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The pandemic makes my breast cancer treatment longer and lonelier – CBC.ca

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This First Person article is the experience of Ann Cavlovic, a writer based in western Quebec. For more information about CBC’s First Person stories, please see the FAQ.

A cancer diagnosis is brutal at the best of times, let alone at the start of a pandemic. Yet people still seem surprised by how the timing of my diagnosis affected my treatment.

Surely, they think, a life-threatening tumour would push me to the front of the line.

The reality is that we’re still digging out of a backlog of elective surgeries that were cancelled before we understood how this virus worked. That term “elective” is deceptive; cancer surgery is not “elective” like a class in school. It just means you likely won’t die if surgery happens on Thursday instead of Tuesday unlike a burst appendix.

For the type of breast cancer I had, it’s normal to start with a mastectomy. Then, based on test results, determine whether chemotherapy or hormone treatments are needed. But I was scheduled to first start chemotherapy to remove one name from the operating room’s waiting list.

I protested, saying there’s a decent chance I might not need chemotherapy, which is powerful but causes all kinds of other damage to the body.

After a lot of stressful phone calls — and I believe a herculean effort by my surgeon — I did get a spot for my surgery. But I had to wait three months — the maximum that’s considered an acceptable risk. Every day during that wait, whenever I felt a twinge or ache, I worried that was the moment the cancer was spreading to my bones or organs. At that point, the cancer is no longer curable.

Ann Cavlovic has a blanket wrapped around her while awaiting her double mastectomy in the summer of 2020. (Submitted by Ann Cavlovic)

In the end, I only received hormone therapy and avoided an unnecessary, brutally harsh treatment. And I’m far from the only one who’s had to face suboptimal or disrupted treatments in this pandemic.

Even when things were going according to plan, there were delays getting tests and appointments. But far scarier were the times when I’d finally show up outside the hospital, only to find someone in the lineup irate about putting on a mask. Dodging their cloud of vitriol felt like a deadly combat mission. Cancer, and its treatments, make you more vulnerable to COVID.

The loneliness of it all

The reality is, one of the hardest parts of cancer diagnosis in the pandemic, is going through so much of this alone. 

My family doctor delivered the diagnosis over the phone. Whenever I received bad news at the hospital, I walked to my car without holding anyone’s hand. The day of my surgery in July 2020, I lay on a gurney, my chest marked up with Sharpie where the incisions would be to remove my breasts, and waited for hours staring at the chair no one was allowed to sit in.

A comforting presence at such times is not trivial. It can make the difference between whether or not your brain processes an event as traumatic. Depression is common after cancer treatment. My mental health hit the floor.

My friends were wonderful and sent over meal delivery kits for months. But in that year before we were vaccinated, they couldn’t come over for a hug. They were also drained from the pandemic.

Caregivers, too, are affected. My partner, as my main caregiver, needed to vent his understandably complicated feelings. Although I was the last person he should do that with at certain times, his options to see friends or family were limited. 

Ann Cavlovic and her fellow members of the ‘COVID Cancer Club’ met together in person for the first time in 2021 after meeting online more than a year earlier. (Submitted by Ann Cavlovic)

Yet there have been some pleasantly surprising signs of resiliency in our systems. Thanks to the first fully online breast cancer support group in my city, I made meaningful friendships with other women. We’ve shared our deepest fears and intimacies over Zoom, and finally met in person in my backyard this past summer. I even made a new best friend, or “breastie.”  Yet, because she is more immunocompromised, we have never once hugged. 

Recently, I had a mammogram to see whether the cancer has recurred. The technician shoved my reconstructed body into the machine with a brusqueness I couldn’t fault her for, as she seemed so clearly on the edge of burning out herself.

I walked into the hospital for this mammogram three months later than the normal testing schedule. But now, this wait is so long partly because remaining hospital staff are overburdened with COVID protocols and patients who, at this point, are largely unvaccinated.

While waiting my turn in a blue gown, I stared down the corridor at other patients spaced two metres apart. The vaccine hesitant don’t see this, I thought to myself. What would happen if they could see inside a hospital now? If they knew how every COVID hospitalization has ripple effects on people with cancer and other diseases. Would it tip the scales, for some at least?

As I write this, my wait for results from that mammogram has reached the six-week mark. I’m grateful for the health-care professionals who are working so very hard. And I’m hoping for the best.


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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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