Decrease in mortality attributable to cancer | More survivors, more patients to care for

Faced with the decrease in cancer-related mortality rates, health professionals are facing a new reality: the constant increase in the number of patients requiring care and monitoring.

“Since we treat patients better, we have a lot of cancer survivors. We also have patients who are under treatment much longer, because the drugs work,” observes the Dr Tarek Hijal, director of the radiation oncology division at the McGill University Health Center (MUHC).

“When I see people in my office who would have died three years ago, I am always amazed and dazzled. I am fascinated by what science has been able to do,” says Dr.r Normand Blais, hematologist and oncologist at the University of Montreal Hospital Center (CHUM).

But this increase in the number of patients needing care is straining a health system already at capacity.

We have become so much better at treating certain cancers that our capacity to treat patients is overwhelmed.

The Dr Normand Blais, hematologist and oncologist at the University of Montreal Hospital Center (CHUM)

“For example, about 5% of the lung cancer cases I treated lived five years. Now we are at 30%. That’s six times more patients than I have to see every three months for years,” illustrates the specialist.


While some cancer patients are undergoing treatment for longer, other patients are having to wait longer for exams due to lack of space.

The effect is felt on the patients. “Our patients are waiting longer and longer to have exams, because there is no more space,” says Dr.r Blais. It takes more doctors, nurses, pharmacists, physiotherapists, all the staff who take care of patients in the hospital. »

Family doctors as reinforcements

To relieve hospital congestion, oncologists are trying to direct patients in remission to family doctors, so that they can continue their follow-up outside the major cancer centers.

The MUHC recently set up a project in this direction. “We are developing tools and reports so that family doctors can carry out appropriate follow-ups with patients,” indicates the Dr Hijal.

The shortage of family doctors makes the situation more difficult, underlines the doctor. However, he remains hopeful.

In the context where our patients live longer and have improved survival rates following cancer treatments, we want to see them return to their family doctor.

The Dr Tarek Hijal, director of the radiation oncology division at the MUHC

Aging patients

In children, a similar challenge looms. “The phenomenon that is new is that our patients are living much longer,” says the DD Sonia Cellot, from CHU Sainte-Justine.

Professionals must therefore ensure that they provide long-term follow-up to their patients, sometimes for decades. “A good number of our children will have after-effects which will vary from mild to more serious,” she notes.

In their quest to provide the best care, doctors do not hesitate to seek advice from cancer survivors of the past decades. “Some of these young people, now in their thirties or forties, bring their experience and their vision on the side effects of cancer and on how to approach survival after cancer,” says the DD Cellot.

Read our file “Fight against cancer: a $2,500 exam that sows doubt”

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