Dealing with wait lists

Last February, Jayne Greer faced one of those personal crises that can have a terrible toll on lives and relationships. She discovered a lump in her left breast. Just a year ago that would have meant many weeks if not months of stress and inevitable fatigue as she made her way through the health-care system seeking effective treatment.

The 58-year-old Bradford elementary school principal would have shuttled between medical imaging units, surgical wards for biopsies, cancer clinics and doctors' offices laying all the diagnostic groundwork needed before a treatment plan could be arrived at.

"It was not uncommon for women to spend up to six weeks of tests and clinic visits before receiving a treatment plan," says Dr. Catherine Mahut, surgical oncology lead at Newmarket's Southlake Regional Health Centre.

"Studies have shown that at various hospitals diseases like lung cancer can take 100 days between the time a family physician suspects a patient has a tumour until that patient receives a treatment plan," says Dr. Carol Sawka, vice-president clinical programs at Cancer Care Ontario in Toronto.

Greer, however, saw her family doctor April 16 and one day later was at Southlake's new breast cancer diagnostic unit. On April 20 she had a biopsy right at the unit, which confirmed the lump was indeed a cancer and on April 27, Dr. Dan Campbell, her surgeon, met with her at Southlake to work out a treatment plan.

"If that new diagnostic unit had not been there the stress would have been enormous not just on me but on my husband and three daughters as well," Greer says. "I would have had to run all over the place to get tests with long periods of waiting in-between.

"The worst part would have been the waiting and never knowing how bad it was and what could be done about it."

The new rapid assessment unit is a province-wide initiative to address not just waiting times for treatment of cancer patients but to help alleviate the mental, psychological and real financial hardship the disease can carry with it, says Rowena Pinto, senior director of public affairs at the Canadian Cancer Society.

Currently there are units at R.S. McLaughlin Durham Regional Cancer Centre in Oshawa, St. Michaels Hospital, North York General Hospital and Princess Margaret Hospital, all in Toronto, Grand River Hospital in Waterloo, Southlake Regional Health Centre in Newmarket and The Ottawa Hospital, according to Cancer Care Ontario.

"There is now an understanding right through the health-care community that treating the disease is not enough," says Pinto. "We also need to address the social, mental, psychological and financial impact as well."

Standardized, self-contained, rapid diagnostic assessment centres like the one at Southlake is one of Cancer Care Ontario's four main goals this year," says Sawka.

"We have had variations in different forms in major centres. We now have standards in place, which makes them easier to create and to share information," she says. "The next step will be to measure the effectiveness of different forms of assessment units so that eventually we will be able to hold up one as a model any hospital wanting to create one can follow."

The one thing the entire health-care system agrees on is that the rapid diagnostic assessment centres are of great benefit to patients, she says.

Greer says she is a case in point. Shortly after being diagnosed she found a large lump in her left armpit, a telltale sign that the cancer was starting to grow and spread. The tumour had reached four centimetres in size. As little as five years ago that would have meant removal of the entire breast.

"Instead, since I was in the system, Dr. Campbell immediately scheduled me for five chemotherapy sessions —– one every three weeks to reduce the size of the tumour," she says. "After the second session, however, the tumour had shrunk remarkably and on June 27 they were able to perform a lumpectomy."

While Greer says she is not yet completely out of the woods – the chemo has done its job but she still faces 25 daily sessions of radiation at Princess Margaret Hospital in Toronto – she says the assessment unit has even made that long daily commute easier.

"They pick me up and return me back to the hospital in a van every day," she says. "I don't have to drive and neither does my husband. The care and speed with which they addressed my cancer enormously reduced the toll we expected it to take on our lives."

And that, of course, is the reason Southlake invested millions in creating the new unit, says Mahut, who is slated to become its director. Currently staff deals exclusively with breast cancer, seeing seven patients a day twice a week. The plan, however, is to expand into the most common forms of cancer such as lung, colon and prostrate.

"It is not one-visit shopping but it certainly is one-stop shopping for breast cancer patients right now," she says. "Everything needed for a rapid diagnosis and almost all forms of treatment, except radiation, are all under one roof.

"It saves time, money and most of all, improves quality of life."