Fill end-of-life care gaps: cancer group

Where Canadians live often makes a difference in whether or not they are able to die with dignity where they wish, according to a new report released Wednesday.

The Canadian Cancer Society released a special report about end-of-life care with the Canadian Cancer Statistics 2010 report.

"The rates are stabilizing and declining for the deaths but the actual numbers are going up," said Heather Chappell, director of cancer control policy for the Canadian Cancer Society. "So that's going to be a huge burden not only for families and caregivers but for the system itself to be able to support the number of people who need services at the end of life."

Canada has a "patchwork approach" to providing care at the end of life, which means some cancer patients and their parents aren't getting the high-quality support they need, Chappell said.

Caregiver support

The report showed that when palliative care services were available, people were not necessarily using them. It could be that families aren't aware or doctors may not be referring them early enough to take advantage of the services, Chappell added.

Besides the psychological burden on caregivers, the financial burden reaches about $36 a day or over $1,000 a month on average for a family caring for a cancer patient. The figure includes medications, nutritional supplements and adaptive equipment, but not lost wages if people have to take time off to care for a loved one, the society said.

The society called for:

• An increase in how long a caregiver can receive financial benefits for compassionate care to 26 weeks from the current six weeks, given the unpredictability of death.
• Establish a caregiver tax benefit that would be paid monthly to help caregivers with the costs related to caring for a loved one with cancer.

The society released its annual statistics, predicting an estimated 173,800 new cases of cancer — an increase of 2,800 from last year. Almost 174,000 Canadians will be diagnosed with cancer this year and more than 76,000 will die of it, which remains largely a disease of aging.

Death rates continue to decline for both men and women. Since 1996, the death rate for males has dropped by 1.2 per cent per year and by 1.7 per cent per year for females. This is likely the result of improvements in treatment, such as chemotherapy, the society said.

Healthy lifestyle key

Lung cancer continues to be the leading cause of cancer death for both men and women, which is directly related to smoking rates, Chappell said.

This year's report looked at two cancers in more depth — cancer of the esophagus and of the kidney.

Although cancers of the esophagus are still relatively rare in Canada, the incidence rate of one type of esophageal cancer —  esophageal adenocarcinoma — has doubled in the last 20 years. This may reflect the rising prevalence of obesity and gastro-esophageal reflux disease.

Likewise, the incidence rate of kidney cancer in Canada has increased by about 1.3 per cent per year for both sexes since the late 1990s. These increases may reflect changes in the prevalence of certain risk factors, particularly obesity, the report said.

"We’re seeing the types of cancers that are directly linked to our body weight going up as the rates of our population who are overweight or obese are going up, so that's very concerning to us," Chappell said.

"Just having a healthy lifestyle we think can reduce up to half of the cancers that we’re seeing in Canada."