In common with all developed nations and jurisdictions around the globe, Alberta continues to experience a growing issue with cancer as its population grows and ages
In common with all developed nations and jurisdictions around the globe, Alberta continues to experience a growing issue with cancer as its population grows and ages. The number of new cancer cases in the province in anticipated to grow from 18,000 in 2017 (Canadian Cancer Society Statustics) to 27,000 by 2030 (Alberta Cancer Plan 2013-2030). The incidence and prevalence of many cancers continues to increase, survival rates with treatment improves meaning there are more patients in the system, treatments become increasingly complex and costly. The Alberta Cancer Plan 2013-2030 describes the burden on patients, families and the system as “massive”.
In the face of these challenges, the Alberta Government and its expert advisors decided that the best way to meet the challenge in Calgary was to construct a $1.4 Billion monument to egos and established methods of cancer treatment. What was really needed was a complete re-think of how people with cancer are managed and how their cancers are treated.
I contend that we, the people and taxpayers of Alberta, will come to realize this monument to extravagance as a colossal waste of public money.
I am not for a moment disputing the fact that the approximately 40 year old building called the Tom Baker Cancer Centre is completely overwhelmed and incapable of meeting the demands placed upon it. There is inadequate space for chemotherapy delivery and the out-patients area is hopelessly inadequate but yet, not adequately utilized. But to replace it with the proposed colossus is 1970s thinking rather than thinking of how cancer will be managed in 2050. The life span of the proposed building could well be in excess of 50 or 60 years, so it’s likely that children born in the early 2000s who will be senior citizens by 2070, will be having their cancer treatment in this building. These children, as well as those of Generation X, Y and the millennials will demand something different than that treatment handed to their parents and grandparents. Nowhere in the plan for this building could I find anything that resembles the needed thinking. Cancer is not a 5 day per week, 7.5 hour per day disease. The facilities at the Tom Baker have been underutilizes for years. Why isn’t cancer treatment a 7 day per week, 16 hours per day program? With proper utilization, much could have been done.
I contend the inadequacy and waste based on the following.
- Logistics and accessibility.
- Radiation Therapy.
- Indigenous and First Nations health and
- Missed Opportunities.
- Logistics and accessibility. The commonest complaint received by cancer centres across the country is related to parking and accessibility. The current Foothills Hospital campus is grossly overcrowded, parking is a nightmare despite additional spaces and there is a wholly inadequate service provided by Calgary Transit. Yes, many Calgary cancer patients depend on transit to access treatment and follow up. Adding more facilities, more staff, more patients is only going to make the situation worse. Why is it that patients from Douglasdale, Cranston and all communities south of Glenmore Trail have to travel north to access treatment facilities. On some day, it might be take less time to travel to Lethbridge rather than commute to 29th St. That there are no cancer treatment facilities at South Health Campus is shameful.
- Radiation Therapy. There are at present 10 “bunkers” or “vaults” in the basement of the Tom Baker Cancer Centre which are used to house the machines used to deliver radiation therapy. These “bunkers” or “vaults” have walls that are up to 2 metres thick and are especially constructed to prevent and leakage of radiation from the room. The bunkers in the Tom Baker have a current life expectancy of more than 50 years and can house all modern standard radiation therapy equipment (linear accelerators). Much fanfare was generated in January of this year with the announcement that the new cancer centre would house 12 “bunkers” or “vaults”. These 12 new bunkers will not be additional facilities but rather replacement bunkers for the 10 that are perfectly capable of carrying on being useful for decades more. The current bunkers at the Tom Baker are destined to become the most expensive storage lockers in the history of the province. Thank you Alberta Government.
- Chemotherapy. The plans for the new cancer centre describe a total of 100 chairs in which patients will be accommodated while receiving chemotherapy. As stated earlier, the current facilities are overwhelmed. However, speak to any medical oncologist and you will be told that the future medical management of cancer is in biologics and other targeted therapies and that current chemotherapy will play an increasingly smaller role in cancer management as the years go by. Given this, why would we need 100 chemotherapy chairs?
- Research. Alberta is rich in highly accomplished and expert researchers. However Alberta performs poorly when it comes to generating research dollars. From 2005-2016, research funding per capita in Alberta went down from $2.57 to $1.83. Contrast this to Ontario, Quebec and British Columbia where the per capita funding almost doubled in the same period (Canadian Cancer Research Alliance review 2018). University of Calgary cancer researchers do a fine job but despite the presence of the Cancer Institute of the CIHR on campus, they rank poorly in competitive grants. Alberta Health Services make a miniscule contribution of a fraction of 1% of its total budget to research. There is no evidence that providing new facilities is commensurate with a significant increase in success rates at obtaining competitive funding for research. Similarly with clinical research, where over the course of the last 30 years, the accrual rates to clinical trials remains stubbornly in low single digits with only a couple of years in the early 2000s did it exceed 5%. Pharmaceutical companies have demonstrated only marginal interest in partnering with local researchers on a major scale, preferring instead to work with more established institutions.
- Despite the plan for the new Cancer centre describing a series of villages, nowhere could I find a plan for an Indigenous or First Nations village. This is despite the fact the Indigenous and First Nations health is a stated priority for every level of government across the country. The new cancer centre could and should include a major emphasis on this underserved population.
- Missed opportunity. Despite the massive amounts of time and energy spent by dozens of staff, experts and advisors, coupled with a massive expenditure of $1.4 Billion, there is little that is new or innovative in the proposed building other than the building itself. For a third of the cost, Alberta could have been home to Canada’s first Proton treatment facility. Now that would have been innovative. That would have attracted oncologists and physicists. That would have been a national treatment centre, treating patients from all across the country and even from the northern United States. Instead, we spend millions of dollars annually sending patients to the US for proton therapy. Canada needs a proton therapy facility, but the opportunity is lost for Calgary.
In summary, I believe the colossal waste that is the new cancer centre will be realized in time, long after the experts and advisors who created it have departed and the taxpayers of Alberta are left with the ongoing debt.