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Today, after many months of advocating on this issue, we are very excited to share the news that the Nova Scotia provincial government will begin funding the Oncotype DX testing in the province, making this essential testing accessible and affordable for all women in NS living with breast cancer!

This type of advocacy work does not happen overnight. It involves a lot of meetings and follow up. And, following up again. And again. And when things stall, you have to kick up a bit of a storm on social media. Thank you so much to those of you “storm inciters” who were so active in tweeting and sharing blog posts. It really made a difference. You helped make this access happen for women in Nova Scotia. Thank you, especially, for the social media traction you gave to “Heather’s story.”

Heather’s story bothered us. And, it bothered a lot of you.

We believe that every eligible patient in Canada should have access to Oncotype DX, regardless of financial situation.

Here’s a little timeline of how we worked together to make this happen:

2012 – Cancer Care Nova Scotia Breast Cancer Site team made a positive recommendation to the Ministry of Health to fund a diagnostic test called Oncotype Dx.

2013 A Health Technology Assessment was conducted and presented to the Ministry of Health. This assessment determined a positive recommendation on the use of Oncotype Dx.

October 2014 – Rethink Breast Cancer traveled to Nova Scotia to meet with elected officials and oncologists advocating for the funding of Oncotype Dx for breast cancer patients.

October 2014 Rethink Breast Cancer launched a public engagement advocacy campaign urging the public to write a letter to the Minister of Health voicing their support for the funding of Oncotype Dx. The campaign continued to be promoted through social media.

October 23, 2014 – Opposition Health Critic asked a question to the Minister of Health during Question Period on the timing of a funding decision for Oncotype Dx.

November 2014 – Rethink sent letter to Minister of Health requesting a funding decision for Oncotype Dx.

May 7, 2015 Opposition Health Critic asked the Minister of Health again in the Legislature on when we can expect a funding decision by the Ministry.

September 2015 – New study in the New England Journal of Medicine shows many women with early, low-risk breast cancer may not need to undergo chemotherapy as part of their treatment plan.

November 2015 – Rethink sent a follow up letter to Minister of Health urging a funding decision be made by the end of 2015. We also shared “Heather’s story.”

December 2015 – Time to Kick Up a Storm! Rethink launched a social media campaign directed at local media and elected officials, including the Premier & Minister of Health, on the lengthy wait times for a funding decision for Oncotype Dx.

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December 15, 2015 – Opposition Health Critic asked the Minister once again for an update on the funding of Oncotype DX and if we can expect it’s funding to be included in the Spring budget.

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December/ January – Local media picked up the story in both radio and print.

April 1, 2016 – Nova Scotia makes budget announcement but no details released. Rethink follows up behind the scenes in search of information about status of Oncotype DX funding.

April 19, 2016 – Receive word that Nova Scotia government has confirmed funding for Oncotype DX in Nova Scotia and we are anticipating a formal announcement by the Ministry of Health very soon.

Throughout this entire campaign, we were constantly in contact with elected officials, healthcare providers and patients in Nova Scotia urging them to raise their voices in support of the funding for Oncotype Dx in Nova Scotia. And we asked our supporters to help make this happen. You did.

Thank you!

For more Oncotype Dx news click here!

I was diagnosed with stage 1 invasive breast cancer in July 2015. Although I was devastated with this diagnosis, I was pleased to find out that I was a candidate for the Oncotype DX test due to the characteristics of my tumour.

The Oncotype DX test determines the likelihood of cancer recurrence and whether or not the risks of chemotherapy would outweigh the benefits for a particular individual. I was shocked and very disappointed to find out that Nova Scotia’s MSI program does not currently cover the Oncotype DX test, despite the fact that research has shown it to be a very effective test and many other Canadian provinces do cover the cost of this important test.

I believe that Nova Scotians deserve to have the Oncotype DX test done if their oncologist feels that they could benefit from it. I did end up having the Oncotype DX test done and it definitely changed the course of my treatment for the better. I received a low score on the test which meant that I would NOT benefit from having chemotherapy. As you could imagine, this was a huge relief for both myself and my family.

I am a mother of 2 young children and if I were to have unnecessarily undergone chemotherapy it would have negatively impacted both my family and society as a whole as I would have been unable to work for the last 6 months. As it turned out, I was only off work for 3-4 weeks.

I believe the cost of the Oncotype DX test would pay for itself several times over in savings from unnecessary medical expenses, as well as increased tax revenues from patients being able to quickly return to work, as I did. Chemotherapy is toxic and has many side effects that often lead to future health problems which would put financial strains on the Nova Scotia health care system in the years to come.

In addition, I saw my oncologist in November and he discharged me from his care since I did not end up needing chemotherapy. Thus, freeing up the healthcare system for people that need it and saving MSI money, as I no longer need oncology followup appointments since I did not have chemotherapy.

I think that the Nova Scotia government needs to realize that the Oncotype DX test can save the province significant amounts of money in the long run not to mention the mental and physical anguish it can save breast cancer patients. I am very thankful that I had the Oncotype DX test and feel that other Nova Scotians deserve the opportunity to be spared the toxic effects of chemotherapy which in turn will also save the province money rather than being a penny wise and a pound foolish.

Sincerely,

Sarah (a breast cancer survivor)

Want to help our campaign to fund Oncotype Dx in Nova Scotia? Share this post, send a tweet, send a letter and let’s make this happen!

I was diagnosed in November 2014 with stage 2, grade 2 Invasive Ductal Carcinoma. I was 35 years old, young for a breast cancer diagnosis. I had a single mastectomy just three weeks after my diagnosis. The pathology report showed that my tumour was strongly hormone positive, and that there was no lymph node involvement. In short, I was the perfect candidate for the Oncotype Dx test. One problem: I live in Nova Scotia, where the Oncotype test isn’t funded by the provincial health care system.

I knew about the Oncotype test, because a young family member had been diagnosed and treated for early stage breast cancer in Ontario. She had the test done as part of the standard practice of care in her province. She was able to make treatment decisions based on evidence specific to her tumour, something that Nova Scotians are currently not given easy access to.

After my surgery, I had resigned myself to the fact that I would receive chemotherapy, as this is currently the protocol for women with breast cancer in my province. I was willing to do it without the information available from the Oncotype test, as I was unable to afford the $4800 expense, and I didn’t want to ask for a loan or gift of that amount.

I underwent the preliminary tests to determine if my heart could withstand chemotherapy. I went to the hospital’s chemotherapy information session, in which I was the only participant under age 70. I asked questions about fertility, job retention, and whether it would be safe for me to ride public transit during chemo. During a break in the session, one of the other participants asked me if I wouldn’t mind asking my questions to the instructor after the session because she (correctly) identified that my chemotherapy fears were dramatically different from the rest of the group’s.

In a meeting with my oncologist days before I was scheduled to begin chemo, with my family present, he strongly recommended that we find a way to have the test done, and my wonderful parents agreed to pay for it without hesitation.  There was still time to delay chemotherapy until the test results came back, without compromising its effectiveness. I consider myself very fortunate to have parents who were able to afford the test, and generous enough to offer to pay on my behalf. Many women are not so lucky.

When the test results came back, I was blown away. The Oncotype test gives you a score out of 100, with a high score indicating that there is a high chance of breast cancer recurrence, and a strong likelihood that chemotherapy will be helpful in reducing this risk of recurrence.

My score was three. Three! That’s about as low a score as you can get on the Oncotype test, which means that undergoing chemotherapy would have been completely unnecessary.

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My province would have assumed the cost and the risks for me to receive chemo, without knowing that it would have next to no benefit. How many women are being asked to compromise their health for no good reason other than that it’s the provincial protocol?

Chemotherapy is a costly treatment in itself. There’s the cost of the medication, but there’s also the costs of:

  • Preliminary tests to determine if a person is well enough to receive chemotherapy
  • The salaries of health care workers to administer chemotherapy safely, and to monitor the person’s health during treatment
  • Blood work before each chemotherapy session
  • Surgical procedures (for some recipients) for chemo administration device insertion, like Port-a-Caths
  • Cleaning and maintenance costs of medical equipment, and treatment centre rooms
  • Medical care for secondary health complications from chemotherapy, including hospitalizations and emergency room visits due to infection and dehydration
  • Medical (and psychiatric or psychological) care for a person who has long-lasting, even lifelong side effects and harm from receiving chemo treatments

There’s also the potential cost to governments in supporting women if they’re unable to work during and after chemotherapy, whether that be through employment insurance, income assistance, or employer’s insurance. Compared to the cost of receiving chemotherapy, a $4800 price tag for a prognostic test is miniscule.

For women who receive the Oncotype test and score in the higher range, there would be confidence that the risks of chemotherapy will have personal benefit, and the costs to the province would be easily justified. For the women who score low, the financial cost to the Nova Scotia health care system would be dramatically reduced.

The Oncotype test is also valuable to doctors in determining treatment plans that are unique and highly specific to the individual patient’s needs. This, of course leads to better outcomes in treatment effectiveness.

My parents’ generosity saved me from unnecessary chemotherapy. I sincerely hope that the Oncotype test will be funded for all eligible women in Nova Scotia, in order to allow for people to make evidence-informed decisions about their breast cancer treatment. I hope that the people in charge of making decisions to fund the Oncotype test read my story and recognize the importance of this test becoming part of Nova Scotia’s standard practice of care.

Heather from Nova Scotia, diagnosed with breast cancer at age 35

Listen up! Did you know that there’s a test that can help determine if a woman with breast cancer should receive chemotherapy? Did you know that this test is available to some Canadians, but not all, depending on where they live? Crazy, right? We think so too.

Nova Scotia currently does not cover the Oncotype Dx test for women with breast cancer who qualify. This means that they either pay thousands of dollars out-of-pocket, or they don’t get the test at all.

Why should you care?

Chemotherapy is no walk in the park. The treatments can cause hair loss, bone pain, nausea, vomiting, neuropathy, extreme fatigue and serious long-term side effects such as fertility damage, heart toxicity, and risk for leukemia. For many women, these treatments are necessary. But for some women, the risks outweigh the benefits.

For breast cancer patients who are early-stage, estrogen-positive, and lymph-node negative, the Oncotype Dx test can provide a score that will predict likelihood of recurrence and whether or not chemo is necessary.

Without this test, some women may be receiving chemotherapy who do not need it, causing unnecessary pain, long-term consequences and wasteful spending of important healthcare dollars.

The government of Nova Scotia has been dragging their feet for too long on this issue, and we want them to act NOW. We are calling on Nova Scotia’s Minister of Health and Wellness and asking him to approve funding for Oncotype Dx. Funding this test is a no-brainer. By not supporting it, the government of Nova Scotia is doing a massive disservice to women with breast cancer and all Canadians.

Share this post, send a tweet, send a letter and let’s make this happen!

Rethink Breast Cancer is calling on the Minister of Health in Nova Scotia to fund a diagnostic test called Oncotype Dx.

On October 8th, Rethink’s Founder & Executive Director, MJ DeCoteau & I traveled to Halifax, Nova Scotia to meet with Members of the Legislative Assembly and the Deputy Minister of Health. The purpose of these meetings was to introduce them to Rethink and also highlight the importance this test could have on women diagnosed with breast cancer in the province.

oncotype-stat1Oncotype Dx helps identify which women with early-stage, estrogen-receptor positive and lymph-node-negative breast cancer are more likely to benefit from adding chemotherapy to their hormonal treatment. This test also helps assess the likelihood that an individual woman’s breast cancer will return. More than 12,000 patients in Canada have benefited from the additional information that the Oncotype Dx test has provided.

During Question Period on October 23rd, Progressive Conservative Health Critic, Honourable Chris d’Entremont raised this issue with Minister Glavine. Read their exchange here.

Oncotype Dx is considered a standard of care in the United States and has received approval from various committees including the Ontario Health Technology Assessment Committee. This test has been approved in 6 other provinces and with your help we can ensure that women of Nova Scotia receive equal treatment as women in other provinces such as Alberta, British Columbia, Newfoundland and Labrador, Ontario, Quebec and Saskatchewan.

writealetterNSConsider joining our letter writing campaign to voice your support on the importance Oncotype Dx will have on young women diagnosed with breast cancer in Nova Scotia. Visit here for more information.

One size does not fit all when it comes to a breast cancer diagnosis. This test will hopefully lead to a more personalized approach in breast cancer treatment, which may be more cost effective in treating cancer patients.

 

As part of Breast Cancer Awareness month, I had the unique opportunity to travel to Nova Scotia (aka home) with Rethink’s Founder and Executive Director, MJ DeCoteau. Now that I live in Ottawa I don’t usually spend much time on the East Coast in the Fall and forget just how beautiful that part of the country is this time of year. The colours on the trees were near their peak and the smell of the salt water in the air brought me back to my childhood, growing up on the west coast of Cape Breton Island.

Ashley in Halifax
It’s good being back home in Nova Scotia.

The purpose of this trip was to meet Members of the Provincial Legislature (MLAs) to introduce them to Rethink Breast Cancer and to advocate on behalf of young women for greater access to evidenced-based treatments and diagnostic testing to empower these young women facing breast cancer to make more personalized treatment decisions.  Joining MJ & I at these meetings was Amanda Hudson-Frigault, a young woman who was diagnosed with breast cancer at the age of 32. Amanda spoke eloquently about her breast cancer journey as a young woman and of the many unique challenges she faced.

The MLAs we met with were very engaged in our cause and it is my hope that we can continue to foster these relationships and work with them to improve the lives of young women diagnosed with breast cancer in Nova Scotia.

Next, MJ and I head to Manitoba to meet with MLAs there.