The British Columbia government is adding $440-million in funding to the province’s cancer agency over the next three years to address an increasing need for services and a shortage of staff, which have led to a slide in the quality of care.
At the Vancouver headquarters of BC Cancer on Friday, Premier David Eby and Health Minister Adrian Dix acknowledged this additional money is a result of “warning signs” that the agency is not meeting key benchmarks for average days a person must wait to first see an oncologist, to start chemotherapy or to begin radiation treatment.
Pressures on the system, the politicians added, will increase as B.C.’s population grows and ages over the next decade – with the more than 30,000 people now being given a cancer diagnosis each year expected to increase by 10,000 patients over this period. The government estimates one in two British Columbians will be diagnosed with the disease in their lifetime.
“It is unacceptable to be in a situation in our province where someone is waiting for screening or waiting for treatment to the point that it’s compromising their cancer care,” Premier Eby said when asked about internal wait-time averages recently obtained by The Globe and Mail.
The new funding will come in the form of a one-time $170-million grant from this year’s $5.7-billion provincial surplus and then adding $90-million for each of the next three years to the cancer agency’s budget of nearly a billion dollars. Some of this money will go toward a push to hire more oncologists, whom the premier said Friday are being given a $62,000 raise to be paid $472,000 per year – a salary higher than their counterparts in any province.
The new funding will also extend hours into the weekend for some treatment centres and help more patients living in smaller towns across the province travel to the agency’s regional hubs for care.
In November, a Globe investigation found growing wait times for cancer care in the province are worsening outcomes for patients and leaving some to die before their first medical consultations. Meanwhile, BC Cancer physicians, working to compensate for systemic pressures, are self-reporting the highest levels of stress, burnout and disengagement among oncologists across Canada.
The Globe investigation found that some cancer patients in B.C. are now waiting months to begin treatment. As of last fall, only one in five patients referred to an oncologist received a first consultation within the recommended period of two weeks, The Globe found. In comparison, about 75 per cent of patients in Ontario are seen within two weeks.
By early January, mean wait times had increased for these crucial first appointments to around 43 days from 30 in April, 2021, according to BC Cancer data provided to The Globe.
On Friday, Mr. Dix repeatedly refused to answer questions about how long the average cancer patient was waiting for care and treatment, saying his ministry will make this information public on a monthly basis.
Kim Nguyen Chi, a medical oncologist who was named chief medical officer at BC Cancer and vice-president of the Provincial Health Services Authority in 2019, said three core benchmarks must be hit: that 90 per cent of patients seeing an oncologist do so within four weeks of a referral, the same percentage get chemotherapy within two weeks of being ready and the same percentage also receive radiation within a month of being prepared.
“These are achievable goals,” said Dr. Chi, an internationally recognized prostate cancer researcher who began his career at BC Cancer in the late 1990s.
He acknowledged that new recruits won’t join overnight, but could not provide a timeline for when the agency should begin hitting this trio of benchmarks.
Since the beginning of 2020, 18 medical and radiation oncologists had left BC Cancer. Some told The Globe they did so because they felt they could no longer provide an appropriate level of care. Other doctors said patients with terminal diagnoses are turning to medical assistance in dying, or MAID, when their pain and anxiety grow unbearable.
The organization once was, in the late 1990s and early 2000s, established as a leader in global cancer control. It had made significant investments in recruiting and had spent heavily on emerging fields of expertise, such as genome sciences, functional imaging and molecular pathology.
A change in governance structure in 2001 shifted BC Cancer’s priority from excellence in cancer control to fiscal management, leading to the growing waiting times and staff burnout now plaguing the system, according to four former heads of the agency.
Mr. Eby said Friday that funding for this important cancer research is being restored so patients can get more access to specialized treatments, including increased clinical trials that study treatment approaches requiring fewer visits to hospital. As well, he said, genomic testing will be enhanced to deliver more tailored treatment to every single patient.
Lisa Danyluk, whose mother, Geneva Reynen, had her surgery cancelled in December while facing Stage 3 ovarian cancer, welcomed the investments.
“Any little bit is better than nothing,” Ms. Danyluk said. “But I think they so far behind, that it’s going to take a while to get where we need to be as a province.”
Gynecologic cancer cases have been particularly affected by the backlog at BC Cancer, and Ms. Reynen’s surgery to remove a tumour and tissue was cancelled just minutes before it was set to begin. Ms. Danyluk said she can understand how burned out health care workers in the cancer system feel: “The oncologist surgeon was as devastated, I think, as our family was.”
After The Globe had profiled her experience in December, Ms. Reynen received chemotherapy and is now doing “really, really well,” her daughter said