Cancer and Tobacco Control Non-Communicable Diseases (NCDs)

Poor access to cancer treatment

Cancer patients relying on the state health system are increasingly struggling to access timeous treatment or their diagnosis and treatment is delayed until it is too late, cancer advocacy and support organisations have warned.

Their warnings come in a week where the South African health minister addressed stakeholders on non-communicable diseases and world leaders prepare to gather under the United Nations banner in New York to make serious commitments to stem what many have warned is a ‘€œhealth tsunami’€.

Campaigning for Cancer and People living with Cancer have confirmed that they are receiving an increasing number of reports from patients struggling to access treatment.

One of the most harrowing cases is a cancer patient who for almost a year was sent from pillar to post at Johannesburg’€™s Charlotte Maxeke Hospital, without being offered any treatment and sent home until there was external intervention.

Patient D’€™s story was first revealed by a friend at a ‘€œVoice of Cancer’€ meeting in Cape Town earlier this year where a number of survivor’€™s shared their stories of living with cancer.

Patient D is now unable to care for herself due to the cancer having spread to her brain.

‘€œAfter receiving no response from the hospital we escalated Patient D’€™s case to the DG of health. Only then did Patient D receive appropriate treatment,’€ said Neil Kirby Chairperson of Campaigning for Cancer.

Patient D is currently gravely ill, partially blind and unable to take care of herself.

Health-e held off exposing Patient D’€™s plight after the national health department pleaded for time to investigate her case.

A report from the hospital CEO reveals that Patient D had been referred to Johannesburg hospital in October last year.

It appears as if her treatment was only started in May, almost seven months after her first visit to a hospital. The Johannesburg hospital CEO’€™s clinical report does not deal with any of the accusations that the hospital had failed to communicate with the patient and does not explain the delays in radiation treatment which only started once Campaigning for Cancer intervened on her behalf.

In another case Patient C was diagnosed in March this year with cervical cancer at the Port Elizabeth state hospital and was referred for radiation treatment to the Dora Nginza provincial hospital in Port Elizabeth.

Here, doctors in turn referred her to Groote Schuur hospital in Cape Town for surgery. At Groote Schuur she was told that surgery was not indicated and was sent back to Port Elizabeth for radiation treatment.

She contacted People Living with Cancer (PLWC) in July. Campaigning for Cancer as alerted and wrote to the Eastern Cape health department as well as the Director-General in the national health department.

Again, it was the DG Precious Matsoso’€™s intervention that led to action.

Kirby said they had been writing several letters to hospital CEOs, but that the only time they have had any response had been when they contacted Matsoso.

A case brought to the attention of People living with Cancer involved 55-year-old Patient B who was referred by her doctor to Johannesburg hospital with a lump in her neck. She was told she could not be seen at the academic hospital and was sent to Helen Joseph where she had to wait for weeks before being seen.

Subsequent surgery confirmed that the lump was cancerous. Patient B was subsequently informed that the cancer had also spread to her lungs.

Eleven weeks after being referred by her GP, but without any treatment for the diagnosed cancer, Patient B turned to People living with Cancer. She has been referred back to Johannesburg Hospital but the appointment next week is too late, according to the family doctor.

Her health has deteriorated and new lumps have appeared. She weighs 45kg and is weak.

‘€œObviously cost is a factor of which we feel at this stage it is a life or death situation and money is irrelevant, we just need your help and treatment,’€ her son pleaded in a letter.

Kirby confirmed that they were receiving increasing reports of patients who unable to access treatment.

‘€œIn many cases by the time patients are able to access treatment it is too late,’€ she said.

Proactive diagnosis is a problem, with many patients not being diagnosed when they first report for medical assistance. ‘€œThey are sent from pillar to post and by the time they reach the point where they are diagnosed, it’€™s too late. The referral process from day hospitals to specialist cancer units at tertiary hospitals is not effective and is hampering all efforts made to educate people about early detection of cancer,’€ said Linda Greeff of People living with Cancer.  

Health minister Dr Aaron Motsoaledi met with non-communicable disease (NCD) representatives this week. He is expected to accompany President Jacob Zuma to the United Nations High Level meeting on NCDs in New York on Monday and Tuesday next week.

‘€œWe are not going to let these matters pass. Many of these patients have been failed by the health system on numerous occasions and one has to ask the question whether the outcome could not have been different had they been assisted when she first went to the hospital,’€ said Kirby.  

NCDs include cancer, cardiovascular disease, chronic respiratory diseases and diabetes.

About the author

Anso Thom