Surgery wait times in Quebec three times longer than government benchmarks

MONTREAL – Surgery wait times for deadly ovarian, cervical and breast cancers in Quebec are three times longer than government benchmarks, leading some desperate patients to shop around for an operating room.

But that’s a waste of time, doctors say, since the problem is spread across Quebec hospitals.

And doctors are refusing to accept new patients quickly because they can’t treat them, health advocates say.

A leading Montreal gynecologist said that these days, she cannot look her patients in the eye because the wait times are so shocking.

Lack of resources, including nursing staff and budget compressions, are driving a backlog of surgeries while operating rooms stand empty.

The latest figures from the provincial government show that over a span of nearly 11 months, 7,780 patients in the Montreal area waited six months or longer for day surgeries, while another 2,957 waited for six months or longer for operations that required hospitalization.

“It’s a crisis for Quebec women”
The worst cases are gynecological cancers, experts say, because usually such a cancer has already spread by the time it is detected.

Instead of four weeks from diagnosis to surgery, patients are waiting as long as three months to have cancerous growths removed.

“It’s a crisis for Quebec women,” said Lucy Gilbert, director of gynecological oncology and the gynecologic cancer multi-disciplinary team at the McGill University Health Centre.

Her team has had access to operating rooms only two days a week for the past year, with dozens of patients having surgeries postponed week after week.

Patients are prioritized according to need, Gilbert said, but surgical delays are still too long.

Gilbert says there are days she can’t face going into work at the Royal Victoria Hospital, a renowned cancer centre in gynecology, and dealing with crying patients.

“Put yourself in their place . . . I have difficulty making eye contact with patients. I am ashamed to be in such a situation.

“People are suffering. People are waiting too long,” Gilbert said.

“This should not happen. No matter how good your surgery is, no matter how good your chemotherapy is, if you delay the surgery there could be a problem. The cancer grows. The cancer spreads.”

“The doctors are amazing but the system isn’t working”
One worried patient, a mother of five children who waited three months for surgery for invasive breast cancer, said she is worried about the effects of such a long wait.

After surgery, she paid $800 for a bone scan in a private clinic rather than wait five months for a scan at the Jewish General Hospital.

“They needed the scan to see what kind of treatment to give me,” said the woman, 40, who asked that her name not be published because she is starting chemotherapy this week.

“The doctors are amazing but health system is not working.”

Montreal health advocates meeting in Toronto on Monday planned to discuss surgery delays in oncology, said Cathy Ammendolea of the Canadian Breast Cancer Network and a volunteer at the Hope and Cope Wellness Centre at the Jewish.

“We’re talking wait times of two to three months.

Women are desperate and doctors are frustrated,” said Ammendolea, who encountered physicians at the hospital distraught they could not take on new patients because operating rooms are not available in a timely manner.

“To the point where they are not going to see patients that fast, because if they see the patient, they have to treat the patient, and to do that properly you need access to an OR. It’s crucial for ovarian cancer,” she said.

Officials at the Jewish were not available to comment Monday.

But according to advocates, women are shopping for available ORs in secondary hospitals not suited for complex cancer surgeries, Ammendolea said: “Once they are diagnosed, they are trying to get rid of it as quickly as possible.”

Dr. Robert Sabbah, president of the Association of Obstetricians and Gynecologists of Quebec, said some patients will seek care elsewhere to reduce wait times.

But most are getting surgery within three months, he said.

In 2007, Quebec announced it would reduce surgical wait times to less than four weeks for all types of cancer, but it’s a rare doctor who has wait-lists of less four weeks, Sabbah said.
 

Why the wait?
Quebec’s promise to cut delays translated into improvements in eye, knee and hip surgeries, Sabbah said, but oncology remains a bottleneck because of budget deficits and staff and equipment shortages.

“Cancer patients are very vulnerable – no patient should wait, but especially cancer,” Sabbah said.

CHUM delays two years ago
Two years ago, because of potentially devastating delays, oncologists at the Notre Dame Hospital of the Centre hospitalier de l’Université de Montréal sent women with gynecological cancer to other hospitals in Quebec City and Trois-Rivières.

Doctors had to alter treatment in women where the cancer had advanced, CHUM and Notre Dame oncologist Philippe Sauthier told The Gazette in an earlier interview.

At the time, the wait-list there had about 120 women and 50 of them were waiting longer than four weeks.

Sauthier then wrote an open letter accusing the Quebec government and his hospital of ignoring best practices in favour of balancing the books.

As of March, things began to improve, Sauthier noted in an email, once the CHUM added a sixth operating room dedicated to fast tracking gynecological cancer.

By September, 61 per cent of the CHUM’s cancer gynecology operations were done within four weeks of diagnosis, said CHUM spokesperson Sylvie Robitaille.

MUHC wait times
In August, the McGill centre had at least 100 women waiting for gynecological cancer surgery; 78 of them waited longer than 28 days.

As of September the wait-list shrunk to 46 women, 33 of whom were on a wait-list more than 28 days, said MUHC spokesperson Ian Popple.

Ariane Lareau, a press attaché to Health Minister Réjean Hébert, said budgets have little to do with OR congestion and it’s up to each hospital to determine its priorities.