us,” the vice said. -executive chairman of the Canadian Cancer Society, Dr,” Stuart Edmonds said in an email.

Almost half of cancer patients reported disruptions in the first wave of the pandemic in surveys conducted by the society from July 2020. By August 2021, this had decreased, but one in five still reported delays in getting treatment.

Cancer patients “feel forgotten,” Edmonds said.

Worse still, he noted that one study found that delaying cancer treatment by four weeks increases the risk of death by about 10%.

Here, the treatment of gynecological cancers is not so much COVID-related as “COVID-amplified,” according to Finlayson.

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Even before the pandemic, wait times exceeded what is recommended for the best outcomes. The BC Ministry of Health insists help is coming.

BC Cancer has received funding in 2021 to recruit 25 additional physicians, including an unknown number of gynecological oncologists, the ministry said in an email response.

“Recruitment is well advanced, with some of these positions already filled,” according to the ministry. “We expect the remaining positions to be filled in the second half of 2022.”

When everything is in place, 48 new positions will have been added over the past three years.

But if gynecological oncologists are recruited, that’s news for Finlayson.

“We are not aware of any additional funding, opportunity to post a new position, or new support for program expansion,” she said Friday. “Indeed, doctors in Victoria have been advocating for a third surgeon for 10 years and have failed to find a fair and sustainable solution to allow them to hire.”

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No other specialists will be added outside of Vancouver. Instead, BC Cancer specialists will provide “patient consultation and treatment services,” as well as treatment recommendations to patients and their doctors.

The ministry said, “This approach enables BC Cancer to provide a consistent level of high-quality cancer care to patients across the province and to help patients get the care they need as close to home as possible. at their home.

This seems a somewhat hypocritical statement.

Ennis lives in the Fraser Health Region, which is home to 40% of British Columbians. However, she was unable to have the operation there.

Women in Prince George, Kamloops, Kelowna or northern aboriginal communities are more disadvantaged. It takes them well over an hour to drive to Vancouver or Victoria.

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One of these women contacted me this week. When fluid accumulated in her abdomen in 2020, doctors were only doing virtual consultations.

During several “visits”, she was diagnosed with allergies, acid reflux and lactose intolerance before insisting on a CT scan. She was diagnosed with stage 3 ovarian cancer and was put on the Vancouver surgery waiting list.

Other delays were “compounded by the lack of continuity of care”, she said in an email. “From what I’ve observed, the problems…become more acute the further you get from Vancouver.”

The ministry says it is committed to making British Columbia “a leader across the full continuum of cancer care through the creation of a 10-year Provincial Cancer Action Plan” . But plans being developed in consultation with BC Cancer and the Provincial Health Services Authority have yet to be finalized.

Meanwhile, cancer patients continue to wait – with potentially devastating consequences.

dbramham@postmedia.com

twitter: @bramham_daphne

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