Study looks at cancer rates, care, and survival on Haida Gwaii

A study based on 40 years of patient records looks at how aboriginals and non-aboriginals experience cancer on Haida Gwaii.

A new study looks at how cancer rates, care and survival differ for aboriginal and non-aboriginal people on Haida Gwaii.

Based on over 40 years of local patient records, the findings will be presented for the first time at a May 3 community dinner in Old Massett.

Led by Dr. Rob Olson, a radiation oncologist and researcher at the BC Cancer Agency centre in Prince George, the study also suggests ways to improve cancer care for remote places.

Dr. Tracy Morton, a Queen Charlotte physician with extra training in oncology, joined Dr. Olson as a co-investigator in the research.

“We looked at things like the number of trips, how long it took to get from symptom to seeing your doctor, from the doctor to the cancer agency, and the cancer agency to treatment,” said Dr. Olson.

“We were trying to see if there were some bottlenecks, and things we could improve on.”

In 2014, Dr. Olson led a survey that compared the unmet needs of aboriginal and non-aboriginal cancer survivors living in eight remote places across northwest B.C.

“Certainly, some of the aboriginal communities felt more out of the loop,” he said.

“They also felt like the resources weren’t there for them.”

For example, Dr. Olson said counselling services were often unavailable for aboriginal survivors, despite being listed on a website as standard care.

Haida Gwaii is a unique place to study the issue because everyone, aboriginal or not, lives far from major cancer care centres.

“It really narrows it down much better than in other studies,” said Olson.

While it still has a ways to go, Dr. Olson said cancer care in the northwest is improving.

The BC Cancer Agency Centre for the North, which opened in Prince George in 2012, has a healing room for aboriginal patients and a dedicated aboriginal care coordinator.

Healthcare practitioners can now take a course, Indigenous Cultural Competency, to better understand cultural barriers in the medical system.

Whether they go to the Prince George centre or not, Dr. Olson said staff there have become “quarterbacks” for cancer patients across the northwest.

“In the past, people definitely complained that we didn’t seem to get how remote they were,” he said.

“We would do things like call a day before and say, ‘We’re cancelling your appointment tomorrow, it’s going to be in a week.’

“People would say, ‘But my plane is booked already!’”

Now, he said, staff in Prince George remind their Lower Mainland colleagues not to book patients as if everyone lived across the street.

The agency is also getting better at bundling multiple visits, said Dr. Olson.

A few years ago, it wasn’t that uncommon for someone with a lung-cancer diagnosis to make separate trips for a chest X-ray, then a CT scan, and then see a respirologist before finally making a fourth trip for surgery.

“It was just ridiculous,” he said. “Now we’re trying to co-ordinate that.”

Video-conferencing has also reduced the number of trips people need to make.

Oncologists were wary at first, given how important a physical exam is for making a cancer diagnosis.

But new oncology training for general practitioners—something that the islands’ own Dr. Morton was among the first to do—means local doctors can perform some of those exams, talk with specialists in the major centres, and prescribe chemotherapy.

It doesn’t work in all scenarios — Dr. Olson treats head and neck cancers, which require more surgical equipment and training. Patients who need radiotherapy still have to go to off-island centres.

But for other, common types of cancer, it means their care is faster, as well as more convenient.

“With a breast cancer patient, there’s no need to actually see a chemotherapy doctor anymore,” said Dr. Olson.

“That saves people a lot of trips, it means we can see them quicker, we have follow-ups via video-link — I think that’s really helped.”

Asked if there are other places in Canada that might be a good model for providing cancer care to remote areas, Dr. Olson said no, it’s  just not a high priority.

Australia, which has a similarly dispersed population, has been more focused on the issue, he said.

“What they’ve done is develop really small centres, but lots of them, and they report to a central place,” he said.

To do the same thing here might mean having radiation therapy machines at three small centres across northern B.C., he said, rather than two in Prince George.

“That’s an alternate model,” he said.

“But there are downsides to that, because it’s often hard to get an oncologist to live in those communities, so you get people rotating through.”

Dr. Olson said the Haida Gwaii study has not been submitted for publication yet — he agreed to share the findings with people here first — and he hopes to hear more from islanders themselves at the dinner on May 4.

“I’ll be open to having discussions,” he said. “I want people’s feedback.”

The study will be presented at community dinners scheduled for 6 to 8 p.m. at the Old Massett Village Hall on May 3, and from 7 to 9 p.m. at the Haida Heritage Centre at Ḵay Llnagaay on May 4. For more information, or to RSVP, contact Susan Vasilinda at 250-559-4353 or Susan.Vasilinda[at]northernhealth.ca.