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Earlier discussion

Pat Kelly on Canada's cancer strategy

Continued from Page 1

All cancers: 149,000 diagnosed, 70,000 will die.
Impact of putting knowledge to work: Overall rate of cancer deaths could be cut in half over next generation.

The gap is huge — and we can do something about it NOW — imagine if corporate Canada decided to get serious about cancer control by ensuring that all employees who were eligible got screened for colon, breast, and prostate cancers? What if there was a competition for the community that had the highest screening rates, or an award for the school board that created innovative programs in healthy living, or if every dental professional complied with the expectation that all patients be screened for oral cancer?

Its time to change the conversation about cancer from blaming governments to taking control by learning what to do for yourself, your family, your coworkers and employers and raising everyone's expectation for excellence.

Jim Connors from Dartmouth writes: I am interested in learning more about how Newfoundland and British Columbia came to approve Avistin for funding while other provinces continue to hold back. Is there anything that happened in those two provinces to obtain government approval that can be applied usefully in other provinces where colorectal cancer patients could benefit from this effective but catastrophically expensive drug? Any advice you may have as an "advocate" on how to maximize the chances of successfully lobbying other governments to recognize and fund this drug would be much appreciated.

Pat Kelly: Jim, you've nailed the single most pressing issue facing provincial cancer agencies — how will the provinces pay for new cancer drugs? Because the provinces must fund cancer services for their citizens, and each province has a separate decision-making process and subsequent formulary or approval process, and every province determines its own cancer control priorities, we spend a great deal of effort and resources coming to provincially-based decisions. Key influencers are the human resources required to make complex decisions in a timely manner — especially critical in view of the fact that cancer drugs are only considered curative if they work the first time a patient gets chemo — the political priority for cancer, the size of the patient population and therefore the magnitude of the problem. Ideally, decisions about access to drugs are based upon evidence of effectiveness -- but as you point out, each province operates independently in this regard and thus we have differences in availability — and most importantly, differences in mortality and quality of life for cancer patients.

Jeannie Hardie from Brownsburg-Chatham writes: I am a cancer survivor and want to know the latest developments in cancer treatments.

Pat Kelly: To Jeannie — YIKES!! Explaining the latest news in cancer treatments is beyond my meager human abilities. HOWEVER — as you are clearly computer-smart, you might look to some of the expert websites that are dedicated to keeping the public informed — including Oncolink, www.oncolink.org; the American Institute for Cancer Research, www.aicr.org; and the American Society for Clinical Oncology, www.asco.org.

I have a bias toward US-based cancer treatment information as I have found in my work that because they are client-focused and market-driven, these sites stay current, comprehensive and are not limited in terms of information provided.

R. M. from Regina writes: At the outset I hope you will pardon my cynicism, fuelled by year after year of government announcements and pronouncements and "new" funding. I just do not see how the following will occur, as quoted from the initial announcment of this program: "...it's going to mean that Canadians right across the country, wherever they live — whether it's in large centres with tertiary care or small communities — will have access to programs and services that are based on the best possible knowledge that's available out of international (medical) literature and local learning. I fail to see how the above "vision" can be possible (or for that matter is even defensible) for something as complex as human health and I certainly do not see how the small, by today's standards, approximately $50 million dollars [per year] can accomplish this goal.

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