Colleen Tkachuk is facing difficult odds. She has Stage 4 recurrent ovarian cancer. The diagnosis is frightening but the 48-year-old says the worst part is feeling like she’s facing the disease alone.
“If you have an issue, you don’t know who you’re going to see. You don’t know who you’re going to contact. It’s scary,” Tkachuk said.
Last October, there were two full-time gynecological oncologists based in Tkachuk’s hometown of Saskatoon. By the end of the 2018, there was none.
Instead, patients are left to rely on locum doctors who fly in for a few weeks at a time. In nearby Regina, the situation is not much better. The city is losing one of its two specialists this June.
“When you go from four specialists (in Saskatchewan) to one, it’s a pretty scary thing for patients,” said Stephanie Gosselin, Saskatchewan and Manitoba regional director for Ovarian Cancer Canada.
Gynecological oncologists are highly trained specialists who treat cervical, uterine, vulvar and ovarian cancer. Ovarian cancer is the fifth-leading cause of cancer death for women in Canada. According to Ovarian Cancer Canada, 1,800 women will die of the disease each year.
According to the Society of Gynecologic Oncologists of Canada (SGOC), the city of Kingston, Ont. is also struggling to recruit and retain specialists, especially as Canada deals with a national shortage brought on by a perfect storm of medical leaves, retirements and international competition.
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SGOC President, Dr. James Bentley says physician burnout is also a major factor.
“If you are in a small specialty, your on-call requirements are going to be significant,” Dr. James Bentley said. He added in some cancer centers, doctors are sharing on-call loads with just one or two other physicians.
“Year after year, that is going to wear on people.”
For patients like Tkachuk, seeing her specialist struggle under such a heavy workload was worrisome.
“You can see how tired they are.
“When someone gets burned out and tired, they’re not enjoying what they’re doing anymore. Maybe they don’t want to help you anymore? You don’t know.”
That’s why Bentley says the SGOC released a set of Pan-Canadian guidelines for Gynecologic Oncology last year. Produced in partnership with the Canadian partnership against cancer, the document calls for every Canadian cancer centre to staff a minimum of three specialists.
“A minimum of a three-person gynecological team can reduce surgeon fatigue, contributes to shorter operative time and thereby produce optimal outcomes,” the document reads.
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The SGOC is currently working to speak with provincial ministers of health across the country to discuss ways to implement the new standards.
For ovarian cancer patients in Quebec, there is another problem limiting access to specialized care: geography.
Most of the province’s gynecologic oncologists are based in Montreal, Quebec City and Sherbrooke, meaning women in northern and eastern Quebec must travel significant distances for appointments.
“We know that not all women are opting to travel these distances and are not being diagnosed and treated by gynecological oncologists and we also know that this is associated with poorer outcomes,” said Jennifer Laliberté, Quebec Regional Director at Ovarian Cancer Canada.
Back in Saskatchewan, an international recruitment campaign is well underway.
Tkachuk says she’s hopeful that a permanent doctor can be found soon.
“When you know that they’re there with you for this long journey, it takes away the fear because no one wants to go through it alone.”
WATCH BELOW: Seventy-five women are diagnosed with ovarian cancer in Saskatchewan each year, and 55 lose their lives. But does that outcome need be so severe? Ovarian Cancer Canada thinks not and it is hopeful a new drug can reduce that number. David Baxter has more. (Jul 27, 2017)
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