CRISIS IN GYNE CANCER CARE IN SASKATCHEWAN

REGINA, September 7, 2010 - Dr. Maryam Al-Hayki, Regina’s remaining gynecologic oncologist has taken emergency medical leave. With the recent closure of Dr. Brydon’s office, this puts gynecologic cancer care in Regina in a crisis; leaving the Regina Qu’Appelle Health Region (RQHR) and the Saskatchewan Cancer Agency (SCA) scrambling on a day-to-day basis to provide the best available care for women needing diagnosis, surgery, treatment and follow-up. Darlene Gray, President of Ovarian Cancer Awareness & Treatment in Saskatchewan (OCATS) was advised that the RQHR has doctors searching for a temporary replacement and that the RQHR feels this is a situation that could not have been planned for. “However,” Gray stated, “we’ve been speaking with the government for well over two years now about a possible crisis that we now face. We’ve been asking for proper space in the hospital to ensure retention of our specialists, nothing was done and we lost one specialist. We’ve been sharing our concerns about the hardship placed on the remaining gynecologic oncologist and about losing her too. Obviously, emergency medical leave was not anticipated but human beings get sick. It was unrealistic to not consider that having one specialist 24/7 was a crisis in the making, and prevent that.” OCATS has learned that current patients will be reassigned to medical oncologists and two gynecologic oncologists (Brydon and Lucero) at the Allan Blair Cancer Centre (ABCC) and gynecologic oncologists in Saskatoon while the RQHR looks for a replacement doctor. Both the SCA and the RQHR share Gray’s concerns and are diligent in handling this crisis on a daily basis. Dr. Brydon though does not have the credentials to make chemotherapy decisions for patients with recurrent cancer. Dr. Lucero is on assessment until mid October, his credentials to deliver 2nd line chemotherapy are unknown to OCATS. Gray said, “it is critical that patients know the best chance at survival is getting proper treatment from a gynecologic oncologist, patients need to alert their general practitioners of the situation. Patients waiting for surgery need to ask for the proper surgeon in a timely manner – on an emergency basis. We have excellent doctors in Regina and Saskatoon but they were busy before this crisis. We are aware that everyone involved is doing the best the can and working hard to address the situation. It is appalling though that the situation we have worked so hard to prevent is now our reality. Our intent is not to scare patients, but the situation is upsetting and women have a right to know.” “I worry for women needing a gynecologic oncologist for diagnosis and/or surgery right now. I am concerned for those having to endure a very difficult chemotherapy and travel too. I am anxious for my own follow-up as I have been unable to get an appointment for a couple of months for an examination.” Gray stated. Women in Saskatchewan need to know that gynecologic oncologists play an important role in improved survival rates through accurate diagnosis and treatment, essential for ovarian cancer patients diagnosed in late stage. Only a skilled surgeon who is a gynecologic oncologist can effectively debulk advanced ovarian cancer before the administration of chemotherapy. Patients who have completed chemotherapy need a gynecologic oncologist for follow up monitoring with diagnostic tests and internal examinations to diagnose and treat recurrence. According to the John Hopkins Pathology, as many as 70-90% of ovarian patients will have recurrence at some point. Initial chemotherapy treatment for ovarian cancer is very standardized, but monitoring, quality of the patient’s life and treatments for recurrent disease is very individualized. For more info contact Darlene Gray at 306-775-1848 or cell 306-529-3199. - 30 –

Regina Specialist On the Move, Media Release

M E D I A R E L E A S E Regina Cancer Specialist On the Move For Immediate Release REGINA, Aug 17, 2010 - Regina’s only remaining gynecologic oncologist is on the move. Dr. Al-Hayki, an oncologist who must retain a private practice to see confirmed and suspected cancer patients not under the care of the Allan Blair Cancer Center has closed her current office location. OCATS (Ovarian Cancer Awareness & Treatment in Saskatchewan) has been assured by the RQHR (Regina Qu’Appelle Health Region) that Dr. Al Hayki is in discussions about a new office location, a move that may be imminent. RQHR has also offered to assist Dr. Al-Hayki with the situation. The office move poses a problem for women with suspected cancer who need to be referred to a gynecologic oncologist immediately. Since the Allan Blair does not have a mandate for their oncologists to see these women, there are no other specialists in Regina that they can be referred to. This potentially means the transfer of patients to other centers or women with an urgent need for an appointment waiting to begin treatment because of essentially a real estate issue. With Regina down to just one gynecologic oncologist, working conditions are worse and the quality of cancer care is lowered in Saskatchewan. Darlene Gray, Director of OCATS says, “We are reassured by the information from the RQHR as we have witnessed their commitment to improved gyne oncology care in Saskatchewan, however, we are tired of the office space issue and can’t help but worry that our specialist is as well. No one wants a gifted cancer specialist to be wasting her valuable time looking for office space and moving. We are asking again that office space be provided in one of our hospitals as soon as possible. This was an urgent issue in 2008; it became an unworkable situation for Dr. Brydon and she closed her private practice for good. Now the situation has deteriorated further.” Gray explained that the real answer is Gynecologic Oncology Units in both Regina and Saskatoon to ensure these specialists work efficiently, leading a team providing the proper care for women with cancer of the reproductive organs. The OCATS group and other stakeholders have been working diligently for over a year to design a gynecologic oncology program for our province Gray stated, “We appreciate the offer of support of the health region in helping Dr. Al-Hayki find a new private office, but we want office space for our specialists in the hospital like other oncologists have. We are also encouraged by a new way of approaching issues by the Saskatchewan Cancer Agency that has come with new personnel. But we need an answer to the office space issue today.” -30- For more information: Please contact Darlene Gray OCATS 306-775-1848, 306-529-3199 darlenegray@sasktel.net

tHe art of the Matter

Update - Biggest Best Teal Panties Party Ever!

BSB4uD, Be Smart Before you Donate!

A very interesting article from Sandi at Ovarian Cancer and Us. Please check out the graphic and answer Sandi's question at the end.... BSB4uD (Be Smart Before You Donate) So……. Always questions concerning donations? When it comes to donations, how much do you really know? Who do you believe, and why ? How do you decide ? Do you even care where you donate – if you donate? Time or money or….. Speaking of Trust: Who gains? What’s the priority? Who loses? Who leads? Little, or nothing....... to gain /to lose? Top down? Bottom up? It’s…….Up to you to ask the right questions. Be smart, it’s your right to ask - your right to know. Here’s a start – add your own walk through this start of information - what you need or should know & think about but most likely don’t Here’s the question: I donate because……

Patients Suffer from Lack of Leadership on Gyne Cancer Issues

M E D I A R E L E A S E PATIENTS SUFFER FROM LACK OF LEADERSHIP ON GYNE ONCOLOGY ISSUES For Immediate Release REGINA, April 13, 2010 - Patients in attendance at the Legislative Assembly hoping to hear the Minister of Health demonstrate leadership on the issue of retention of specialists were gravely disappointed. Although suffering from cancer and treatments, they have been steadfast in calling for the Ministry of Health to use his leadership to come up with solutions. Rather, the royal run around so evident in his answer to Ms. Junor, Health Critic, Official Opposition in the Legislative Assembly on Monday was sadly familiar to the group known as OCATS (Ovarian Cancer Awareness & Treatment in Saskatchewan). Patients are not disappointed with Dr. Brydon, rather they are impressed with her willingness to put patients’ needs first. Dr. Brydon has seen the shortfalls and has advised all the authorities. No one has acted on it. Disappointment has been crushing though as this group of patients, many of who are in treatment or recovery of ovarian cancer (only a 20% survival rate, many patients dying within months of diagnosis) have asked for very little in fact. Darlene Gray, a director with OCATS, said, “Money is and is not the answer. The amount of funding required up front for a gynecologic oncology unit providing office space and appropriate nursing support would be so little and would save so much. The financial savings to the government in terms of 2nd line chemo which is extremely expensive is a good investment in our budget, but also in terms of Saskatchewan women’s lives saved. Not to mention the increased awareness.” Gray explained that when women are diagnosed earlier and have successful surgeries performed by gynecologic oncologists the chances of remission are higher, and the need for pricey 2nd line chemotherapy is reduced. Gray also asked, “Why is the Minister of Health continually referring questions on the issue of retention of gyne cancer specialists to a Working Group he is responsible for establishing, and then in the same breath warning us not to expect this same Working Group to deal with these specific issues? It’s confusing, frustrating, demoralizing, we have to wonder if that is the goal: take a bunch of cancer patients who are ill, exhausted, at risk of dying but who are vocal and crush them emotionally, intellectually and physically.” Gray cites how last week Ms. Jordan of SaskHealth stated her preference is to refer patients now to gynecologists/obstetricians (baby doctors) for these high-risk surgeries requiring skill and experience with cancer, saying “this puts Saskatchewan women’s lives at risk and everyone knows it.” If the Health Region doesn’t take care of the problem what will the Minister of Health do about it? Essentially it’s his baby. Make no mistake, the Regina Qu’Appelle Health Region, the Sask Cancer Agency and the Ministry responsible is failing the women of Saskatchewan. For more information contact Darlene Gray at 775-1848, cell 529-3199, email darlenegray@sasktel.net . # # #

LP Writer Murray Mandryk digs a bit deeper, if money isn't behind the problem for Dr. Brydon, what is?

Sask Minister of Health Questioned on Closure of Gyne Onc Office

THIRD SESSION - TWENTY-SIXTH LEGISLATURE of the Legislative Assembly of Saskatchewan N.S. VOL. 52 NO. 42A MONDAY, APRIL 12, 2010, 1:30 p.m. LEGISLATIVE ASSEMBLY OF SASKATCHEWAN 4697 April 12, 2010 April 12, 2010 Saskatchewan Hansard 4705 ROUTINE PROCEEDINGS INTRODUCTION OF GUESTS Ms. Junor: — Mr. Speaker, I too on behalf of the opposition want to welcome the members from the Red Hat Society, all the women that have come today. From what I know about this group, not only are they very visible because of their hats — and it’s unfortunate that the member didn’t wear hers; that would have been entertaining — I understand that these women are extremely enthusiastic and they have a lot of fun. That’s what I always hear, that you have a lot of fun. Look at all the hats nodding. So I too would like to welcome all the women here today to the legislature. While I’m on my feet, Mr. Speaker, I want to introduce others who are in the gallery. On the very top row is Darlene Gray, the director of OCATS, the Ovarian Cancer Awareness and Treatment in Saskatchewan, and Elan Morgan board member. Wave? And sitting beside Elan are Joan and Harvey Schneider, also board members. I just want to say about Joan before I sit down and welcome them, Joan was the executive secretary to the president of SUN [Saskatchewan Union of Nurses] when that was me. So I’m very happy to see Joan here today and welcome them all to the Assembly. QUESTION PERIOD Gynecologic Oncologists Ms. Junor: — Mr. Speaker, for two years the minister has ignored the pleas of women with ovarian cancer and gyne-oncologists to address substandard working conditions in southern Saskatchewan. As a result, Dr. Brydon, one of only two gyne-oncologists practising in southern Saskatchewan, has closed her practice because she is burned out. To quote Dr. Brydon, “Physically and emotionally, I can’t cope any more.” Mr. Speaker, the minister’s incompetence and failure to address the substandard working conditions of gyne-oncologists in Regina is putting at risk the lives of women with ovarian cancer. Why? The Speaker: — I recognize the Minister of Health. Hon. Mr. McMorris: — Thank you, Mr. Speaker. First of all, Mr. Speaker, on behalf of the government, we want to thank Dr. Brydon for all the work that she has done in southern Saskatchewan. These people are very specialized doctors. They are, Mr. Speaker, gynecology oncologists, which is a very specialized area. We have had four in our province, Mr. Speaker. Dr. Brydon is closing her practice to move on to other options. The health region, the health region as well as the government, is working hard to ensure that that position will be filled, Mr. Speaker. But what I will say is that in the last two and a half years of our government, we have done more to recruit physicians into this province compared to the 16 years. And especially when you look at the front page of the Leader-Post, from 2001 to 2006 the net out-migration of health care workers in Saskatchewan was 1,160 health care workers out, Mr. Speaker. In our first two and a half years, we have attracted 164 more physicians to our province than under that government, Mr. Speaker. The Speaker: — I recognize the member from Saskatoon Eastview. Ms. Junor: — Mr. Speaker, that tired rhetoric is no consolation to women who have ovarian cancer. Mr. Speaker, in every other jurisdiction, including Saskatoon, gyne-oncologists work in a hospital setting with the proper support around them — not so in Regina where the specialists have to find their own office space and work without the support of a nurse. Mr. Speaker, to the minister: is he going to provide immediate office space and examining room space in the Regina General Hospital along with the proper nursing support, or is he going to continue to ignore the issue until the second gyne-oncologist closes her practice? The Speaker: — I recognize the Minister of Health. Hon. Mr. McMorris: — Mr. Speaker, we have a gynecological oncology program working group that was established, Mr. Speaker, under our government. This working group has patient support, is represented through patient support groups. It also has a gynecology oncologist, the four that were in the province, working on this group as well as the health authorities of Regina Qu’Appelle, Saskatoon, and the Saskatchewan Cancer Agency to deal with this issue to have an ongoing program. Mr. Speaker, the ministry officials have informed me that progress is being steadily made, Mr. Speaker. And yes, there are going to be decisions made by physicians to step aside. But, Mr. Speaker, we’re going in the right direction. It isn’t the working of that group . . . [Interjections] The Speaker: — Order. Order. I’d ask the opposition members to give the minister the same opportunity to respond as the government gave the member to ask the question. I recognize the minister. Hon. Mr. McMorris: — Mr. Speaker, it isn’t the working of that group that would get into the micromanagement of what happens within a health region or the Cancer Agency. That is the auspices of the Cancer Agency or the regional health authority in their particular area, Mr. Speaker. The Speaker: — I recognize the member from Saskatoon Eastview. Ms. Junor: — Mr. Speaker, this is clearly a lack of leadership. The working group has been ongoing for over two years. They’re going to just keep spinning their wheels unless the minister says, do this. The minister’s incompetence and failure to address the problems means there’s now only one gyne-oncologist looking after all of southern Saskatchewan women. This will put additional pressures on the remaining gyne-oncologist and potentially will increase the wait time for women who are waiting for even an initial diagnosis. My question to the minister is this: will the Sask Party government be forced to send women out of the province for diagnosis and treatment because of their incompetence and failure? The Speaker: — I recognize the Minister of Health. Hon. Mr. McMorris: — As I had mentioned earlier that the health region, the Saskatchewan Cancer Agency, the Regina Qu’Appelle Health Region will be working hard in the next . . . in the past but as we move forward over the next month or so to attract another gyne-oncologist into the province. I am very proud of our government having set up a physician recruitment agency that will deal with this very issue, these very issues, Mr. Speaker. Unfortunately that hadn’t been done for many, many years — never even contemplated under the former government when we saw hundreds and hundreds of doctors leaving this province, Mr. Speaker. In the last two and a half years, we’ve seen more doctors come to the province than leave — an increase of about 164. There is more work to do. That’s why we set up a recruitment agency, Mr. Speaker. And that’s why we’ve also increased the number of training seats in the College of Medicine and the number of residency positions, up to 108 residency positions in the province, Mr. Speaker, that will bode this province very well into the future. The Speaker: — I recognize the member from Saskatoon Eastview. Ms. Junor: — Mr. Speaker, ducking and weaving, I mean there is no answer in the minister’s rhetoric. And Dr. Brydon’s leaving her practice now because the province will not set up a gyne-cancer unit in Regina. This unit would allow women to be diagnosed, treated, and receive follow-up care in one place. To quote Dr. Brydon: I actually don’t think that the way the system is structured in this province at this time allows anybody to do the job that needs to be done properly and that is because we do not have a gynecologic women’s cancer unit the way all other provinces do. Mr. Speaker, to the minister: is the minister going to establish a gyne women’s cancer unit in the province now, or is he going to wait and wait and wait, and talk and talk, and talk and continue to risk the lives of women with ovarian cancer? The Speaker: — I recognize the Minister of Health. Hon. Mr. McMorris: — Mr. Speaker, we know and understand the very importance of this issue, Mr. Speaker. That’s why we set up a working group that has patient representative groups on it, that has the oncologists on it, that has the Cancer Agency, that has the health regions, to look at how to best manage this project, Mr. Speaker. There has been progress made, absolutely. But it’s interesting that they would stand and criticize the way the program and the way the health system is being run, when they have been in government for 16 years prior, setting up the very program they’re criticizing now, Mr. Speaker. Mr. Speaker, we’re looking at how we can improve this program as we move forward. We’re looking at how we can have the proper complement of gyne-oncologists within the province, Mr. Speaker, because we know that it is a very important issue, and we’re working to improve the health of women in our province, Mr. Speaker.

Crying Shame Dr. Brydon closing office

Dear Editor:

We want to thank Pam Cowan for an excellent article about Dr. Brydon, Regina Gynecologic Oncologist being forced to walk away from her practice (LP, Apr 9/10) but what a crying shame to see this happen after two years of educating the Ministry of Health about the risk of losing this specialist so needed for gyne cancer patients in Southern Sask. We must ask again, why is Sask having such a difficult time retaining cancer specialists? In the various reasons for Dr. Brydon’s physical and emotional frustration the brutal winter weather was never mentioned. It would have been so easy and inexpensive to have prevented this office closure. Some oncology nursing support, some in-hospital office space, some ownership by the Ministry of the problem in Saskatchewan with the delivery of gyne cancer care. It’s not so complicated and it has been dealt with very well in all other jurisdictions in Canada. Why is Sask willing to let women’s lives hang in the balance doing more study and design with no clear objectives and date for completion, while great examples for a gyne onc program are all around us?

Ms. Jordon of SaskHealth is quoted in the article as stating that while the RQHR recruits a gyne oncologist “referrals will be made to other providers such as gynecologists”! This is alarming. Gynecologists in Sask are great at what they do, but they are not trained, experienced or necessarily have the skills to tenderly lift up vital organs and scrape cancer cells away, remove organs from the abdomen and do a thorough search for lurking cancer cells. One of the most challenging parts of a hysterectomy performed for a patient suspected of having cancer can be the cutting away of cancer cells that have attached to the bowels. This can mean life or death right on the operating table if not done perfectly. If Dr. Brydon feels her skills aren’t up to par, what is the chance that a regular gynecologist can replace her? This is a tragedy for the women of Saskatchewan. It seems delivery of Sask gyne cancer care is going backwards.

Also backward is Jordon’s stated aim to “coordinate care for women and provide information about services, but not to set up a physical unit”. This flies in the face of proper standard gyne cancer care delivery, hardly a recruitment strategy to lure skilled gyne oncologists to Saskatchewan. It’s not like no one knows – about a year ago a mentor in the delivery of gyne cancer care, Dr. Ehlan, from the BC Cancer Centre was in Saskatchewan doing a presentation on an excellent program in BC. This is just one piece of information provided to SaskHealth.

We’re also very curious about Jordan’s interpretation of patients’ input in the Patient First Review. I guess she hasn’t read our contribution. We can’t visualize “hands-off of care” but know this – for patient-centered care a gyne cancer UNIT is definitely needed in Regina and in Saskatoon and is a world wide standard and expected by all gyne oncology graduates. Without an actual UNIT for care, how can specialized delivery of intraperitoneal chemotherapy be delivered? Where will our gyne oncologists be based? Where will the radiologists, pathologists, oncology nurses go for advice, consultations, supplies, information? Like the Breast Health Clinic in the Pasqua Hospital, a Gyne Cancer Unit will lead to better care, understanding, diagnosis, treatment and awareness. Why wouldn’t this be part of a Sask gyne oncology program?

We concur with Dr. Brydon’s suggestion that someone in the Ministry of Health, SaskHealth, health districts, cancer agencies and department needs to own the problem. We suggest that the Ministry assign a Communicator immediately and bring the gyne cancer program working committee together properly with a time line and simple parameters to ensure high quality work in a short period of time and holds the participants accountable. We need to stop wasting time and putting women’s lives at risk. We need to implement a program, provide proper support/offices/nursing, update outdated Sask gyne cancer policy. It’s time for women in Saskatchewan to take notice and ask for what is needed – before being diagnosed! We can assure you that once you are fighting cancer, it’s very difficult to also try to advocate for a proper doctor.

Darlene Gray, On Behalf of OCATS

Ovarian Cancer Awareness & Treatment in Saskatchewan

Regina gyne oncologists forced to walk away from practice

Women's Cancer Specialist Closes Office

Today in Regina, Sask, Dr. Brydon, Gynecologic Oncologist closes her office and will not be taking new patients or be on the regular schedule for gyne cancer surgeries. As reported to OCATS, Ovarian Cancer Awareness & Treatment in Saskatchewan, Dr. Brydon states the unworkable working conditions as a contributing factor to the closure. Working in oncology is a difficult, stressful job and it takes it's toll. Substandard working conditions have taken their toll. Read the media release. Thank you.

Ovarian Cancer Awareness, You Can Help!

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tHe art of the Matter

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ocats membership form

Support For New Gyne Cancer Patients ON THE WAY!

I want to send big the biggest and warmest heartfelt thank you to all the Saskatchewan women who came forward to help women with gynecologic cancers. Today, we celebrate a dream come true. Last year we wanted to find a way to deliver support to gyne cancer patients by other patients. OCATS, with the help of many, raised over $10,000 towards the development and assembly of New Patient Care Kits to be delivered to patients directly upon diagnosis by our gyne oncologists. We have started assembling the kits and today are making our very first delivery. Today, it feels really good to be a volunteer! Thank you everyone who helped make this dream come true - the work continues. Love, Darlene xxxx and OCATS

It is very difficult to report to you all that Dr. Brydon, Gynecologic Oncologist for Regina area will be closing her private practice this spring, likely at the beginning of April. This is the news we have been anticipating and dreading. And this is the very situation we have all worked so very hard to avoid. However, it is impossible for Dr. Brydon to continue in gynecologic oncology. For over two years Dr. Brydon has alerted everyone within the system as to the working conditions and has prepared for her departure. It's just so sad to see it happen, when it could have been avoided. For current patients, Dr. Brydon, on her 1 day a week contract (which will continue) with the Allen Blair Cancer Centre, will see you throughout and she will be available for your surgery, your treatment and for your follow-up although I am not certain the Allen Blair Cancer Centre will facilitate this. Upon the closure of her office, she will not see any new gynecologic oncology patients and she will not be on the schedule to do surgeries for new patients. We are now short one gynecologic oncologist, have dreadful working conditions and no gynecologic oncology program in order to recruit a replacement. It is my concern that the working conditions in this new situation can only make the issue of retention of the remaining gynecologic oncologist in Regina more delicate. This is a tragic scenario for women in Saskatchewan. It is important for us to ensure support of current patients - and current patients have no reason to be concerned, your treatment and care will proceed. It is important for us to not alarm anyone unnecessarily. However, it is also important for the women of Saskatchewan to know the truth. The truth is Saskatchewan has been unable/unwilling to provide appropriate working conditions to retain our specialists, and now recruitment of a replacement specialist is going to prove even more difficult. The truth is that 3 gynecologic oncologists probably can't handle this workload. The truth is that some Regina area patients will be forced to go to Saskatoon for treatment. We cannot advocate for our own health, and that of our sisters, without knowing the truth. Together, with the truth behind us, we are very powerful. It was always our intent to prevent this situation rather than deal with the consequences and all our hard work was directed to that goal, but that is now the past. Rather than do a Media Release at this moment, we are going to give the benefit of the doubt to the powers that be to respond; we will be watching for concrete evidence. It is hoped that the current situation will convince the Medical Services Branch (i.e. the "secret committee") to implement an immediate solution within the next 30 to 60 days. However, once Dr. Brydon's office is closed we will have no choice but to educate the public about the situation and we will need your support to do so. Darlene Gray, Director OCATS

What bugs you about having Cancer? Besides the Obvious?

What Bugs You About Having Cancer, Besides the Obvious?
OCATS
Ovarian Cancer Awareness & Treatment in Saskatchewan
A SUPPORT & ACTION GROUP FOR PEOPLE AFFECTED BY GYNECOLOGIC CANCERS
December 2009 Support Group Meeting
What Bugs You About Having Cancer – Besides the Obvious?