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Earlier discussion

Globe reporters answer cancer questions

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The Centre for integrated Healing in Vancouver was a Canadian example, the only clinic providing integrative cancer care that receives public funding in this country. It is a smaller version of the big integrative medicine centres in the United States, but seeks to do the same thing for patients on a more modest scale.

None of these programs deals with navigation, however. Nova Scotia has patient navigators in its cancer-care system, but there are few of them and they are overworked. Quebec has nurse navigators tied to hospitals. Other provinces like Manitoba and Alberta are looking at hiring patient navigators as in Nova Scotia. But some people believe these navigators, while a welcome first step, are band-aid solutions for a system that has deeper problems when it comes to affording respect to patients and their advocates. From my own experience, I would say that those who advocate for themselves, becoming a thorn in the side of oncologists and nurses wherever necessary, receive better cancer treatment. Hard as it is, cancer patients can never relax and believe their case is being properly handled. They must be vigilant because files get lost, appointments get postponed, and wait times get stretched.

At Sunnybrook where I was treated, I had to fight to see my own file. I had never seen my own pathology because the hospital charged a prohibitively high fee for copying each page. And even when I saw the file, it was done surreptitiously by a nurse who told me in the clearest terms that I was not supposed to see it. Excellent though my treatment was at the hospital, I believe its approach to my information suggests a paternalistic attitude to cancer patients and a failure to respect our right to know everything about our treatment.

Rebecca Dube, globeandmail.com: Thanks to both our guests for joining us online today, and thanks also to everyone who sent in questions. Ms. Philp and Ms. Anderssen, any closing comments?

Erin Anderssen: I want to extend a final thanks to all the organizations and individuals who helped the Globe and Mail with our cancer series.

One of the messages that came through over and over again in the stories that I wrote is that cancer patients need to be able to talk about the disease — openly and frankly, to their doctors and to family and friends. The health care systems need to continue to develop programs that cover the emotional needs of patients, to alert them to the resources that are available and to identify patients who are struggling most to navigate the system. But outside of their medical experience, cancer patients said, over and over again, that they needed their friend and family to be willing to talk to them about the disease in a more honest way than often happens.

But there were also a lot of stories of hope — and we should be able to look within the tragedy of the disease and see those as well. Canadians told us of how a cancer diagnosis had brought about deeper relationships with loved ones, or altered their life's priorities. I remember the stories of the couples who had just started dating when a cancer diagnosis came along — and yet were able to face it together. Or people who got married even in the face of a terminal illness. And the many people who face a cancer diagnosis, and survive. The series was extremely important for its work on gaps in the health system and new scientific process, but it was also about generosity and kindness and being resilient in adversity. This is the part that as a writer, I will always remember.

Margaret Philp: Thanks to everyone for their questions. I feel encouraged by the level of passion and interest among Canadians for tackling cancer; both the environmental causes that may help us prevent the disease in the first place and the problems of a medical system that still provides a differing level of care to different Canadians, depending on where they live and, to some extent, who they are. I think as journalists we need to be writing more about this. And as Canadians, we need to be taking responsibility for our health wherever possible -- eating lots of vegetables and exercising regularly, for example -- because we can make a difference. But we also need to vote with our feet: We need to buy food that has not been blasted with pesticides, purchase products like detergents that do not contain harmful, cancer-causing chemicals, and pressure government to address issues such as clamping down on the carcinogens that are currently allowed in many consumer products. I guess my message is this: Whether we are fighting cancer now or want to prevent ever getting it, we are not powerless.

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