Some patients opt to pay for U.S. cancer screening, even as new B.C. program seeks to lift backlog

Leah Rowntree found out she had cancer just over four weeks ago — but might have still been oblivious had she not pushed to get a special screening that showed a lump in her breast.

And had the West Vancouver, B.C., resident not paid out for a private MRI scan in the U.S., she wouldn't have known exactly how serious that lump was. 

As some B.C. cancer patients were offered trips to Bellingham, Wash., this week to take up radiation treatments in an effort to clear up a cancer treatment backlog, Rowntree is among a number of residents already paying for private cancer care south of the border due to lengthy wait times here.

Doctors say that while B.C.'s move to offer radiation treatments in Washington state will be helpful, the province still has to improve other aspects of cancer care — like diagnostics — in order to help alleviate pressure on the system.

Rowntree, 49, says she has been vigilant about checkups since her mother died of breast cancer at the age of 55.

She said she waited at least a year for special ultrasound screening for dense breast tissue, which can appear the same as cancer in a mammogram. 

She got the screening on March 18 but had to wait almost four weeks for the results. During that time, a mammogram showed no problems. 

However, the screening results she received on April 11 showed a lump, and the results of a biopsy another two weeks later — which had originally been scheduled for June 28 before a cancellation made an earlier appointment possible — confirmed it was a cancerous growth.

But it wasn't until Rowntree made a trip to the U.S. that she learned her condition was a lot more serious.

While she waited another two weeks for an appointment with a surgeon to work out a treatment plan, a friend who had had a similar type of cancer urged her to get an MRI scan. Learning there was a year-long wait for such a scan at Lions Gate Hospital in North Vancouver, she paid out $1,400 US for an MRI and lymph node screening during a trip to Los Angeles.

The results she received the same day showed the lump was bigger than the biopsy indicated and that she had Stage 3 breast cancer that had spread to the lymph nodes.

"I went from having a clear mammogram to now having Stage 3 breast cancer, which is still potentially curable," she said.

But Rowntree says she feels lucky because if she hadn't gotten that critical diagnosis, she might have been facing a worse prognosis in the months ahead.

She says the results of the MRI scan, and a followup PET scan she had done privately in Burnaby, meant her surgeon was able to mark her case as urgent and she could see a B.C. Cancer oncologist within 10 days instead of the standard six weeks — which, Rowntree says, would have been recommended based on her original ultrasound.

Wait times up across the board

Leanne Kopp, the executive director of the Island Prostate Centre, says that wait times in B.C.'s medical system have become longer and longer due to the impacts of the COVID-19 pandemic.

"It's a double-edged sword for patients because you know how great [it is] that there is a temporary solution," she said, referring to the plan to send patients to Washington state.

"But … not only are you dealing with a cancer diagnosis, now you're dealing with the reality of not even being in your own community, in your own home, helping you heal during this stressful time."

Dr. Chris Hoag, a urologist in North Vancouver and president of the B.C. Urological Society, said there are a lot of "upstream waits" in the cancer care system that were leading to pressure on those providing radiation treatment in the province — such as increased wait times for diagnostics and referrals to oncologists.

"Consultant specialists have been saying that it's good we have to address these downstream waits for [radiation] treatment," he said.

"If we really wanted to be serious about improving cancer care in this country, in this province, we need to address all the upstream waits, too."

Province says it's beefing up hiring

Health Minister Adrian Dix said that the target wait time for a patient to access radiation treatment is 28 days, and B.C. Cancer reports the target is being met for 82.9 per cent of patients.

Data shows that B.C. has lagged behind the national average over the last four years when it comes to cancer patients receiving timely radiation treatment.

Prostate cancer and breast cancer patients will be the first to be offered trips to Bellingham for radiation treatment, which will be covered by B.C.'s public health insurance system.

Dix says up to 50 patients per week will be offered the radiation treatments in Bellingham and that B.C. Cancer is increasing hiring as part of the province's 10-year cancer plan. The Health Ministry says that, as of April 1 this year, the annual compensation for oncologists at B.C. Cancer was increased.

The health minister also recently announced plans to build cancer centres in Nanaimo and Kamloops, which he says will eventually lead to more capacity for treatments in B.C.

"We know that the 10-year cancer care action plan, and the $440 million in funding driving it, support immediate steps to better prevent, detect and treat cancers," he said.

According to the health ministry, B.C. Cancer has received 45 referrals from doctors to have patients sent to Bellingham for radiation.

"B.C. Cancer is working with Bellingham treatment centres to confirm the number of patients that will start treatment this week," a spokesperson said in a statement.