A mastectomy is the easier option
Coast and Timaru, who have to travel more than three hours to get treatment.
She said that often, she has patients with small cancers that want to have mastectomies because they can’t cope or afford to travel – whether that be due to work, time away from family, care-giving responsibilities or the physical impact.
“Somebody has used a very unique, antiquated formula and said the justification for having a radiotherapy unit in this
region is because of population,” Todd said. “Nobody looked at the number of cancers, or if it justifies forcing patients to travel long distances and stay in another city just for their treatment.”
Alex Brown, an oncoplastic breast surgeon based in Wellington, said breast cancer patients have more treatment options in some areas of the country.
Because of the lack of radiation centres, the lack of radiation oncologists and even the lack of training in newer techniques, some women in rural areas have fewer choices than women in main city centres like Wellington or Auckland. “Because of those geographical variations in surgeons experience and abilities, a patient who comes to see me may have a couple of extra options that someone in Nelson doesn’t have.”
It isn’t just breast cancer that is being affected by travel. RANZCR estimates radiation is used in 40% of all cancer cures.
Health New Zealand reported that 27,869 people were diagnosed with cancer in 2021. According to RANZCR estimates, 11,147 of these people were eligible for radiation.
Health New Zealand said it was building two new radiation centres, one in Whangārei and one in New Plymouth. It said each centre would be able to treat 370 patients a year.
As for staffing the centres, Health New Zealand plans to spread the existing workforce across the new sites.
“The new facilities at Whangārei and New Plymouth will operate as satellite sites of the existing services, respectively, in Auckland and Palmerston North,” it said in a statement.
“The workforce will be shared across these sites, and we are confident they will be fully operational on their expected completion dates.”
The Whangārei facility is expected to be completed in mid 2025, whilst the New Plymouth centre is expected in 2026.
No new centres are currently planned for the South Island.
Todd said the “huge” disparity between urban and rural health care needed to be addressed.
When asked if women choose mastectomy because travel is too much for them she immediately said yes. “I have to almost convince them to change their mind,” she said.
If Jones had had a radiation centre near where she lived, she said she would have considered keeping her breast. But because she didn’t, having a mastectomy was, for her, the only choice. It meant she got to be with her husband for his final months.
“I’m happy that I chose to have the breast off, otherwise we would’ve been away all that time apart, right when we needed each other the most.”
“Somebody has used a very unique, antiquated formula and said the justification for having a radiotherapy unit in this region is because of population.” Josie Todd, above Oncoplastic breast surgeon