Source: globalnews.ca
Four years ago, Ontarian Rebecca Grundy got a nightmare diagnosis that sent her into a blind panic.
She was only 28 years old and had no reason to believe she was anything other than perfectly healthy, except for a few headaches.
But after waking up on a stretcher in the hallway of a Toronto hospital after suffering three grand mal seizures, doctors found a cancerous tumour the size of her fist on the front left lobe of her brain.
“As soon as I was told, everything closed in around me… I felt like the floor was falling beneath me and the world was just spinning around. And I literally couldn’t see out of the tears that were coming down my face,” she said.
“In that moment, my life was changed forever.”
Her diagnosis: grade four glioblastoma, an extremely aggressive form of brain cancer with one of the lowest survival rates — typically less than 18 months.
And it’s not usually seen in adults under the age of 45.
When it comes to treating cancer in Canada, it turns out that age does matter.
The drug Grundy needed to survive, an at-home chemotherapy treatment called Temozolomide, is not covered provincially for patients of her age.
As shocking as it may seem, for cancer patients under the age of 65 in Ontario, provincial drug programs only cover intravenous chemo administered in hospitals.
Patients who choose in-hospital treatments can start taking them as quickly as they are needed, in some cases within two weeks, according to the CanCertainty Coalition, a group of more than 30 Canadian patient groups, charities and caregiver organizations that work to improve affordability and accessibility of cancer treatment.
But patients who would benefit from more targeted treatments administered at home in pill form or by self-injection face a “maze of prescription drug coverage programs,” the coalition says.
People diagnosed with cancer under the age of 65 must navigate their own funding solutions for these life-saving medications, as Ontario’s public coverage only includes individuals over 65 and under 25 and those on social services.
That is a huge subsection of people — with a gap of 40 years — who are not eligible for the appropriate care.
A similar situation exists in Atlantic Canada, where public drug insurance plans are designed to support patients only on social assistance or those 65 and older, according to a 2022 study on disparities in public cancer drug funding by Dalhousie Medical Department oncologists Dr. Stephanie Snow and Dr. Ceilidh MacPhail.
Young adults who would benefit from at-home therapies – many of which are newer, more targeted and come with fewer side effects – must first exhaust all private insurance options, and many younger Canadians are uninsured or underinsured.
A 2021 study conducted by the pharmaceutical pricing consultancy PDCI Market Access found 17 to 30 per cent of cancer patients aged 25 to–64 in Ontario have no form of drug coverage whatsoever.
Those patients are left to navigate complex bureaucratic red tape as they attempt to apply to emergency or high-cost provincial drug programs, or to compassionate programs provided by pharmaceutical manufacturers to avoid eye-popping medical bills.
All of this paperwork takes time, and a vast amount of already-depleted energy to complete.
Needless to say, for Grundy, both time and energy were in short supply after her rare-cancer diagnosis.
“I would have to jump through all of these hoops as a young person under the age of 65 to get access to this treatment that is supposed to kill the cancer cells and save my life. And that’s just not fair,” she said.
She spent weeks waiting for provincial assistance. In fact, trying to find a way to pay for her medications was more stressful than recovering from the brain surgery she underwent to have the tumor removed, Grundy said.
“This is a time that I should have been focusing on my wellness, and instead I had to fight for the treatment when I really should have been fighting for my life.”
Meanwhile, in Quebec, where all adults are mandated to have private or public drug insurance, oral cancer drugs are covered and treated the same as hospital-administered therapies.
