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Tuesday, February 27, 2024

Sask. breast cancer patient still waiting for surgeon consultation 5 months after finding lump

A mother of two from Weyburn, Sask., has known since early December that she has breast cancer. But by the time she sees a surgeon for a consultation, it will have been two and a half months since she got the diagnosis and more than five months since she first found a lump.

Lisa Vick, 48, is one of many women in the province facing bottlenecks in the health-care system due to a shortage of radiologists and surgeons with breast specializations. Vick cannot discuss a treatment plan for her cancer until a surgeon consultation has been completed.

Vick said she has good support from her family, but long wait times and scarce communication have taken a toll on her mental health.

“I’m usually very healthy, but the mental anguish of just not knowing … I got very sick and I had several trips to the emergency room to get treated,” said Vick.

Vick found a lump in her right breast in September 2023. She tried to book an appointment with her family doctor, but it would have been a month-long wait, so she saw a different doctor who put in a referral for a mammogram and ultrasound. She then had to wait two months for those procedures.

Vick said she has felt the lump grow since she first detected it in September.

“It’s starting to cause me some discomfort and [impede] on my movement. Just knowing that it’s there…” Vick paused, touching her hand to her chest.

Three surgeons wearing scrubs are pictured looking down at a patient in an operating room.
Saskatchewan’s Ministry of Health tells CBC it’s working with the SHA to provide additional supports to Regina doctors who provide breast cancer surgeries so they can meet surgical timelines. (lenetstan/Shutterstock)

It’s been a little over two months since the province announced it would send patients to a clinic in Calgary to tackle breast cancer testing backlogs. After Vick was officially diagnosed with breast cancer on Dec. 4, a doctor deemed her case urgent and referred her to Calgary for a breast biopsy.

The procedure would determine exactly what kind of breast cancer she has. She travelled to the clinic on Jan. 10 and received the pathology results on her MySaskHealthRecord a week later, but said the results have not been clearly explained to her. All she knows is she has invasive and in-situ ductal carcinoma. Now she is waiting for her surgeon consultation, scheduled for Feb. 20.

WATCH | Sask. breast cancer patient still waiting for surgeon consultation 5 months after finding lump: 

Sask. breast cancer patient still waiting for surgeon consultation 5 months after finding lump

Lisa Vick, 48, is one of many women in Saskatchewan facing bottlenecks in the health-care system due to a shortage of radiologists and surgeons with breast specializations.

Dr. Adam Ogielglo, a family physician in Saskatoon, said Vick’s long wait for a consultation with a surgeon is concerning.

“This patient felt their breast lump in September and here we are in February, five months later, and we still haven’t done anything for the patient in terms of treatment,” said Ogieglo.

“All that leads to more advanced cases, more difficult recovery times, more challenging prognosis for patient [and] more costs to the health-care system in dealing with more advanced cancers.”

There’s a lot of unknowns, but just the communication of someone saying, ‘hey, we’re working on this, we understand that there’s an issue,’ is a huge help.– Lisa Vick, Weyburn

Vick said this weighs heavy on her mind. She thinks of the many other women who are a part of the same online breast cancer advocacy groups.

“How many women are going from a curable cancer to an incurable, metastatic cancer? They’ve been waiting for treatment, and now their treatment options are fewer. They have to fight it way more aggressively, and their lives are at risk. All because [of] the waiting, the waiting, the waiting.”

Self-advocacy

Vick said she understands the province is dealing with bottlenecks in the health-care system and has accepted that wait times are the reality. But she said communication about what is happening has been lacking, not only from overworked doctors, but from the province as well.

“I’ve had to advocate for myself. I would still be sitting at home wondering when the phone is going to ring and if it’s going to be oncology, if it’s going to be a surgeon, if it’s going to be my [general practitioner] asking me to come back in and go over some results,” Vick said.

She decided to take things into her own hands and reach out to various centres and doctors along the way to confirm that her various referrals had been received.

“There’s a lot of unknowns, but just the communication of someone saying, ‘hey, we’re working on this, we understand that there’s an issue,’ is a huge help.”

A man in a grey suit stand in front of flags in an office.
Saskatchewan Health Minister Everett Hindley says Lisa Vick’s long wait for a consultation with a surgeon is unacceptable. He says work is being done to recruit more surgeons that specialize in breast surgeries in Regina, but admits the ministry could do a better job of communicating its progress with the public. (Laura Sciarpelletti/CBC)

Vick said she feels comfortable advocating for herself and digging around for answers, but knows many women in her situation may not. She said she wants to see the government step up and release regular reports on how it’s progressing with diagnostic and upcoming surgical backlogs.

“I want to know that they’re hiring more radiologists and breast specific surgeons to help alleviate these bottlenecks that we are seeing in this province.”

Health Minister Everett Hindley sat down with CBC last week to discuss the status of the bottlenecks, as well as Vick’s experience. He said her wait time for a surgeon consultation is unacceptable, and echoed Dr. Ogieglo’s concerns.

“It isn’t an acceptable period of time because every day, every week that passes when it comes to a cancer diagnosis impacts the chances of being able to treat it properly and successfully,” Hindley said.

“If at any point along that pathway there is a bottleneck or there is a gap that impacts the patient and their chances of being able to successfully be treated, that it isn’t acceptable.”

If at any point along that pathway there is a bottleneck or there is a gap that impacts the patient and theirchances of being able to successfully be treated, that it isn’t acceptable.– Minister of Health Everett Hindley

Hindley said the province is focused on shortening the wait times as much as possible. The Saskatchewan Health Authority (SHA) told CBC in a statement that it began calling patients on Nov. 30 to receive breast biopsy and diagnostic mammography care in Calgary. As of Feb. 2, a total of 172 patients had been referred to the private health company Clearpoint. Of those, approximately 108 patients already had their diagnostic procedures completed there, SHA said.

Health minister says province should improve communication

Hindley said the province is making progress in its search for breast-specialized radiologists and surgeons, but admitted it could and should do a better job at communicating updates with the public.

“We need to make sure that, number 1, we’re getting patients the diagnosis and the treatment as quickly as possible,” he said.

“But as part of helping them move through that system, we need to make sure that we’re doing our best job that we can to provide that communication so that patients know what the next steps are and so [we] reassure them that they are going to get taken care of.”

A health care profesional looks at images taken during a breast biopsy.
According to the SHA, Regina has only one full-time radiologist who specializes in breast diagnostics. Meanwhile, it has four full-time radiologists and one locum radiologist who collaborate in providing this service in Saskatoon. (Dr. Brian Goldman)

Hindley’s office told CBC that the SHA is currently in the process of staffing a nurse navigator in Regina whose role is to guide breast cancer patients through the diagnostic and treatment pathways.

According to the SHA, Regina currently has only one full-time radiologist who specializes in breast diagnostics. Meanwhile, it currently has four full-time radiologists and one locum radiologist who collaborate in providing this service in Saskatoon.

Throughout 2023 and 2024, eight surgeons have performed breast surgery in Saskatoon, according to the SHA. There are only four surgeons in Regina who do these procedures. However, one is going on maternity leave, and another does not take breast cancer patients as frequently as the remaining two.

When asked if the province will have to consider sending breast cancer patients out-of-province for surgeries, Hindley said that’s not an option the province wants to consider.

Now that patients are going to Calgary, the Ministry of Health told CBC it has a plan for how to treat the likely influx of newly diagnosed breast cancer patients. It said it’s working with the SHA to provide additional supports to Regina doctors who provide breast cancer surgeries so they can meet surgical timelines.

An interior shot of the new emergency ward at Saskatoon's Royal University Hospital from Sept. 5, 2019, show the Saskatchewan Health Authority logo.
The SHA tells CBC that as of Feb. 2, a total of 172 patients have been referred to the private health company Clearpoint in Calgary. Of those, approximately 108 have had their breast diagnostic procedures completed there. (Trevor Bothorel/CBC)

New technology in the works

In a statement to CBC on Friday, the Ministry of Health said the Saskatchewan government is investing in more lab resources and technology. This is meant to improve lab turnaround times for biopsy results in the province’s major lab centres in Regina and Saskatoon.

“For example, Saskatchewan has begun trialling a new technology that streamlines and supports a more patient friendly breast tumour localization.”

Traditionally, a radiologist inserts a wire into the breast tissue to pinpoint the tumour for the surgeons prior to surgery.

“This was often uncomfortable for patients and required the radiology and surgery to be scheduled on the same day. With this new technology, a ‘seed’ is implanted by the radiologist up to 30 days prior to the procedure, allowing the patient and surgeon to better co-ordinate their surgical date,” said the ministry.

It said additional surgeons in Regina and in regional sites will and are being trained to perform these ‘seed’ procedures. General surgeons in Moose Jaw will be part of the pooled referrals for breast surgeries for Regina and area.

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