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Letter from the editor

No more whispering: looking clearly at a personal tragedy, a national scourge

From Saturday's Globe and Mail

I didn't understand very much the summer my grandmother died. I was only 7, the youngest of 12 grandchildren and the most indulged. We lived in a duplex in a Montreal suburb: my family in the downstairs unit and my grandparents upstairs. My grandmother and I were very close. We watched game shows and wrestling matches together. She cooked and baked for me and pinched various body parts at will.

I don't think I had previously heard the word cancer. One day, my parents drove my sister and me to the back of the Jewish General Hospital in Montreal. They pointed at a window high up the building and said to watch for a waving handkerchief. A while later, I could see a flutter in the window. It was the last I ever saw of my beloved Bubbie.

Back then, cancer seemed some kind of personal shame. The young me thought it must be contagious. Today, we have thankfully emerged from those dark ages. But cancer remains a national shame for a country as advanced as ours, with uneven levels of care and no coherent strategy for improving the situation. And that is why, starting in Focus today and continuing in the News and Focus sections over the next several weeks, The Globe and Mail is going to shine our journalistic light on the affliction that in 2007 will surpass heart disease as the biggest killer of Canadians.

We started down this road last April as we prepared for the annual Michener Award ceremony for public service journalism. Globe medical correspondent Lisa Priest was among the nominees for a series of stories on how governments in this country dragged their feet in approving the use of the drug Herceptin for breast cancer patients.

Lisa and I shared a taxi on the way to Rideau Hall for the ceremony not knowing she would win the award. I asked her about other gaps in the cancer care system. She outlined several — the bottom line being that public policy failures were exacerbating an already distressing situation.

And so editors met, as editors will meet, to try to find a way to tell stories about cancer without them sounding like the same old, same old. We wanted to convey the human element of this scourge, for certain, but our efforts had to amount to more than that. A cancer series needed to pin back the ears of our institutions, pointing out those failures that should embarrass us as a society, as well as those areas in which progress is being made.

We decided we would produce three waves of stories: the first, a very personal compilation that we call Cancer: A Day in the Life. That would be followed by Cancer: A National Shame, dissecting the policy failures Lisa and I discussed in the taxi. Our final wave would examine hopes and fears as we look ahead.

For the first wave, which appears in Focus today, we initially set out to chronicle the tribulations of every single person who died of cancer in Canada on a given day, some 200 people, we figured. We contacted funeral directors, scoured death notices in community newspapers and lobbied provincial bureaus of vital statistics. But there were simply too many deaths to track and often they were attributed to secondary conditions. Moreover, we realized the story of cancer is not merely a story of death. It is also the story of those who live with cancer, those who battle against it, those who survive it.

And so we ended up with A Day in the Life, a portrait of 60 cancer patients written by Erin Anderssen and edited by Carl Wilson. Erin has spent the past five months in regular contact with about 100 cancer patients who went through the cancer care system on June 15, 2006. Her profiles resonate with courage and grace. And, sadly, failure and tragedy. "No other story I have ever done has affected me the way this one did," she said at project end. "Every day I talked to people who were dying, but trying to live."

She discovered along the way how lonely most of them felt, how their friends and family could manage to talk to them about their tumours and treatments but not their fears. "What makes cancer so horrific is how it continues to torment and taunt its victims long after the treatments are finished."

For a special project, we wanted a special look and feel. Designer Cinders McLeod retired to her garden and settled on a scrapbook concept inspired by a 1912 botany student's notebook she had picked up in a junk shop in Scotland. We decided that assigning the photos to professionals was both impractical and would detract from the personal feel of Cinders' design. Better, we thought, to ask those chronicled to send in their own snapshots and anything else that illustrated their journey.

Deputy photo editor Moe Doiron was initially uncomfortable making the calls. He avoided the word cancer, referring to "this time in your life" or "your condition." But everyone he called spoke openly about their cancer and thanked him for including them in this project. Their generosity overwhelmed him.

As the photos and other artifacts came in, Cinders was struck by how full of life they were. There were gardens and kisses and flowers and beaches and sporting events. And there was Shelby, whose picture appears on our front page today, beaming and dancing as she approached death at 3.

Today's Focus section packs quite an emotional wallop, as does much of the accompanying material on globeandmail.com. There are slide shows, including one narrated by Shelby's mother, whose humanity will make you weep. But ultimately the point of this exercise is about getting public officials to address the unforgivable inequities and inanities in our cancer care systems.

If your colorectal cancer spreads, you are better off in Grand Falls, Nfld., than Toronto because Newfoundland and Labrador funds a drug that extends lives in incurable cases. But the poorer Atlantic region is not where you want to be if you need drugs outside hospital.

If you need radiation, the government has set targets of four weeks before treatment, twice as long as radiologists say is adequate. But even at that, the system misses this mark as often as it meets it.

If you are counting on the incredible promise of genetic treatments, think again. The paradox far too often is that we can't afford the cost of progress.

Canada is far from the worst in the world when it comes to the prevention, detection, treatment and research of cancer. But we are far from as good as we should be. We still await the national cancer strategy promised both by the former Liberal government and the current Conservative one. And Ottawa seems far less committed to medical research than it was several years ago.

We intend over the coming weeks to challenge this system and the officials responsible for it. Shelby and thousands of others deserve more than good. They deserve our best.

Edward Greenspon

Editor-in-chief

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