More than 160,000 colorectal cancer screening tests and up to 154,000 mammograms have not been performed in Quebec since the start of the pandemic, which suggests dark days in the fight against cancer. This disease, which kills three times more than COVID-19, has fallen into the “blind spot” of the health network, decry patients and doctors who announce the holding of general meetings on this scourge.
After the failure of a first chemotherapy, doctors gave only three months to live for Sylvie Breton, who was diagnosed with a rare form of kidney cancer in 2018. Then, in the midst of a pandemic, the absence of access to clinical trials and genetic testing nearly destroyed his last chance of survival.
“I did the research myself, I paid for genetic testing in the United States and Europe. I ended up finding myself that a research protocol was going on on my type of cancer in Toronto, which I was able to participate in for free, from February to November 2021. It is not normal to have had to do all this alone, and not to have this care in Quebec. I felt abandoned”, says this patient, still alive three years later.
Sylvie Breton had to travel to Toronto and back each month, paying more than $8,000 in travel and accommodation costs to obtain these treatments, before she was finally able to receive the radiotherapy adapted to her type of cancer in a hospital in Sherbrooke.
“He urges holding general meetings on cancer to target the alarming problems in our cancer care system, present before the pandemic, but which have worsened. I have known people referred to palliative care, although clinical studies on their type of cancer existed in another hospital. The information does not circulate, ”denounces this survivor, who will be vice-president of the states general scheduled for May 2.
The leading cause of death in Quebec, cancer kills 22,000 Quebecers each year, recalls the Cancer Priority Coalition, which judges that the same energy must be deployed to improve the lot of people with cancer as that deployed to fight COVID-19. In a study published in 2021, a researcher from McGill University estimated that the delays in diagnosis induced by the pandemic could result in an increase of 8,000 cancers in Quebec by 2025.
“The impact of the pandemic on cancer incidence will be felt for another 10 years. However, we are always sailing blind, we do not measure our results, ”said the general director of this coalition, Eva Villalba, on the eve of World Cancer Day.
An observation that the D also makesr Jean-Paul Bahary, radio-oncologist at the CHUM, according to whom Quebec is lagging behind in the detection and diagnosis of cancer which will result in the medium term in an increase in the number of advanced cancers.
“We don’t even have accurate up-to-date data in Quebec on cancer sites. We do not participate in Canadian statistics. This was the case 20 years ago, it is still true today. The creation of a Quebec Cancer Registry is urgent, he says, because the most up-to-date Quebec data from the tumor registry is almost 10 years old.
“We cannot, without accurate information, properly assess our performance or the results of our treatments, or monitor our survival rates. It’s the basis of everything,” he says.
Deficient follow-up
This radiation oncologist says Quebec is lagging behind in personalized medicine because of poor access to biomarker testing through which the most effective cancer treatments can be tailored based on each patient’s genetic profile. “Dozens of breast and brain cancers have specific biomarkers, which indicate what care to give to which patient. It should be an integral part of cancer care. It avoids unnecessary treatment and suffering, and it can save valuable time,” he says.
Biomarkers have changed Sylvie Breton’s clinical trajectory. The results of the genetic tests that she underwent at her own expense abroad taught her in particular that she was carrying the only mutation responding to the chemotherapy treatment offered for her type of cancer.
According to the Dr Bahary, patient follow-up suffers from the lack of cohesion and clear governance in the organization of oncological care. “Unlike the largest university or hospital centers in the world, there are few or no oncology services in Quebec. It is an aberration which is observed nowhere else. In addition, some cancer treatment centers, without electronic records, struggle to effectively transfer the clinical records of cancer patients to other facilities, he adds.
US President Joe Biden has just announced a national plan to halve cancer mortality in the United States, notes Eva Villalba, of the Cancer Priority Coalition. France also announced in February 2021 to inject 1.7 billion euros over five years to reduce the incidence and mortality associated with the seven most lethal types of cancer in France.
Every year, no less than 56,000 Quebecers are diagnosed with cancer in Quebec, continues Ms.me Villalba. These states general on cancer must bring about solutions to current problems, not only with the help of patients, but also of clinicians and researchers. “During the pandemic, we also abandoned the vaccination of children against the human papilloma virus (HPV), responsible for cancer of the cervix,” she says. The pandemic has exacerbated problems that already existed, and created new ones. The system currently lacks transparency. It is high time to have a clear strategy and specific objectives in Quebec, given what the coming years promise. »