Tag / cancer patients

by Jacqueline Chartier

Cruel and Unusual Punishment: The Impact of Danielle Smith’s Policies


I’m appalled that Premier Danielle Smith’s government is implementing certain policies that will increase the suffering of sick and vulnerable Albertans, including cancer patients. At what point does a government’s disregard for the marginalized become “cruel and unusual punishment” or almost contempt for the poor, sick and disabled?

I’m a long-term cancer survivor, understandably I have a deep connection with those in the cancer community and Albertans who must be hospitalized. Smith’s attack on public healthcare has been unending since she came to power Recent cuts have included limiting food services for outpatients using Alberta hospitals and treatment facilities. Patients visiting the emergency department and oncology patients having chemotherapy in short stay units are now being asked to bring their own food or money for purchasing some. 

At first, this government policy was even going to be implemented at the Alberta Children’s Hospital for pediatric cancer patients! However, as the outrage grew over “taking popsicles from cancer kids” an exception was finally made.

A woman with a young son undergoing cancer treatment posted the following on Facebook:

“After almost two years in this clinic, as our son continues to battle brain cancer, we have witnessed and experienced first-hand how a simple popsicle can calm a crying child who has just endured another needle poke, or an IV access, or a dressing change, or a lumbar puncture. A ginger ale works to calm a nauseous belly from all these chemo medications. 

How this policy passed into action, I can’t even imagine. Had they asked the nurses, the patients, the parents, maybe they would have realized they could have cut back a bit on the “meals” that often go untouched … but the popsicles? Why the ginger ale or crackers when they literally cannot stomach anything else? Don’t take away this small and sweet piece of joy to these unlucky kids enduring hell… find something else to pick on. Us Oncology families are dealing with enough.”

While Danielle Smith’s government is undermining public healthcare and basic comforts like food services for cancer patients, her lack of compassion has also been evident in other ways. For low-income patients or some cancer survivors with financially disadvantage backgrounds, the only option may be to apply for provincial government assistance. If cancer treatment has left a low-income individual unable to work, or they can work, but only part-time, they will typically qualify for the Alberta government’s Assured Income for the Severely Handicapped.

The AISH allowance is less than $2000 a month, but it’s what some chronically ill or disabled Albertan’s depend on to pay rent and buy food. The federal government recently announced the Canada Disability Benefit, a new program to supplement AISH and alleviate some of the poverty endured by recipients. This was welcome news for approximately 75,000 Albertans, but Smith and her government have made a cold-hearted and morally unacceptable decision.

Our premier has chosen to “claw back” the $200 a month supplement from the federal government. With over 70,000 people on AISH, her United Conservative government stands to take in $15,400,000 a month from the money that is supposed to be lifting some cancer patients and other chronically ill Albertans a little more out of poverty. Smith argues that AISH is generous and already enough for severely disabled Albertans to live on. However, this claim is without evidence, it also doesn’t consider inflation or the rising cost of most everyday essentials like food and rent. 

The appalling news was delivered in a blunt and callous letter sent out to all AISH recipients. First, the letter confirmed the Alberta government’s intention to claw back their new benefit.

“Income from the Canada Disability Benefit will be treated as non-exempt for AISH clients, meaning that your AISH benefits will decrease by the amount of the federal CDB that you receive, With the $200 from the CDB, AISH clients will receive a total monthly government income of $1,901, which is unchanged from their current monthly AISH benefits.”

Secondly, the correspondence stipulated that people on AISH must apply for their federal benefit to ensure that Premier Smith’s government can take it!

“As a client of the Assured Income for the Severely Handicapped (AISH) program, you are required to access all sources of income for which you are eligible, including federal programs such as the Disability Tax Credit and the new Canada Disability Benefit.”

My question is whether growing public pressure will ultimately cause the Alberta government to do the right thing and allow AISH recipients to keep their supplemental income—it’s revenue they desperately need and obviously deserve. Meanwhile, critics continue to raise concerns about the potential impact of Danielle Smith’s proposed changes to many social programs. 

Beyond specific policies, I question Smith’s overall approach to social issues, too often she demonstrates her lack of empathy and understanding for the challenges faced by marginalized groups.

by Jacqueline Chartier

Advocating for Cancer Patients: Why Political Action Matters

Those of us who are facing cancer or who have a loved with the disease are likely to be experiencing the most chaotic and turbulent time of our life. The personal, social and financial burdens are enormous—during treatment every ounce of our time and energy is precious. Still, I believe that we need to try and advocate for ourselves and hold people in positions of power to account. Why should you become more politically active? Here are two important reasons why I’ve personally chosen to speak out about issues affecting cancer patients.

Political Scandals and Corruption in Healthcare

Recently, the outgoing CEO of Alberta Health Services highlighted serious allegations about the potential misuse of taxpayer money by AHS and the Government of Alberta. There are allegations that the Minister of Health, Adriana LaGrange, was involved in dictating the price that AHS was to pay for multi-million-dollar contracts, including chartered surgical facilities. It’s also alleged the minister subsequently directed AHS to cease its internal investigations and conceal the findings.

As a cancer survivor and someone who relies heavily on the public health care system, my reaction is disbelieve and complete outrage. Essentially Alberta’s UCP government is accused of funnelling over $600 million, to a key political donor and then covering it up by firing health executives who were investigating. If proven true, the size and scope of the funding involved would be unprecedented in Alberta history.

The Auditor General is currently conducting a limited review and several other investigations are underway, transparency is essential, and Albertans deserve it. Both Alberta’s New Democrats and the Alberta Medical Association have stressed that a comprehensive, independent public inquiry is needed. Meanwhile, with every new revelation in what the NDP have dubbed the “CorruptCare” scandal, the chorus calling for a public inquiry grows louder.

An inquiry, conducted under the Public Inquiries Act, would ensure a non-political and impartial investigation, allowing the public to assess health care spending and address any potential government interference. It would ultimately allow cancer patients and their families to assess an unprecedented scandal that may have potentially undermined their quality of treatment.

Misinformation and Detrimental Health Policies 

The Trump administration is a threat to healthcare, both in the United States and globally. For instance, Robert F Kennedy Jr.’s appointment as Secretary of Health and Human Services is cause for grave concern. Long before the COVID-19 pandemic, Kennedy was building up a following with his anti-vaccine nonprofit group, Children’s Health Defense, and becoming one of the world’s most influential spreaders of fear and distrust around childhood vaccination. Now President Donald Trump has chosen Kennedy to lead the Department of Health and Human Services, which regulates vaccines. 

As the secretary of the HHS, Kennedy has oversight over 11 agencies including the FDA, the CDC and the National Institutes of Health. He has frequently come under fire from both Democrats and Republicans for some of his controversial beliefs – the most contentious being his extensive history of anti-vaccine work and rhetoric. I’m especially concerned about his active stance against cancer vaccines and his efforts to undermine confidence in them. 

Kennedy has specifically focused on the HPV vaccine Gardasil. In a 2019 video posted on his Children’s Health Defense website, Kennedy called Gardasil “the most dangerous vaccine ever invented.” In truth studies have proven Gardasil is safe and that it is nearly 100 per cent effective against cancers caused by the human papillomavirus – most notably cervical cancer. 

New estimates were published last month by the Centers for Disease Control and Prevention. The U.S. government report adds to evidence that the HPV vaccine, once called dangerous by Kennedy, is preventing cervical cancer in young women. The recent report found that from 2008 to 2022, rates for precancerous lesions decreased about 80 per cent among 20 to 24-year-old women who were screened for cervical cancer. 

HPV, or human papillomavirus, is common in the adult population. Most HPV infections cause no symptoms and clear up without treatment. But HPV also has the potential to develop into cervical cancer as well as some other forms of malignancy, thousands of cases a year, according to the CDC. Women in their 20s are the group most likely to have been given the Gardasil vaccine, which has been recommended in the U.S. since 2006 for girls and since 2011 for boys.

HPV vaccine, including Gardasil, is currently free in Canada for certain ages and groups of people through publicly funded programs. It’s also available for purchase privately. All provinces and territories currently offer the vaccine for free through school-based programs and catch-up programs. In Alberta, students in grade 6 receive the HPV vaccine as part of the school immunization program.

by Jacqueline Chartier

Cancer as a Loaded Gun and Other Metaphors

Over a decade has passed since I last underwent surgery or had chemotherapy, in many ways my ordeal has become a distant memory, a blur of hospitalizations, trips to the cancer centre and having my life completely upended. Only about half of women with ovarian cancer live beyond five years, fewer still become cancer free. Yes, I’m one of those fortunate ones. However, I still don’t believe in the term “cured” to describe the status of my ovarian cancer, I will only say that I”m in remission or NED (no evidence of disease). 

For me the fear of recurrence is ever-present, an insidious shadow that lingers in the back of my mind. I’ve been released from the cancer centre, and I no longer visit my oncologist for regular assessments. Still, I’m constantly reminded of the fragility of my remission by every ache, every medical scan, and every follow-up visit to my family physician. This uncertainty is a heavy burden to bear. It can be like living your life on a precipice, not knowing if or when you might fall off.

Every moment of normalcy is tinged with an underlying sense of dread that the cancer might return, that the nightmare might start all over again. I’ve somehow learned to navigate life with this invisible weight, to cherish the days of health while always bracing for the possibility of illness. For me, it’s become a delicate balance between hope and fear, between trying to live fully and the anxiety that the disease could reappear at any time.

The lifelong threat of recurrence that I’ve had to accept is complicated to convey to those who’ve never had their physical health suddenly and viciously destroyed. One person graphically compared the experience to being forced to live with a loaded gun pressed against the back of your head.

“Imagine you’re going about your day, minding your own business, when someone sneaks up behind you. You feel something press up against the back of your head, as someone whispers in your ear. “Sssshhhhh…. don’t turn around. Just listen. I am holding a gun against the back of your head. I’m going to keep it there. I’m going to follow you around like this every day, for the rest of your life.”

“I’m going to press a bit harder, every so often, just to remind you I’m here, but you need to try your best to ignore me, to move on with your life. Act like I’m not here, but don’t you ever forget one day I may just pull the trigger, or perhaps I won’t. Isn’t this going to be a fun game?” 

I find this an effective metaphor for what it’s like to be diagnosed with cancer—to be living with any stage of cancer, or any type of the disease. For most survivors, remission doesn’t change the constant fear, the profound uncertainty and apprehensiveness never entirely disappear. Please, if you have friend or loved one who has ever been diagnosed with cancer, consider this fact. They may never talk about it, or they may wish to talk about it often. The most compassionate thing you can do is listen to them. They aren’t asking you to make it better; they simply want you to sit with them in their fear, their sadness, their anger, just for the moment. 

Don’t try to talk us out of the difficult emotions that we’re experiencing. That approach doesn’t help, and it will only make us believe that what we are going through is being minimized. Don’t remind us of all the good things we still have in our life, we know, and we’re grateful. But some days we’re tremendously uneasy—we feel that gun pressing ominously against us, and we need to talk about it. Offer us an ear.

by Jacqueline Chartier

Some Words of Inspiration for Cancer Survivors in 2025

As we welcome 2025, I’m not going to use this blog to give a lecture about New Year’s resolutions or to suggest that you make elaborate promises to yourself. I realize that living with cancer often renders such gestures trivial and that your life is probably being planned week-by-week or month-by-month. Instead, I’ve chosen to share some of my favorite motivational quotations, may these compelling words make the beginning of another year a little less daunting for you and may the theme of infinite hope provide you with strength and inspiration for your cancer journey.

A letter from poet Ralph Waldo Emerson to his daughter

“Write it on your heart
that every day is the best day in the year.
He is rich who owns the day, and no one owns the day
who allows it to be invaded with fret and anxiety.

Finish every day and be done with it.
You have done what you could.
Some blunders and absurdities, no doubt crept in.
Forget them as soon as you can, tomorrow is a new day;
begin it well and serenely, with too high a spirit
to be cumbered with your old nonsense.

This new day is too dear,
with its hopes and invitations,
to waste a moment on the yesterdays.”

Anthem a song by Leonard Cohen

The birds they sang
At the break of day
Start again
I heard them say
Don’t dwell on what has passed away
Or what is yet to be

Ah, the wars they will be fought again
The holy dove, she will be caught again
Bought and sold, and bought again
The dove is never free

Ring the bells that still can ring
Forget your perfect offering
There is a crack, a crack in everything
That’s how the light gets in

“The best way to predict your future is to create it.”
A famous quote from Abraham Lincoln

This quote from Lincoln emphasizes the importance of taking control of our own lives and shaping our own future. It suggests that we more often than not have the power to create our own destiny through our actions and choices. It’s an urgent call to action, reminding us that we are in control of our own lives and that we can shape our future. It encourages us to be proactive and take action to achieve our goals, rather than waiting for things to happen to us. Above all this quotation suggests that our future is not completely predetermined, but rather something that we can actively influence and shape. It maintains that in most situations we have the power to change our circumstances and create a better future for ourselves.

by Jacqueline Chartier

The Dangers of Trump’s Health Policies: A Canadian Cancer Survivor’s Perspective

I am devastated by the results of the 2024 U.S. presidential election; I’m gravely concerned about what a second Trump administration means for that country and our already turbulent world. I’m worried about the impact a Trump presidency will have on the sick, the disabled and the marginalized. As a survivor of ovarian cancer, my thoughts are especially with the cancer community.

If Trump is true to form, he’ll work tirelessly to achieve his detrimental campaign promises, his proposed policies would utterly decimate cancer research and health insurance coverage. I personally believe that basic healthcare should be a right rather than a privilege, maybe I’m radical that way—in that case, I’m proud to be extreme. If thinking that getting cancer shouldn’t be a leading cause of bankruptcy makes me a woke leftist, then so be it. 

Long before the COVID-19 pandemic, Robert F. Kennedy Jr. was building up a following with his anti-vaccine nonprofit group, Children’s Health Defense, and becoming one of the world’s most influential spreaders of fear and distrust around vaccines. Now, President-elect Donald Trump has chosen Kennedy to lead the Department of Health and Human Services, which regulates vaccines. Experts warn of what’s to come now that Kennedy has been placed in control, it’s especially worrying for children, the elderly and cancer patients.

Whenever I think about the American people choosing Donald Trump to lead them for the second time, a poem that I know immediately comes to mind. In 2007, Beat poet Lawrence Ferlinghetti wrote the poem Pity the Nation. He was inspired by Kahlil Gibran’s poem of the same title first published in 1933. Ferlinghetti wrote his version of Pity the Nation when he was 88. Putting pen to paper near the end of George W. Bush’s presidency, he saw much to protest and had a loud voice amongst the literary left.

Pity the nation whose people are sheep
And whose shepherds mislead them
Pity the nation whose leaders are liars
Whose sages are silenced
and whose bigots haunt the airways
Pity the nation that raises not its voice
but aims to rule the world
by force and by torture
And knows
No other language but its own
Pity the nation whose breath is money
and sleeps the sleep of the too well fed
Pity the nation Oh pity the people of my country
My country, tears of thee
Sweet land of liberty!

by Jacqueline Chartier

Cancer Guilt: Understanding the Misconceptions

Cancer isn’t our fault.

One of the most disturbing revelations for me after being diagnosed with cancer was the amount of guilt and blame there is surrounding the disease. We still live in a society that subtlety, or even openly, tells cancer patients that it’s our fault. Two years ago, before she was Alberta’s provincial leader, Premier Danielle Smith made a shocking comment in which she essentially blamed cancer patients for their condition.

Smith’s now infamous comment was made during a podcast with naturopathic doctor Dr. Christine Perkins. The two were discussing healthcare and their shared belief that there’s a need for both mainstream and naturopathic medicines.

“Once you’ve arrived and got stage four cancer and there’s radiation and surgery and chemotherapy, that is incredibly expensive intervention — not just for the system, but also expensive in the toll it takes on the body,” Smith reasoned. “But, when you think everything that built up before you got to stage four and that diagnosis, that’s completely within your control and there’s something you can do about that that is different.”

We aren’t simply on vacation or short-term sick leave.

Ordinarily healthy people tend to assume that having cancer or a serious chronic illness is comparable to a couple of weeks spent recovering—perhaps from a slight injury or minor surgical procedure. This attitude probably stems from genuine ignorance, far too many people don’t understand the impact that cancer and cancer treatment have on the human body. Still, it can be devastating when co-workers or relatives imply that you are lazy or enjoying a relaxing break. “Why aren’t you back at work yet? It must be nice to be able to stay home all the time.” 

We can’t just resume our lives as if nothing happened.

Some pundits seem to think that, once we regain some of our strength and physical health, we should put the fact that we had cancer behind us and simply carry on with life. While I’m currently in remission, those dark days of surgery and chemotherapy have permanently changed my body and affected my psyche. In addition to a fear of recurrence, I’ve had to accept physical changes. These transformations include the fact that my abdomen is severely scarred and that I have significantly less energy or vitality than I did prior to undergoing cancer treatment. It’s also worth mentioning that, like so many other cancer survivors, I’ve had to deal with disability. In my case, I had substantial hearing loss prior to my cancer, but the chemotherapy drugs that were used have spitefully robbed me of even more

We don’t need medical advice from non-experts.

When I was undergoing treatment, I can remember getting angry when people other than my cancer care team would try to give me medical information. “If I want information regarding cancer or cancer treatment, I’ll ask for it,” I thought. The many articles from newspapers, magazines or online publications that I received from people who had never personally had cancer were annoying. For the most part these pieces were irrelevant and unnecessary. Also friends and family should be careful when presenting teas, potions or homeopathic remedies to treat cancer. When some individuals gave me a gift basket with ginger and dandelion root, I didn’t bother to explain to them that these nutrients are specifically mentioned on a list oncologists give to their patients. Ginger and dandelion root do not combine well with many traditional chemotherapy drugs, and therefore I was told to refrain from using them during active treatment with Carboplatin and Taxol.

Our cancer journey doesn’t end once our treatment is over.

As a woman who has experienced gynaecological cancer, I’ve come to accept one commonly held view of cancer survivorship:

“Cancer survivorship begins at diagnosis and covers the physical, psychosocial, and economic issues of cancer, from diagnosis until the end of life.” 

First, I accept the all-encompassing notion that’s presented in this definition because cancer does impact every single aspect of a person’s life. In retrospect, I also believe that my survivorship began that moment in my gynecologist’s office when he told me the devastating details of my pathology report. 

Simply being diagnosed with cancer made me a survivor, from this perspective I didn’t have to wait until after I had completed a full year of treatment or until I was officially in remission. Before the surgeons at the Tom Baker Cancer Centre cut into my body, and before the first drop of chemotherapy solution ran ominously into my veins, I was already a survivor in the eyes of the cancer community. I appreciate now that I’ll always be part of this incredible, strong and resilient group.

by Jacqueline Chartier

Cancer Care is on Life Support While Patients Languish

For cancer patients in Alberta, and indeed for the entire cancer community, there’s a looming sense of dread—a feeling that the status quo is unsustainable and the system that provides care to us could soon collapse. 

The backlog of patients, due for the most part to the province’s shortage of oncologists, has become increasingly dire. An internal report that was presented to Alberta Health Services this May found that the number of new cancer referrals grew by 18 per cent between 2018 and 2023. Furthermore, the report revealed the number of patients seen outside the Alberta Health four-week target jumped by nearly 70 per cent over the last five years.

As the number of new cancer patients continues to outpace the number of new oncologists in the province, wait times are going up. Five years ago, patients requiring medical oncology care waited an average of 6.3 weeks for their first consult. In the first quarter of this year, the average wait time for it was 10.3 weeks. There have been several cases recently of Alberta patients dying before they could be formally assessed by a medical oncologist or start a treatment plan.

Steven Wong of Edmonton died in mid-July, leaving his wife without her husband, their three young boys without their father and a family without faith in Alberta’s health care system. Not once did Wong or his wife, Cici Nguyen, see or speak to a medical oncologist — doctors who specialize in the diagnosis and treatment of cancer — before his death.

The new Arthur J.E.Child Comprehensive Cancer Centre in Calgary sits unused and is scheduled to open later this year. With a shortage of cancer specialists the magnificent building alone may not be enough.

Athletic at age 41, Wong was a project manager for a real estate investment company and busy dad of three — he was a non-smoker and non-drinker and was healthy, as far as he knew. However, earlier this year a diagnosis of gastric cancer changed everything. An ER visit’s endoscopy had shocking news. It found a large stomach tumour. Wong’s tumour took him from heartburn to “inoperable” in just weeks. Referrals to the Cross Cancer Institute timed out as complications set in. Gastric bleeding. Perforation. A collapsed lung. Infection.

The stark reality is that Alberta has an excellent system of cancer care, but it’s functioning with tremendously limited resources. With resources as scare and labour intensive as they are, the triage of oncology is the tyranny of the healthiest, the earliest diagnosed, with priority going to the ones most likely to benefit in a life-saving way. Wong’s cancer was advanced, and almost surely not curable.

CiCi Nguyen is certain her husband would have died with, or without, the timely help of a medical oncologist. But she insists it’s just not right Alberta’s medical system failed to give Steven Wong the opportunity to prolong his life. “We never heard from the actual oncologist themselves or anyone from the Cross Cancer Institute explaining to us why we couldn’t see somebody,” said Nguyen. “He didn’t deserve the way he was treated at the end.”

As with many cancer survivors and cancer care specialists, I’m furious as well as demoralized— with much of my growing frustration directed at our provincial government. A report presented to Alberta Health Services CEO Athana Mentzelopoulos from Cancer Care Alberta confirmed a widening gap between cancer referral and cancer treatment in the province since the UCP government took power. Waits for oncology and treatment have surged over the past seven years, while the number of new cancer patients has significantly increased.

Dr. Alika Lafontaine, a former president of the Canadian Medical Association, has voiced his concerns regarding healthcare in Alberta.

The Cancer Care Alberta study points to several major factors affecting Alberta’s capacity for cancer treatment, one is that as medical science has advanced there is a growing complexity and chronicity of cancer care. However, the other factors cited are largely the responsibility of the provincial government, under their control is workforce and manpower as well as capital infrastructure and equipment.

The report’s author, Dr. Dean Ruether, medical director of community oncology in Alberta, said the province continues to struggle with wait times that are unacceptable and getting worse. “Physicians continue to advocate for their patients, express concerns over the delays in getting patients into our system and to treatment and are sharing their own distress at watching this problem grow,” he stated. Of course, patient complaints about delays are increasing, many are expressing their outrage to oncologists, to Alberta Health and the health ministry,

I wasn’t surprised when Dr. Alika Lafontaine, a former president of the Canadian Medical Association, took to social medica to stress just how serious the overall healthcare crisis has become.  “As a rural specialist who has been in Northern Alberta for the past 12 years, I can compare the state of healthcare today with rural healthcare when I first arrived here,” he wrote. 

“Capacity just wasn’t an issue in 2011. If an emergency came in, we handled it. There was no triaging of resources or placing patients in doom loops where they cycled round and round as they were promised care but never received it. It is clear we do not have enough skilled providers in the health system to accommodate demand. If more professionals leave to other places—private insurance, private care, another province, the US, or leave medicine entirely—health access will disappear.”  

by Jacqueline Chartier

Confronting Alberta’s Oncology Crisis

As a cancer survivor, who may face a recurrence at some point, I’m worried and outraged as I observe the looming cancer care crisis in Alberta. The Alberta Medical Association is warning that if the provincial government doesn’t take appropriate action soon, more patients will face delayed treatment or even die unnecessarily. 

In a recent interview AMA president Dr. Paul Parks emphasized that wait times in the province have increased, delaying treatment. “Sometimes cancers that could have been curable are no longer curable because of the delays” he said. “They are seeing cases and examples where, because of delays cancers that were localized and easily treatable initially sometimes spread and it becomes not curable, and ultimately some people are succumbing because of delays and that’s why we’re raising the alarm.”

Worst of all, the Alberta government doesn’t appear to be listening to the urgent pleas of health care professionals or patients. I’m disheartened by Alberta’s UCP government and their attitude. In my opinion there is an appalling lack of compassion or empathy that’s being demonstrated. Two years ago, before she was our provincial leader, premier Danielle Smith made a shocking comment in which she essentially blamed cancer patients for their condition.

Smith’s now infamous comment was made during a podcast with naturopathic doctor Dr. Christine Perkins. The two were discussing healthcare and their shared belief that there’s a need for both mainstream and naturopathic medicines.

“Once you’ve arrived and got stage four cancer and there’s radiation and surgery and chemotherapy, that is incredibly expensive intervention — not just for the system, but also expensive in the toll it takes on the body,” said Smith. “But, when you think everything that built up before you got to stage four and that diagnosis, that’s completely within your control and there’s something you can do about that that is different.”

It’s evident that the ideology of our premier and her government regarding healthcare and cancer treatment only compound the serious problems we’re already facing. To me this is completely unacceptable. In the case of cancer care, delays of even a few weeks can limit the range of treatment options. A patient who might have been a candidate for an exciting new treatment that could cure the disease may no longer be eligible. Instead, they face longer treatments, poorer outcomes or, even worse, may only be palliative.

The reasons for the crisis in cancer care are complex and they aren’t being adequately addressed by those in power. One cause behind the crisis can be explained through simple math, demand is outpacing supply. Official statistics indicate that cancer rates in the province are outpacing population growth. Alberta’s population is increasing rapidly, and more patients equal a need for more care. Alberta’s population is also aging, and older patients have a much higher incidence of cancer. 

Another important concern is that oncology is always evolving. Advancement in the field of oncology and better cancer treatment are things to strive for, but it can sometimes present a paradox. For example, technological innovation like genomic therapy can now save patients who would not have survived short years ago. This is wonderful news, but it adds a new population of complex patients who need special care after treatment, often over a period of years.

According to the AMA there are several issues that must be addressed related to cancer care. First, Albertans are facing reduced access to family doctors or generalist care. Too many patients at risk of cancer lack a family doctor or a consistent primary care provider. Add to this the pandemic disruption to screening and preventive measures. Today patients show up in emergency departments with advanced cancers that could have been detected and treated earlier. The number of new cancers being diagnosed in overcrowded emergency departments, which are simply not resourced for this type of care, has never been higher.

Furthermore, the organization overseeing Alberta’s doctors says the government is failing in its obligation to both recruit and retain oncologists There’s an urgent need for more oncologists as we face a severe shortage. Alberta has approximately the same number of cancer specialists in the province as we did 10 years ago, and the system is now experiencing acute strain.

All oncologists in Alberta are employees or contractors, meaning there can be no recruitment if spaces are not established first by the funder. An oncologist cannot just decide to move to Alberta and a community cannot simply hire one. Unfortunately, despite the increasing need, new oncology positions have not been created to keep pace. Calgary is supposed to open a new state-of-the-art cancer centre this fall. But I worry that if it opens on schedule The Arthur Child Cancer Centre might lack enough specialists to provide premium care to patients.

Obviously, our province must do everything it can to hang on to the oncologists we have today. Then, assuming more spaces become available, we must begin to recruit. The AMA says we need to deal with the problem that Alberta is not currently competitive with other provinces in retaining or attracting oncologists. We have fallen behind. Few new Alberta-trained graduate oncologists have stayed in the province in recent years. Meanwhile, other provinces like BC and Ontario are actively hiring as many cancer specialists as they can. The Royal College of Physicians and Surgeons of Canada will produce only 25 new oncologists for all of Canada this year. Alberta alone could use two-to-three times that many today.

by Jacqueline Chartier

Now and Then: The Rapid Evolution of Cancer Care

I underwent several major surgeries as well as chemotherapy for my ovarian cancer approximately a decade ago, meanwhile I watch in amazement as I observe many of the new options that are available for patients today. In my opinion the speed at which cancer treatment and patient care have evolved is truly amazing. 

One perfect example is that today many patients who are diagnosed with cancer are assigned a nurse navigator through their cancer centre. When I was going through treatment, I didn’t have access to one because at that time nurse navigators were still extremely rare. I believe that if I’d been matched with a nurse to work with me one on one, it would have made my adjustment to becoming a cancer patient less stressful and a great deal easier.

What exactly is a nurse navigator and how do they assist you when you’re going through one of the most confusing and turbulent periods of your life? Nurse navigators are now commonly employed in oncology to help patients through their cancer diagnosis and individualized care plan. An oncology nurse navigator (ONN) is usually a professional registered nurse with oncology-specific clinical knowledge. Their job is to offer individualized assistance to patients, families, and caregivers. Essentially a navigator is there to help you overcome healthcare system barriers. In essence your navigator is your advocate for care—from initial consultation right through treatment. 

The CBC radio show White Coat Black Art recently covered the topic of nurse navigators. The first cancer navigation program in Canada was created in 2002 in Nova Scotia, followed by Quebec launching a similar program in 2005. Most provinces and territories have since implemented different forms of a cancer navigation program. Programs between provinces differ — from who is covered, to what a navigator helps with. Each health authority has adopted a distinct strategy and customized the program for their region.

Lorie Kielley is a registered nurse who works as a cancer patient navigator with Newfoundland and Labrador Health Services. “Having someone to reach out to, to guide them through what to expect, what supports are available to them and guide them through the whole process, is definitely something that can at least take a little bit of stress out of the experience,” Kielley told White Coat. 

I’m grateful that if I must go through cancer treatment again, I’ll be much more likely to reap the benefits of my own personal nurse navigator. There are other important innovations that I’m aware of at my cancer centre —for one thing, Enhanced Recovery After Surgery (ERAS) frequently makes surgery less difficult for patients. Drawing from best practices and evidence from around the world, this new approach improves patient care related to nutrition, mobility after surgery, fluid management, anesthesia, and pain control. 

When I underwent surgery there were some standard protocols that I found hard to bear and that probably made my body even more weak when I was struggling to recover. First, I was required to fast for 48 hours and prepare my bowel by drinking noxious medications, then I was taken shivering into a cold operating room. This isn’t the case with some gynecologic cancer patients today, some women at my cancer centre are able to participate in ERAS. On the day of their surgery, they’re usually allowed to drink or eat until just a few hours before their procedure and they’re kept warm and comfortable, even after they enter the operating room.

Instead of rigorous fasting and becoming stressed out in the days or weeks leading up to my surgery ERAS would recommend enhanced nutrition and physical activity to make sure that I was in optimum condition for a major surgical procedure. This new method makes patients part of the team by involving them in preparation for their surgery and post-operative recovery. The main objective is to help patients stay strong, improve outcomes, and reduce complications.

ERAS guidelines consist of about 20 different practices before, during and after surgery. They include keeping patients well-nourished, giving them anti-coagulants and pre-operative antibiotics, avoiding cold in the operating room, avoiding the use of long-acting sedatives, using non-opioid pain medications (where alternatives are medically appropriate), using anti-nauseants, and encouraging patients to move as soon as possible after surgery.

Meanwhile, my standard surgical recovery was almost gruelling, I needed to be hospitalized for 10 days before I was finally released. The encouraging news is that at my cancer centre there are now some patients who would normally spend about 10 days recovering from surgery going home in only five days because of ERAS. “Everything just went so smoothly, there was no reason for me to hang around,” one patient recalls. “I felt great — the nausea was well-controlled, the pain was well-controlled, and I was up and walking. It was incredible — you don’t want to stay in hospital any longer than you need to.”

Despite recent progress, I still try to be realistic about how far treatment for ovarian cancer has come, I know there’s still an extremely long way to go in the war against this insidious disease. Ovarian cancer patients are having better outcomes because they have more treatment options, but the cancer still frustrates doctors and their patients because it often remains undetected until it has spread. Oncologists admit that they are facing enormous challenges. While surgical advances and new treatment approvals have improved the outlook for ovarian cancer patients, late diagnosis and tumour resistance remain as the two most significant barriers in overcoming the disease.

by Jacqueline Chartier

Starting 2024 With Hope and Optimism

In my opinion living with cancer is one of the most difficult and brutal things that any person will ever have to face, to have cancer is to live moment by moment and it’s not always easy for us to look toward the future. Still, I feel I’m in a better situation than many because I’ve been in remission for eleven years. My long remission and the fact that my city, Calgary, Alberta, intends to open a new state-of-the-art cancer centre this year has me facing the New Year with hope and optimism.

The Arthur J.E. Child Comprehensive Cancer Centre

At some point in 2024 I’ll witness the grand opening of Canada’s largest and newest comprehensive cancer centre! I experienced how desperately we needed a new cancer centre when I was going through treatment. Our city’s existing Tom Baker Centre has been serving men and women diagnosed with cancer for approximately two generations now; it opened its doors over 40 years ago in the early 1980s. At the time, Albertan’s marveled at the spacious and innovative new facility. The building had been meticulously designed to provide cancer care for Calgary’s population and the rest of southern Alberta. Although the Baker Centre’s first doctors once pondered how exactly they’d fill all the new space available to them, I saw the present day oncologists, nurses and technicians grapple with cramped offices, crowded reception areas and patients lining the hallways waiting for treatment. 

An artist’s rendering of Calgary’s new Arthur Child Cancer Centre

When it opens later this year, it’s promised that the new Arthur J.E. Child Comprehensive Cancer Centre will engage patients as the focus of a multidisciplinary health system, we will have access to comprehensive cancer care services in a state-of-the-art facility. In fact, the extensive scope and integration of cancer care services at Calgary’s new hospital will make it one of the most comprehensive cancer centres in the world. Operationally, the Arthur Child will include both inpatient and outpatient services. Services based on clinical priorities are to include:

  • more than 100 patient exam rooms
  • 160 inpatient unit beds
  • more than 100 chemotherapy chairs
  • increased space for clinical trials
  • 12 radiation vaults, with three more shelled in for future growth
  • new on-site underground parking with 1,650 stalls.
  • numerous outpatient cancer clinics
  • clinical and operational support services and research laboratories

Important Oncology Breakthroughs

There’s no doubt that COVID-19 caused a huge backlog in cancer diagnosis and treatment. However, there is still plenty of positive news. Despite the recent global pandemic, medical advances are still accelerating the battle against cancer. Here are a few of the exciting recent developments in the field of oncology!

The seven-minute cancer treatment

The National Health Service (NHS) in England is to be the first in the world to make use of a cancer treatment injection. It takes just seven minutes to administer, rather than the current time of up to an hour to have the same drug via intravenous infusion. This will not only speed up the treatment process for patients, but also free up time for medical professionals. The drug, Atezolizumab or Tecentriq, treats cancers including lung and breast, and it’s expected most of the 3,600 NHS patients in England currently receiving it intravenously will now switch to the new injection.

Precision oncology

Precision oncology, defined as molecular profiling of tumors to identify targetable alterations, is rapidly developing and has entered the mainstream of clinical practice. Precision oncology involves studying the genetic makeup and molecular characteristics of cancer tumours in individual patients. The precision oncology approach identifies changes in cells that might be causing the cancer to grow and spread. Personalized treatments can then be developed. Because precision oncology treatments are targeted – as opposed to general treatments like chemotherapy – it can mean less harm to healthy cells and fewer side effects as a result.

Liquid and synthetic biopsies 

Biopsies are the main way doctors diagnose cancer – but the process is invasive and involves removing a section of tissue from the body, sometimes surgically, so it can be examined in a laboratory. Liquid biopsies are an easier and less invasive solution where blood samples can be tested for signs of cancer. Synthetic biopsies are another innovation that can force cancer cells to reveal themselves during the earliest stages of the disease.

Car-T-cell therapy

A treatment that makes immune cells hunt down and kill cancer cells was recently declared a success for leukaemia patients. The treatment, called CAR-T-cell therapy, involves removing and genetically altering immune cells, called T cells, from cancer patients. The altered cells then produce proteins called chimeric antigen receptors (CARs). These recognize and can destroy cancer cells. In the journal Nature, scientists at the University of Pennsylvania announced thattwo of the first people treated with Car-T-cell therapy were still in remission 12 years on.