By Sonja Puzic, Windsor Star
WINDSOR, Ont. -- For weeks, Patricia Grubb sat by the phone, nervously waiting for her cancer treatment to begin.
Despite being diagnosed with advanced colon cancer, an entire month passed between the senior's surgery and her first cycle of radiation therapy at the Windsor Regional Cancer Centre.
The Essex woman, who relied on friends to drive her to medical appointments, fretted about how the wait would affect her chances of survival.
"I'm not happy about it," she said last fall.
"I mean, OK, fine, I figure I'm going on 78, but I've always been very, very active.... I've always been pretty healthy. I've still got years to live."
Even though improvements have been made in Windsor and across Ontario when it comes to wait times for cancer surgeries and treatment, many targets are still not being met.
Just over 55 per cent of patients provincewide waiting for chemotherapy saw an oncologist within the recommended two weeks, according to the latest available data on Cancer Care Ontario's website. Fewer than 40 per cent received systemic cancer treatment -- which includes chemotherapy and hormone therapy -- within the recommended time.
At the renowned Barbara Ann Karmanos Cancer Institute in Detroit, the goal is to see patients within a week of referral, said Dr. Shirish Gadgeel, who specializes in lung and chest wall cancers.
"I've heard of people (in Canada) waiting six or seven weeks to see an oncologist or get treatment," said Gadgeel, who has treated a number of Canadian patients and discussed cases with his Canadian counterparts. "To me, that's unfathomable."
When the Ontario figures are broken down by specific types of cancer, there are obvious disparities. For example, nearly 80 per cent of malignancies affecting the central nervous system and close to 70 per cent of head and neck cancers are checked out within 14 days. But breast and lung cancers don't even hit the 60 per cent mark and fewer than 50 per cent of people with skin cancer are seen within the target time.
The president and CEO of Cancer Care Ontario, Terrence Sullivan, has admitted that wait times continue to be a problem, despite huge efforts to improve them.
"We need to do a better job," he has said.
When it comes to radiation treatment wait times, the province does a better job of meeting CCO targets. Close to 70 per cent of patients are currently getting a consultation with an oncologist within two weeks of referral and 80 per cent are getting treatment within the same time period after being deemed "ready to treat."
At the Windsor Regional Cancer Centre, more than 80 per cent of patients referred for radiation treatment are seen for a consultation within the target of 14 days. But only about 40 per cent actually begin the treatment within the target time. About 80 per cent undergo cancer surgery within CCO's target. Cancer surgeries are done within 28 days, depending on priority. Windsor Regional Hospital CEO David Musyj says most urgent surgeries are done within 24 or 48 hours.
"In Windsor, we've had some challenges either because of manpower issues -- getting specialists in the field of oncology is sometimes not easy -- or because we have to work within the guidelines of our budget," said Dr. Ken Schneider, chief of oncology at the Windsor cancer centre.
Gauging the impact of waiting more than two weeks to see an oncologist or start cancer treatment is difficult, cancer experts say.
"There is no universal answer to that because every patient, every tumour, every malignancy is different," said Windsor oncologist and researcher Dr. Caroline Hamm.
Dr. Patricia LoRusso, an experienced oncologist at Karmanos, agrees.
"You can't generalize it at all," she said. "But if the cancer is in the early stages, waiting a few weeks in most cases does not translate to a poorer outcome."
Grubb was diagnosed with Stage 3 colon cancer after her first colonoscopy in July. She underwent a colostomy -- a surgical procedure in which the colon is cut to divert excrement -- on Aug. 13.
She didn't begin her prescribed cycle of 28 radiation and chemo treatments until Sept. 13.
"No one ever said why ... they just couldn't fit me in," she said.
But the treatments managed to shrink the tumour in her colon enough to allow a surgeon to remove it safely last week. Grubb is now recovering from surgery at Hotel-Dieu Grace Hospital.
"I had to wait ... but I guess it worked," she said Sunday.
More rounds of chemo await Grubb, but she's doing her best to remain optimistic.
"I've just got to keep my fingers crossed and keep going to church."
The philosophy behind treating cancer patients may differ in Canada and the United States, but the countries' cancer survival rates are comparable.
According to latest available data, the five-year relative survival rate for lung cancer -- which has among the poorest outcomes because it's often caught in late stages and is difficult to treat -- is about 16 per cent in both the U.S. and Ontario. The rate for prostate cancer is 99 per cent in the U.S. and 97 in Ontario. For breast cancer it's 90 per cent in the U.S. and almost 90 per cent in Ontario. In the U.S., the survival rate for cancers of the colon and rectum is 66 per cent, while in Ontario the survival rate for colon cancer is 65 per cent.
A recently released international study shows that Ontario has among the best cancer survival rates among 12 jurisdictions across six countries, including the U.S., England, Australia, Sweden and Denmark. For colorectal cancer survival, Ontario ranked first in Canada and third among the six countries. It ranked second overall when it comes to lung and ovarian cancer survival rates.
Windsor's proximity to reputable U.S. teaching hospitals and Karmanos exacerbates local frustrations because patients here are bombarded with stories and advertisements touting immediate test results, expedient surgeries and no lineups for MRIs and CT scans on the other side of the border.
Local health care officials point out that comparing wait times in Ontario and the U.S. is like comparing apples to oranges.
Canada's universal health care system gives everyone access to services, whether it's at a walk-in clinic or a cancer centre. Across the border, those without health insurance, medicare or a credit card don't even get to see an oncologist.
"If you go over to Henry Ford (Hospital) today with a credit card, you will get an MRI today, no problem -- whether you need it or not," said Musyj. "But you have to keep it in perspective. There are no waits in (Detroit hospitals) because a large chunk of the population doesn't have coverage and can't get care.
"In our system, wait times are our weakness and access is the strength while the opposite is true in the U.S."
Despite being diagnosed with advanced colon cancer, an entire month passed between the senior's surgery and her first cycle of radiation therapy at the Windsor Regional Cancer Centre.
The Essex woman, who relied on friends to drive her to medical appointments, fretted about how the wait would affect her chances of survival.
"I'm not happy about it," she said last fall.
"I mean, OK, fine, I figure I'm going on 78, but I've always been very, very active.... I've always been pretty healthy. I've still got years to live." Even though improvements have been made in Windsor and across Ontario when it comes to wait times for cancer surgeries and treatment, many targets are still not being met.
Just over 55 per cent of patients provincewide waiting for chemotherapy saw an oncologist within the recommended two weeks, according to the latest available data on Cancer Care Ontario's website. Fewer than 40 per cent received systemic cancer treatment -- which includes chemotherapy and hormone therapy -- within the recommended time.
At the renowned Barbara Ann Karmanos Cancer Institute in Detroit, the goal is to see patients within a week of referral, said Dr. Shirish Gadgeel, who specializes in lung and chest wall cancers.
"I've heard of people (in Canada) waiting six or seven weeks to see an oncologist or get treatment," said Gadgeel, who has treated a number of Canadian patients and discussed cases with his Canadian counterparts. "To me, that's unfathomable."
When the Ontario figures are broken down by specific types of cancer, there are obvious disparities. For example, nearly 80 per cent of malignancies affecting the central nervous system and close to 70 per cent of head and neck cancers are checked out within 14 days. But breast and lung cancers don't even hit the 60 per cent mark and fewer than 50 per cent of people with skin cancer are seen within the target time.
The president and CEO of Cancer Care Ontario, Terrence Sullivan, has admitted that wait times continue to be a problem, despite huge efforts to improve them.
"We need to do a better job," he has said.
When it comes to radiation treatment wait times, the province does a better job of meeting CCO targets. Close to 70 per cent of patients are currently getting a consultation with an oncologist within two weeks of referral and 80 per cent are getting treatment within the same time period after being deemed "ready to treat."
At the Windsor Regional Cancer Centre, more than 80 per cent of patients referred for radiation treatment are seen for a consultation within the target of 14 days. But only about 40 per cent actually begin the treatment within the target time. About 80 per cent undergo cancer surgery within CCO's target. Cancer surgeries are done within 28 days, depending on priority. Windsor Regional Hospital CEO David Musyj says most urgent surgeries are done within 24 or 48 hours.
"In Windsor, we've had some challenges either because of manpower issues -- getting specialists in the field of oncology is sometimes not easy -- or because we have to work within the guidelines of our budget," said Dr. Ken Schneider, chief of oncology at the Windsor cancer centre.
Gauging the impact of waiting more than two weeks to see an oncologist or start cancer treatment is difficult, cancer experts say.
"There is no universal answer to that because every patient, every tumour, every malignancy is different," said Windsor oncologist and researcher Dr. Caroline Hamm.
Dr. Patricia LoRusso, an experienced oncologist at Karmanos, agrees.
"You can't generalize it at all," she said. "But if the cancer is in the early stages, waiting a few weeks in most cases does not translate to a poorer outcome."
Grubb was diagnosed with Stage 3 colon cancer after her first colonoscopy in July. She underwent a colostomy -- a surgical procedure in which the colon is cut to divert excrement -- on Aug. 13.
She didn't begin her prescribed cycle of 28 radiation and chemo treatments until Sept. 13.
"No one ever said why ... they just couldn't fit me in," she said.
But the treatments managed to shrink the tumour in her colon enough to allow a surgeon to remove it safely last week. Grubb is now recovering from surgery at Hotel-Dieu Grace Hospital.
"I had to wait ... but I guess it worked," she said Sunday.
More rounds of chemo await Grubb, but she's doing her best to remain optimistic.
"I've just got to keep my fingers crossed and keep going to church."
The philosophy behind treating cancer patients may differ in Canada and the United States, but the countries' cancer survival rates are comparable.
According to latest available data, the five-year relative survival rate for lung cancer -- which has among the poorest outcomes because it's often caught in late stages and is difficult to treat -- is about 16 per cent in both the U.S. and Ontario. The rate for prostate cancer is 99 per cent in the U.S. and 97 in Ontario. For breast cancer it's 90 per cent in the U.S. and almost 90 per cent in Ontario. In the U.S., the survival rate for cancers of the colon and rectum is 66 per cent, while in Ontario the survival rate for colon cancer is 65 per cent.
A recently released international study shows that Ontario has among the best cancer survival rates among 12 jurisdictions across six countries, including the U.S., England, Australia, Sweden and Denmark. For colorectal cancer survival, Ontario ranked first in Canada and third among the six countries. It ranked second overall when it comes to lung and ovarian cancer survival rates.
Windsor's proximity to reputable U.S. teaching hospitals and Karmanos exacerbates local frustrations because patients here are bombarded with stories and advertisements touting immediate test results, expedient surgeries and no lineups for MRIs and CT scans on the other side of the border.
Local health care officials point out that comparing wait times in Ontario and the U.S. is like comparing apples to oranges.
Canada's universal health care system gives everyone access to services, whether it's at a walk-in clinic or a cancer centre. Across the border, those without health insurance, medicare or a credit card don't even get to see an oncologist.
"If you go over to Henry Ford (Hospital) today with a credit card, you will get an MRI today, no problem -- whether you need it or not," said Musyj. "But you have to keep it in perspective. There are no waits in (Detroit hospitals) because a large chunk of the population doesn't have coverage and can't get care.
"In our system, wait times are our weakness and access is the strength while the opposite is true in the U.S."
© Copyright (c) The Windsor Star
No comments:
Post a Comment