TORONTO - An advocacy group for cancer patients says the current cancer
system in this country is out of date, and Canadians are experiencing
inconsistent care.
The Cancer Advocacy Coalition of Canada released its annual report card Tuesday,
with graphs and charts to illustrate that many of the new oral, take-home cancer
drugs are paid for by public money in Manitoba and points west, while private
insurers are picking up the tab to a greater extent in Ontario and eastward.
"Cancer management in Canada is inconsistent across the country, and in some
areas it's relatively ineffective compared to others," said Dr. James Gowing, a
hematologist oncologist based in Cambridge, Ont., and board chairman of the
coalition.
Gowing said the Maritime provinces come off the worst, while British Columbia
could serve as an example to the rest of Canada and the world.
"They spend more money per head of cancer patients. And as a result, drugs which
are unavailable to cancer patients in other provinces are available in British
Columbia," he said.
"And the new drugs that are coming out are exceptionally effective. They are
more targeted. They have often fewer side-effects and they actually work."
The coalition, in its 68-page report card, did not delve into the situation of
cancer patients without access to private or public insurance, but it is
concerned about this too.
"What about the person in Ontario or Nova Scotia who doesn't have insurance
coverage, or can't afford insurance coverage? They're out of luck," Gowing said.
As well, the coalition, which has numerous pharmaceutical companies among its
corporate sponsors, said the clinical trials system for new drugs needs to be
refined so that promising treatments can be used by patients much sooner.
And it raised concerns about the well-being of cancer patients between ages 15
and 39, noting that the cancer survival rate for this demographic hasn't risen
as it has for children, older adults and seniors.
"They represent less than 10 per cent of people who develop cancer in Canada,
yet they represent nearly 30 per cent of the useful years of life lost," Gowing
said.
The report suggested that little research money is targeted toward fighting
cancer in this age group.
Teens or young adults have unique psychosocial problems to deal with, Gowing
said.
"If you're diagnosed with cancer at age 16, we treat you and you're cured, (but)
try applying for insurance. Try applying for a job in some places. They're
discriminated against. That shouldn't be."
Geoff Eaton, 32, of St. John's, N.L., is a two-time survivor of acute leukemia
and wrote a part of the report card on young adult cancer patients.
"Cancer is not necessarily more difficult for young adults than it is for kids
or adults or seniors, but it's very different," he said, listing emotional
issues like isolation and concerns about fertility.
Commenting on the report, Terry Sullivan, president and CEO of Cancer Care
Ontario, said while most cancers in the young adult population are treatable, it
is a group that has a long experience with cancer in the course of a lifetime.
"We probably need to do a better job of understanding in particular the
supportive care needs of this population as they grow older," he said.
Cancer Care Ontario is an umbrella organization that steers and co-ordinates the
province's cancer services and prevention efforts.
And Heather Logan, director of cancer control policy and information for the
Canadian Cancer Society, said there needs to be more understanding of the
long-term effects of being treated with radiation and chemotherapy.
Concerning the cost of cancer drugs, Sullivan agreed that there are wild
variations in what is and is not covered.
"Ontario has had a very clear and defensible process," he said. "All the
decisions are posted now from the last few months on the web - the reasons for
yes, the reasons for no."
Drugs are evaluated based on their cost-effectiveness, he noted.
Some attempts at "soft harmonization" among all the provinces, except Quebec,
are being made through the Joint Oncology Drug Review committee, which was set
up by the premiers just over a year ago, Sullivan said.
He called it "one step in the right direction" but noted the absence of any
national pharmaceutical strategy, which has been talked about for years.
"And we have seen almost zero forward motion," Sullivan said. "So if we had a
national pharmaceutical strategy and some focus on catastrophic drugs, then we
might be in a better position."
Source : The Canadian Press
