Widowed by cancer, a Waterloo woman wants to see screening return to pre-pandemic levels

Jane Mitchell sat in her car in the parking lot of the Grand River Hospital listening on the phone as her husband sat in an office across from an oncologist.

She wasn't allowed to go inside the hospital with him on that day in October 2020 because of COVID-19 protocols.

She listened as the oncologist told John he had stage four esophageal cancer. He had six months, maybe a year to live.

Mitchell heard her husband crying in the office alone.

In the car, she wept, too.

"That was pretty tough," Mitchell says.

What followed were incredibly difficult and exhausting months of helping John feel comfortable as the cancer spread, says the former regional councillor and past executive director of HopeSpring Cancer Support Centre in Waterloo.

There were appointments with doctors by phone. Sometimes, Mitchell took photos of John in his deteriorating state to send to doctors.

"He did have some chemotherapy and radiation," Mitchell said. "One time his oncologist said to me, 'Oh, don't you like that radiologist with his nice little beard?' And I said to her, 'I have never met that man.' And I thought to myself, and I have never met you either because it was all over the phone."

Their daughter came to live with them to help care for her dad. The family didn't move John into hospice out of fear they might not be able to be with him at the end. 

John died on May 22 of this year with his family beside him.

Mitchell says she has heard about people being hesitant to go see doctors during the COVID-19 pandemic, leading to missed scheduled cancer screenings.

She said her husband went for regular cancer screenings and his illness wasn't caught — but she urged people both to continue to get screened and not to ignore unusual symptoms.

"If you're just feeling unwell generally and you seem to be losing your appetite and sleeping … go to the doctor," she said. "I know people worry, 'Oh, it'll be nothing. I'm bothering the doctor.' No, just go be checked just to make sure that you're OK, because it can sneak up on you."

Screenings dropped during 2020

On March 23, 2020, following a Ministry of Health directive, Ontario Health recommended that all routine cancer screening tests be temporarily deferred as COVID-19 began appearing in the province.

A report from researchers, including those from Ontario Health, found there were 900,000 fewer cancer screenings done in 2020 compared to a year earlier due to the pandemic.

Stephen Piazza, senior manager of advocacy with the Canadian Cancer Society, says cancer screenings in Ontario dropped by an estimated 47 to 56 per cent in 2020.

"This drop is alarming," he said in an emailed statement.

The province says it resumed cancer screenings in May 2020, but Piazza says there are people who missed appointments and routine screenings who still need to be seen.

"We are concerned that there could be serious impacts as [a] result of delays to cancer diagnosis and treatment," he said. "While some progress has been made, the province must seize every opportunity to address the backlog in cancer screenings as soon as possible and ensure that screening programs are sufficiently resourced."

The province says it's nearly back on track when it comes to the number of screenings being done.

In an email to CBC Kitchener-Waterloo, a spokesperson for Ontario Health said as of this past September, breast and colorectal cancer screenings have "reached or exceeded pre-pandemic volumes" while screening for cervical cancer has not reached pre-pandemic volumes but it is "steadily increasing."

Ontario Health also said there are a number of initiatives underway to address the backlog of people who put off getting cancer screenings, including reminder letters to people who are due or overdue and the development of a cancer screening awareness toolkit for health-care providers.

Don't wait to feel unwell

Dr. Neil Naik is also asking people to book their cancer screening appointments, particularly if they were delayed due to the pandemic.

"Screening is important because catching it early has a better outcome," said Naik, who is the interim regional primary care lead of the Waterloo Wellington Regional Cancer Program.

He noted that a regional drop of 16 per cent in pap tests done in July compared to July 2019.

"We have not returned to those pre-pandemic levels yet," he said.

He said people shouldn't wait until they're feeling unwell.

"Screening regularly is meant for people who don't have any symptoms … for people who feel that they're healthy, who feel that there is nothing wrong — we're trying to catch it in the early stages."

Mitchell says she plans to go to her next colon cancer screening because both her father and grandmother died of colon cancer. She's had one non-cancerous polyp removed because of screenings and it gives her peace of mind.

She also encourages people to take care of their health in general.

"If you have diabetes like me, you should still be getting your diabetes checked…. that's really important," she said. "Make sure you keep up with all your things. If you are immunocompromised, you want to have your health the best."