Can Our Health System Manage The Cancer Onslaught?

Cancer is a terrible disease. Too many of us know this from first-hand or other close experience.

This year alone, the Canadian Cancer Society says 225,800 cases will be diagnosed in Canada¹. That’s very close to the total number of COVID-19 cases reported in Canada from the start of the pandemic to the end of October 2020².Cancer eventually will strike one in every two Canadians, and lead to the death of one out of every four³.

In doing so, it requires many resources from our health system, including: regular screening of large numbers of Canadians to find cancer earlier; sophisticated scans, surgical biopsies, lab tests and more to make accurate diagnoses; and then treatment using one or more of the four pillars of therapy –  surgery, radiation, chemotherapy and immunotherapy. This latter treatment uses the body’s own immune system to recognize and kill the cancer cells.

The need for these resources will only increase because, despite all the great progress made to diagnose and treat cancer, the number of cases is growing and will continue to do so at least until well into the next decade⁴.

That’s because 90% of cancers are diagnosed in people aged 50 years and older⁵.So as our population ages – Statistics Canada predicts that by 2036 there will be 60% to 75% more Canadians age 65 or older compared to 2017^6,7 – the demands for cancer screening, diagnosis and care will also skyrocket.

On top of this demographic trend, Canada now faces a huge backlog of cancer diagnosis and care that has been delayed due to the pandemic, which itself is stressing the health system to its limits.

Canadian patients already know that the health system isn’t prepared enough to meet the coming cancer onslaught. A 2018 poll conducted for the Canadian Medical Association showed that just half of Canadians have confidence that the health system will be able to meet these growing needs⁸.

Last year, a survey specifically about cancer care conducted by C.A.R.P. (also known as the Canadian Association of Retired Persons showed that more than 90% of respondents said their provincial healthcare system should make new investments to be better prepared to treat cancer and that increasing cancer screening and providing timely treatment should be the healthcare system’s top priority⁹.

“The voice of our members from this survey couldn’t be more clear,” says Bill VanGorder, Chief Policy Officer for C.A.R.P. “We need a societal commitment to ensure our health system is given the resources it needs so every Canadian has the best possible chance of getting high-quality care for cancer, as well as for other conditions.”

There is also unanimity among Canadian provinces and territories that they need more financial resources from the federal government to meet these health challenges. All of Canada’s premiers have asked for increases in the federal Canada Health Transfer so they can access the additional resources needed to fund patient care^10,11.

While the COVID-19 pandemic simply adds to a great need that was already there, some also see a potential silver lining.

“The pandemic and how we are fighting it shows that we as a society do have the power to take on big medical challenges and change the expected outcome,” says Dr. David Stewart, a medical oncologist at The Ottawa Hospital whose primary clinical focus is the treatment of advanced lung cancer. “With COVID-19, we did not accept the idea that tens of thousands of Canadians would die without us doing everything possible to lessen the toll. We can do the same thing with cancer and not accept as inevitable that more than 80,000 Canadians will die of cancer every year. We can do much, much better.”

One of the things that can be done better is improving the time from cancer diagnosis to treatment. The C.A.R.P. survey showed that almost half of cancer treatments or surgery were started more than one month following the cancer diagnosis, with almost one in five not occurring until two months or more following diagnosis.

“That’s an agonizingly long time for patients to wait, knowing every day means your cancer might be spreading and diminishing your chances of treatment success,” added Bill VanGorder. “The best thing a person receiving a cancer diagnosis can be given is hope. But they can only have hope if they believe the health system is prepared and willing to give them their best shot at survival and overcoming the disease.”

Many people are working to ensure that happens.

SOME ADDITIONAL RESOURCES

_{¹ Canadian Cancer Society, Cancer Statistics at a Glance, Incidence and Mortality, https://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=qc}

_{² Government of Canada, Coronavirus disease 2019 (COVID-19): Epidemiology update, 240,263 cases of COVID-19 as of Nov. 2, 2020, 7 pm, https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html}

_{³ Canadian Cancer Society, Cancer Statistics at a Glance, Chances (probability) of developing or dying from cancer, https://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=qc}

_{⁴ Canadian Cancer Society, Canadian Cancer Statistics 2019, Chapter 1, How many people get cancer in Canada? What do these statistics mean?, p. 22: https://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2019-EN.pdf?la=en}

_{⁵ Canadian Cancer Society, Canadian Cancer Statistics 2019, Chapter 1, How many people get cancer in Canada? Key Findings, p. 10: https://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2019-EN.pdf?la=en}

_{⁶ Statistics Canada, Population projections for Canada, Highlights: http://www.statcan.gc.ca/pub/91-520-x/2010001/aftertoc-aprestdm1-eng.htm}

_{⁷ Statistics Canada, Population by sex and age group, 2017: http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/demo10a-eng.htm}

_{⁸ Ipsos Canada, July 17, 2018, https://www.ipsos.com/en-ca/news-polls/Canadian-Medical-Association-Seniors-July-17-2018}

_{⁹ Canadian Cancer Survivor Network and C.A.R.P. press release, Consider needs of one in two Canadians who will get cancer, survivors urge MPs and candidates headed to campaign trail this fall, June 11, 2019: https://hriportal.ca/canadian-cancer-survivor-network-consider-needs-of-one-in-two-canadians-who-will-get-cancer-survivors-urge-mps-candidates-headed-to-campaign/}

_{¹⁰ Premiers’ website, October 30, 2020: https://www.canadaspremiers.ca/health-care-costs-are-on-the-rise-in-canada-and-covid-19-is-a-new-cost-driver/} 

_{¹¹ CMA’s website, Senior Care: https://www.cma.ca/seniors-care}

No content of this article is intended as medical advice. If you have questions about your health, consult a healthcare professional.

Developed by C.A.R.P./Zoomer with financial support from Merck Canada Inc.