In the spring of 1992, Linda Armstrong was working as an apprentice plumber, helping to build the CBC Broadcast Centre in downtown Toronto. But she was so sick and in so much pain, that she quit her job.
It would take months of doctors' visits, tests and even a lengthy hospitalization to determine that she was suffering from non-Hodgkin's lymphoma, a form of cancer.
What followed was an intensive year of treatment, including chemotherapy, radiation and drug treatments, and another year of recovery. "I was off work for two years," Ms. Armstrong said.
Because she quit her job, she was ineligible for Employment Insurance, and she did not have disability insurance or a drug plan. "I ended up spending every penny I had, including my RRSPs."
A decade after being declared cancer-free, Ms. Armstrong, 55, is a proud survivor. But while she is in excellent physical health, her financial health continues to suffer.
Being a plumber had too many physical demands so she retrained, and works as a teacher's assistant. "My friends are all talking about retirement, but I'm just starting my RRSPs again. Because I had cancer, I'm in for the long haul; I'll never be able to retire," Ms. Armstrong said.
Her story underscores one of the oft-overlooked realities of cancer -- its economic impact on individuals and society in general.
According to a report released yesterday by the Canadian Cancer Society, cancer costs the national economy at least $14.3-billion annually, including $2.5-billion in direct costs for treatment, care and rehabilitation, and another $11.8-billion in indirect costs, principally the loss of productivity from the disability and premature death of cancer sufferers. They are conservative estimates, based on 1998 data.
Those economic costs are also expected to soar, as it is projected that the number of new cases of cancer diagnosed each year in Canada will increase by 60 per cent over the next two decades and more effective -- and often more expensive -- screening tests and treatments are adopted.
This year, it is estimated that 145,500 Canadians will be diagnosed with cancer and 68,300 will die.
"This disease is robbing Canadians of precious years of life and productivity," said Heather Logan, director of cancer-control policy at the Canadian Cancer Society.
The new report suggests that, by the year 2010, cancer will be the leading killer, supplanting cardiovascular disease. While an individual's risk of developing cancer has remained relatively stable for several years, the number of new cases of cancer and deaths from the disease continue to climb because the population is aging.
"These statistics tell us that there is an urgent need to address the crisis in health care that cancer is becoming and implement the Canadian Strategy for Cancer Control," said Dr. Brent Schacter, CEO of the Canadian Association of Provincial Cancer Agencies.
The strategy has been developed by a consortium of cancer groups, but has yet to be implemented. It aims to improve health promotion and cancer care, ensuring that care is sustained, co-ordinated and comprehensive.
But consumer groups such as the Cancer Advocacy Coalition of Canada have been critical of the strategy, saying it is woefully underfunded and largely ignored by government. No price tag has been put on the strategy but most experts believe that a minimum investment of $150-million a year (1 per cent of the cost of cancer) is required to set the wheels in motion.
For Ms. Armstrong, the problem is that cancer care is too narrowly focused on treatment of the disease, and ignores the devastating impact on a person's personal life and finances.
"If you ask me, there's a big hole in the medicare system," she said. "You can't really say that health care is free if a person with cancer has to give up their job, lose their life savings and can't afford to put their kids through university. . . . When you have cancer, your life is so full of uncertainty, and the last thing you need is an economic burden."
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Cancer in Canada
A look at the top five types of cancer in men and women in Canada and the estimated deaths and new cases of cancer for 2004. Also the direct and indirect costs of cancer in Canada in 1998.
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Estimated deaths
Men
Lung: 10,700
Coloretal: 4,500
Prostate: 4,200
Pancreas: 1,600
Non-Hodgkin's Lymphoma: 1,550
Women
Lung: 8,200
Breast: 5,200
Colorectal: 3,900
Pancreas: 1,700
Ovary: 1,550
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Estimated new cases
Men
Lung: 20,100
Colorectal: 11,900
Prostate: 10,400
Pancreas: 3,700
Non-Hodgkin's Lymphoma: 3,300
Women
Breast: 21,200
Lung: 9,800
Colorectal: 8,800
Body of Uterus: 3,800
Non-Hodgkin's Lymphoma: 2,900
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Costs of cancer in Canada, 1998
Direct
Hospitals: 74%
Physician care: 14%
Drugs: 9%
Additional direct: 3%
Indirect
Mortality: 90%
Long-term disability: 8%
Short-term disability: 2%
SOURCE: NATIONAL CANCER INSTITUTE OF CANADA
André Picard