Dr. Pierre Whitlock- Monday, April 12th, 2010

List of Atlantic Dialogue Speakers
(Organized by Core Issues)

Core Issue #1: Cancer Care & Population Health:

Session Lead: Dr. Louise Parker
Participant: Dr. Krista Wilkins, (Patient Perspective)
Participant: Dr. Donna Murnaghan, (Health Professional)
Participant: Dr. Chris Kaposy, (Health Care Ethicist)

Core Issue #2: Cancer Care & the Health System:

Session Lead: Dr. Kara Laing
Participant: Ms. Pam Bowman, (Patient Perspective)
Participant: Mr. Geoff Eaton, (Patient Perspective)
Participant: Dr. Pierre Whitlock, (Health Professional)
Participant: Mr. Chris Skedgel, (Health System Economist)

Core Issue #3: The Science Behind Cancer Care:

Session Lead: Dr. Geoff Porter
Participant: Dr. Stewart Rorke, (Health Professional)
Participant: Dr. Eshwar Kumar, (Health System Economist)

I think I'm going to be the bad boy here. So when I heard about the cancer care and the health system, for me the cancer care system is under pressure, for good reasons. First of all there are very good reasons. We have many good new medications, good drugs like renal carcinoma? That was 12 years ago, and we're just looking with surgery??? So now we have access to new drugs, however this access is not for every province or every patient, so personalized treatment is the main point here. We have access to the better screening tests--PET scans, MRI, CAT scans, surgeons, expertise.

The other point, we have long term survivors now, so these patients stay in the system of oncology for a longer period. So let's say 20 years ago you had breast cancer or Hodgkin disease or lung cancer you were in the system for roughly 5 years now we are dealing with patients who are in the oncology system for 10-15 years because we have long term survivors we have to follow these patients for long term side effects. Some of these patients are on protocol like MA17R, so it puts a lot of pressure on the health system and as an oncologist I'm seeing more patients but we need more nurses, dieticians, and the system is lacking in all these specialists. We are overloaded--in NB we are close to 12 oncologists, in Montreal they have 12 in a single institute. We have to deal with that, we have to face the reality, we are in rural Canada we are working in some big cities but basically we need more doctors, nurses people trained for treating cancer patients and long term survivors. It costs something and I agree with that-I'm not an ostrich. We have to realize that eventually a lot of people here will have cancer and we have to be prepared for this patient in the next future. Actually I don't think we are. We're are patching, we are dealing on a daily basis, it's management by crisis, exactly what I am seeing every day. We're going to international meetings and having discussions with other colleagues. They're dealing with other problems but the main problem is the lack of doctors and nurses trained in oncology, psychologist and all the rest. I think the system was -and still is, under pressure and if we don't do anything now the system will crash.