Concerns over possible late diagnosis

One N.W.T. woman, convinced she had been diagnosed with lung cancer too late, before she died asked a lawyer to sue the territorial government on her behalf.

Woman dying of lung cancer asked lawyer to sue government on her behalf

Addy Tobac was diagnosed with lung cancer in May 2010 after zig-zagging across the territory for months, trying to find out why she was feeling so sick. She died in July 2010. (CBC)

It's a disease where timing is everything. 

Being diagnosed too late makes fighting cancer far more difficult. 

Just getting to see the doctor can be a huge hurdle for people who live in a remote community. This is the story of one woman who died, convinced she had been diagnosed with lung cancer too late.

Strong Dene woman

Addy Tobac grew up in Fort Good Hope, N.W.T. She was articulate, educated with a degree in sociology from the University of Calgary and was well-known in the Dene community. She reportedly led a healthy life and was very involved in the community.

In December 2009, she went home sick from the community’s medical centre, where she worked. Within a few weeks, she was so sick that she felt she wouldn’t be able to ever go back to work. Her primary complaint was that it felt like something had settled in her chest and it was impacting her voice.

By May 2010, she was diagnosed with lung cancer. She died in July 2010.

"Boy, that was devastating," said John Louison, Tobac's brother. "And it's not an easy thing to talk about, after that too. When you're very close to your siblings, it's hard."

Medical visits in Fort Good Hope, Inuvik, Yellowknife

Her lawyer, Garth Wallbridge, said she asked to see a doctor in Fort Good Hope repeatedly. A doctor came and went, and Tobac somehow got missed. She put in a second request to see a doctor, and that also somehow got missed when the next doctor came and went.

Tobac paid out of her own pocket to fly to Inuvik, N.W.T., to see a doctor because she was becoming increasingly frustrated by what she perceived to be an unwillingness to either pay attention or believe her.

"One day in Inuvik she was told she had tuberculosis. The next day in Inuvik the same doctor said she had pneumonia," said Wallbridge.

Tobac's lawyer, Garth Wallbridge, said it seemed like she was getting diagnosed with one thing one week, then another the next. (CBC)

Tobac then continued to fly back and forth between Inuvik, Yellowknife and Fort Good Hope until she was diagnosed in May.

Lung cancer difficult to diagnose

The N.W.T. Health Department won’t speak to specific cases such as this one, but it did provide some statistics.

It said 45 per cent of cancers are caught early, but 20 per cent are caught at stage 4.

The number of new cancers and cancer deaths in the N.W.T. has doubled since 1992. That figure must be taken into account with the aging population; the number of people over the age of 60 has doubled during that time.

In particular, lung cancer can be difficult to diagnose, and 42 per cent of lung cancer diagnoses are made at a late stage. Of all cancers in the N.W.T., lung cancer has the highest rate of late diagnoses.

Wallbridge said Addy went to see him weeks before she died.

"She said to me, ‘Garth, I want to sue the Government of the Northwest Territories’ Department of Health – she made that very clear to me," said Wallbridge.

Tobac claims she was misdiagnosed and ignored repeatedly during the months leading up to her diagnosis.

She gave Wallbridge detailed notes she had taken to document her experience.

The territory’s health minister, Tom Beaulieu, said worries over late diagnoses in communities aren’t lost on him.

"It seems to be a common concern right across the territory. We're looking at medical practices now at the community level, regional level. We think a lot of it is a personal responsibility as well.  How far are they prepared to go to identify what their health issue is?" said Beaulieu.

Tough personality

Tobac had a reputation for being pushy. Her brother said she could be stubborn — refusing at one point to take antibiotics she'd been prescribed.  He said that tough personality could make people less inclined to deal with her.

"She believes that people at the nursing station felt she just wasn't sick enough or was too much trouble," said Louison. 

Wallbridge told her even if a case went forward, there was no guarantee of any money. He said Tobac told him it wasn’t about money.

"She wanted to make people accountable. And this gets back to her being a strong advocate for herself - she said, ‘if myself as a pushy woman who is strong-willed and I'm well educated — if I've been treated this poorly, how many other aboriginal people and how many other people are being poorly treated?" said Wallbridge.

Wallbridge has passed Tobac’s file on to a litigator who specializes in cases like these. They are looking at it to decide if there is enough information to go forward.