Dan Quayle marked his 52nd birthday on Oct. 7 in Victoria General Hospital waiting to find out when chemotherapy would start for an aggressive form of esophageal cancer.
He would die waiting.
After 10 weeks in hospital, Quayle, a gregarious grandfather who put on his best silly act for his two grandkids, was in so much pain, unable to eat or walk, he opted for a medically assisted death on Nov. 24 — despite assurances from doctors that chemotherapy had the potential to prolong his life by a year.
His family prayed he would change his mind or get an 11th-hour call that the chemo had been scheduled, said his step-daughter Shayleen Griffiths, whose mother, Kathleen Carmichael, had been with Quayle for 16 years.
As the weeks dragged on in hospital, Carmichael kept pressing for answers on when chemo would be scheduled.
“There was never a timeline on that,” said Griffiths, who lives in Victoria. “Their exact words were: ‘We’re backlogged.’ ”
Even as they are still grieving Quayle’s death and planning his celebration of life, the family felt compelled to speak out about his inadequate care, following the stories of two Vancouver Island women who went public with their decisions to seek treatment in the U.S. to avoid delays in B.C.
“I think I could still have my Dan if he had gotten treatment sooner,” Carmichael said.
Six months into the B.C. government’s move to send breast cancer and prostate cancer patients to two clinics in Bellingham in Washington state to ease the treatment backlog in B.C., the province’s wait times have actually gotten worse.
Just 75 per cent of cancer patients are receiving radiation therapy within the Canadian benchmark of 28 days, according to B.C. Cancer Agency data provided to Postmedia, a drop from 77 per cent in May.
That is well below the national average of 97 per cent and one of the worst rates in the country.
The agency did not provide wait time data for chemotherapy.
Part of the explanation from B.C. Cancer is that the number of patients needing treatment has gone up, with 16 per cent more patients starting treatment in the last four weeks compared to April 2023.
However, the latest wait-time figures paint a different picture than the one given by B.C. Cancer’s chief medical officer, Dr. Kim Nguyen Chi, who insisted last week that things have improved because of recruitment of additional radiation therapists.
In an interview with Postmedia before the data were released, Chi said the backlogs are being addressed through the hiring of 27 radiation therapists since Oct. 1 and by sending eligible cancer patients to the U.S. for radiation therapy.
In May, Chi said he anticipated sending 50 patients a week — or 20 per cent of patients needing radiation — to the U.S., which would help improve wait times in B.C. in a matter of months.
But last week, BC United released provincial data that show an average of 12 cancer patients a week have travelled to Bellingham for radiation therapy. Of the 1,310 breast and prostate cancer patients referred for radiation treatment in the U.S. between May 29 and Nov. 10, just 310 have started treatment.
Chi said those figures don’t tell the whole story.
From September to early November, the average daily number of patients receiving radiation therapy in the U.S. was 42, Chi said. In the last two weeks, that number has risen to 51.
That shows the program is “successful,” he said. “It just took some time to ramp up.”
Chi said there are no immediate plans to expand the program beyond breast and prostate cancer patients, since they make up the largest patient population receiving radiation and face the longest waiting times.
The B.C. cancer-care system has been plagued by long wait times in every step of the cancer process, from diagnostic imaging to initial consult with an oncologist, radiation therapy and chemotherapy.
Chi, a medical oncologist and an internationally recognized expert in prostate cancer who has been with the B.C. Cancer Agency since 1997, said he shares the “distress that patients and their loved ones feel when they’re faced with cancer.”
“We want a system that responds very quickly to patients, and I appreciate that any wait is too long for someone with cancer,” said Chi, who couldn’t speak to any specific patient cases because of confidentiality rules.
He said he has faith in the province’s 10-year cancer plan, which includes $440 million in spending in the first three years and new care centres planned for Nanaimo, Surrey, Burnaby and Kamloops.
“I think the steps that have been started and the steps that are going to take place are going to improve the system. I wish it could be faster for the patients that I see every day.”
Last week, two Vancouver Island women shared their experiences with the province’s cancer system and delays that pushed them to seek medical treatment in U.S.
Allison Ducluzeau paid $200,000 out of pocket for surgery in the U.S. after a B.C. Cancer oncologist told her she was not a candidate for the procedure.
Kristin Logan, a 43-year-old Campbell River woman diagnosed with Stage 4 ovarian cancer, sought chemotherapy in Washington state after she was told to expect a three- to four-month wait for treatment in B.C. The treatment was covered because Logan is a dual citizen and U.S. military veteran.
Carmichael is sad the answer has become leaving the country for faster treatment.
“If we had more money, we could have gone to the States. But we’re just regular people.”
Quayle started experiencing sharp pains in his stomach and blood in his stool this past spring. Quayle, tall and burly at six-foot-one and 250 pounds, worked in metal recycling, so he was used to physical labour. Suddenly, he felt constantly fatigued and dizzy.
His doctor dismissed it as side-effects from the diabetes medication he was on, Ozempic.
In July, Carmichael took Quayle, in extreme distress, to Victoria General Hospital. An ER doctor said he didn’t think there was much they could do for Quayle’s ailments, which included debilitating sores on his body.
“I had to beg them, please don’t send him home,” she said.
After a medical imaging scan, doctors told them: “We found something that doesn’t look good. We’re very concerned.”
The couple was sent home to wait for the results, which eventually would show he had Stage-4 esophageal cancer.
One day in September, Quayle’s face swelled up and he said his body felt like “he was in a house fire.” He was rushed to Victoria General in an ambulance and eventually transferred to the cancer centre at Royal Jubilee Hospital. He never returned home.
“Every week would go by and I’d say: ‘It’s just another week [without treatment],’ ” Carmichael said.
Quayle, a foodie who especially loved cheesecake and homemade pie with strawberries from the couple’s garden, was so sick in his final weeks, he couldn’t eat solid foods. That sent him into a depression and his family barely recognized the energetic man known as Papa Dan to his grandkids.
He was able to have cheesecake in hospital on his 52nd birthday, surrounded by his mother, his two children and their partners, and two life-long friends.
On Nov. 22, still without a timeline for chemo, Quayle said: “I just can’t do it anymore,” Carmichael recalls. He requested a medically assisted death.
The night leading to Nov. 24, Carmichael pulled a bed next to Quayle’s and snuggled in with him for the last time.
As the life-ending medication was administered, she said goodbye as they listened to the heavy-metal version of The Sound of Silence by Disturbed, a nod to Quayle’s love for heavy-metal music.
Carmichael said no one should go through what Quayle and his family experienced.
“I realize our system is broken,” she said. “There’s too many people with cancer waiting too long.”
Want to share your experience with B.C.'s health care system for a possible story? Contact Times Colonist health reporter Cindy E. Harnett at firstname.lastname@example.org.