By: Olivia Visser, Copy Editor
Content warning: discussions of cancer, death, and medical assistance in dying.
As of 2019, cancer is the second-leading cause of death worldwide, and the diagnosis rate in people under 50 has increased by 80% over the last three decades. In Canada, cancer is the leading cause of death, with two in five Canadians being diagnosed and one in four dying from the disease. Improving cancer care, which involves prevention, early detection, and treatment, is of utmost urgency. February 4 was World Cancer Day, and while many people’s first encounter with cancer is their own or a loved one’s diagnosis — cancer care begins with awareness, which goes beyond just knowing what cancer is. It’s also not intended to scare or fear-monger. Knowing what to do if you or a loved one receives a diagnosis is important, as is knowing how to mitigate your risks. Given cancer’s prevalence within our increasingly strained healthcare system, one thing is clear: cancer care must be revolutionized.
The deadliest types of cancer typically receive the lowest amount of funding. Research has found that cancer funding is skewed toward cancers such as breast cancer and leukemia, which have high incidence rates and low mortality rates compared to other common cancers. This may be due in part to the utilitarian idea that funding curable cancers is more productive than trying to cure terminal cancers. Yet, considering that many terminal cancers have poor prognoses because they are detected too late, the lack of funding feels degrading and inhumane. Don’t misinterpret the pleas for increased funding as pleas to reduce resources for other cancers, either. All cancers deserve quality treatment. However, brain cancer, for instance, receives less than 3% of total cancer funding. Glioblastoma is the most common type of brain cancer, accounting for just over 50% of primary brain cancers — meaning cancers that originate in the brain. The median survival time for this type of cancer is 14 months, and the incidence rate in Canada is four in 100,000 people. Of these people, only 6.9% will survive five years past their diagnosis date.
One of the major issues with cancer treatment is that each type of cancer is unique and requires its own standard of care. It’s why experts often correct people who speak about finding a “cure for cancer,” as if one singular cure would suffice.
Aggressive cancers, with their lower funding levels, have standards of care that are far from adequate. The standard of care for most cancers typically involves surgery followed by a combination of radiation and chemotherapy, which aims to slow or stop cell division by killing tumour cells. For glioblastoma, treatment may slow tumour growth for a brief period, but advocates have pointed out that this type of cancer requires a different standard of care that is yet to be implemented. A brain cancer vaccine that uses a patient’s unique cells to attack the disease has shown promising results in preliminary studies. However, without enough funding, it could be a very long time before this technology reaches the public.
Among other cancers, pancreatic cancer is also starkly underfunded. The five-year net survival rate for this type of cancer is around 5–10%. One of the main reasons pancreatic cancer is so deadly is that it usually doesn’t produce symptoms until it reaches an advanced stage. However, experts believe it’s potentially curable if caught early. There is currently no standard early screening test for pancreatic cancer, but that doesn’t mean there never will be. Increased cancer funding is imminently needed for aggressive tumours, and this involves both treatment and early detection.
Spending more resources on early detection would drastically reduce cancer death rates and improve survival times. About 50% of cancers are already advanced when diagnosed, which contributes to high mortality rates. Breast, prostate, and cervical cancers are often diagnosed early due to regular screening protocols, but many other cancers don’t receive the same level of proactive care. Researchers are working hard to reduce cancer deaths and provide better outlooks for patients. For example, a new blood test is in the works to detect brain cancer early on. If effective, this would be groundbreaking for detecting brain cancers before they advance to later stages.
One action any individual can take is emailing their local MP to push for increased funding for these deadly cancers. Additionally, if you have a family history of cancer it’s crucial to speak with a doctor about risks and potential genetic testing, as well as early screening services. Mammograms are recommended for any person with breasts over the age of 50, but can be done for people 30 and younger who are at a higher risk of developing breast cancer. The same is true for prostate exams. Pap smears should also be performed every three years for people with vaginas between ages 21–29 who are sexually active. For trans folks who may be uncomfortable seeking out care from their regular physicians, Trans Care BC is an organization with access to trans-affirming sexual health resources.
Coupled with healthcare system strain from the ongoing COVID-19 pandemic, cancer care in Canada is on a downward spiral. In BC, wait times to see an oncologist are significantly higher than the rest of the country. Many patients have been reporting disease progression after having to wait months to see an oncologist. Some have opted for Medical Assistance In Dying because of treatment delays. One woman told CTV News she was given a ten-month wait to receive chemotherapy after being diagnosed with stage four adrenal cancer, which spread during that time. The Canadian government has also been paying to send hundreds of people with aggressive cancers to the US for treatment, as our healthcare system cannot keep up with the number of patients requiring immediate intervention.
The state of cancer care in Canada is devastating for everyone, but marginalized and low income folks receive the short end of the stick. Most working class people cannot afford or crowdfund enough money to travel abroad for better care, and the Canadian government doesn’t cover experimental treatments. A recent Canadian Cancer Society survey also found that the monthly costs for cancer patients are around $300 a month. This is on top of bills and necessities, and can increase significantly depending on the type and severity of cancer.
On an individual level, we should do what we can to mitigate risk. This involves attending regular cancer screenings and reducing our exposure to notable cancer-causing agents, known as carcinogens. The American Cancer Society has a list of “Known and Probable Human Carcinogens,” which is worth having a look at. It’s also important to note that fear shouldn’t be your motivator when it comes to preventative care. Carcinogens usually only pose a major risk to people with high levels of regular exposure or who possess genetic predispositions, but avoiding them to a reasonable degree is a worthwhile effort. Additionally, if something about your health feels wrong and you aren’t being taken seriously by medical professionals — demand a second opinion. Cancer can be preventable and even curable, and self-advocacy is a huge mitigator.
BC Premier David Eby recently acknowledged that the current cancer wait times are “unacceptable,” and vowed to change the system. However, it’s not enough for us to say something needs to change. It’s not even enough to increase the number of oncologists in the province. Cancer cases are rising significantly due to a multitude of factors such as inadequate diets, excessive alcohol and tobacco use, physical inactivity, and environmental toxins. These factors are amplified for marginalized and low income people who cannot afford quality foods, and may work jobs that expose them to carcinogens. Cancer is a systemic issue, and it’s deeply intersectional. One of the biggest ways this country must improve health equity is by vastly increasing funding and support for what is now the leading cause of death — but it doesn’t have to be.
If you or a family member have recently been diagnosed with cancer, BC Cancer offers support such as free counselling, information about financial resources, and more. A list of local MPs and their contact information can be found at www.ourcommons.ca/Members/en/search?province=BC.
