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Earlier discussion

Globe Publisher Phillip Crawley on the project

Globe and Mail Update

"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," Globe editor-in-chief Edward Greenspon wrote Nov. 18.

"And that is why . . . 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."

The cancer series began Nov. 18 and continues until Dec. 9 in the pages of the News and Focus sections of The Globe. All stories, along with discussions, narrated photo galleries, interactive graphics, an opportunity to share your personal stories and photos about cancer, and much more can be found in our special online report on cancer.

We were very pleased that The Globe's publisher and CEO, Phillip Crawley was online earlier today to take your questions about his personal experiences with cancer and what he, as an individual, wants the series to achieve in terms of government response.

Your questions and Mr. Crawley's answers appear at the bottom of this page.

The Harper government did say on Friday that it will support the formation of a national agency to co-ordinate the fight against cancer, a long-awaited strategy that many involved in the battle say will help iron out inequities in prevention and care that currently face patients in different parts of country.

The prime minister announced that Ottawa will dedicate $260-million over five years to the Canadian Partnership Against Cancer, fulfilling a promise Mr. Harper made during the last federal election campaign.

Phillip Crawley has been publisher and CEO of The Globe and Mail for more than seven years. He came to Canada in 1998 after working for newspapers in New Zealand, Britain and Hong Kong in editorial and management roles.

His wife, Joyce, was diagnosed with breast cancer in 1993 and died in Toronto in 2004. In 2005, he underwent surgery for prostate cancer at Toronto General Hospital.

Mr. Crawley is a member of the board of Sunnybrook Hospital, Toronto. This month he gave the annual Penfield Lecture about his wife's cancer diagnosis at the Montreal Neurological Institute, and also spoke to Ontario Cancer Care's management retreat.

Editor's Note: globeandmail.com editors will read and allow or reject each question/comment. Comments/questions may be edited for length, clarity or relevance. HTML is not allowed. We will not publish questions/comments that include personal attacks on Globe journalists, other participants in these discussions, questions/comments that make false or unsubstantiated allegations, that purport to quote people or reports where the purported quote or fact cannot be easily verified, or questions/comments that include vulgar language or libellous statements. Preference will be given to readers who submit questions/comments using their full name and home town, rather than a pseudonym.

Jim Sheppard, Executive Editor, globeandmail.com: Good afternoon, Phillip, and thanks for joining us today to take questions from the readers of globeandmail.com on The Globe's month-long cancer project. Could you start by giving our readers an idea of why The Globe chose this approach and what response it hopes to get from governments at all levels?

Phillip Crawley, publisher and CEO, The Globe and Mail: Thanks, Jim. The Globe made a decision to turn the spotlight on cancer because it affects so many lives, and because Canadians want to understand more about why there are such huge regional variations in the treatment available to patients.

I make no apologies for using the power The Globe possesses to put this topic at the top of the agenda, for our readers and users, and for our politicians.

There is a lot of great work going on in our hospitals right across the country, and I welcome the federal government's announcement of a national cancer strategy last week.

But I am also well aware that researchers are worried that funding is being cut back, and that we risk losing some of the key people working in this field.

Let me be clear that I am commenting as an individual who has experienced cancer, and as an experienced user of the health care system here and in other countries. My views are not necessarily those of the Globe and Mail. We have an editorial board which decides our policy positions as a newspaper, and I am not part of that board. That's what we call church-and-state separation here.

Like a lot of people in Canada, I care deeply about making a difference to the care that can be offered . . . there are a lot of positive developments, and a lot of hope, and we want to capture that message in The Globe too.

Jasmine Francis, Halifax: Mr. Crawley, I was sorry to read on this page about your wife. I lost my husband to cancer two years ago. Fortunately, he didn't suffer too long. But it has left a huge void in my life. If it's not too personal a question, did the loss of your wife lead you to take on your work on the hospital board and with the cancer agency?

Phillip Crawley: Jasmine, yes, I have taken an active role in helping out in the health care area since my wife died, because I feel I have some knowledge that other patients might find useful.

I used the money that was donated in memory of my wife to create a fund at Sunnybrook Hospital in Toronto, where she was a patient for four years, which provides help and advice for cancer patients waiting for treatment.

She spent many hours in those waiting rooms and met many other women who were needing information and guidance.

The doctors are busy and don't always have the time to explain in person, so the better informed you are, the better chance you have of dealing with the problem.

Barbara Tremblay, Prince George, B.C.: I have been following your series with great interest, as I was diagnosed with cancer of the esophagus in March, 2001. Thanks to good, prompt treatment and great support from family and friends, I am alive today. One thing I have not seen comments on are support programs which help to ease the feeling of isolation experienced by those who are going through treatment. I am a volunteer with Cancer Connection, which is run by the Canadian Cancer Society. In this program, we are matched with those with the same type of cancer, and other similarities, so we can share practical stories and offer emotional support. I used this when I was a patient, and now I am talking to others across the country, and hopefully helping them. [Can you comment on this approach?]

Phillip Crawley: Support programs are enormously valuable, both for the emotional value and the information source they provide.

I have some knowledge of an organisation called Wellspring which has centres in six locations in Ontario, and is looking to expand across the country. Having visited one of their Toronto centres, I can vouch for the quality of their support, which comes free, despite having no government funding.

Meeting other patients, sharing experiences, and being able to read up on a treatment in a well-stocked library, are all very important to a patient facing up to the various choices.

Sam Butera, Toronto: Canada has many levels to its health system, and it is no longer universal. For example, I work for a small company [and] this year I paid over $1,800 for prescription drugs, tests, etc. from my own pocket whereas a unionized worker at a large company may get all of that covered. Revenue Canada will send me a tiny reimbursement. If I was diagnosed with cancer, I would have to die. I could not afford rent, medications and recovery time. I would probably lose my job and my apartment. Is The Globe going to write about this discrepancy in its Health Section or its cancer series?

Phillip Crawley: Sam, one of the articles in The Globe series last week focussed on the inequalities between different provinces in terms of supporting prescription drug costs . . . there are big differences in the levels of support. We will continue to highlight the discrepancies you describe.

Michael H., Edmonton: As an academic cancer researcher working at the University of Alberta, I have some real concerns about promises made based upon prevention. For example, it seems to me that the best preventative approach would be to use all $250 million [of the government's new cancer strategy] to lobby the government to make tobacco products illegal. We could simply replace tobacco with nicotine sprays etc. This won't happen but would be the most effective strategy. The same with our approach toward obesity -- again, no amount of advertising is going to make a significant dent. Screening for colorectal cancer may be an effective strategy. The real (obtainable) solutions, in my mind, are chemoprevention and new therapies. There is also a great deal of misinformation related to "natural" foods etc. That tells me the education campaign that is needed is not about the obvious and well-known hazards but about debunking the perception that "natural" is "good" and synthetic is "bad." Do you agree or disagree?

Phillip Crawley: I share your scepticism about some of the "natural" remedies, but I am impressed by some of the recent research I have seen showing how diet can impact cancer prevention.

I listened this month to the surgeon who did my prostate cancer surgery while he gave a breakfast talk about the results of studies done on the value of taking certain vitamins and eating certain foods . . . in a nutshell, they show very convincing differences can be made if you take a combination of Vitamin E, Silenium, green tea, soy products and lycopene, which comes from eating cooked tomatoes.

Even though I have had my prostate removed, I am taking some of those things daily because the belief is that it lowers the prospect of recurrence, which is the fear of everyone who has ever had cancer.

Baldev Sood, Toronto: Cancer is man-made disease caused by chemicals all around us. We breath, drink and eat them. The human body is a very complex machine that will take a million more years to understand fully. But the issue is actually very simple to understand: This body needs natural things, not chemicals. I think we are spending billions on treatment but not addressing the root cause. What is your opinion on that?

Phillip Crawley: I agree that there is a lot more learning to be done about why people who live in different parts of the world develop different kinds of cancer.

Breast cancer is relatively uncommon in Hong Kong, where I used to live. Same goes for China and Japan. And men in those countries suffer far less prostate cancer than men in the West.

The researchers are figuring out that there are environmental and dietary reasons, but I don't think they are widely understood yet. So campaigns that create greater awareness of what constitutes healthy living are to be welcomed.

Jim Whitney, Kearney, Ont.: Mr. Crawley, without naming names and pointing fingers, after reviewing your experiences with the Canadian medical system, what shortcomings were apparent and what changes would you recommend?

Phillip Crawley: Jim, I likened it in a lecture to a sprint relay team where there are some brilliant runners, but the teamwork isn't very good, so they keep dropping the baton at the changeover.

My frustration with the system was that you really had to fight for attention, to make sure your case didn't get lost in the system. You have to chase around to get your results, or to fix your next appointment. The hospital bureaucracy can be impenetrable for patients.

My advice is that you should never assume that it is all being taken care of . . . your file might just be sitting at the bottom of the pile, or in the wrong place.

I know of a woman who waited 24 weeks from first seeing her GP to getting treatment for cancer . . . it turned out the GP had given up practice, so she simply fell out of sight.

So my recommendations for improvement are mainly about making the process more transparent for the patient, so that they know what is going on and understand why. You already have enough to worry about when you are dealing with cancer without fretting about whether you have been forgotten about by the system.

Joshua Regan: Why did The Globe write this article now? Just to try to embarrass the Harper government? Would you have written the same series if the Liberals were still in power?

Phillip Crawley: Most funding for health care comes from the provinces, so the main concern for health administrators, doctors and researchers is not about what the federal government is going to do, but what the politicians in their own areas are willing to support. You can see from the articles we ran last week that the quality of treatment available in Canada varies greatly depending on where you live.

I have no problem in embarrassing any government, whatever its political colour, if it fails to support the research going on in our teaching hospitals.

We would be losing a great opportunity to make a difference to many lives if research funding is cut back. When you bring a talented researcher from the U.S.A. to work in Canada, and then nickel-and-dime him by cutting his research grant in half, he'll probably go back home . . . and that's a case I know.

Jason Schmidt, Saskatoon: Mr. Crawley, thank you and thank The Globe for devoting so much time and resources to covering this important topic. Can you speak a little bit about what a "national cancer strategy" is and why you think it's important? When you lived in so many other countries, did they have such a strategy?

Phillip Crawley: Jason, I lived in the U.K. where the value of a national cancer strategy has emerged over recent years. Britain has many similar issues to Canada, such as the regional variations in the availability and quality of cancer care, even though their National Health Service is more centrally controlled than our health system here.

I see the value of a national cancer strategy as putting it more firmly on the national agenda, rather than leaving the provinces to go their own way, which leaves many Canadians puzzled.

I would like our main political parties at the federal level to give the whole topic of health care more attention, more debate . . . It deserves it. It's the No.1 issue for Canadians.

Jim Sheppard, Executive Editor, globeandmail.com: Phillip, thanks again for taking the time today to answer questions from the readers of globeandmail.com. I'm sure they appreciated hearing both your own personal experiences with cancer and your insight on the issues related to the fight against the disease. Any last thoughts?

Phillip Crawley, publisher and CEO, The Globe and Mail: Thanks for the opportunity, Jim.

Getting feedback from our readers is always valuable, and I am hoping there will be more questions and comments in the days ahead as we continue to run our cancer series. There is a lot more to say on this subject.

Thanks to everyone who sent in questions for taking the time and trouble, and I'm sorry if I didn't get to answer your particular question.

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