When Catherine Tolton went to see a doctor about a lump in her breast, a physical exam indicated it was benign.
A mammogram showed it was benign.
But her doctor removed some cells from the lump with a needle, and took them to a pathologist, who diagnosed the tumor as malignant on Jan. 26.
“Somewhere else, without that expertise, the doctor may have just said, ‘Your mammogram’s benign, don’t worry about it, see you next year,'” said Tolton.
That’s why she is thankful for the breast care program at the Misericordia Hospital in Winnipeg, one of only a few centres in Canada that offers diagnosis, treatment, education and counselling at one location.
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And that’s why she feels strongly about a proposal that would move the surgical part of the program to other hospitals in the city.
Tolton, a lawyer and law teacher, has sent provincial politicians a six-page explanation of why she believes it’s important to keep the program whole.
“I hope that they’ll wake up and realize what we’re going to lose as Manitobans,” she said in an interview.
Switch focus
As part of the regionalization of health care in Manitoba, the Winnipeg Health Authority announced in March it would devote the Misericordia Hospital to long-term geriatric care.
Acute hospital services, including surgery for women with breast cancer, would be done at other hospitals in the city.
The hospital has since been negotiating with health minister Darren Praznik to keep the surgery.
“We’re saying we don’t think it’s right to transport our patients or have them go to another place when the care is really right here,” said Ron Hill, a spokesperson for the hospital.
“We’re hoping to come to a logical, common sense agreement.”
There has been an outpouring of public support for the hospital, and opposition members in the legislature have taken up the case.
NDP MLA Rosann Wowchuk said she’s worried about how the change would affect rural women with breast cancer who stay in an attached hospice during their treatment.
“All of the support was there (for rural women),” said Wowchuk. “And now, if it’s spread apart, it’s a step backwards in my opinion.”
Tolton said the program’s accessibility is one of its strengths. Women can simply call and make an appointment without a referral from their family doctors.
“The thing that scares me is the average (general practitioner) doesn’t have the expertise to diagnose these lumps,” said Tolton, adding she has met many women who were misdiagnosed.
“By the time their cancer is discovered, they’re at a stage where it’s no longer curable.”
Cost effective
In her letter to politicians, she shared her personal experience, from diagnosis through surgery, post-operative care, chemotherapy and counselling to illustrate how having all services at one location saves money for the health-care system.
Twenty-one percent of breast cancer surgery is done at Misericordia. Delays for surgery in other city hospitals are well-documented.
Tolton doubts there’s another hospital that could take over Misericordia’s share.
And she worries that the team of specialists who work out of Misericordia would lose the efficiency, expertise and communication that comes from working closely at one site.
Tolton pointed out new Canadian Medical Association guidelines that recognize evidence showing social and emotional support helps ease pain, nausea and depression in breast cancer patients.
The guidelines note support can even help prolong patients’ lives.
Tolton says that’s the kind of support she feels from the doctors, nurses and other professionals at the hospital.
She recently started a six-month course of chemotherapy, “an exhausting, gut-wrenching and sometimes terrifying process.”
But it’s eased by the compassion and respect she feels from her new “community” at the hospital.
“I’m a whole person, and Misericordia treats that whole person by having all these services.”
