We must build back better for cancer care

Let's not allow the lessons from the pandemic go to waste, write Gerald Batist and Barry Stein.

After SARS-COV-1 nearly 20 years ago, governments largely ignored calls to prepare for an even greater future pandemic. This left health systems generally unprepared for the COVID -19 pandemic. Despite enormous efforts by health-care workers and policy-makers in the face of it, there is no denying that the cost has been heavy for Canadians and the economy.

The pandemic revealed some of the gaps in our health-care system and reminded us that even before it was not in an optimal state.

Now, as our collective focus remains on the pandemic, we are confronted with an even more deadly health emergency, one that has been growing for decades: rising rates of cancer. Over the past year, cancer has quietly killed four times as many Canadians as COVID -19, and the treatment delays resulting from the pandemic have only exacerbated the situation.

The pandemic has made the fight against cancer more challenging and complex on all levels. Testing and screening numbers dropped dramatically since the first wave and have still not caught up. In Quebec alone, 91,000 fewer mammograms and 60,000 fewer colonoscopies were done between April and December 2020 than in the same period a year before. Patients who discover lumps or have other worrying symptoms have been reticent to seek medical care. Diagnostic biopsies and other procedures have been delayed, as have thousands of vital cancer surgeries and other treatments.

These delays, coupled with increased cancer incidence due to an aging population, explain the tsunami of cancer we face now, and it will get worse in the coming years. We need immediate action.

We now have an opportunity to rebuild our health-care system to make it more resilient, efficient and better able to meet the future care needs of patients. To achieve this, we need to start doing things differently.

Efforts are now directed at enhancing health-care capacity with new approaches — not by building hospitals, but by moving some health services outside of hospitals closer to the patients. Public-private partnerships with pharmacies and infusion clinics might also help. A new approach that respects and fairly compensates nurses is critical. But we can only increase capacity by so much.

We must turn to innovation and research to confront this challenge. Luckily, we're also in a period of enormous innovation in cancer care. Emerging new health technologies are redefining how we diagnose and treat cancer with the advent of personalized health care and precision medicines. The innovation, ingenuity and technological disruption that were deployed during the pandemic should encourage us that much more is also possible for cancer care.

Importantly, a national infrastructure to establish standards and share learnings and technology in diagnosis and treatment is essential. For example, while access to next generation gene sequencing is slowly but surely implemented province by province, Pan-canadian collaboration to move this forward across the country more rapidly will help.

We've also learned the importance of a vibrant research ecosystem in partnership with the biopharmaceutical industry to enhance our ability to bring new therapeutic innovations to Canadians more rapidly. In this context, accelerating research, development and health system adoption of new innovations so that patients can benefit from them as quickly as possible is essential if we want to rebuild our health systems and make them more resilient. We must accelerate focused investment in a concerted fashion across the country.

While health care is a provincial jurisdiction, the federal government and provinces need to co-ordinate and enhance investments in research while working together to integrate research with the treatment environment.

Winston Churchill famously said of the creation of the United Nations after the disaster of the Second World War that we should “never let a good crisis go to waste.” Let's not squander the opportunity to rebuild from the pandemic so that we can manage the cancer crisis.

The pandemic has made the fight against cancer more challenging and complex on all levels.