Radiotherapy queue too long to prevent surgery

By MARTIN JOHNSTON health reporter

Two women forced to wait too long for radiotherapy because of the crisis in cancer treatment have had to undergo further surgery for breast cancer.

They were on a "routine" Auckland Hospital waiting list which had blown out to 16 to 20 weeks, mainly owing to staff shortages.

The hospital will not say what the additional surgery has meant for the women, but doctors say such cases are likely to involve either further tissue removal or the loss of an entire breast.

They may be the first casualties of the hospital's long wait for radiation therapy.

"The fact these relapses occurred before radiotherapy raises the concern that the reason may have been that the radiotherapy hadn't been given on time," said the clinical director of radiation oncology, Dr John Childs.

One woman had been cleared of cancer by the surgery, the other would have her next radiotherapy on time, and both were now okay, Dr Childs said.

He was not sure how long they had waited, but thought it was "some months from the time of their surgery ... One was just about due to start her radiotherapy."

"I think in both instances they had already waited longer than we would have normally recommended."

While the 16-week wait for "routine" patients started at the decision to use radiotherapy, the total delay from surgery to radiotherapy could be six months for breast patients not also receiving chemotherapy.

Such delays were too long, he said.

They probably increased slightly the risk of relapse before radiotherapy, and might reduce its long-term effectiveness a little, but studies had not produced clear results.

Nationally, nearly half of radiotherapy patients are having to wait more than the four weeks benchmark - from the decision to treat to starting therapy - for it to begin.

Cancer Society medical director Dr Peter Dady said this was a disgrace and health boards should award big pay rises to help stem the flow of radiation therapists overseas, as Canada had done.

Neil Woodhams, chief operating officer of the Auckland District Health Board, which runs Auckland Hospital, said its therapists' pay was comparable with many countries, but New Zealand could not match Canada. Boards were "severely constrained for funding."

Health Minister Annette King said the treatment delays were "very, very unsatisfactory and we are doing all we can to relieve the situation ... we've got international recruitment and money going into the Machines, people shifting around to try to provide the service."

Government funding of radiation therapy had increased by around $2 million this financial year, she said.

A sixth radiation therapy machine, installed at Auckland Hospital last week, will be ready for use by October. An existing one is planned to be replaced later.

Dr Childs hoped the treatment delays would reduce during the next six months as more staff were hired from overseas.

Waikato Hospital is still sending some patients to Australia for radiotherapy, but Dr Childs said Auckland did not have enough money for this and was concentrating on long-term solutions instead.

National Party associate health spokeswoman Lynda Scott said the Government must provide money to permit the Australian option for all patients until proper care was available here.

* ACC is reviewing a cervical cancer patient's compensation claim that she suffered medical misadventure when her smear slides were misread.

The Accident Compensation Corporation had rejected the claim of Far North woman Sharon Pahau, but said yesterday that it would now review it in the light of additional slides it had just received.

The 39-year-old mother of three was diagnosed with cancer in 1995, despite a history of "normal" smears, and has undergone extensive treatment.

Her lawyer, Antonia Fisher, said yesterday that five of eight smears dating from 1988 had been misread.

The corporation said it had been asked initially to look at the 1992-95 period, but would now check the earlier slides.

Sharon Pahau said yesterday that it seemed her case was not being taken seriously. "Nobody is being held accountable."

She ntse has complained to the Medical Council about her GP, one of the pathologists who mis-read her slides, and Dr Parry, whose practice was restricted because of failings in his treatment of Colleen Poutsma, who died in April.