‘Horror spectacle’ as BC specialist shortage leads to agonizing wait for cancer surgery

Opinion: The human resources crisis is at a critical point not only for patients and their loved ones, but it is devastating for healthcare workers.

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UPDATE: On Wednesday morning (January 26), Kelly Ennis underwent emergency surgery for the ovarian cyst and two lymph nodes. Once she has recovered from surgery, the next step is chemotherapy. Since the tumor was first discovered in mid-December, it had grown almost five centimeters.

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Kelly Ennis appears to be eight months pregnant. At 48, that would be a small miracle. Instead, it’s a tragedy.

Ennis has ovarian cancer. She got the bad news on December 13 that she needed urgent surgery.

A CT scan revealed an irregularly shaped tumor the size of a large orange, a ‘haze’ in his omentum – the curtain of fatty tissue that hangs down from his stomach and liver and wraps around his intestines – as well as fluid on the wallcovering and enlarged lymph nodes.

“I was told to expect a call within seven to 10 days,” the mother of three told me. “I thought it was great to be able to see someone so quickly. But with the holidays approaching, I haven’t heard anything.

Ennis’ time frame is the benchmark for best care – a referral to an oncologist within 10 working days, followed by surgery within two weeks of that referral.

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But that didn’t happen. His mother, Dianne Davis, calls what happened next “a horror show,” adding that it’s time the provincial government realizes there’s more going on than COVID.

Over the next few weeks, Ennis and his gynecologist’s receptionist made several attempts to contact the specialist. Emails, voicemails. No answer.

Finally, on January 5, Ennis was informed that her case had been forwarded to the BC Cancer Agency in Vancouver. Five days later, the cancer agency called Ennis to say his gynecological oncologists were overwhelmed. Ennis has been put on a waiting list.

On January 14, Ennis had so much abdominal fluid that she could barely breathe or walk. He was told to travel to Vancouver General Hospital from his home in Surrey, not one of Fraser Health’s hospitals, as that is where the agency’s gynecological oncologists work. Cancer.

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Over two days, six liters of fluid were drained from her abdomen using a procedure Ennis described as “painful” and “barbaric”.

Finally, on January 19, she was granted a surgery date – February 28 – almost three months after her gynecologist made the first urgent referral.

Within days the fluid started to build up again, which is not unusual for the type of ovarian cancer she has. But it’s more than uncomfortable.

When we spoke on Monday, Ennis rated his pain eight on a scale of 1 to 10. “The pain is unreal.”

Still, she sympathized with healthcare workers.

“My heart goes out to the doctors, nurses and support workers who are so overworked. There just isn’t enough support for them.

On Tuesday, Ennis returned to the emergency room at VGH, unable to cope at home. His condition has deteriorated to the point that the wait is almost over. She is due for emergency surgery today.

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Kelly Ennis has ovarian cancer and needs urgent surgery.  But in mid-January, as she waited, her stomach filled with nearly six liters of fluid that had to be emptied.  On January 25, she was back in the emergency room with fluid in her abdomen.  Her cancer surgery isn't scheduled until February 28, not because of COVID, but because of a long-standing shortage of gynecological oncologists.
Kelly Ennis has ovarian cancer and needs urgent surgery. But in mid-January, as she waited, her stomach filled with nearly six liters of fluid that had to be emptied. On January 25, she was back in the emergency room with fluid in her abdomen. Her cancer surgery isn’t scheduled until February 28, not because of COVID, but because of a long-standing shortage of gynecological oncologists. PNG

Ennis’ journey through the medical system began Dec. 4 in the emergency room of Delta Hospital, just days after British Columbia reported its first case of the Omicron variant.

Many cancer surgeries have been canceled due to COVID. But the pandemic didn’t delay Ennis’ initial surgery date. This has only amplified the acute and long-standing shortage of gynecologic oncologists in British Columbia, according to Dr. Sarah Finlayson, head of the gynecologic oncology program at the University of British Columbia and who practices at the BC Cancer Agency and the Vancouver General Hospital.

“British Columbia has a human resources crisis,” she said in an interview. “We have approximately the equivalent of seven full-time gynecological oncologists serving a population of five million people.”

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She compares this with other western Canadian provinces – Alberta has 12 for a population of 4.3 million, Saskatchewan has six for a population of 1.1 million, Manitoba has five for 1 .3 million.

And here’s another contrast: Fraser Health Authority has a population of 1.9 million (including Ennis) and doesn’t have a single one.

Fraser Health’s response to questions was to refer me to the BC Cancer Agency and Vancouver Coastal Health.

It’s not that BC can’t attract these highly skilled specialists, or even that there aren’t enough trained in Canada each year. UBC, for example, graduates one person in the subspecialty each year.

The problem is the money or the will. Make your choice. But the result is the same.

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Every week, 30 to 40 more women from across the province are referred to specialists at the cancer agency.

Even though the population has grown by almost three-quarters of a million over the past decade (and continues to grow during the pandemic), the government, health authorities and hospitals have not funded a single new position for these specialists. nor increased their operating time. .

Finlayson doesn’t know why. It’s not because the authorities haven’t been notified.

But here’s her fear: “I think when we do it right — and we’ve been providing incredible care for women with gynecological malignancies for years — you’re not the fire in the room.”

Today, the human resources crisis is at a critical point not only for patients and their loved ones, but it is devastating for healthcare workers.

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“We feel this critical lack of adequate personnel in our hearts,” Finlayson said. “We pride ourselves on our ability to provide world-class care, and when we don’t have the capacity to do that for every woman, it makes us all terribly sad.”

It is a terrible irony that it took a pandemic for Canadians to realize the big gaping holes in a health care system that may not be completely rebuilt, but certainly needs a substantial renovation.

[email protected]

Twitter: @bramham_daphne


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