Cancer care in British Columbia has been buckling under a growing strain that has driven medical specialists to quit, while some terminal patients suffering in great pain are opting for medical assistance in dying amid growing delays in access to life-prolonging treatments.
The agency that delivers the care, BC Cancer, hit a low point in 2023. One in 10 patients needing radiation therapy will wait more than 55 days to begin treatment – well in excess of the benchmark of 28 days.
The pressures on cancer care are growing relentlessly. The number of cancer patients is rising because the province’s population is aging, and also because the population of B.C. has increased. As well, cancer treatment is increasingly complex.
None of these factors should have snuck up on those responsible for funding and delivering care, yet the investments needed to meet the province’s needs have failed to keep pace. The cracks began to show in 2022, when clinicians began to speak out about the declining state of care.
The province has taken a number of steps this year to begin to address the backlog, and there are now some hints of improvement. These actions should have been started a decade ago, and it will take sustained commitment to ensure that the promised changes are delivered.
The provincial government unveiled a 10-year plan for cancer care in February, with an initial investment of $440-million. In May, Health Minister Adrian Dix promised to build four new cancer centres – in Kamloops, Nanaimo, Surrey and Burnaby.
BC Cancer has engaged in an unprecedented hiring spree, assisted in no small part by a significant pay raise this spring for radiation therapists and technologists.
The province also started sending patients to private clinics in Washington State in June for prostate and breast cancer treatment.
As a result, roughly 40 per cent fewer patients are waiting to start radiation therapy compared to the backlog in April.
All these measures – mostly implemented over the past six months – are long overdue.
An investigation by The Globe and Mail last fall chronicled the frustrations of burned-out staff who have quit BC Cancer over their inability to provide timely care. Growing wait times for cancer care means worsening outcomes for patients. Patients waiting for treatment have opted for a medically assisted death rather than live with the pain and uncertainty.
Former leaders of BC Cancer warned management at the Provincial Health Services Authority of an impending crisis as early as 2012. To build new treatment infrastructure, and to train and recruit new specialists, takes years. But they did not get the resources to deal with growing demand, and recruitment challenges only grew as oncologists and other specialists departed the agency.
In the reporting period of April to September of 2022, 85 per cent of cancer patients who needed radiation therapy in B.C. received their care within the recommended four weeks – the second-worst performance in the country. It has deteriorated since. For the same six-month period in 2023, only 72 per cent received treatment within 28 days.
Premier David Eby, speaking to reporters at a health news conference on Dec. 14, agreed that British Columbians have a right to expect better.
“I am not satisfied with where we are on cancer care in the province,” he said.
There is some suggestion that a turnaround is starting, however: From Oct. 13 to Nov. 9, that rate climbed to 75 per cent, according to data provided to the Globe.
To maintain the momentum shown in the past six months, government and health leaders need to be held accountable. The province needs to provide timely updates so that the public can see if wait times are improving. The public also needs to see construction move with haste on the promised new cancer centres. And BC Cancer needs to fill its critical vacancies.
It is worse than ironic that some patients must wait months for cancer treatment, but are able to access medical assistance in dying in as little as two days.
Strong action is needed to reduce treatment wait times, and to restore the faith that has been lost in this system during a very bad year.