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andre picard

The wait times for diagnosis and treatment of thyroid cancer in Canada are among the longest in the Western world, according to a new study.

The data, presented Monday at the International Thyroid Conference in Paris, found that waits of up to a year are not at all unusual.

Almost half of Canadian patients wait more than a month to see a specialist for a diagnosis when a family doctor suspects thyroid cancer, and for one in five patients, the wait stretches out as long as 40 weeks. Then, once a diagnosis is made, the wait can be even longer, with additional delays of up to nine months in some cities.

"The journey to thyroid cancer surgery can be likened to a game of Snakes and Ladders," said Rita Banach, president of Thyroid Cancer Canada. By that, she means that patients advance slowly toward care then slide back to the bottom of another queue and start waiting anew.

She said as bad as the situation is now, it risks getting worse. That is because thyroid cancer is the fastest-growing form of cancer in the world.

An estimated 5,200 Canadians were diagnosed with thyroid cancer in 2009, according to the Canadian Cancer Society. Four in every five cases occurred in women. But the mortality rate is extremely low; the disease claimed about 80 people last year.

"The doctors keep telling me that thyroid cancer is the best cancer to have," said Lorrel-Lee McCurdy of Kenora, Ont. "But it's still cancer, you know."

Ms. McCurdy first noticed a problem in May of 2007, when she had trouble swallowing. She went to the emergency room but was told it was nothing serious and to visit her family doctor.

It took three weeks for an appointment, during which the side of her neck swelled noticeably and she had increasing difficulty swallowing. Ms. McCurdy's family doctor referred her to a head-and-neck specialist, but it took three months for an appointment and she had to travel to Winnipeg.

That visit, she said, lasted five minutes and Ms. McCurdy was again told the problem was not serious, just a benign growth. When she returned three months later, the growth was worse so she was referred for surgery. The surgery was done a month later, bringing her total wait for treatment to eight months.

Only after her thyroid was removed did a test of the tissue show that she had thyroid cancer.

"The waits were horrendous," Ms. McCurdy said. "My health didn't get any better during that time. I could have lost my voice box."

In fact, the new data showed that post-surgery complications are commonplace. They include 36 per cent of patients experiencing voice problems and 38 per cent with low blood calcium.

One of the worst parts of the ordeal though is preparation for surgery, during which most patients undergo radioactive iodine treatment. More than 80 per cent of those receiving RAI treatment had side effects.

Ms. Banach said she was shocked by the high rate of complications and by the inconsistency of treatment around the country. "Canada's care of thyroid cancer patients fails on many counts and we have so few people paying attention to that," she said.

The glimmer of good news in the findings is that when Canadians do have surgery, it tends to be successful. In many countries, repeat surgeries are commonplace. The survey also showed that Canadian thyroid cancer patients were the most likely in the world to pay for their prescription drugs. The medication reduces the side effects of cancer treatment.

The data were compiled from a survey of 2,398 thyroid cancer patients in 40 countries, including 274 in Canada.

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