'It's just better being at home': New clinic brings cancer care to Nunavut

When Ellen King's husband Eliyah was diagnosed with pancreatic cancer in 2020, it was just the start of a long health journey — one that would require the couple to travel far from home to Ottawa frequently and for long periods.

That's because there are few oncologists — cancer specialists — who work in the North. The first time King and her husband travelled for Eliyah's treatments, they left in December, and they didn't return home until May.

"It's horrible, cause we have to leave our family, we have to leave our friends and worst of all we have to leave our fur baby — and the dog is Eliyah's shadow and they do everything together," King said.

Starting this week, the couple's stress over cancer treatments might lift at least a little — for the first time ever in Nunavut, an oncologist team will be offering follow-up care to some cancer patients at the Qikiqtani General Hospital in Iqaluit, in the territory's first specialty cancer clinic.

Over the past year or so, King has been getting support for her husband from the patient support line out of the Ottawa Hospital, which helps her get answers to questions about prescriptions, for example, or to just "talk me off of the ledge of freaking out."

Now, having a specialist available at the Iqaluit hospital, they'll get that kind of care in person.

"It's almost like having patient support line here in the hospital, but they can actually look at [the problem]," she said. "If he gets a little condition on his skin or anything like that, it's really hard to describe it over the phone … [now] they'll be able to see it for themselves and understand what I'm saying."

A 'springboard' for care in the North

Marc Gaudet is a radiation oncologist and head of the division of radiation oncology for both the Ottawa Hospital and the University of Ottawa. He's been working alongside Dr. Gad Perry, one of his oncologist colleagues, for a few months to get a physical presence on the ground in Iqaluit for cancer patients in Nunavut.

They'll be seeing people who either have a new diagnosis of cancer or who are being followed after their cancer treatments, but won't be offering chemotherapy, which will still require travel south. The team also includes staff from the Indigenous Cancer Program at the Ottawa Hospital, including its clinical director and the Indigenous nurse navigator. The clinic began Monday.

Meetings to make the clinic happen began in the spring of this year, Gaudet said, adding he met with the Iqaluit hospital's chief of staff and the territory's public health officer, among others to work out details, like who would be seen and how often. Both he and Perry have since been licensed to practice in Nunavut.

Gaudet said he has experience working in other outreach clinics outside of Ottawa, including in northern Quebec.

"The idea is to allow us to see people with many, many different types of cancers," Gaudet said.

"The advantage that we have being on the ground [in Nunavut] is that we … know who to contact in Ottawa if there are very specific things to deal with."

Gaudet said the clinic is part of a relationship that's been building for many years and he calls it a "springboard" to getting access to more care in the North.

"We've been responsible for treating people from up North for a very long time, but it's now five or six years that we've been building that collaboration even more and I mean, it's the first step in actually getting us on the ground to see people close to home and understand your reality a lot better," he said.

"As of now, there's very little oncology presence in the North."

During the pandemic, Gaudet said several patients were able to receive a form of cancer treatment at home in Nunavut. He hopes this clinic can help build on that too.

"There was a great relationship between the staff at the Qikiqtani General Hospital and our staff to make that work," he said.

"It's a long process to get all these protocols in place and get everybody trained in the right way to make it just as safe to do this up North as it would be to do it in Ottawa … The fact that we'll now be regularly going up will help us build those relationships and make sure we can provide training when we are there."

Gaudet also hopes having a clinic closer to home will produce better outcomes in Nunavummiut diagnosed with cancer.

One of the challenges he's observed with cancer in the North is patients presenting later in the disease, partly due to issues with accessing health care services. 

And of course, there's the stress of having to travel south for care. 

'Long overdue'

For King, the reduction in that stress has been enormous. 

She said her husband's had excellent care from their oncologist in Ottawa, Dr. Rachel Goodwin. But they were grateful when Goodwin gave Eliyah, on June 27, the blessing to return home to Nunavut from Ottawa. 

"She is amazing and always took her time with us to make sure all our questions and concerns were answered," King said of Goodwin. "If she wants to see him, we'll get on a plane, no hesitation.

"But just the fact that he can be seen here, they can take notes, they can send [the notes] to her in the language that you know — doctor talk — it lets her know, as well, just how well he's doing."

And, King says, this clinic "long overdue."

"Being at home … he can sleep when he wants, I can cook what he needs. I can, you know, make him anything he wants anytime he wants it in the comfort of bed. He can be out on the land," King said.

"It's just better being at home."