I am not an oncologist, but I have lived for six years with incurable cancer. This makes me a de facto expert in the cancer patient experience in our healthcare system. It is in this capacity that I add my voice to that of the Dr Denis Soulières to demand from our leaders actions that are prioritized, integrated and consistent with the Quebec reality of cancer and its alarming flaws. I have less and less time to waste.
If patients like me do indeed have “a personal story over time” that clinicians feel they are losing, in particular because they do not have the ability to intervene at the right time and with the appropriate means, how can we not demand a concrete mobilization of our decision-makers against what looks more and more like a public health crisis?
Need we remind you that cancer is “the leading cause of death in Quebec, before cardiovascular disease”?2 and “that on average, in Quebec, someone dies of cancer every 24 minutes”. How then can we not call for emergency measures to improve our ability to stem the “158 new cases of cancer per day”?2
How not to be alarmed, among other aberrations, by the fact that Quebec is “the only province not to have a screening program for colorectal cancer, most often discovered at stage 3”3when we know that the probability of survival is determined by the speed of access to care?
Since it seems that the difficult questions relating to cancer do not arise in the offices of government bodies or on the boards of directors of the institutions of our health system, then how can we not demand that “our government” have the courage to commit to developing a concerted, long-term vision with those involved in the fight against cancer to stem this health crisis?
Recent advances in medical assistance in dying inevitably stimulate individual and collective reflection on the conditions in which we will end our lives. Before arriving there, the course of care is often long and clearly perfectible to ensure people with incurable cancer a relative quality of life.
Indeed, the period extending from the announcement of an incurable prognosis to death is an existential epic strewn with pitfalls.
Caregivers are already struggling with the limits of science in terms of understanding and controlling cancer. They should be able to obtain from our leaders the means to give maximum “health to the time” that remains to their patients.
Otherwise, how can we be surprised that “66% of the 3,663 people who requested medical assistance in dying in 2020-2021 had cancer”?4 As a last option, they have only the choice to assume the full right to what remains of their quality of life.
In conclusion, I do not wish us another policy for which we would have neither the political will nor the field capacity to implement. Nor do I believe we need another super parastatal that will make recommendations that won’t be enforced by rotating governments.
I hope that we will give ourselves the means to provide integrated, humane and effective end-of-life care to people struggling with any incurable chronic disease such as cancer, in particular by learning about the dialogue of the patient-doctor-hospital chain. -institutions-managers-elected. In my opinion, this requires continuous monitoring and the implementation of international best practices based on indicators relevant to our specific context.
Finally, I wholeheartedly hope that “those who built Quebec”, namely the representatives of its aging population, particularly affected by cancer, will have access to care that will allow them to live and die without undue suffering caused by failures of a system whose repercussions we will all experience at the cost of our existence.
3. According to figures from the Department of Health and Social Services, 2,550 people die each year as a result of colon cancer in Quebec. Despite everything, you still have to go through a doctor or a specialized nurse practitioner (SNP) in order to obtain a prescription to take a screening test.