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One in four Canadian cancer patients still experiencing cancelled appointments: survey

In the field of cancer treatment, nothing is more important than diagnosing and treating the problem as quickly as possible — but according to new survey data, about one in four Canadian cancer patients report that they are still experiencing cancelled or postponed appointments.

It’s been three years since the COVID-19 pandemic came to Canada, placing an enormous burden on the health-care system. While there have been some improvements in cancer care lately, there’s still a long way to go, experts say.

“While exhausted health-care providers are busy doing their very best to get Canadians the life-saving treatments and screenings they need, the cancer care system remains strained, and that needs to change,” Dr. Stuart Edmonds, executive vice-president of mission, research and advocacy at the Canadian Cancer Society (CCS), said in a news release.

“With approximately 1.5 million people in Canada currently living with or beyond cancer, we must do everything in our power to ensure the needs of people with cancer and their caregivers are a priority as decision-makers address the challenges to our health-care system.”

CCS, Canada’s largest national cancer charity, surveyed 700 patients and caregivers across the country last fall as part of its continued tracking of cancer patients’ experiences during the pandemic, and is releasing the latest results to mark World Cancer Day, which is Feb. 4.

The survey found that along with missed appointments, one in three patients reported that they weren’t confident they would receive quality care in a timely manner if they suffered a cancer-related emergency.

For the majority of patients and caregivers surveyed, the most difficult type of medical care to access was a consultation with a specialist.

Although the pandemic brought renewed delays to cancer care, many of these issues have existed in Canada’s health-care system for a long time.

‘A HUGE TUMOUR’

It’s been nearly nine years since Yves Dubé took an at-home test for colon cancer and had the sinking realization that something was wrong.

There was blood found in his stool, which could have been a sign of cancer or an indication of another issue, such as an infection.

He didn’t have the family history or risk factors that would immediately spark concern, outside of having recently turned 50, the age at which doctors recommend regular screening for colon cancer. But when his doctor told him they could run tests in four to six months’ time, Dubé knew that wasn’t soon enough.

He knew how dangerous a delayed diagnosis could be because, years ago, a friend of his had experienced the same symptoms and ended up in hospital.

“He died within three months,” Dubé told CTVNews.ca in a phone interview. “When I got that first result, I remembered that, so that’s why I didn’t want to wait.”

After seeking a test on his own, he found out that his caution was well-warranted: he had Stage 2 colon cancer.

“I had a tumour, a huge tumour,” he said. “The oncology specialist told me that if I had been diagnosed six months or a year later, it would have been too late.”

This was in 2014, and today Dubé is cancer-free. But with cancer patients still dealing with delayed tests and cancelled appointments in 2023, his story is still one he finds himself sharing frequently as a patient ambassador for CCS.

“The point about my story is the importance of getting rapid diagnosis about the extent of the damage,” he said.

Receiving a quick diagnosis became even more difficult during in the pandemic, with screenings reduced by at least 18 per cent and up to 76 per cent in some parts of Canada in 2020, compared to in 2019.

In a report released last fall, CCS estimated that a six-month interruption in breast cancer and colorectal cancer screening could lead to about 1,210 additional deaths.

These impacts have been seen in clinical settings as well. In June 2022, Canadian doctors reported seeing patients with more advanced stages of cancer than usual, something they attributed to the pandemic’s huge burden on the health-care system.  

It’s hugely important to get the full answer as quickly as possible if a person is experiencing symptoms that could be cancer, or an initial test shows that it could be a possibility, Dubé said.

“If your doctor doesn’t propose to do the test, well, ask for it,” he said. “When there’s a problem, you have to know.”

TURNING TO PRIVATE HEALTH CARE

In some parts of Canada, the strain on the health-care system has seen panicked patients increasingly turning to private care to avoid wait times, something that experts say should be a wakeup call for governments to properly fund the public system.

Ontario Premier Doug Ford sparked widespread condemnation from health experts recently for his decision to siphon provincial funding away from hospitals and into private clinics in a bid to deal with backlogs by performing public health services with private providers.

In a joint statement in January, five major Ontario health-care unions slammed the move, warning it would “further starve our public health-care system of funding and divert front-line staff to enrich private shareholders and diminish access to publicly delivered health care.

“Patients will wait even longer for health care under this scheme and should not be misled into believing they will not pay out of pocket.”

Dubé said he was thankful he could afford to seek a colonoscopy immediately in the private sector instead of having to wait for four to six months, as it caught the issue before it could expand out of control.

But he’s aware that paying out of pocket is not an option everyone has.

He agreed that there are “definitely” patients being left behind when the public system is experiencing such long wait times that the only way to get a diagnosis on the timeline that cancer treatment requires is by paying for it.

“Obviously, when I paid so much taxes and stuff, I would have liked to do (the test) in the public sector,” he said. The surgery to remove his tumour was done through the public sector.

“I could afford the exam … but I spent about $1,000. For many people, even if the $1,000 is available, somebody might choose to apply that $1,000 somewhere else, if need be, in the family or anything like that. That’s a big expense.”

In the new CCS survey, the most important resource that caregivers reported needing to manage the care for their loved one with cancer was financial support.

The need to improve care within the public sector, instead of allowing governments to shirk responsibility by getting Canadians pay out of pocket, is something CCS is hoping to address.

It is holding a letter-writing campaign in the hopes that patients and their loved ones can spur more action from governments. Letters written through its online portal will be sent to elected officials.

“As governments, policymakers and administrators shape a health-care system that has capacity to meet rising demands and weather the unexpected, they have a responsibility to ensure that system is designed with people at its core,” Edmonds said in the CCS release.

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