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Montreal

Lack of pathologists leaves Quebec cancer patients in limbo

A Sept-les surgeon says Quebec needs to ensure doctors have access to pathologists in their day-to-day work. Dr. Marion L'Esprance says the shortage means she has to send her lab samples to private clinics in Ontario.

People on Quebec's North Shore waiting months in some cases for biopsy results

Arlne Beaudin, pictured here with her daughter Stella, was first diagnosed with breast cancer in 2012, and again in August 2016. (Submitted by Arlne Beaudin)

Sept-lesresidentArlne Beaudin was diagnosed with breast cancer for the second timethis summer, but still doesn't know how doctors will treat it.

For many cancer patients on Quebec's North Shore, the gap between diagnosis and treatment can take weeks, if not months, and Beaudin is no different.

She says she has started taking sedatives to calm her anxiety, finding it hard to cope with everyday life not knowing what to expect.

"I haven't started taking pills to treat my cancer. Right now, I'm taking pills to wait," she said.

No improvement

For the mother of two, little has changed since her first experience with cancerin 2012.

Beaudin underwent a partial mastectomy in June of that year.

The biopsy samples were sent fromSept-lesto a private clinic in Ontario.

The results arrived six weeks later. They were inconclusive, so she had to have another operation in Augustand then wait another five weeks for those results.

Months later, her doctor eventually prescribed chemotherapy treatment.

'I think everyone in Quebec should have the right to the same medical care, regardless of their postal code.- ArlneBeaudin, Sept-les resident

Sylvie Bellavance's story issimilar.

As a cancer patient,Bellavancealso had to go under the knife twice for the same biopsy.

As a nurse, she's seen the effects losing Sept-les's only pathologist has had on the medical staff's efficiency.

''Three weeks, six weeks, it's really difficult not knowing what's ahead chemo, radiotherapyor the whole package,'' she said.

Biopsies sent to Ontario

Quebec's North Shore hasn't hada pathologist since 2012, which has forced doctors and surgeons to send lab testselsewhere in the province.

Dr. MarionL'Espranceis a surgeon at theSept-leshospital and isonBeaudin'smedical team.

Becausepathologists are a rare commodity, Quebec hospitalsprioritizetheir own patients, she said.

''Something hasto be done so that in Quebec every surgeon and every patient has the right to get their pathologyanalyzedin Quebec, and promptly,'' she said.

Marion L'Esprance says when she was hired in 2009, the Sept-les hospital had a full-time pathologist who could assist during surgeries, but that's no longer the case. (Submitted by Marion L'Esprance)
Chantale Baril, the director of professional services for the regional health centre,says samples are beingsent to Ontariobecause no hospital in Quebec can meetSept-les'sneeds.

Baril recognizes the situation isn't ideal and thatthe Health Ministryand the Quebec association of pathologists need to work together to find a solution to the pathologist shortage.

"Clearly, if I am negotiating where mytests end up sample by sample, there is a problem," she said.

Thinking outside the box

Health MinisterGatan Barretteacknowledges Quebec has seen a shortage of pathologistsfor several years.

He says the solution to the delays in Sept-leslies with Optilab, Quebec's plan to centralize laboratory testing. It is expected to be implemented in the area some time in the next year.

''Optilab is the answer. Optilab will guarantee efficiency and speed,'' he said.

Quebec Health Minister Gatan Barrette announced his plan to centralize laboratory testing last year. (Jacques Boissinot/Canadian Press)

Under the Optilab program, Sept-les would send its samples to Chicoutimi.But L'Esprance says even if the Chicoutimihospital can take on more work, it won't replace having a real pathologist in the operating room.

L'Esprancealso suggests using tele-pathology, a telecommunications systemSept-les used when they lost their pathologist.

Under the system, information was digitized and sent to a pathologist in Rimouski.

L'Esprance says the infrastructure for that system is still in place, but the agreement with the regional health authority in Rimouski ended in 2015 and hasn't been renewed.

A requestfor comment from the Quebec association ofpathologists was not returned.