She has Stage 4 cancer. But as Omicron delays her surgery, all she can do is wait and worry
As she waits for word on when she may be able to get into surgery, Cassandra Di Maria worries the cancer inside her is growing.
The 30-year-old Woodbridge resident has Stage 4 colon cancer and stopped chemotherapy in October after 17 rounds of treatment. She was expecting to undergo an operation to remove a tumour from an ovary as well as spots, including on her liver.
After the operation, Di Maria planned to focus on her recovery and organize her wedding, scheduled for later this year.
Then Omicron came to Canada, filling hospitals to the brim with COVID-19 patients, and dealing a vicious blow to Di Maria's hopes of leaving her cancer in the past and moving on with her life.
I'm young and I'm trying to do a lot of things and this has affected that," she said. I was excited to get this over with and start living my life again, but, no."
Since Di Maria stopped chemotherapy, she has had her surgery delayed three times, and now has no date for when it can be performed. In the meantime, she said, she hasn't been able to book a scan to see if her cancer is spreading.
An email from Toronto's Mount Sinai Hospital, where her surgery is to be performed, specifically said the delay is due to the situation with COVID" and that she would be contacted as soon as they know when they can set a new date.
Not starting chemo again, in case a slot for her surgery comes up, Di Maria sits, waits and worries the progress she has made fighting cancer since November 2020 might be undone.
Being off chemo gives the cancer the opportunity to possibly spread further," she said. I'm concerned that things have gotten worse since my last treatment."
As Di Maria calls on all parties involved" to rethink how they are balancing resources in the midst of COVID, her plight is not unique.
A number of surgeries have been cancelled across Ontario as hospitals struggle to make room for COVID patients and the Omicron variant ravages the province. As of Friday, Ontario had more than 3,800 people in hospital with the illness.
New federal government modelling suggests Canada could see 170,000 cases per day by the end of the month, even with restrictions.
The Ontario Ministry of Health says that due to the Omicron variant it has issued directive #2" for hospitals and regulated health professionals. The directive temporarily pauses" nonemergent and non-urgent surgeries, Bill Campbell with the ministry's media relations department wrote in an email.
Campbell did not answer how many such surgeries have been cancelled in Ontario, but that the directive has opened up 1,200 to 1,500 acute care beds.
We know this difficult decision can be distressing for people requiring hospital care," he wrote.
It is up to hospitals to balance their resources between COVID patients and those needing operations for things such as cancer or bypasses and to decide what surgeries cannot be delayed, he wrote.
But the Canadian Cancer Society calls the delays for people like Di Maria deeply concerning."
Dr. Stuart Edmonds, executive vice-president of mission, research and advocacy at the society said while it is appreciated that health-care systems are under a lot stress due to COVID, governments need to be careful about making decisions that impact other diseases.
We urge our provincial governments to really carefully consider the impacts of suspending or delaying all kinds of cancer services at this time," Edmonds said.
He said nearly 85,000 Canadians were expected to die from cancer in 2021, underscoring the importance of prioritizing cancer surgeries.
Edmonds said a delay of four weeks, for example, could increase the risk of death from cancer by 10 per cent.
As well, he said, delays in the cancer-screening process can lead to more people diagnosed with cancer at later stages of the disease. He said in the future there could be significant issues from the pause in screening programs.
These delays are not a surprise, said Canadian Medical Association president Dr. Katharine Smart. The CMA has been raising concerns about the strain COVID would put on surgeries throughout the pandemic, Smart said.
The health-care system was under resourced prior to the pandemic, she said, and with the Omicron variant spreading fast, there's nothing it can do but wait. Making the problem even worse are shortages of hospital staff as the Omicron variant affects them.
To be honest, I don't think we have any lever right now that's powerful enough to really significantly change this trajectory over the next few weeks," Smart said.
Canada's health-care systems have been operating on the edge" for some time, she added, and now the results are emerging with collateral damage" hitting the people who need serious operations.
Smart said surgeries being cancelled due to the Omicron surge amounts to triage.
We need to be honest about what's going on in our system," Smart said. We need to be clear that, right now, we are unable to meet the needs of many that are urgent and emergent. It likely is going to get worse over the coming weeks before we emerge from this wave."
Di Maria, meanwhile, said the situation she finds herself in can't be blamed on any one agency or person. She said COVID has brought on a number of challenges that have added up to it.
Though, she said, she doesn't know what can be done to get her and others on the operating table more quickly, it's clear changes to the system need to be made.
COVID is serious, yes, and they deserve treatment, but so do I, as well as other people with other illnesses," she said. We all deserve the treatment that we need."
Jeremy Nuttall is a Vancouver-based investigative reporter for the Star. Follow him on Twitter: @Nuttallreports