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report shares vision for a successful post-pandemic cancer care system

addressing health-care worker burnout, ensuring timely diagnoses and using technology are the three ways to build a successful cancer care system, says the canadian partnership against cancer.

by maija kappler

jun 20 2022

5 minute read

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report shares vision for a successful post-pandemic cancer care system

the pandemic has shown change within the health-care system is possible, says rami rahal, vice president of cancer systems, performance & innovation at the canadian partnership against cancer. supplied

canada will face a surge of new cancer cases as a result of pandemic-related delays, according to a new report called the “ road to recovery: cancer in the covid-19 era ” published by the canadian partnership against cancer (cpac).

fewer cancer screenings and fewer visits to family doctors over the last couple of years have meant a lower number of cancer diagnoses — somewhere between seven and 12 per cent less. in the case of skin cancer, cases have dropped a whopping 40 per cent. unfortunately, that doesn’t mean there are fewer incidents of cancer — just that they haven’t been diagnosed yet.

family doctors are often the first to identify potential cancer

“a lot of people may not know this, but many cancers are actually caught incidentally,” says rami rahal, vice president of cancer systems, performance & innovation at the canadian partnership against cancer.

people with noticeable tumours or other major symptoms are likely to have sought care, he says, but there are also many people who just haven’t realized anything is wrong.

“especially for something like melanoma skin cancer — somebody shows up at a family doctor, and the doctor finds a mole that looks suspicious, and [orders] a biopsy, and it turns out to be melanoma which can then get treated. those kinds of things aren’t happening.”

it’s a situation that could be lethal for some canadians: a cancer patient’s risk of death is increased by six to 13 per cent by a delay of just four weeks.

“obviously, there are cancer cases that are latent. they’re not yet symptomatic,” rahal says. “and as we know, with cancer, you want to catch it early, when it is curable. in my case, i’ve had my deviated septum surgery delayed for for two years, and that’s fine. i can live with that. but when you’re talking about a cancer, then it becomes much more problematic as it progresses.”

the organization has put together a plan to tackle the potentially devastating lag, and suggest other jurisdictions replicate what ontario’s been doing in terms of prioritizing the most serious cases. ontario health has adopted centralized wait lists so that hospitals and clinics across the province can work together to get care for the most urgent patients first. and both ontario and quebec have developed guidelines to help with that kind of prioritizing.

prioritizing marginalized communities

it’s also critical to acknowledge the communities that have been most impacted by covid.

“we saw that in the burden of covid, large urban centres, people of lower income, people of colour, people who work in service industries and frontline industries were the most impacted by covid,” says rahal. “people of colour had a much higher rate of infections, hospitalization, and icu use at death; significantly higher than white canadians. that has actually translated into into cancer care as well.”

many new immigrants also don’t have a family doctor, which, if they have cancer, could mean a potentially deadly late diagnosis.

and although indigenous people are more likely to live with a chronic condition than non-indigenous people, according to statistics canada, a situation rahal says has been helped by the lack of access to culturally safe care, many indigenous communities have developed their own support strategies. for example, there’s a successful pilot program in saskatchewan that provides assistance for people in the métis nation who need to travel to receive medical care — programs like these and others would benefit from help from the provincial and federal governments.

dealing with health-care worker attrition and burnout

we’ve known for some time that doctors, therapists, technicians and other health-care workers — especially nurses — are leaving the industry in droves. overworked before the pandemic, and for the last two years, people working an already difficult job have had to contend with extreme stress , dangerous working conditions, long hours, limited time off, sometimes hostile patients, and — in the case of nurses — low pay.

“the workforce is highly stressed and strained at this point, and really under threat from attrition from burnout,” rahal says.

cpac’s plan proposes several ways to address the burnout crisis, including training family doctors in rural areas to deliver chemotherapy to their patients to ease the burden on city health-care facilities.

“if you need chemotherapy and you’re in northern b.c., you need to travel down to vancouver to get that therapy,” rahal says. “what you end up with is up to big pressures on the urban centres and the staff there to deliver care.”

shifting certain tasks and responsibilities could also be a big help to alleviate backlogs, such as allowing student nurses to provide care, as alberta did . ontario, for instance, is considering offering mobile health clinics that could offer certain low-risk surgeries and provide more efficient care, while freeing up hospitals to treat cancer patients. and in quebec, administrative assistants are being hired to help nurses with admin responsibilities so that more time can be spent looking after patients.

“nurses have a huge paperwork burden that they have to take care of in addition to taking care of patients,” rahal says, adding that the move will allow them to “actually focus their time and effort to what they’re trained for, which was providing clinical care to patients.”

the healing potential of technology

virtual care, rare before the pandemic, is now the norm, and while the ability to connect with a health-care provider online is good for help those living in rural areas, far from a health-care provider, virtual appointments also reduce the spread of secondary viruses, such as covid.

another significant use for technology is data.

the u.s. started collecting race-based medical information in the 1970s, but canada has been resistant to do the same until the canadian institute for health information (cihi) announced two years ago took it on. the delay in gathering this data — information which allows experts to identify and quantify disparities in health care — may be due to a “fear that in general, collecting race and ethnicity [data] is not a ‘canadian thing’ to do, in quotations,” rahal says. “that we’re a society that doesn’t need to ask people what their race and ethnicity is, in order to understand what their needs are.”

change may be more possible than we think

while it can be hard to implement change in the health-care system, rahal says, the pandemic showed that it is possible — the rapid adoption of telehealth is just one example.

“the main barrier in the past has always been the fact that doctors couldn’t bill for virtual visits,” rahal says. “but once the pandemic began, that changed overnight, literally within days.”

“sometimes the solutions are easier than we think — we just need the right kind of momentum and the right incentive to make it happen.”

maija kappler is a reporter and editor at healthing. you can reach her at mkappler@postmedia.com

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report shares vision for a successful post-pandemic cancer care system

addressing health-care worker burnout, ensuring timely diagnoses and using technology are the three ways to build a successful cancer care system, says the canadian partnership against cancer.

family doctors are often the first to identify potential cancer

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prioritizing marginalized communities

dealing with health-care worker attrition and burnout

the healing potential of technology

change may be more possible than we think

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report shares vision for a successful post-pandemic cancer care system

addressing health-care worker burnout, ensuring timely diagnoses and using technology are the three ways to build a successful cancer care system, says the canadian partnership against cancer.

family doctors are often the first to identify potential cancer

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