Thursday, November 1, 2018

My Fight Song and Why This Bell Matters

For all of October I was in Edmonton receiving radiation treatment. On Monday, I had my last treatment, lucky number 19. After 18 treatments with the same radiation therapists in the same room on the same machine, I was put in a different room with different therapists, because my room was running behind. In the grand scheme of things not a big deal, so even I'm surprised at how much this threw me off my game, how anxious and upset this made me. Maybe it’s because the radiation therapists I had for 18 of my treatments were the first clinicians in 8 months of care that made me feel like a person…..

Throughout my treatment in Grande Prairie, I was scheduled to see my medical oncologist once. I’ll repeat that – ONCE. And only after I had healed from my initial surgery performed by a general surgeon. The surgeon successfully removed my entire tumor and obtained great margins. Essentially I’ve been “cancer free” ever since. But, here’s the rub: I had to decide what course of treatment was best for myself without talking to any cancer specialist, without having much in the way of knowledge as to the best course of action, without completing tests that may have determined which treatment was more effective. I was scheduled to see my radiation oncologist twice. However the first time I met his resident only, who misspoke on the number of treatments I would receive, but otherwise tried his best to answer my questions. I met my radiation oncologist once, on my last day of treatment, when he didn’t have the time or inclination to answer much.

Had I lived in a major urban centre, say Red Deer, Edmonton, or Calgary, I would have had access to the Comprehensive Breast Care Program. This is a fantastic program that assigns a person a navigator to help walk them through all the steps of cancer care, to ensure that the patient is aware of all of their options, has all the information to make an informed decision, and has someone in their corner throughout treatment.

I was assigned a Cancer Navigator at the Grande Prairie Cancer Clinic once I was healed from surgery. He gave me my appointment date with my medical oncologist and taught my initial chemotherapy class (like an orientation class). In the class we were given a list of things that might happen while receiving chemo, a list of reasons to call your navigator immediately, and made to feel all happy, happy cause someone was there to support you, that you have a whole team to behind you! The reality though was that when I called, my calls would be unanswered, or I would leave a message which would not be returned until leaving days of messages, only to be told to contact the nearest Emergency Room or Walk-In Clinic. Every time I had a pre-infusion or infusion appointment, I was assigned a different RN. The reality of my treatment is that I was on my own, even when mistakes where made (and mistakes were made which were later reported). There was no “team” to help me through, despite being assigned one on paper. And there were times when I needed help.

Initially I called the Comprehensive Breast Care Program centre for assistance, but they refused because I was not in their region.

And here is where I get to the point…..

Postal Code.

The cancer care received by those in urban centres is phenomenal. Patients from urban centres are made to feel like people, like they matter, and they have a team that actually cares, a team that checks up on them and makes sure that they are ok, that listens to their concerns and talks them through.

The cancer care received by those in rural areas (for the purpose of this story, consider anywhere cancer treatment is given outside of Red Deer, Edmonton and Calgary), the treatment is very different. It can be downright scary. I wish I was just talking about myself and the care I received, but from the number of rural Albertans I’ve met going through cancer treatment, I know now that my story is not completely unique.

I have been appalled to hear of the young mom who went nearly two years of being misdiagnosed until finally getting frustrated enough to schedule and pay for her own MRI which diagnosed her with stage 3 breast cancer. Of the woman who spent hours in the ER after a chemo infusion made her so sick she lost 17lbs in two days only to not be seen by a doctor at all. Of the person who felt something was wrong in July, received a CT scan in August and assumed no news was good news only to find out 6 months later that that same scan led to a lymphoma diagnosis. Of the people who never met their oncologist at all. Of the lady who had to threaten to not leave the hospital unless some kind of post-treatment follow-up was arranged. Of the person who was thrilled with their care only because they don’t know what they don’t know.... Of every other person out there who has felt like only a mere cog on a conveyor belt getting treatment, and who has fell through the cracks…..

I am writing in case one person may hear and realize that they have to fight and research and kick and scream, and be their own advocate.

After my discouraging meeting with my radiation oncologist, I went to a meeting… a few weeks back I had attended seminar and met a doctor who put me in touch with someone from the Cancer Strategic Clinical Network (C-SCN). The C-SCN brings together stakeholders from across the province from prevention programs, health care delivery services, research institutes, and policy development groups to lead and support evidence-based improvements and bring innovation in cancer prevention and management in Alberta, to empower clinicians to provide care that is patient-focused, accessible, and sustainable.

I have been invited to be a Patient Advisor volunteer. The timing may not be great, while I still struggle with some side effects from chemo, and definitely from radiation side effects. But, I am more than pink and I have a voice, even if it may sometimes take me slightly longer to form a thought and turn it into a sentence (who knew that chemo could affect cognitive ability?), and I intend to use that voice.


There must be reasonable access to consistent care for all who need it.The type of care a patient receives should not depend on where in Alberta they are from!

The meeting I had on Monday was regarding mainstreaming genetic testing for those diagnosed with breast and ovarian cancer. Had I had access to genetic testing when I was first diagnosed, the results may have changed my entire treatment plan. Instead, I now wait for genetic results from a private company from the States and when I receive the results I will have to make a decision as to whether I need or want further treatment.

The comments made at Monday’s focus group will have a direct impact on how genetic testing is done in Alberta, with changes made by quarter one of 2019. The changes won’t fix everything, not even close - there’s tons more that need improvement. One small, tiny, minuscule step for mankind, but one made in the right direction. If I can help constitute change by sitting at a table and telling my story and giving a suggestion on how I would have felt better treated, I’ll be on that panel every . single . time. And maybe one day it actually won’t matter if you’re from Edmonton or Grande Prairie, or Hinton, or Peace River, etc.

After my last radiation treatment, after my radiation oncologist left me disappointed, scared and with questions, he shook my hand, said my treatment is done, and told me to ring the bell in the halls of Cancer Institute, and once again I refused. Because I am not done. I’m still healing physically and mentally, and hell, I still may need more surgery.

But I did ring the bell at Sorrentino’s Compassion House, while in the company of new friends. A bell that states simply: “The Bell of Hope and Compassion” because I have more compassion now than I ever have, and because I do have hope that I will never have to grace the halls of the Cross Cancer Institute for treatment again, that my cancer will not return, and I have hope that the system will improve for those who come after me.


To those who have feedback regarding healthcare services or other support services you or a family member has received in Alberta, click the following link for more information: https://www.albertahealthservices.ca/about/patientfeedback.aspx