Slow government approval process for new treatments hurting breast cancer patients: experts

It’s time for Canada to step up its game for breast cancer patients just as it has in the fight against COVID-19.

That’s what experts are saying following a recent report that looks at how Canada is faring in adopting new testing, technologies, treatment and techniques for breast cancer patients.

While Canada is doing well for its patients overall, experts like Dr. Sandeep Sehdev of The Ottawa Hospital say Canada is lagging behind when it comes to bringing care for breast cancer patients into the future. 

“In Canada, we generally have high quality care,” Sehdev explained. “We’re very evidence-based and very cost conscious. The problem we have in Canada is that sometimes we’re slow to adapt breakthrough changes because our vigorous processes to implement and review are quite slow and onerous.

“And that’s the problem we have now: we’re trying to incorporate the newest technology and what we call ‘molecular finger-printing’ of cancer to find individual Achilles heel of a patient’s cancer to fight it properly.”

And while the vetting process helps to make sure patients are getting the best, it’s a Catch 22. A slow and more cautious approach to care in an ever-evolving space is also causing delays and setting Canada and Canadians with breast cancer back.

“When I talk to patients they do find it frustrating because the treatments we’ve had in the past have been effective but now we have technology to really understand the cancer at the genetic level,” Sehdev said. “The gene setter abnormalities vary from patient-to-patient and we can often find a particular genetic weak spot in a cancer — a fingerprint to cancer — to better tell what the best treatment will be for that patient, and when.”

And it disappoints Sehdev to see because he knows the tools and technology exist and they are within reach. In fact, many of them are used for treatment in neighbouring western countries like the U.S.

But until Canada approves those tools itself, Sehdev says he will be restricted with what he can do for his patients.

And the time he’s forced to wait to be granted access to those tools not only show a lack of response on the system’s part, Sehdev said, but the time it takes for policy and lawmakers to give the rubber stamp of approval could mean life or death for some patients. 

“We, as a system, when it comes to precision oncology and new treatments in general, it’s an ever-evolving space and it’s changing dynamically and it’s new,” said Niya Chari, director of public affairs and health policy at the Canadian Breast Cancer Network. “There needs to be a real need for consensus and standardization and a framework to develop to facilitate access.

“We’re all trying to figure out how to best implement something like this into our health-care system and get these treatments that are so effective to the patients that could best benefit from them.”

According to the Canadian Cancer Society, it is estimated that in 2021, 27,700 women in Canada were diagnosed with breast cancer — that’s 25 per cent of all new cases in women in 2021. 

In all, about 5,400 Canadian women were estimated to have died from breast cancer, which represents 13 per cent of all cancer deaths in 2021. 

On average 76 Canadian women were diagnosed with breast cancer every day, and 15 women died from breast cancer daily. 

But seeing what has been accomplished with COVID in a short amount of time, Chari says there is no reason the government can’t do the same and have the same attitude when it comes to other areas of medicine like cancer, illness and more. 

“The lessons from COVID are really important to remember here — whether it’s for breast cancer or any type of cancer,” she said. “When it really matters, we’re able to mobilize the political will to change our regulatory pathways, view real world evidence and get treatments to people when they need it. I think we need to apply those same lessons and opportunities and pathways that were created for COVID and keep that momentum going for other diseases, including cancer.”

And considering the ever-evolving space for researchers, medical professionals and patients, both Sehdev and Chari agree that releasing a report looking into these issues was long overdue. 

“I would hope we’d be able to treat patients and not guess what the treatment should be, and not operate in the dark. Just like I would never treat a cancer without a CAT scan or blood tests we do every day ,” Sehdev said. “I think we need this ability now to properly profile a patient’s cancer and to plan what the best treatment should be.”

But the disparity between provinces and even postal codes within our province, Sehdev says, is unnecessary.

And, Chari adds, that inequity in the system — another barrier — is preventing some patients from getting the treatments they could benefit from. 

“It’s based all upon varying policies’ access to funding,” Sehdev said. “I don’t think Canadians would stand for that if they realized that.”