SOMBA K'E/YELLOWKNIFE
Cancer is the leading cause of death among NWT residents and the territory's deputy chief public health officer wants survivors' voices to be heard.

Cancer survivor Sabet Biscaye encourages NWT residents to advocate strenuously for early cancer screening for themselves and their loved ones, regardless of appointment waiting lines and other obstacles. - Daron Letts/NNSL photo

"Cancer survivors need our support as they face physical, emotional, spiritual and financial issues, even years after diagnosis and treatment," Dr. Kamie Kandola said.

To this end, the GNWT Department of Health and Social Services is preparing to launch two three-year programs designed to improve the cancer journeys of Northerners, with an emphasis on aboriginal residents, later this fall. The programs are being overseen by the department's new Aboriginal Health and Community Wellness division, created one year ago.

The Canadian Partnership Against Cancer, an independent organization supported by the federal government to accelerate action on cancer control for Canadians, has provided $774,325 for the delivery of the Dialogue and Storywork Project and $675,000 for the Continuity of Care Project, each of which is set to run from 2014 to 2017.

The storywork project aims to record the stories of aboriginal cancer survivors throughout the NWT so their experiences may be used to improve the delivery of care in the territory and in southern medical centres that serve Northern patients. The information gathered will be used to inform the Continuity of Care Project, which will serve to improve after-care for survivors, Kandola said.

The stories survivors share will assist in the development of informational resources to help patients navigate the health system and will allow medical staff to identify inefficiencies in the present system.

Although the two programs are not set to begin until later this year, Kandola encourages cancer survivors to begin sharing their stories on the department's ChooseNWT website.

Sunday is National Cancer Survivors Day, first established in the United States in 1988 as a celebration of the lives of cancer survivors and their families and friends to be held on or around the first Sunday of June. The day has since spread to Canada and several other countries.

"In recognition of this day, we would like to initiate a discussion about what it means to be a cancer survivor," Kandola said.

Kandola defines a cancer survivor as a person living after a cancer diagnosis, regardless of how long he or she lives. The term relates not only to the physical, but also the emotional and spiritual impact of cancer on someone's life, she said.

As a cancer survivor, Sabet Biscaye knows the importance of sharing one's voice. Biscaye, 56, was diagnosed with colorectal cancer last fall, but not after advocating for herself when faced with long wait times as she awaited a colonoscopy last summer.

After Biscaye's father was diagnosed with colorectal cancer about 12 years ago, she was advised to have a colonoscopy because the disease is hereditary. She had a colonoscopy a few years ago and polyps were discovered that had the potential to develop into cancer.

When it came to a follow-up, she struggled to arrange an appointment.

"Finally, I did make that call in July and that's when I told him I didn't want to be one of those cases where I get the news too late and an appointment was made for Sept. 4," she said.

A tumour was found and she had surgery to have it removed a month later. Chemotherapy was not required, but Biscaye remains under cancer watch.

"I am hopeful that I have managed to survive and that I am going to be a long-term survivor," she said. "Part of the reason why it took so long for me to be diagnosed or assessed for colon cancer was that there was always a backlog. I was supposed to go back for my follow-up colonoscopy, but they were overbooked. It took an effort on my part and my doctor's part to get that scheduled in. Now, if I hadn't been pushing for it, and hadn't gotten my doctor to help push for it, I might still be living with cancer today and not know it."

Because of the remoteness of Northern communities and the demands placed on the healthcare system, Biscaye said NWT residents need to be empowered to seek the best treatment options available.

"We have to be advocates for ourselves. When there's something wrong we know that ourselves and it's up to us to push to get diagnosed," she said. "If you get diagnosed with cancer there are treatment options and I think people have to speak up for themselves. Ask a lot of questions. You have a right as a patient to ask questions and to understand what treatment options are available and then discuss those with your doctor and your family."

Earlier this spring, the Department of Health and Social Services released its 44-page NWT Cancer Report, which covered cancer trends from 2001 to 2010. The study identified cancer as being responsible for one quarter of deaths in the territory, above cardiovascular disease and diabetes.

Cancer by the numbers

Cancer's rank as a cause of death in the NWT

• 111 - average number of new cases of cancer diagnosed in the NWT each year
• 45 - average number of cancer-related deaths in the NWT each year
• 22 - percentage of deaths in males due to cancer in the NWT
• 30 - percentage of deaths in females due to cancer in the NWT
• 25 - percentage of cancer-related deaths are due to lung cancer in the NWT
• 1.5 - the number of times higher the rate of female lung cancer deaths is in the NWT compared to the rest of Canada
• 2 - the number of times higher the rate of colorectal cancer is in NWT males and females compared to the rest of Canada
• 20 - approximate percentage of eligible individuals in the NWT aged 50 to 74 who had a colorectal cancer screening test in 2011 and 2012
• 53 - percentage of eligible women in the NWT aged 21 to 69 who had a Pap test in 2011 and 2012
• 55 - percentage of eligible women in the NWT aged 50 to 69 years who underwent a mammogram

Males

• Dene - Colorectal (33 per cent), Prostate (17 per cent), Lung (16 per cent)
• Inuit: Colorectal (22 per cent), Prostate (16 per cent), Lung (13 per cent)
• Metis: Prostate (20 per cent), Lung (16 per cent), Colorectal (14 per cent)
• Non-aboriginal: Prostate (26 per cent), Lung (16 per cent), Colorectal (12 per cent)

Females Dene: Colorectal (28 per cent), Breast (25 per cent), Lung (15 per cent) Inuit: Lung (26 per cent), Breast (24 per cent), Colorectal (18 per cent) Metis: Breast (43 per cent), Colorectal (19 per cent), Lung/Thyroid (15 per cent) Non-aboriginal: Breast (40 per cent), Colorectal (11 per cent), Lung (8 per cent)

Source: GNWT Health and Social Services

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