Ontario woman denied coverage for cancer surgery in Germany says system failed her

Click to play video: 'Ontario woman seeking cancer surgery says system failed her' Ontario woman seeking cancer surgery says system failed her
WATCH ABOVE: An Ontario woman has paid for her own cancer surgery, thanks to donations from family, friends and strangers. She says it seemed the medical system was working against her. Christina Stevens reports – Jun 7, 2016

Sixty-five-year-old Colleen Walters has undergone cutting edge cancer surgery in Germany, after family and friends came through when she says the medical system failed her.

Walters said four years ago her doctor failed to mention a mass seen on a CT scan. Still suffering symptoms, a new doctor ordered an emergency ultrasound in January.

“Within five minutes he came over to me, he said, ‘We have a problem,'” she told Global News.

The diagnosis was inoperable pancreatic cancer and it was hoped chemotherapy would stop the tumour’s growth.

Walters said doctors in Ontario offered no other options. Then a family member found a video online that showed an innovative treatment in Germany called nanoknife surgery, in which tumour cells are destroyed using an electric current.

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“I am after it, because I want to live,” said Walters.

Once approved by the German surgeon, Walters began the application process to get OHIP to pay for the $32,000 surgery. That was in April.

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“Our hopes were that OHIP would come through and deliver for my mom,” said Bryan Hewitt, Walters’ son.

Walters said on May 16 she hand delivered the main request form from her doctor to the medical records department at London Health Sciences Centre, to be sent to OHIP immediately.

But she found out on June 1 the paperwork was still at the hospital, which she said was “very disheartening.”

A flurry of activity followed, rushing the forms to the right places.

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OHIP managed to turn around the request in just two days, but the decision was not the one the family was hoping for and the application was denied.

The denial letter said that the treatment requested was considered experimental.

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A former OHIP lawyer explained provincial health insurance doesn’t cover experimental treatments.

Perry Brodkin said, in his opinion, the rejection was automatic — because according to the denial letter the oncologist who applied for Walters suggested himself that it is an “experimental” surgery.

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“He was not in any way acting as an advocate for the family,” said Brodkin.

Neither the doctor nor the hospital has responded to requests for comment from Global News.

The surgery has been performed in the U.S. for five years and in Germany for 18 months, where the surgeon there said it’s not considered experimental.

“There are different places in the world, we are doing that,” said Dr. Matthias Birth, speaking from Straslund, Germany on Skype.

Walters’ family has used GoFundMe to raise about half the cost of the surgery, and are sill figuring out how to pay the rest.

She said instead of dwelling on how the medical system has failed her, she is focused on how family, friends and strangers have helped.

“What an awesome thing to do, awesome,” she said.


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