Beyond Polarity

TO REPEAT–I’M DEALING WITH A CANCER SCARE. I’M NOT DYING.

Today, I met with my radiation oncologist—Dr. Natalie Logie. She’s spunky, straight-talking & obviously talented; I like her. It was our first meeting and I totally concur with her recommendation to move forward with the radiation of my right breast as a pre-emptive measure to reduce future cancer risk. It’s kind of like heeding the advice of your car mechanic who tells you: “Wintery roads ahead; time to replace those all-wheel drives with snow tires!” 

So, that’s the plan. I’m scheduled for a CT scan this week and ten blasts of radiation begin early in January. ‘It should be a radiant 2024,’ she says.

My physicians and family history suggest radiation isn’t a stupid thing to do. And it aligns to my sense of responsibility to the community; I don’t want to be a burden on my family or Alberta’s healthcare system. I come by this honestly. As I’ve shared, my father turned down available treatment for late-stage lung cancer:

“In his 82 years of living, my dad never once spent a night in a hospital bed. That’s rare. Dad recognized his good fortune. He was happy to have paid far more into the system than he extracted. Although it made me cry at the time, I could not have been prouder of my father than when he asked his oncologists whether certain cancer treatments offered him were worth the expense.” 

Since my diagnosis in May, not a day has passed where I’ve not said a quiet prayer of thanks for the good fortune of having access to routine mammograms & Alberta’s cancer care system. This pre-emptive intervention wouldn’t necessarily have happened in other provinces—and would be nearly impossible in our country’s remoter regions.

In Canada, this is what a healthcare success story looks like.

That said, I struggle with the waiting times. This season, kids are waiting for Santa. Throughout the year, most Canadians with a cancer diagnosis are waiting, anxiously, for next steps in healthcare. I suck at waiting. Friends tell me—in kindness—impatience is my weakness. I call it a deeply embedded sense of urgency!

It was a very long five weeks between the diagnosis of breast cancer and a meeting with a surgeon to learn I had ductal carcinoma in situ. The weeks waiting for a lumpectomy and then a revision surgery were long. And the nearly 20 weeks between my first surgery (in early August) and today’s meeting with the oncologist has been a very long stretch of waiting.  

When Alberta Health Services (AHS) pings me, to tell me it’s time to move along in this cancer journey, I ask lots of questions about expected wait times for those next steps. And for the most part, the answers are vague and frankly, sometimes a little patronizing. They tell me to wait…until I see the surgeon, the oncologist, the expert. But, as I’ve said, I’m not very good at waiting. Who doesn’t get a bit anxious when you don’t get a clear answer? And isn’t that the aim of healthcare–to relieve anxiety as much as possible?

In Alberta, there’s a wait time website to tell you what the historical wait times have been for different cancer treatments over the past three months. The charts are broken down by region within the province. Calgary is particularly busy: For 50% of cancer patients in Calgary, the wait time from referral to first consult with a radiation oncologist has been 4.9 weeks; 90% of patients are seen within 16.3 weeks. Wait times from ready-to-treat to radiation is 2 weeks for 50% of patients and 90% of patients are treated within 3.7 weeks. This all starts to sound like engineer- or economist-speak!

Understandably, lower risk patients—like me—are lower priority.  No quarrel with that. But who determines the medically-recommended wait times for these different steps in cancer care & what are the wait times that AHS aspires and manages to? That’s not so obvious. It’s not a perfect science–I get it–but what assumptions does AHS use to design and fund our province’s cancer care system? I’m curious to know more.

Across Canada, backlogs in wait times for cancer care are under pressure. In Quebec, there’s an uproar about long wait times for cancer surgeries. And in B.C., the Globe & Mail today reports that “one in 10 patients needing radiation therapy will wait more than 55 days to begin treatment.” That, notwithstanding that BC has been sending breast & prostate cancer patients to private clinics in the state of Washington for treatment since June.  

This cancer diagnosis has taught me patience…if I understand the underlying rationale for the timelines, I can wait with unbated breath as next steps in treatment unfold.

I believe we can do better. While Alberta can afford to throw more money at the healthcare system right now–and generous infusions of cash may well help attract & retain cancer care specialists– this isn’t just about dialing up the dollars. Our province’s high-performing energy economy is under siege from Ottawa. And if the feds crash our economy, down the road, we might not be able to afford the health care we presently enjoy in the province. We need to build a transparently-managed made-in-Alberta healthcare system that citizens trust, and one that can be sustained in good times and in bad.