canadians continue to pay the price for governments that refuse to prioritize cancer care
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cancer action now is an alliance formed by patients groups and life sciences companies to press governments for better cancer care system. getty
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gabriela grosu’s frustrating, often harrowing, tangle with canada’s health-care system began in 2016 when she was rushed to the hospital with an apparent heart attack. although doctors ruled out any cardiac issues, the montreal native, 46 at the time, complained of pain in her back on the left side. suspecting a blood clot, the doctor ordered a ct scan, which showed a nodule on her right pulmonary lobe. she was quizzed about her lifestyle, including smoking history. she had never been a smoker and was otherwise fit and healthy, so she was told not to worry and sent home with a recommendation to come back in six months for any followups.
“i didn’t accept that,” says grosu, who works in medical physics and knew something about the system she was navigating. “i insisted on seeing a pulmonologist.”
the doctors and specialists initially ignored her concerns, telling her she was fine because she was not a smoker. but grosu kept pushing, phoning doctors and clinics, even showing up at one hospital when her calls went unanswered. she finally got an appointment with a pulmonologist, who ordered more testing, followed by ablation surgery to remove the node. the biopsy showed carcinoma. the lung cancer she was assured she didn’t have was there all along.
subsequently, during treatment and followup screening, grosu was diagnosed with breast cancer and underwent a double mastectomy. and while her physical health is now stable, her emotional and mental health is still in recovery.
“people shouldn’t have to fight the system when early detection is the only chance for survival,” says gabriela grosu.
why is it a fight to get timely life-saving treatment?
in an ideal world, people like grosu would not have to fight for life-saving treatment in a timely manner. but we don’t live in an ideal world, even here in canada, where we tout our medical system as among the best.
“it’s not just the people who work in specific disease areas like cancer, advocates have been [pushing] for years for better access to medicines, better screenings, better diagnoses, and better treatments,” says sabrina hanna, managing director of advocacy group the cancer collaborative.
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hanna says these issues pre-date the pandemic, but covid-19 shone a brighter light on a system badly in need of repair. staff shortages, funding shortfalls — including for research and development — and a lack of political will all contribute to the problem.
“i think politicians and other bureaucrats see [health care] more as an expense rather than an investment,” she says. “something [needs to shift that] perspective to see we need to invest in health care, because, at the end of the day, it’s the lives of canadians that are at risk.”
determined to refocus that perspective, about 30 groups, including the cancer collaborative, patient organizations, professional associations, life sciences companies and various pharmaceutical companies, which are partially funding the initiative but have no decision-making authority, came together under the banner cancer action now to press governments to fix the cracks in the system.
“we are asking premiers across the provinces to make cancer a political priority, and that means addressing the backlogs in screening, diagnosis and care. but it also means putting an emphasis on making sure we have access to the innovative medicines that cancer patients need,” she says, adding that developing a national data strategy is also critical. “in quebec, we don’t even have a registry so we don’t really know how many people are getting cancer every year specifically in quebec. technically, [canada has] 19 different health-care systems, not just one, [and] there are a lot of inequities across provinces.”
![“i think politicians and other bureaucrats see [health care] more as an expense rather than an investment,” says sabrina hanna, managing director of the cancer collaborative. supplied](https://smartcdn.gprod.postmedia.digital/healthing/wp-content/uploads/2023/01/img_4769.jpeg?quality=90&strip=all&w=1128&h=846)
“i think politicians and other bureaucrats see [health care] more as an expense rather than an investment,” says sabrina hanna, managing director of the cancer collaborative. supplied
where’s the political will to make cancer a priority?
louise binder, a health policy consultant for the save your skin foundation, another alliance member, says that despite widespread knowledge about the challenges facing our health-care system — wait times, early diagnosis, and access to innovative cancer treatments — the will to address it is lacking.
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“and when the pandemic hit, it became completely unsustainable,” says binder, citing the backlog of cases that piled up as a result. “it was also incomprehensible to us that things were allowed to reach such a shocking state for people with a life-threatening illness, and an illness for which we know that every day you’re not diagnosed or treated is a day less likely that you’re going to have a favourable outcome.”
hanna references b.c.’s former premier john horgan, diagnosed with cancer himself, who ran on a platform in 2020 that included a commitment of $10 million for a cancer action plan. three years later, that plan has failed to materialize.
“it goes back to making cancer a political priority,” she says.
one step toward improving the cancer care situation would be for the ontario government to pay for patients’ take-home oral cancer drugs, says louise binder, a health policy consultant for the save your skin foundation. supplied
premiers would likely counter that cancer — and all health care — is a political priority for them. it is the will of the federal government that needs bending, or at least the granting of a meeting, which they’ve been demanding for two years. they’ll finally get that sit-down on feb. 7 when they meet with prime minister justin trudeau to plead for an increase from 22 per cent to 35 per cent in mostly unconditional health-care spending. ottawa, however, continues to insist on accountability measures before the purse strings are loosened.
both hanna and binder, despite the deep frustrations, sense things may be turning around, however slowly.
“i think there is a recognition that this is a profound problem but it’s been very hard to get it to rise to the top,” says binder.
she says one small step toward improving the situation would be for the ontario government to pay for patients’ take-home oral cancer drugs, saving them from having to get them at the hospital, which would free up space there. “why wouldn’t you [follow] what all the other provinces long ago recognized, which is that it’s best to treat people out of the hospital if you can?”
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“doctors should be able to work across provinces”
binder also points to the shortage of nurses and other health-care practitioners, hoping the government makes good on its promise to speed up acceptance and certification of foreign workers.
“without them there’s no moving forward,” she says. “expanding the ability of doctors to work across provinces would be very useful as well, because a lot can be done through virtual appointments.”
she cites as an example the small handful of specialists in the country with the expertise to treat rare cancers. “it’s not realistic to think that people can travel to see those doctors if they can’t even get appointments with them.”
binder also notes the need to shift attitudes about data sharing so that specialists and researchers can better analyze, evaluate, monitor and, ultimately, solve cases.
“it’s been disappointing to hear provinces say they own their data, and that they don’t want to share it in order to receive more canada health transfers,” she says. “we’re all in favour of governments getting what they need financially to manage this issue but surely it’s not unreasonable to ask for them to provide transparent, measurable outcomes for the funding that they’re receiving.”
ultimately, transcending all these issues is patients’ access to lifesaving care. as grosu puts it: “people shouldn’t have to fight the system when early detection is the only chance for survival.”
to add your name to the petition supporting the cancer action now initiative, click here.
robin roberts is a vancouver-based writer.
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