TORONTO — According to the Ontario health-care system, Jill Anzarut, 35, discovered she had breast cancer too early.
The mother of two young children, Anzarut went to her doctor in December after finding “something” on her right breast.
“I had always thought that breast cancer would be detected by an actual lump, but this [didn’t feel like that] so I wasn’t that worried.”
She had it checked out with her doctor, however, who sent her for an ultrasound, and ultimately for a biopsy at Princess Margaret Hospital’s rapid diagnosis clinic.
The results were that she had an aggressive form of breast cancer – HER2 (human epidermal growth factor receptor type 2) – and treatment included chemotherapy and the drug Herceptin, which has been found to halve rates of recurrence within four years of diagnosis for women with that type of breast cancer.
Anzarut, who had her first round of chemotherapy on March 9, said the problem is that she does not qualify for the $40,000- or $50,000-a-year medication under OHIP until the tumour is greater than one centimetre, and her benefits package at work does not cover it.
“The irony is that if I purchase the drug privately, government regulations do not allow Princess Margaret Hospital to administer it, so I would have to pay a private clinic. That means even more money.”
Ron MacInnes, manager of public affairs at Cancer Care Ontario, said that ultimately, Deb Matthews, minister of Health and Long-Term Care for Ontario, has to approve the funding of the drug.
“Recommendations are based on direct evidence, and [at the size of this tumour] there is no evidence available on [Herceptin’s] effectiveness. The decisions are not ours to make.”
David Jensen, media relations co-ordinator, communications and information branch, Ministry of Health and Long-Term Care, said that Herceptin is currently funded through the New Drug Funding Program (NDFP) for the treatment of patients with certain types of early stage breast cancer following surgery and after chemotherapy, and the treatment of patients with certain types of metastatic breast cancer.
Reimbursement requires compliance with clinical eligibility criteria developed, based on evidence-based guidelines and approved by the provincial expert committee, he said.
Jensen said the Breast Cancer Disease Site Group (Breast Cancer DSG) produces evidence-based reports to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. The DSG recommends the use of Herceptin if the patient has a node-negative tumour with size greater than one centimetre.
In a new development, however, it was reported in the March 18 Globe and Mail that the Ontario Ombudsman is investigating the government’s failure to provide Anzarut the drug. Andre Marin announced that he is investigating whether the province’s decision to limit funding was informed and reasonable. “Based on our informal interviews with oncologists and officials from Cancer Care Ontario and the ministry, I’ve determined that this case raises issues serious enough to warrant a systemic investigation,” he said in a news release.
Anzarut has met with Ken Dryden, member of parliament for York Centre, and Monte Kwinter, member of provincial parliament for York Centre, who have both been supportive, she said.
Meanwhile, Prime Minister Stephen Harper announced last week, the government’s plans to renew support for the Canadian Partnership Against Cancer, an independent, not-for-profit organization whose goal is to help save Canadian lives.
Although weakened from last week’s treatment and battling a cough and cold, Anzarut said she is “hanging in. At the end of the day, I have no choice but to take the drug. We’ll have to do what we need to do to get it.”
