Evidence of meeting #103 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was access.
A recording is available from Parliament.
11:30 a.m.
Liberal
11:30 a.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you, Mr. Chair.
Welcome to all of our witnesses.
I'll be focusing my line of questioning today on screening and early detection using genetic profiling technologies and biomarkers, with a special focus on research. What are we are doing? How we are fairing against other countries, for example, in the OECD? I will open it up to any of our witnesses who are comfortable talking about where we are on research and development, specifically around genetic profiling technology, the use of biomarkers and where we should be. How far are we from a solution, and how are we comparing to other countries?
Anyone, go ahead.
11:30 a.m.
Advocacy Manager, Prevention, Canadian Cancer Society
I can jump in. I know that at the Canadian Cancer Society we're really interested in this, and we are investing in research to better understand the opportunities and limitations of such screening. I'm not sure we're at a point to necessarily bring it forward, but as I said, we're continuing to invest in seeing where this could go, because it is quite exciting.
Maybe you have something to add?
11:30 a.m.
Director, Advocacy, Canadian Cancer Society
I think what we would really just like to highlight as well is that we really support anybody who would like to advocate for themselves to receive that additional testing. We absolutely support that in terms of the mechanisms through which they can accomplish that.
11:30 a.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
What kind of research are we doing across all the different types of cancer using genetic profiling or biomarkers in Canada? Are we doing enough research? Are we leading in research? Do we have the technology?
11:30 a.m.
Director, Advocacy, Canadian Cancer Society
There is certainly more to be done on the research front, just with respect to overall investment in the research ecosystem. The Canadian Cancer Society is the second-largest funder of cancer research outside of the federal government, and that's the role of the charity.
We hope that, as we can connect with you and with other levels of government, we can all prioritize investments in research, because we really do know that this is the way forward for people living with cancer and their loved ones.
I'm sorry. We're not specifically answering the question.
11:35 a.m.
Liberal
11:35 a.m.
Medical Oncologist, As an Individual
Actually, I just wanted to mention something. It's not only about research; it's about access to genetic testing. There are two different kinds of genetic testing if you're talking about prevention. If you have either a personal history or a family history, a family member who has had cancer....
I'll talk about Atlantic Canada. Our main hub for testing is the IWK in Halifax, and their wait time is anywhere from 18 months to two years. That is huge when it comes to prevention.
When it comes to genetic testing that can dictate your treatment, the type of treatment you need, that could be easier and faster to get access to. I just wanted to mention that, unfortunately, even when we know exactly what works, access is still an issue.
11:35 a.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you. That's, I think, a complementary point of view.
I'm still trying to get a sense of where we are in Canada around the research. I have a company in my riding that has patented a technology that can use the plasma off of the blood to detect different cancer types and the stages they are at. I'm trying to get an understanding of where we are. Does anyone else want to comment?
Dr. Simpson, you might want to comment on that.
11:35 a.m.
Obstetrician Gynaecologist, St. Michael's Hospital, Toronto, As an Individual
Yes. I think that earlier this week the committee heard from Dr. Shannon Salvador, the president-elect for GOC. I do think that research in general for women's cancers in Canada is lagging behind and is under-resourced.
Speaking to endometrial cancer specifically, often in younger women this is actually the first obesity-related diagnosis they will receive. A good number of those patients will actually have Lynch syndrome, which puts them at risk of other types of cancer, such as colorectal and ovarian cancer.
I do think that there are some good steps forward in terms of better characterization of early endometrial cancer, identifying those patients and routinely looking for Lynch syndrome in those patients, and better characterization of who is at a higher risk of occurrence for endometrial cancer as well.
11:35 a.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you.
Dr. Ambreen Sayani, do you want to comment on that?
11:35 a.m.
Scientist, As an Individual
I would just say that all research, particularly if it is precision medicine based, needs to include the patient perspective, because we can create as many interventions, products, devices and plasma testing that exist under the sun, but if they're not acceptable to patients and they're not accessible to patients, then we've lost the plot. The investment in research needs to ensure that there is a patient-driven perspective that's woven into the discovery journey.
11:35 a.m.
Liberal
11:35 a.m.
Liberal
11:35 a.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you, Mr. Chair.
Thank you to all the witnesses for their opening remarks. It's always very inspiring, even though this is an extremely delicate subject. I'd like to come back to what stood out for me from what each of you said.
Ms. Sayani, you talked about the financial issue, the administrative burden, but beyond the administrative burden, we know that it takes time to heal. This has financial implications.
I'd like to talk about employment insurance, and why the number of weeks currently allowed is not enough for people with cancer to recover. The Bloc Québécois has already introduced a bill on this. Given that 26 weeks isn't enough, we talked about 50 weeks to give people real time to recover in the event of a serious illness.
Can you expand on the importance of removing this mental burden and stress from people who are suffering?
11:40 a.m.
Scientist, As an Individual
Financial toxicity is a huge burden that anyone already going through a cancer diagnosis shouldn't have to face. For women, I think it's particularly important. Because of socially constructed roles, they may already be at higher risk of losing their livelihoods, of being underpaid and of being unemployed.
Deep consideration is needed into what their financial situation is already, and then, if we top that up with a cancer diagnosis, what does it look like? We have experiences of cancer patients who have shared that “we're precariously employed” or “we have contract jobs”, and I think the contingent labour market is one that is on the rise. That disproportionately affects women.
It's about due consideration in terms of how the employment structures are set up and the financial implications for women when they are faced with a cancer diagnosis. Does that mean they are left unemployed? Does that mean they do not have benefits, which, as we discussed earlier, are needed to access the support services they need for a good quality of care, treatment and survival?
The employment insurance sickness benefit is one that I have studied particularly. In terms of the 15 weeks, if I can quote one of the patients in the study, “It's like a slap in my face.” It does an absolute disservice to their quality of life given that cancer treatment is not for 15 weeks. It is at least 26 weeks of treatment followed by a year of recovery. That means supporting them through that journey with financial means so that they are not having to pick and choose between medicine, gas and food, or making sure that they have a good pathway to return to good employment that supports them financially—and with benefits—as they recover.
11:40 a.m.
Bloc
Andréanne Larouche Bloc Shefford, QC
Studies show that even 26 weeks isn't enough. That's why we were talking about 50 weeks. We wanted to give people time to fully recover.
I am the status of women critic.
Ms. Sonea, you raised the issue of unpaid work and what it means for family caregivers. You mentioned a refundable tax credit. Besides that, a women's group is calling for a day to recognize invisible work in order to reflect on this issue. As we all know, cancer has a huge impact on the patient's loved ones. Caregivers must be involved. One cannot go through an ordeal like cancer all alone. The consequences are enormous. Women are particularly and disproportionately affected.
By designating a day to recognize this invisible work, we could also reflect on all the ways in which invisible work could be appreciated more. This could have an impact on cancer caregivers.
11:40 a.m.
Director, Advocacy, Canadian Cancer Society
Thank you very much for the question.
We really appreciate the opportunity to be able to highlight this, because it is such a women's health issue. Caregiving disproportionately impacts women, and I really appreciate the opportunity to elevate that here to this group today.
We know that financial support is the most significant need identified by caregivers. Our recommendation around making the federal caregiver tax credit refundable is one step to accomplish that. However, there is much more that we can do.
At the Canadian Cancer Society, we have the privilege of being able to engage on an ongoing basis with people with lived experience and with their loved ones. A survey we conducted last fall demonstrated to us that the number one need identified by caregivers was mental health supports, in addition to that financial need. Very often, you have individuals who don't have access to that, and very often when individuals are in the role of caregiving, they are on a fixed income—or no income.
There are so many things we can do. I'm really thrilled that you brought up the employment insurance system, because there are lots of opportunities and strides that we can continue to take in this space, including expanding the sickness benefit further and making compassionate care leave more accessible for caregivers as well. Even eliminating the mandatory one-week waiting period to receive an employment insurance benefit is a very practical thing that could happen.
We also would really recommend developing national standards. You might hear that woven into various answers, because we do lack a significant amount of just oversight and understanding of where the gaps continue to be in order to keep informing our policy decisions. In particular, as it relates to the caregiver tax credit, we recommend developing national standards that both the government and the employers can use to measure and evaluate the overall success of programs, services and supports to meet the needs of working caregivers.
For example, right now, we were very pleased to see the sickness benefit expanded last year. We look forward to hearing a little more in the coming weeks and months about how this program change has been taken up across the country, by people living in this country, and—
11:45 a.m.
NDP
Heather McPherson NDP Edmonton Strathcona, AB
Thank you very much to all of you for being here today.
I'm new to this committee. I haven't sat on this committee before. Thank you for letting me come and participate, everyone. You're a very well-behaved committee so far today—much better than foreign affairs.
11:45 a.m.
Voices
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