But when weighing all of the many factors, in the end the cost may be the biggest hurdle to overcome and justify.
“I’ve been studying this for some time and looking and discussing it with people,” says Dr. Drew Bethune, medical director of the Provincial Program of Care for Cancer with the Nova Scotia Health Authority. “I’ve discussed it with the (hospital) foundation in Yarmouth a couple of times over the past eight months or so, and I’ve discussed it with the radiation therapy department in Halifax here.”
A 2014 document contained detailed estimates of what it would cost to put a linear accelerator (a radiotherapy machine) in Yarmouth. Bethune says to build and install a device the cost runs around $40 million. To maintain it the cost is about $3.5 million a year.
“The cost of building and installing the machine, and the cost of running the machine, were seen to be, at the time, too high to justify just going ahead and putting it in, even though we would love to,” Bethune says.
The machines are also specialized and complicated. In Halifax there are 10 PhD physicists who run and adjust the linear accelerators there.
When the question – Should radiation services be available in Yarmouth? – is put to the public, the answer is a resounding, emotional, yes. People experiencing cancer themselves, or if their loved ones are, say the burden of constant travel to Halifax takes a toll financially, physically and emotionally.
At its last council meeting, Yarmouth town council approved a motion to write a letter to the health department asking that consideration be given to making radiation services available at the Yarmouth Regional Hospital.
WHAT WOULD IT TAKE?
Bethune says there are many factors to consider. Population base is one, which would also take into account where the cutoff in western N.S. would be for people to access services in Halifax versus Yarmouth. In other words, what’s the closer option and how would that impact numbers?
The cost of one part of the cancer care system in the province also has to be considered in the context of the province’s entire cancer system, Bethune says. And staff recruitment is another challenge. He notes there would also always be specialized radiotherapy needed in certain cases that patients could only access in Halifax.
But Bethune certainly understands why people in western Nova Scotia want to see radiation services here. He says through the cancer care program they do try to deliver cancer care to patients at home, or as close to home, as much as possible.
“This includes all aspects of cancer care and there is great opportunity to improve this,” he says. There are 11 satellite locations (including Yarmouth) where people can receive chemo treatments. But they’re also looking at other tests and consults that people require.
“One of the areas that we’re trying to improve is provide consultation services for radiology therapy so people don’t have to come to Halifax. We’ve had radiation oncologists visiting Yarmouth and we’re also looking at enhancing the use of telemedicine/teleoncology. There are a number of different strategies that we are doing to try and prevent all cancer patients from traveling too much,” he says. Exploring better transportation arrangements is also happening.
At the end of the day it still boils down to the question: Is it completely beyond the realm of possibility that radiation services be offered at the Yarmouth Regional Hospital?
“The feasibility? It’s very borderline because of the population base and the cost of the machinery,” Bethune says. And yet he still can’t bring himself to dismiss the idea entirely.
“We will review this and see if there is anything we can change in those numbers, if there is anything with new technologies that might change those numbers,” he says. “It’s just not an easy one to say ‘Let’s do it,’ because of these considerable expenses.”
No matter how hard, he says, everyone wishes they could.
Your thoughts?
What are people’s thoughts on having radiation services in Yarmouth? We recently asked on our Facebook page, these are some responses:
• Elaine LeBlanc: “It would be a definite asset to the hospital and surrounding communities. Dealing with the cancer is stressful enough. To have this in our area would be wonderful for the patient and their families.”
• Judy Bain: “Fabulous idea. Halifax is too far to go for cancer patients, some of whom have no access to transportation and may be too sick to travel.”
• Adrienne Speck: “Having our own radiation unit would make it so less stressful for all those who are already stressed by the necessity of going through the procedure.”
• Brenda Slevin: “Yes it would be so much better than having a person so sick with cancer having to drive all the way to Halifax every time they need radiation. This doesn't help them any as it tires a person out that is already so very tired and sick from the cancer.”
• Elaine Surette: “As someone that had to go to Halifax, for all my chemo and four weeks of radiation, and don't drive, I say it is definitely needed.”
• Julie Bancroft: “Many, many, people have had to make these trips, myself included. It is very expensive with gas, meals, etc. I had 20 treatments that were spread out over three weeks. The staff in Halifax told me Yarmouth represents a large percentage of their patients.”
• Loretta Davis: “It would be so wonderful for the entire Tri-county area.”
