When Norm Jamison was diagnosed with liver cancer in June, the former Member of Provincial Parliament looked into various treatment options with his doctor and settled on radioembolization, an innovative treatment in which radioactive glass or resin beads are injected in the tumour through a liver artery and attack it. But he discovered that the Ontario Government wouldn’t cover the cost of the treatment even though it had been recommended by his specialists.

Family members sprang into action and, through a short GoFundMe campaign, raised the $19,000 needed. Jamison, who served in parliament from 1990 to 1995, underwent the treatment in the summer, but by then it was too late. The treatment extended his life but couldn’t save it. He passed away in October.

His wife and four daughters are left with a lingering question: Why won’t the Ontario Government cover the cost of a therapy with the demonstrated potential to save lives — even though it is publicly funded in other provinces in Canada? “My dad has served in government and government has let him down,” his daughter Shannon Spoelstra told The Simcoe Reformer just before her father underwent treatment.

“I don’t feel this is right. I feel things should change... This is Canada and this procedure is not covered in Ontario. That’s crazy.”

Norm Jamison with his wife Sharon after treatment.

Interventional radiologists sing praises of Y90 therapy

The Ontario government’s stance also confounds interventional radiologists, many of whom have been singing the praises of the treatment for several years now.
They note that radioembolization targets the tumour while leaving the surrounding tissue relatively unharmed. That means radiation can be delivered without damaging the liver, which is difficult to do otherwise. The treatment — which is also known as Y90 therapy because the beads contain the radioactive isotope yttrium-90 — can be used to shrink large tumours down to the point where they can be surgically removed, to keep tumours small so patients can receive liver transplants,  and to treat tumours that are not responsive to chemotherapy.

Radioembolization is more expensive upfront compared to chemoembolization, the current standard of care, but could save taxpayers money overall. As an example, Dr. Amol Mujoomdar, an interventional radiologist at London Health Sciences Centre and Associate Professor of Radiology and Oncology at Western University in London, Ontario, cites the fact that most patients are able to be treated on an out-patient basis, able to leave the hospital on the same day without needing an overnight stay, rather than be admitted into the hospital. The procedure also has fewer side effects than conventional treatment, which means most patients don’t require as much medical care. “Radioembolization has shown a lot of promise and should be funded at this point,” Mujoomdar says.

Canadian patients “need to advocate for themselves”

His views are also shared by MEDEC, the association representing Canada’s medical technology industry, which believes many other cutting-edge treatments should also be available to Canadian patients. “The challenge is dealing with each of the silos in the health care system. Each one thinks about its own costs and not necessarily about the big picture,” says Gerry Frenette, the organization’s executive director of public and member relations. “But each stakeholder should recognize the broader value of investing in new treatments and technologies — so we’re working with our partners to break down barriers for innovators and create a paradigm shift toward value-based procurement.”

Frenette notes that radioembolization is one of several technologies that are the  standard of care in other countries but not in all Canadian provinces and territories. He notes that the Canadian Health Policy Institute ranks Canada near the bottom of 75 countries when measuring medical device spending as a percentage of total health spending.

Canadian patients should be mindful of the status quo when making important health decisions, says Mujoomdar, who treated Jamison. “People need to be aware of the situation and to advocate for themselves and their families when it comes to health care — especially when treatment that could benefit them is available elsewhere.”

The Canadian Cancer Survivor Network urges Canadians to advocate for improved access to medical devices by sending a letter to your local representative, asking to help make these treatments available for the Canadians who need them.

Simcoe Reformer story: http://www.simcoereformer.ca/2017/07/06/jamison-about-to-undergo-19g-procedure-to-battle-liver-cancer.