Dying Cancer Patients Need More Support

Canadian Cancer Statistics 2010 Released by the Canadian Cancer Society with Special Focus on Care and Support for Dying Patients

TORONTO, May 19 /CNW/ - The type and quality of care and services to ensure a cancer patient dies with dignity in the setting of their choice depends on where the person lives in Canada, according to a special report about end-of-life care in Canadian Cancer Statistics 2010, released today by the Canadian Cancer Society.

"Right now, in Canada we have a patchwork approach to providing care at the end of life. This means that some cancer patients and their families are not getting the support they need during a very difficult time," says Heather Chappell, Director, Cancer Control Policy, Canadian Cancer Society. "Uniform, high-quality support for any person dying of cancer should be available no matter where they live."

Cancer is the leading cause of death in Canada - in 2005 (the most recent data available), 29% of all deaths in Canada were from cancer. Due to our aging and growing population, the number of deaths from cancer and other chronic diseases will increase.

"Action is needed to ensure palliative care services are in place to meet the needs of patients now and in the future," says Chappell.

Caring for a dying cancer patient is part of a palliative approach that is provided when a patient's healthcare team determines that a cancer is unlikely to be cured. The goal of this type of palliative care is to improve quality of life. This includes:

    
     -  managing physical symptoms such as pain, nausea and shortness of
        breath
     -  meeting emotional needs such as anxiety and depression
     -  addressing spiritual needs
     -  support for caregivers
    

The special report is a compilation and comparison of data from end-of-life research in three provinces - British Columbia, Ontario and Nova Scotia. Findings show:

    
     -  There are inadequate services to allow people to die at home when
        this is their preference.

        -  Survey data show that most terminally ill people would prefer to
           die at home, but more than 55% of deaths occur in hospitals. One
           reason for this is because community-based services are not
           available for dying people in some jurisdictions.

     -  Palliative care services exist, but they are often not used.

        -  Patients and their families sometimes are not aware of available
           services.

        -  Because it is often difficult to anticipate death, healthcare
           providers may not be able to judge when people with cancer should
           begin receiving care that is focused on palliative needs rather
           than disease treatment. Late enrolment to palliative care can mean
           a patient will not receive the benefits from care specifically
           focused on the needs of the dying.

     -  Families caring for dying people experience significant psychological
        and financial burdens.

        -  The family of a person with cancer assumes most of the costs and
           other burdens of home care. A caregiver's financial burden is
           about $36 a day or over $1,000 a month. This does not include lost
           income due to time off work to provide care for the terminally ill
           loved one.
    

Dr. Prithwish De, co-author of the special report and an epidemiologist with the Canadian Cancer Society, acknowledges that dying from cancer or any terminal illness is a difficult topic, but it's crucial to continue examining this issue.

"We must gain more knowledge and insights about this important group of people with cancer so we can determine what care and services will ensure they have a good quality of life until their death," says De.

Currently, data about quality of care for people with cancer at the end of their life are sparse and inconsistently collected across Canada. Knowledge about this subject is limited because:

    
     -  there is variation in the type of data collected across jurisdictions
        (without common data it is difficult to compare information so that
        gaps in care can be identified)

     -  there are, in many instances, no formal monitoring systems in place
        to consistently collect and report on end-of-life care across
        provinces

     -  there are no standard timeframes for the end-of-life period (studies
        have looked at one month, six months or nine months prior to death)
    

"Doing more research and better surveillance on care at the end of life is vital to our future efforts in this area," says Dr. Eva Grunfeld, co-author of the special report and researcher at the Ontario Institute for Cancer Research.

Recommendations

To help ensure uniform, high quality support is available for people dying of cancer, it is recommended that:

    
     -  surveillance about end-of-life care be improved to help define the
        needs of people dying from cancer and to allow better planning

     -  definitions and methods of reporting end-of-life care be standardized
        so that surveillance data are more comparable across jurisdictions -
        this would allow researchers, policy makers and healthcare planners
        to more easily identify gaps in care
    

"The Canadian Cancer Society supports these recommendations," says Paul Lapierre, Vice President, Public Affairs and Cancer Control, Canadian Cancer Society. "Each and every person who is dying from cancer deserves the best of care no matter where they live."

A caregiver's perspective

Joanne Morrison calls the four and a half years she looked after her husband Guy, "a rollercoaster ride."

"He was certainly very ill sometimes and a lot better other times," says Joanne.

Diagnosed in 1997 with glioblastoma multiforme, an aggressive brain cancer, Guy was given 12 to 18 months to live but survived until March 2002, when he died at age 52.

Guy suffered seizures, so Joanne took over the driving. As well, confusion resulting from Guy's cancer meant he needed frequent monitoring, leaving her with little time to herself. Joanne's employer was close to home and flexible, which helped. So did family members and a hospice volunteer who spent one afternoon a week with Guy. But in the last weeks of Guy's life, Joanne realized she could no longer do it alone and her two grown children and daughter-in-law moved in.

"It took four of us to look after him," Joanne says, adding that Guy was able to die at home.

Joanne wishes more information on patient and caregiver support could be made available right in medical offices. It's that need for information that inspires her to serve as a Canadian Cancer Society CancerConnection volunteer for other caregivers.

Caregivers should not try to be a "super person," she stresses. "Make a list of everything that needs to be done. If anyone asks, 'What can I do?' give them the list and ask them to pick something."

Highlights: Canadian Cancer Statistics 2010

    
     -  An estimated 173,800 new cases of cancer (excluding 75,500 cases of
        non-melanoma skin cancer) and 76,200 deaths from cancer are expected
        to occur in Canada in 2010.

     -  More than one-quarter of all cancer deaths - 27 per cent - are due to
        lung cancer.

     -  More men than women are diagnosed with cancer, but the gap between
        the two sexes has narrowed in recent years (51.7 per cent of cases
        are in men vs. 48.3 per cent of women).

     -  The death rate for all cancers combined is declining for males in
        most age groups and for females under 70.
    

Canadian Cancer Statistics 2010 is prepared, printed and distributed through a collaboration of the Canadian Cancer Society, the Public Health Agency of Canada, Statistics Canada, provincial and territorial cancer registries, as well as researchers based in universities and provincial or territorial cancer agencies.

The Canadian Cancer Society fights cancer by doing everything we can to prevent cancer, save lives and support people living with cancer. Join the fight! Go to www.fightback.ca to find out how you can help. When you want to know more about cancer, visit our website at www.cancer.ca or call our toll-free bilingual Cancer Information Service at 1 888 939-3333.

For more information about Canadian Cancer Statistics 2010, visit the Society's website at www.cancer.ca.

    
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Media backgrounder No. 1 for: Canadian Cancer Statistics 2010

Special Report: End-of-Life Care

Fast Facts

    
     -  In 2005 (the most recent available data), 230,132 Canadians died and,
        of these, approximately 67,300 died from cancer. This made cancer the
        leading cause of death - representing 29% of all deaths.

     -  The number of cancer deaths in both men and women has been increasing
        in both sexes, largely due to a growing and aging population.

     -  In contrast to the number of deaths, overall rates of cancer death
        (the number of deaths per 100,000 people) have been declining or have
        remained stable.

    Place of death

     -  Survey data suggest that most terminally ill people would prefer to
        die at home, but more than 55% of deaths occur in hospitals. This is
        often an indication that community services to support palliative
        care are inadequate.

    Costs

     -  Cancer accounts for 29% of all deaths in Canada and for 32% of all
        costs related to death.

     -  Hospitalization and direct medical costs account for more than half
        of the costs associated with people dying of cancer.

     -  Cancer care is most expensive in the period following diagnosis and
        immediately preceding death.

    Costs of family caregiving at the end-of-life

     -  Some people dying of cancer choose to stay at home for as long as
        they can. In such cases, family members or friends are the primary
        caregivers with support from a healthcare team, such as palliative
        care nurses and doctors.

     -  The caregiver of a person with cancer assumes most of the costs and
        other burdens of home care. A caregiver's financial burden is about
        $36 a day or over $1,000 a month.

     -  A large proportion of the caregiving financial burden is related to
        time. It has been estimated that the main caregiver commits about 2.6
        hours a day to the patient.

     -  Family caregiver costs include:

        -  purchasing prescription and non-prescription medications

        -  nutritional supplements, special meals and vitamins

        -  diapers, hygienic products, dressings and other supplies

        -  furniture and devices such as beds, armchairs and toilet seats

        -  time away from work

        -  transportation and parking
    

Canadian Cancer Statistics 2010 is prepared, printed and distributed through a collaboration of the Canadian Cancer Society, the Public Health Agency of Canada, Statistics Canada, provincial and territorial cancer registries, as well as researchers based in universities and provincial or territorial cancer agencies.

The Canadian Cancer Society fights cancer by doing everything we can to prevent cancer, save lives and support people living with cancer. Join the fight! Go to www.fightback.ca to find out how you can help. When you want to know more about cancer, visit our website at www.cancer.ca or call our toll-free bilingual Cancer Information Service at 1 888 939-3333.

For more information about Canadian Cancer Statistics 2010, visit the Society's website at www.cancer.ca.

Media backgrounder No. 2: Canadian Cancer Statistics 2010

Cancer in Canada: Fast Facts

Canadian Cancer Statistics 2010 was released today by the Canadian Cancer Society.

In general, the incidence and death rates for the majority of cancer types have stabilized or declined during the past decade.

Current estimates of new cases and deaths

    
     -  In 2010:

        -  There will be an estimated 173,800 new cases of cancer - an
           increase of 2,800 from last year.

        -  There will be an estimated 76,200 deaths from cancer - an increase
           of 900 from last year.
    

The number of new cancer cases and deaths continues to rise steadily as the Canadian population grows and ages.

Males

    
     -  Overall death rate: Since 1988, the cancer death rate for Canadian
        males has been declining.

     -  Overall incidence rate: The cancer incidence rate for males is
        stable.

    For males, the following statistically significant changes (2% or more per
year) were observed.

     -  Male incidence rates (1997-2006):

        -  decreases in stomach cancer (-2.1%), lung cancer (-2.1%) and
           cancer of the larynx (-3.8%)

        -  increases in thyroid cancer (6.8%) and liver cancer (3.1%)

     -  Male death rates (1996-2005):

        -  decreases in lung cancer (-2.2%), oral cancer (-2.4%), prostate
           cancer (-3%), cancer of the larynx (-6.5%), stomach cancer
           (-3.6%), and non-Hodgkin lymphoma (-2.6%)

        -  increase in liver cancer (2.2%)
    

Females

Among females, the overall cancer incidence rate has been increasing slowly since the early 1990s, while the death rate has remained relatively stable since 1981.

Excluding lung cancer, the overall cancer death rate has dropped by nearly 20 per cent in females since 1981.

For females, the following statistically significant changes (2% or more per year) were observed:

    
     -  Female incidence rates (1997-2006):

        -  decreases in cancer of the larynx (-4.3%)

        -  increase in thyroid cancer (9.5%)

     -  Female death rates (1996-2005):

        -  decreases in non-Hodgkin lymphoma (-2.9%), cervical cancer (-3.8%)
           and stomach cancer (-2.5%)

    Prostate cancer

     -  Prostate cancer is the most frequently diagnosed cancer among
        Canadian men.

     -  In 2010, it is estimated that approximately 24,600 Canadian men will
        be diagnosed with prostate cancer and about 4,300 will die from the
        disease.

     -  The prostate cancer death rate declined significantly between 1996
        and 2005 (by 3% per year).

    Breast cancer

     -  Breast cancer is the most frequently diagnosed cancer among Canadian
        women.

     -  In 2010, it is estimated that approximately 23,300 Canadian women
        will be diagnosed with breast cancer and about 5,300 will die from
        it.

     -  The breast cancer death rate has declined by more than 30 per cent
        since 1986. This is likely because of early detection and treatment
        through increased screening by mammography and availability of
        improved treatment.

    Lung cancer

     -  In females, lung cancer incidence and death rates have been
        increasing since 1980:

        -  The incidence rate increased by 1.2% per year between 1997 and
           2006, but longer-term projections suggest that this rate is
           beginning to level off.

        -  The death rate increased by 0.9% per year between 1996 and 2005.

     -  Among males, rising lung cancer incidence and death rates began to
        level off in the mid-1980s and have been declining ever since.
        Incidence rates have dropped by 2.1% per year and death rates by 2.2%
        per year.

     -  Lung cancer remains the leading cause of cancer death for both males
        and females.

    The differences between male and female trends reflect the drop in smoking
that began for males in the mid-1960s and much later - in the mid-1980s - for
females.

    Colorectal cancer

     -  Although the long-term trend in the incidence rates in both sexes is
        complex, recently rates appear to be stable or declining.

     -  Death rates continue to decline for both men and women. Since 1996,
        the death rate for males has dropped by 1.2% per year and by 1.7% per
        year for females. This is likely the result of improvements in
        treatment, such as chemotherapy.

    Esophageal and kidney cancers

    This year Canadian Cancer Statistics 2010 looks at two cancers in more
depth - cancer of the esophagus and of the kidney.

    Esophagus

     -  In 2010, there will be an estimated 1,700 new cases of esophageal
        cancer and about 1,800 deaths from the disease.

     -  Cancer of the esophagus occurs three times more often in males than
        females.

        -  In females, the number of esophageal cancers per 100,000 is two;
           in men, it's six.

     -  The overall incidence rate of esophageal cancer has remained stable
        since the mid-1980s. Since the mid-1980s, the average annual
        incidence rate has increased by 0.3 per cent per year for males and
        decreased by 0.5 per cent per year for females.

     -  Although cancers of the esophagus are still relatively rare in
        Canada, the incidence rate of one type of esophageal cancer
        (esophageal adenocarcinoma) has doubled in the last 20 years. This
        may reflect the rising prevalence of obesity and gastro-esophageal
        reflux disease.

    Kidney

     -  In 2010, there will be an estimated 4,800 new cases of kidney cancer
        and about 1,650 deaths from the disease.

     -  Kidney cancer is nearly twice as common in males than females.

        -  In men, the number of kidney cancers per 100,000 is 17; for
           females, it's 9.

     -  The incidence rate of kidney cancer in Canada has increased by
        approximately 1.3% per year for both sexes since the late 1990s.
        These increases may reflect changes in the prevalence of certain risk
        factors, particularly obesity.

     -  Kidney cancer death rates have declined slightly. Since the mid-
        1980s, death rates have decreased by 0.3 per cent per year for males,
        and for females by 0.7 per cent per year.
    

Canadian Cancer Statistics 2010 is prepared, printed and distributed through a collaboration of the Canadian Cancer Society, the Public Health Agency of Canada, Statistics Canada, provincial and territorial cancer registries, as well as researchers based in universities and provincial or territorial cancer agencies.

The Canadian Cancer Society fights cancer by doing everything we can to prevent cancer, save lives and support people living with cancer. Join the fight! Go to www.fightback.ca to find out how you can help. When you want to know more about cancer, visit our website at www.cancer.ca or call our toll-free bilingual Cancer Information Service at 1 888 939-3333.

For more information about Canadian Cancer Statistics 2010, visit the Society's website at www.cancer.ca.

Media backgrounder No. 3: Canadian Cancer Statistics 2010

End-of-life Care and the Canadian Cancer Society

The Canadian Cancer Society empowers, informs and supports people living with cancer. Here's what we're doing to improve the quality of life for cancer patients.

Advocating for a Canadian family caregiver strategy

The Canadian Cancer Society is urging the federal government to establish a Canadian family caregiver strategy to better support the people who are the invisible backbone of our healthcare system.

The family of a person with cancer assumes most of the costs and other burdens of home care, according to a special report on end-of-life care in Canadian Cancer Statistics 2010.

"The country's population is aging, and increasingly Canadians will be caring for loved ones who have cancer and other serious illnesses that could lead to death," says Aaron Levo, Acting Director, Public Issues, Canadian Cancer Society. "While some financial support currently exists for caregivers, much more needs to be done. Caregivers often suffer financial difficulties and career setbacks while caring for their loved one."

The Society believes key components of a Canadian caregiver strategy should include:

    
     -  Compassionate care benefits
        Increase the period that a caregiver can receive financial benefits
        to 26 weeks; it is currently six weeks. "Six weeks is too short and
        doesn't consider the unpredictability of death," says Levo.

     -  Caregiver tax benefit
        The Society recommends a caregiver tax benefit be established that
        would be non-taxable and paid monthly to help caregivers with the
        costs related to caregiving.
    

"It is simply not acceptable for a person already giving so much to support others, to carry an additional financial burden related to caregiving responsibilities," says Levo. "We will continue to advocate on behalf of Canadians for this important issue."

Research

The Canadian Cancer Society has committed more than $2.7 million to fund end-of-life research since 2007. Projects include:

    
     -  Developing resources to help doctors recognize and ease both the
        subtle and more obvious signs of distress in cancer patients.

     -  Studying whether early involvement of a palliative care team, in
        addition to routine care, will be associated with better quality of
        life in patients with advanced cancer and their family caregivers,
        compared to routine care.
    

Relay For Life

This year all across Canada thousands of Canadians will be participating in the Society's largest national special event - Relay For Life. Relay is more than just a fundraiser. It is an opportunity to get together with family and friends and celebrate cancer survivors, remember loved ones lost to cancer and fight back in the hope of finding a cure for this disease.

Remember loved ones lost to cancer: At Relay For Life, luminaries are lit during a moving ceremony at dusk. Their light pays tribute to loved ones and provides inspiration to participants all night long. Luminaries can be purchased before or at the event for $5.

Join the fight! Go to www.fightback.ca to find out more about Relay For Life.

Support

The Canadian Cancer Society encourages people with cancer and their caregivers to call our peer support program - CancerConnection.

Specially-trained volunteers listen and give valuable suggestions to people with cancer and for the people who care about them. Callers will be matched with someone who has been through a similar experience and who the caller feels comfortable talking with. This telephone-based program is free and confidential.

Call 1 888 939-3333 to get connected to CancerConnection.

Living with Advanced Cancer

The Society recently published a new booklet - Living with Advanced Cancer - for people who have been diagnosed with advanced cancer and their caregivers. Physical, emotional, social and spiritual needs are described in the booklet. Call 1 888 939-3333 to get a copy. It's also available on the Canadian Cancer Society's website - www.cancer.ca.

Information

Information about all aspects of cancer is available by:

    
     -  Visiting the Canadian Cancer Society's website - www.cancer.ca
     -  Calling the Society's toll-free, confidential Cancer Information
        Service at 1 888 939-3333.
    

Share your story

Are you or is someone you know fighting cancer? Share your story and join the fight. The more voices that join together, the louder our rallying cry. Many caregivers have already contributed their stories. Go to www.cancer.ca to find out more.

The Canadian Cancer Society fights cancer by doing everything we can to prevent cancer, save lives and support people living with cancer. Join the fight! Go to www.fightback.ca to find out how you can help. When you want to know more about cancer, visit our website at www.cancer.ca or call our toll-free bilingual Cancer Information Service at 1 888 939-3333.

For more information about Canadian Cancer Statistics 2010, visit the Society's website at www.cancer.ca.

SOURCE Canadian Cancer Society (National Office)

For further information: For further information: Alexa Giorgi, Bilingual Communications Specialist, (416) 934-5681

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Canadian Cancer Society (National Office)

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