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Pink October

Ontario Health care

Breast cancer has several shapes and variants. Each one brings different symptoms and treatments that results in different secondary effects. The Ontario Health Care system covers part of the treatments but is not enough for these women who struggle so much to have a “normal” life.

The number of women living with metastatic breast cancer is increasing and at the same time, they are living longer, especially younger women. This means that these women are going to be on daily treatments during their lives. A big part of breast cancer is hormonal positive; hormones are substances that control some body functions, including how cells act and grow. Changing the levels of hormones or blocking certain hormones can slow the growth and spread of breast cancer cells.

Some side effects of hormonal therapy are hot flashes, sweating (and other symptoms of treatment-induced menopause), sexual problemsweight gain, constipation, diarrhea, high cholesterol, osteoporosis, fatigue, nausea, fertility problems and a panoply of secondary effects that only those who feel them can identify.

                       RETHINK BREAST CANCER  search for rethinkbreastcancer

There are dozens of non-lucrative support foundations to help women in the battle for their lives and quality of life. These charities exists because we still look at cancer as a “die or live” disease and a big part of the doctors see it the same way. Rethink breast cancer is one of those institutions that do a brilliant job. In a colloquium about sex intimacy and cancer women with breast cancer and health professionals exchanged testimonies and tips for women who faced drastic changes in their body. The costs of the pills, injections, alternative therapies are so high that most women can’t afford them. Maja Piwek, Alanna Gatchalin and Inna Prikhodko are three breast cancer thrivers that shared with Milenio their experience with Ontario Health care system.

Maja Adolfo-Piwek

Name: Maja Adolfo-Piwek @mrskittypurr

How did you get your diagnosis?  

I found a lump in my right breast when I was taking a shower, while getting ready for work. I booked a doctor’s appointment right away and saw my doctor the very next day. From then on, the never ending roller coaster began. She sent me for an ultrasound and also referred me to a surgeon. My surgeon sent me for a mammogram and a biopsy. Unfortunately the biopsy confirmed that I had Breast Cancer. In order for her to decide on my treatment plan, my surgeon had me repeat the ultrasound and I also had to complete a cat scan, MRI, and a bone scan to make sure it had not spread anywhere else.”

What was your type of cancer and what you did/do for treatment?

I was diagnosed with Stage 3C Triple Negative Breast Cancer at 39 years young. I have had a single mastectomy with lymph node removal, Chemotherapy, Radiation, two preventative surgeries which was another single mastectomy and Oophorectomy, Trial Inhibitor, and Infusions.

How is your experience with Ontario’s health care system? What treatments are paid by the state and which ones are not?

My experience with Ontario’s health care system has been good thus far, except for the shots that I had to take after each cycle of chemotherapy to maintain my white blood cell levels. This medication was not covered by our health care and luckily I had work insurance to cover most of it and my hospital covered the remaining. I also had to cover all the other medications I had to take to help manage all of the treatment effects. My hospital offers six free sessions for different types of therapists (social worker/psychologist/psychiatrist etc.) for support. After the free sessions, you would have to pay if you wanted to continue. I often attend healing classes at Gilda’s Club and Wellspring and they are all free programs for people battling Cancer. I also have attended retreats for young women battling cancer with Rethink Breast Cancer and Pink Pearl. These are nonprofit organizations that provide free retreats for support and healing.

In your opinion, what do you think should change in the health system to help women with cancer?

I believe that all basic treatments for Cancer including the shots and therapists should be free. Many cancer patients are in financial crisis because we cannot work during treatment and not all of us have a job that will provide sick leave or long term disability payments. We should not have to stress about this while having to be in treatment and trying to stay alive as having a cancer diagnosis is already stressful enough.

Inna Prikhodko

Inna Prikhodko

What your type of cancer and what you did/do for treatment?

I have triple positive invasive ductal carcinoma. I’ve gone through eight cycles of chemo, a lumpectomy surgery and currently waiting for the radiation treatment and hormone therapy.

How is your experience with Ontario’s health care system?

I was impressed with how fast everything was – it’s been 3 weeks since my diagnosis was announced till my first chemo. And in between I had all required scans (like CT, bones, MRI) and doctors’ appointments (like fertility, genetics etc) done. I was also referred to a social worker to help me cope with all these things. That was really helpful because it was my first experience of such a disease and it was quite overwhelming.

I had to pay for some fertility medications and procedures (not all of them but part) and pre-medications for the chemo that were not given through IV and also filgrastim to prevent neutropenia. Luckily most of those things were covered by my private insurance and some of the medications were provided as compassionate drugs which was extremely helpful. Also OHIP does not cover ‘pertuzumab’ which is a new and effective treatment for my type of cancer but Ontario Health does not cover this because of its high cost.

I was referred to a social worker and also for peer support at WCH. This was covered by OHIP but I was not offered any other specialists or consultations.

In your opinion, what do you think should change in the health system to help women with cancer?

I’m glad that the essential treatment is covered by OHIP but it would definitely be better if all necessary things be covered, especially considering that patients often cannot work during the treatment and these extra costs may be quite sensitive for people’s budgets. Also, I’ve noticed that the main focus is on the physical health of the patient which is reasonable but it would be really great if the system could pay more attention to the mental health of patients going through hard times of the treatment because the quality of life is so important for patients and helps them fight the disease.

How did you get your diagnosis?

I have noticed a lump in my breast someday in the spring of 2019 and asked my family doctor for an ultrasound referral. After this I got a referral to a breast centre at Women’s College Hospital where they did a mammogram and a biopsy. A week later I’ve got my diagnosis.

How is your experience with Ontario’s health care system?

I was impressed how fast everything was – it’s been 3 weeks since my diagnosis was announced till my first chemo. And in between I had all required scans (like CT, bones, MRI) and doctors’ appointments (like fertility, genetics etc) done. I was also referred to a social worker to help me cope with all these things. That was really helpful because it was my first experience of such a disease and it was quite overwhelming.

What treatments are paid by the state and which ones are not?

I had to pay for some fertility medications and procedures (not all of them but part) and pre-medications for the chemo that were not given through IV and also filgrastim to prevent neutropenia. Luckily most of those things were covered by my private insurance and some of the medications were provided as compassionate drugs which was extremely helpful. Also OHIP does not cover pertuzumab which is a new and effective treatment for my type of cancer but Ontario Health does not cover this because of its high cost. All other things (chemo medications, all doctors’ appointments, all scans, MRI’s etc) were covered by provincial insurance. I was referred to a social worker and also for peer support at WCH. This was covered by OHIP but I was not offered any other specialists or consultations. In general I may conclude that I am satisfied with how the health system works: all doctors and nurses I met were really nice and open for questions, all required procedures were scheduled quite fast. In addition there are tons of resources like Canadian Cancer Society or Rethink Breast Cancer.

In your opinion, what do you think should change in the health system to help women with cancer?

I’m glad that the essential treatment is covered by OHIP but it would definitely be better if all necessary things be covered, especially considering that patients often cannot work during the treatment and these extra costs may be quite sensitive for people’s budgets. Also, I’ve noticed that the main focus is on the physical health of the patient which is reasonable but it would be really great if the system could pay more attention to the mental health of patients going through hard times of the treatment because the quality of life is so important for patients and helps them fight the disease.

Alanna Gatchalian

Name: Alanna Gatchalian  @alannners

What your type of cancer and what you did/do for treatment?

I was diagnosed in 2017 at the age of 31 with ER/PR+ Her- Stage 3a Invasive Ductal Carcinoma Breast Cancer. I did IVF and froze my eggs just to be on the safe side in case I wanted to have children later and could not due to the effects of treatment. I underwent an 8 hr mastectomy surgery with an immediate diep flap (fat grafting from my stomach) reconstructive surgery. 6 rounds of FEC-T chemotherapy treatment, 25 rounds of Radiation treatment,  8 sessions of Occupational Therapy, and currently on Hormone Therapy (Tamoxifen) for the next 8 years. I also just finished the last half of my breast reconstruction recently as well, the plastic surgeon wanted me to wait a year after radiation to finish minor revisions.

How did you get your diagnosis?

I received my diagnosis in person alone at the Mt Sinai hospital. I went during my lunch break for a quick follow up appointment and wasn’t expecting the biopsy to come back malignant. So it came as a total shock.

How is your experience with Ontario’s health care system?

I found overall once diagnosed with cancer you’re very quickly expedited to scans, surgery and treatment which is amazing. As much as I have some great doctors and nurses, I’ve had my share of mediocre fellows and nurses that could have been better caregivers as well. I’ve heard of numerous horror stories of misdiagnoses from other cancer survivors, so I’m grateful for my experiences.

What treatments are paid by the state and which ones are not?

IVF, mastectomy with immediate reconstruction surgery, chemotherapy, occupational therapy and radiation were covered by our healthcare system. All the medications for IVF (unless you apply for a grant which then you get the medication covered along with your work health benefits are covered), all medications for surgery recovery, steroids for chemo, creams for radiation and hormone therapy is not covered unless you have private health benefits from work.

Talking about the second effects of cancer, do you have consultations in other specialties to help you? For free or paid?

I went to see an Osteopath post-cancer to help adjust my body from the tenseness and pain I had from my body trying to compensate for the lingering effects of cancer. That was not paid for by our health care but a large percentage of it was covered by my work benefits.

In your opinion, what do you think should change in the health system to help women with cancer?

In my opinion, It really is the luck of the draw with your general practitioner and how well they take your concerns seriously to go for further scans and tests. I think especially being a young woman, a lot of the time they don’t take you seriously assuming you’re too young to get breast cancer. Having a compassionate GP would be a start. More importantly, I think the resources for navigating the health care system should be discussed more openly. As well as offering more suggested support and resources would be helpful instead of women having to start the conversation with their oncologists themselves.

Sara Oliveira/MS

 

 

 

 

 

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