The way Canada deals with cancer is haphazard, outdated and needs to be overhauled, says a report Tuesday by the Cancer Advocacy Coalition of Canada (CACC).

The report finds that more money needs to be spent on the prevention of cancer, with only six per cent of research funds currently going toward this initiative.
(CBC)

The 10th Report Card on Cancer in Canada finds that cancer care is inconsistent, with disease outcomes hinging on where a patient lives.

"Tell me your postal code and I will tell you your chances of surviving cancer," said Dr. William Hryniuk, past chair of CACC, in a release.

The report focuses on the lack of funding for the prevention of the disease, the need to streamline how clinical trials are run, the need for increased nursing, and better use of technological advances in treating cancer.

'Tell me your postal code and I will tell you your chances of surviving cancer.'—Dr. William Hryniuk

What Canadians pay for cancer has increased across the provinces, the report finds, with Ontario and Quebec residents picking up a greater proportion of drug costs. In Ontario, the cost of cancer drugs borne by the private sector increased to 40 per cent in 2006 from 31 per cent in 2002. And in Quebec, that figure rose to 39 per cent in 2006 from 28 per cent in 2002.

At the same time, provincial coverage of key cancer drugs is spotty, with some provinces covering the medications and others refusing to do so. For example, Ontario funds the lowest number of the 42 cancer drugs studied in the report, while B.C. funds the greatest number.

"Only a minority of these drugs are actually available to cancer patients who need them," Dr. Kong Khoo, an oncologist based in British Columbia, told CBC News on Tuesday. "A major problem is the cost of these drugs."

The authors recommend a national catastrophic drug strategy and drug plan be established, as well as Canada-wide guidelines to speed access to these medications.

"I think we are making progress," says Khoo. But unless we change how we do business and change how we deliver cancer care, we're not going to change the outcomes of the patients who are going to get it."

Research changes required

The report finds that more money needs to be spent on the prevention of cancer, with only six per cent of research funds currently going towards this initiative. Conversely, 16 per cent of funds are allocated for treatment.

It also states that although Canadian cancer research associations are sharply focused on solving clinical problems, there is a further need to ensure that researchers' priorities are aligned with societal needs when it comes to cancer research.

"Given the results of the present survey of research-dollar allocation, and the one undertaken three years ago, it would appear that the factors driving research continue to be predominantly those of the researcher themselves," the authors say.

Specifically with breast cancer research, the authors of the study feel that if more research findings on late-stage cancers were applied to early-stage cancers, the time it takes for new drugs to become available could be shortened, saving thousands of lives.

"At present, it takes a minimum of 10 to 15 years for a new agent to reach the clinic from the laboratory bench, in many cases 15 to 20 years to become fully characterized, because a sequence of at least four, and usually five types of trials are required for each new drug," reads the report.

"With suggested reforms calling for enhanced efficiency, the time period of testing could be reduced from the present 10 to 15 to less than five years."

Young need more resources

The report finds that young people between the ages of 15 and 39 have a disproportionately high death rate due to cancer, which the authors feel needs to be better addressed by the health-care system.

According to the report, 6,500 young adults are diagnosed each year in Canada with some form of cancer. But between 1975 and 1997, cancer patients between 15 and 39 have seen the smallest gains — and in some cases declines — in five-year survival rates.

The authors say this is caused by a lack of research into the behaviour of cancerous tumours in younger people. They believe the problem is compounded by a lack of support for the unique issues experienced by this demographic, such as a lack of peer support and fertility concerns.

"A combination of factors may be conspiring against this patient group to tip the scales against their odds of survival," reads the report. "Inadequate participation in trials, lack of age-specific protocols, a different physiologic milieu, reduced treatment dose intensity, delays in diagnosis, and treatment inappropriate for their particular malignancies may all be operating."

More strategic nursing needed

According to the report, nurses are a great resource for cancer patients, providing them with the support they need. But the authors feel that many nurses are assigned menial tasks, giving them less time to act as caregivers.

They believe that nurses should be utilized to the fullest to help cancer patients navigate the health-care system. They also feel that health-care authorities should allow nurses to perform less administrative work to assist with this heightened role.

"The amount of time lost to clerical and non-nursing duties is similarly disturbing, as it underlines a lack of professional control over the nurses' responsibilities to patients," reads the report. "Health system managers would do well to recall the old adage nurses should nurse and clerks should clerk."

The Cancer Advocacy Coalition of Canada is a non-profit organization that focuses on citizen advocacy.