Six months after British Columbia began sending select cancer patients to the U.S. for radiation therapy, the province is averaging about a dozen patients receiving treatment across the border per week – far fewer than the 50 per week it has contracted.
The opposition BC United, which obtained a government report containing the figures through a freedom of information request, says it shows that the B.C. government is failing to meet its own targets for cancer care. Health Minister Adrian Dix countered that patients have a choice of whether to travel or wait at home, and that the “significant” number choosing to go stateside is still helping to shorten wait times.
“The service that’s been provided for people who have gone to Bellingham has been really good, and the impact has been very positive, not just for the patients who went but for all the other patients as well,” Mr. Dix said in an interview on Tuesday.
“People can be critical of us doing this, if they want, but I saw this as an opportunity to address a need as we dealt with maintenance on our system of [radiation machines], and as we dealt with health human resources issues and increasing demand.”
A Globe and Mail investigation found that some cancer patients wait months to begin treatment, with delays at one stage – in diagnostic imaging or a first consultation with an oncologist, for example – compounding overall wait times and increasing the risk of poorer health outcomes. Past presidents of BC Cancer have blamed system pressures on government bureaucracy and poor long-term planning, while Mr. Dix and other health executives attribute it to B.C.’s growing and aging population, aging machines used for radiation therapy needing to be replaced and a shortage of health care workers that has only been exacerbated by the COVID-19 pandemic.
In 2022, 85 per cent of patients in British Columbia referred to radiation therapy were able to begin treatment within the benchmark of four weeks, making it the second-poorest performing province in a country where the national average is 90 per cent, according to the Canadian Institute for Health Information. Internal BC Cancer data obtained by The Globe in May showed that only 77 per cent were meeting the benchmark then.
In response, the B.C. government announced in May that it would send eligible patients to Bellingham, Wash., to receive radiation therapy at one of two private cancer centres.
Mr. Dix said then that the initiative would first focus on those with breast and prostate cancer, as they are the largest groups receiving radiation therapy and they have waited the longest. Up to 50 patients a week would be sent south beginning May 29, or about 4,800 over the next two years.
In the out-of-country radiation therapy report, dated Nov. 10, a total of 310 patients had started treatment, for an average of 12 patients a week. Of those, 275 had completed their treatment. In all, radiation oncologists have referred 1,310 patients for treatment in the U.S., among them 846 for breast cancer and 464 for prostate cancer.
Mr. Dix said Tuesday that numbers can fluctuate depending on a patient’s course of treatment, and that more recent figures show that 350 people had begun radiation therapy in the U.S., of which 308 had completed their treatment. There are currently 49 B.C. patients at the two U.S. cancer clinics, he said.
The Nov. 10 document showed that of 755 patients who were screened to travel to the U.S. and did not proceed, 249 wanted their treatment in Canada, and 164 refused treatment in the U.S. Some (163) were not clinically suitable, some (53) did not have required travel documents and some (37) had scheduling difficulties. The rest declined for a number of other reasons.
BC United health critic Shirley Bond said the figures show that people don’t want to be away from the comforts of home, or their loved ones, in the face of a cancer diagnosis.
“Many people are actually making a choice to wait for treatment – for months – rather than be treated in the U.S.,” she said in an interview on Tuesday. “They want to be at home. And that is absolutely devastating for families and for people in this province.”
Under the temporary initiative, a BC Cancer support team arranges appointments and co-ordinates all travel plans. Eligible patients have all costs related to treatment covered, including travel, meals and accommodation, for themselves and a support person. The province also covers all costs for medical services, testing and medication related to the radiation treatment.