Christchurch oncologists say some patients with incurable cancer are waiting so long for treatment that by the time they’re seen there’s nothing that can be done to help them.
The three senior doctors spoke to 1News about the impact growing demand and a lack of resources are having on the Christchurch oncology service, which often cares for patients from around the South Island.
Christchurch oncologist Dr Tony Rahman said the service never used to have a wait list but in 2020 it became necessary after doctor burnout.
“It is probably the most horrible thing that I’ve had to do is work with my team to find some sort of wait list where you are basically deciding who you see and who you don’t see,” he said.
“Knowing full well that there are likely to be people that deteriorate on that wait list to the point that they are unable to receive treatment or they die on that wait list”.
Rahman said while they’re not happy about it, they have to prioritise patients.
“Unfortunately, those wait lists mean that patients that we are treating with curative intent get higher priority than patients that have more advanced cancers which can’t be cured”.
Oncologist Dr Dean Harris mainly treats patients with advanced incurable cancers. He said the wait list means his patients are sometimes left without options for life prolonging treatment.
“The longer you wait to see us there is a chance we miss our window where you are well enough to stand up for the treatments that I have,” he said.
“I’m starting to see increasing numbers of patients whom I’m discussing what treatments would have been a possibility if they’d been fitter”.
Health New Zealand’s Dr Richard Sullivan said it is always been the case that patients need to be prioritised, though acknowledges there is work to do to meet best practice.
“Can we get to see patients within two weeks and can we treat them within two weeks? Now we know we can’t do that at the moment. So these other measures are all about trying to improve the access”.
He said a recent $65m boost for more scans is an example of that.
The three oncologists, who are members of the senior doctors union, said patients often face delays before even getting into the service.
“I think psychologically it’s very hard to know you’ve got a cancer diagnosis and know you’re waiting” Dr Melissa James said.
While there are government guidelines for how quickly patients should receive radiation treatment, according to the type of cancer, James said it is not always possible.
“At best we get about 50/50. At worst it can be up to 70% of patients wait longer,” she said.
James said that can impact the chance of some cancers coming back.
“That can actually mean that our survival outcomes aren’t as good because in certain cancers like lung cancer it’s really important to get the radiation in quickly”.
James said while a new linear accelerator for radiation treatment is in the design phase, it has taken a decade to get to this point.
Health New Zealand acknowledges there are issues with the radiation wait lists in the South Island and it will take a few years before capacity is increased.
The meantime we’ve worked with the team to go actually we need to run extra shifts,” Sullivan said. “That requires more staff so we’re investing in more staff to run the machines longer to try and tackle those wait lists”.
One of the government’s five health targets is faster access to cancer treatment with the goal of patients accessing treatment within 31 days of diagnosis.
Earlier this week the government announced that number had risen to 86.3% nationally. But the oncologists say it doesn’t reflect what’s happening on the ground.
“I think when you look at that target, it can be a little misleading. It doesn’t count a significant number of the patients I see” Harris said.
That’s because it doesn’t include patients whose cancers have reoccurred or reflect any delays to diagnosis, he said.
While Health New Zealand said it collects more data which is internally available, the doctors say more is needed to reflect an accurate picture of cancer care.
“We really need to be collecting data on all patients with cancer and every time point needs to be measured,” Rahman said.
When asked what’s most needed Harris said: “We need more nurses, more infusion space, more doctors”.
This is the first in a two part story about cancer care in the South Island. If you have information about this issue please email [email protected].
