Beyond Polarity

TALKING ABOUT DUCTAL CARCINOMA IN SITU (DCIS) NO LONGER SCARES THE BEJESUS OUT OF ME. That’s progress. Navigating this pre-cancer condition is kind of like reacting to the yellow warning lights flashing on the dashboard of my car. It pays to do the maintenance. 

Since many of you ask—and I’m grateful for that—here’s a quick update. 

Early in September, I went in for re-incision surgery—the surgeon opened up the incision she made during the August lumpectomy on my right breast, and scooped out a further thin layer (we’re talking in millimetres here). That’s all healing up very nicely & I’m hiking again.

Alberta Health Services has already emailed me the pathology report. Based on my interpretation of the report, there’s the possibility yet another thin layer may need to be scooped out (e.g. a second re-incision). I’ll find out for sure later this month when I see my surgeon. 

Thankfully—this isn’t terribly exciting news. But I do have something to share with you that is a little more out of the ordinary. In the last two weeks, I’ve had two intriguing encounters.

First Encounter: Dr. Quan, Breast Cancer Surgeon

Surgeons are busy people. Nobody dares to waste their time. 

On September 7th, my re-incision surgery was scheduled for very late in the afternoon. Dr. Quan, my surgeon, greeted me in the reception area with a big smile and a question: Was I a writer? Yes, I answered, I write a column for the National Post, and I blog. Chuckling, I told her she featured large in recent blog posts about this cancer journey.  Quickly, I explained the blog’s aim: To talk about cancer from a patient’s perspective; and to identify what works and what doesn’t work in the healthcare system.  

Then—for ten uninterrupted minutes—we talked.

First, what works in Alberta’s healthcare system? The nurse navigator—now being tested as a pilot program, and only for breast cancer—is essential to making this system work. That’s especially true when patients are seeing medical test results before they see their doctor or surgeon. 

Second, what doesn’t work? Wait times for radiation in Alberta are becoming untenable. An eight-week post-surgery wait time for radiation treatment is now 17 weeks. In British Columbia, that provincial government chose to refer patients to Washington state for radiation treatment (at three times the cost) when wait times got too long. 

We also talked about how priorities for breast cancer treatment are set (e.g. why is breast reconstruction surgery treated with relative urgency…it may be a case of squeaky wheels getting greased). We talked of the tactics she deployed to recruit  surgeons to Alberta (even with the allure of a brand new cancer centre opening next year in Calgary) to fill the widening gaps. 

Then, knowing there was a surgery schedule to be maintained, we both took a deep breath and walked, together, into the Star Wars-like surgical theatre. 

Second Encounter: Adriana LaGrange, Alberta Minister of Health

Last week, I had a conversation set up with Alberta’s Minister of the Environment, Rebecca Schulz, to talk about how she negotiates with the federal government. My breast re-incision wasn’t painful and I was looking forward to joining Schulz at McDougall Centre in downtown Calgary, the government’s hub in southern Alberta and a place I was familiar with as a former MLA. 

I’m caught off guard when the minister inquires about my recent minor surgery, opening up an unanticipated conversation on the merits of early cancer screening. As it happens, the minister in the next office — Health Minister Adriana LaGrange, whom I’ve never met — is then invited to our discussion to receive some of my feedback on cancer care. Our 10-minute chat about cancer concludes, much to my surprise, with a warm hug from the health minister. And a promise from both ministers—they will read this blog. 

My conclusion from both of these short but intense encounters? There are real-live-humans making decisions about our healthcare system in Alberta and for this patient, that’s heartening.