Patients in western Newfoundland are not receiving the same end of life care as those on the east coast, says a palliative care physician with Western Health.
Désirée Dunn says it is a common occurrence to have patients with incurable cancers decline the option of travelling to St. John’s to receive radiation therapy. They are either physically not up to the cross-province trek, do not want to or cannot financially cover the corresponding costs, or do not want to leave their family and support systems, she said.
Dunn estimates about 95 per cent of her patients are cancer related. The treatment and care she delivers is not just end of life, but begins when the patient learns their disease becomes metastatic or incurable.
“I am helping people live more comfortably, and also live longer with their cancers,” she said.
However, her ability to do so is hampered significantly without a radiation unit to avail of.
The plans for a new hospital in Corner Brook currently does not include such a centre. That decision has received significant criticism in western Newfoundland. People are arguing statistics being used as to why not by Health Minister Susan Sullivan — who has backtracked to say a radiation unit could later become part of the facility — are skewed.
Information obtained from Eastern Health shows that, in 2012, 172 newly diagnosed people from the region serviced by Western Health underwent radiation at the Health Sciences Centre in St. John’s. Another 270 were from Central Health, 59 from Labrador-Grenfell Health and 714 from Eastern Health.
Of the total number of patients to receive treatment in 2012, taking in some previously diagnosed patients who had at least one treatment in that year, 204 were from Western, 302 from Central, 67 from Labrador-Grenfell and 917 from Eastern.
Sullivan said those numbers do not justify putting a radiation unit in this part of the province.
“What is missing is the amount of radiation treatment that could be done that isn’t getting done,” Dunn said.
There are a lot of people who would avail of radiation therapy who choose not to, according to the doctor, and many of them are her patients. She does not have an exact number, but said there would often be multiple cases per week.
It is difficult for her to see people slowly dying, perhaps suffering more than they should, knowing there are services that could improve their quality of life.
“Radiation plays a huge part in helping to manage symptoms, and in helping to prolong life in the setting of having an incurable cancer,” Dunn said.
As recently as Thursday, a patient told her they would not even consider going to St. John’s for radiation therapy. It is not even a prolonged stay, she said, it being less than a week for this treatment.
“They will still say no, even though this may be impacting on the time they have,” she said.
Despite the metastatic or incurable diagnosis, a person can have a lengthy period of high functionality. As time progresses, that ability declines, and they are able to do less and less. Dunn and the medical staff locally still have tools to help with symptom management and she said they are doing an excellent job with chemotherapy treatments.
People are also calling for government to add a PET scanner into the new hospital. The doctor believes decisions about such things as cancer treatments are being made using CT scans, but expects that will soon move to a PET scanner.
“We are expecting a huge boom in cancer over the next 20 years, so using it within the scope of the work I do or the patients I take care of and the needs they have, it is the future,” she said. “Is it today? I don’t know that.”
She believes at the very least the design of the hospital must contain the ability to accommodate a PET scanner at some point. However, Dunn said a radiation unit is needed immediately — something she has recognized as a void since she began working here about three years ago. That need is only going to increase, she said, given she has already seen increases during her time here.