Other cancer centres well below minimums
But cuts demanded here
Six thoracic cancer surgery centres in Ontario are doing volumes well below the minimums that Cancer Care Ontario cites as it tries to force Windsor Regional Hospital to stop doing the surgeries.
The agency and Health Minister with Deb Matthews have defended the move by saying CCO wants to consolidate the programs in larger centres that do at least 150 lung cancer surgeries and 20 esophageal cancer surgeries a year. Windsor does about 50 lung surgeries and nine esophageal surgeries.
But a table of thoracic surgery volumes obtained Friday by The Star shows Windsor has plenty of company when it comes to being below these standards. There are two centres, in Kingston and Thunder Bay, with volumes similar to Windsor, that have been given Level 2 designations.
And there are four Level 1 centres that don’t meet the 150 minimum, the table shows. They are: St. Mary’s General Hospital in Kitchener with 108 in the 2012 fiscal year; St. Joseph’s in Toronto with 129; Credit Valley in Mississauga with 108; and William Osler in the Toronto area with 108.
In addition, the table shows that if Windsor Regional is forced to give up the program — forcing very ill lung and esophageal cancer patients to travel to London for surgery — it will leave the Windsor-Sarnia-Chatham region as one of only two of the province’s 14 health regions (called Local Health Integration Networks) that don’t have thoracic cancer surgery centres.
“It seems quite unreasonable that they would treat us differently in Windsor and Essex County than they do in other jurisdictions,” said MPP Taras Natyshak ( NDP — Essex), who’s holding a town hall meeting Tuesday to fight the loss of thoracic cancer surgery and demand a Level 2 designation. He said these statistics show that the government is treating our region unfairly.
“There are similar communities that have these services available to them,” he said. “Why doesn’t Windsor?”
The Star requested interviews Friday with Health Minister Deb Matthews, CCO president Michael Sherar and MPP Teresa Piruzza (L — Windsor West). None were available, though Matthews’ spokesman Sheamus Murphy provided a statement that pointed out that Windsor’s volumes were “significantly lower” than the four Level 1 centres cited.
Piruzza was meeting with Windsor Regional Hospital officials to discuss the issue that has outraged many citizens.
“Resistance is mounting,” said Natyshak, who has never seen such an emotional response to an issue. An online petition posted Thursday had more than 1,000 signatures in a day. “It’s like a lightning bolt through this community,” he said.
“We want a Level 2 designation, we want fair treatment, equal to the treatment they receive in Thunder Bay and Kingston.”
CCO’s Sherar has argued that centres with larger volumes achieve better patient outcomes. Yet officials in Windsor say the quality of surgery here is very high. The Star requested data from CCO comparing patient outcomes in Windsor, London (with 179 lung surgeries in 2012), Kingston, Thunder Bay and the provincial average. But spokeswoman Tori Gass replied in an email that CCO couldn’t provide those numbers because the small sample size for individual hospitals “creates a large amount of variability and unreliability in the measure as it can change significantly from year to year.”
She did not reply to an email from The Star asking if her reply means CCO has no statistical evidence to show outcomes are better at London than at Windsor.
Windsor Regional CEO David Musyj said his hospital has still not decided whether it will comply with CCO’s order to stop doing thoracic cancer surgery. A letter from Sherar threatening to withdraw $800,000 in annual funding for other types of cancer surgery is still in play as far as he’s concerned, though the minister confirmed Friday that Windsor won’t be losing any cancer funding. If the hospital decides to comply with CCO, it will mean planning how to move the service to London, as well as how to cope with the expected departure of the city’s three thoracic surgeons, who say they may have to leave Windsor or change to another field of medicine.
Their absence would lead to big questions about who’ll take care of chest traumas (gunshot wounds, stabbings, car accidents) that enter the hospital’s emergencies, and the approximately 250 cases of non-cancer thoracic surgery performed annually.
The loss of thoracic cancer surgery could very well mean not just 60 patients going to London, but more than 300, Musyj said. “Some are very sick and some are elderly, so they would have to take some sort of private transport,” which costs at least $300 per round trip, he said. And they’d need to go to London at least three times: for a pre-surgery consult, the surgery and a post-surgery consult.
“Who’s going to pay for this?” he asked.
Belle River’s Ericka Deslippe, who had non-cancer lung surgery in Windsor in 2010 to prevent repeated instances of a collapsed lung, said she would hate to go to London for the procedure. She was in hospital for 10 days, which in London would have meant a long hotel stay for Jayson Mercier and a lengthy separation from her two young children. Having them visit while she was in Windsor meant the world to her and helped her recovery, she said.
“It really, really irritates me to think that (thoracic surgery) won’t be available in Windsor. I can’t imagine.”