CEO of Breast Cancer Canada implores benefits companies to consider implementing therapies and genomic testing in benefits plans
Women’s health has been - and continues to be - at the forefront of organizations’ minds throughout the month of October. As the month comes to a close, Kimberly Carson, CEO of Breast Cancer Canada (BCC), a national charitable organization, is laser-focused on highlighting another critical health issue: breast cancer. She explains the issues and challenges surrounding breast cancer diagnosis, treatment, and the financial impact in Canada.
Carson emphasizes the need to view breast cancer as a manageable condition rather than a terminal diagnosis. "Breast Cancer Canada believes that breast cancer should be a disease you live with, not a life-threatening disease," she explains. “We work with patient advocacy, through research, to ensure that the patients receive the right diagnosis, the right education and the right treatment in a timely manner so that the outcomes are as great as they can be.”
As of February 2021, the World Health Organization declared breast cancer the most diagnosed cancer worldwide. Breast Cancer Canada highlights that 1 in 8 women will be diagnosed in their lifetime. This year alone, more than 28,000 Canadians who will be diagnosed with the disease, with more than 30,000 deaths among women and 300 among men. Carson asserts that one of the main reasons for Breast Cancer Awareness month is to encourage and remind Canadians to get their mammograms before year-end and prioritize their breast health.
“It's still a very impactful disease,” she says. “As much as breast cancer patients are living much longer than they used to, once diagnosed with metastatic breast cancer, the incidence of death is still quite high. Our death rates really haven't changed so we really need to continue to focus on the research.”
Carson emphasizes that women under 55 struggle financially, even with public and extended health benefits, pointing out that treatments like outpatient IV therapies and genomic testing, considered essential in modern breast cancer care, often fall outside the coverage of many benefit plans. As such, she implores benefits companies to consider implementing said therapies.
“Most breast cancer treatments now are outpatient IVs,” says Carson. “When medication isn’t covered by the public funder, private funders often won’t cover it either, leaving a gap in access. We’re imploring the benefits companies to look at that gap.”
One promising tool that could have a significant impact in the future when it comes to advanced screenings is liquid biopsy, a blood test that detects early cancer indicators. When fully implemented, Carson explains, liquid biopsies could complement mammograms, catching potential issues earlier and minimizing the invasiveness of procedures.
Additionally, Carson also underscores the need for genomic testing, which helps identify the most effective drugs for each patient’s specific type of cancer, potentially reducing the time and cost associated with ineffective treatments. “Once that that tumour has been identified, we can do a more substantial genomic test on that tumour and target that treatment in a much more efficient way,” she says. “In the long run, it would save the benefits companies money, it would save the public sector money, and it would be better for the patient overall.”
Carson promises to continue advocating for more coverage of outpatient treatments, genomic testing, and other essential diagnostic tools that could significantly ease financial and medical stress for patients.
"We would love to see the benefits companies help us with that time period between when the drug is approved and the patients receiving it by IV, before it's in the payment process for all of the provinces," she asserts. “A breast cancer diagnosis impacts the productivity of the workplace. [With] our economy, and with that many women being diagnosed every year, we really need to look at how we're going to get them back into the workforce as quickly as possible.”
If breast cancer can be caught earlier, Carson adds, “it's less invasive treatment, it’s not as intense and the outcomes are way better.” After all, early detection is foundational to improving outcomes in breast cancer care. One of the key challenges Carson faces as CEO of BCC is aligning Canada’s screening guidelines with global practices. In Canada, the National Task Force maintains the official screening age at 50, despite recommendations from several provinces and global health agencies to lower this to 40.
“The Task Force seems a little out of line at the age of 50, especially when many provinces have already lowered screening to 40,” says Carson. However, BCC is working with the ones that haven't yet lowered the age, providing them with evidence-based research that shows a younger incidence of breast cancer. She explains that reducing the screening age could ease the financial burden on the healthcare system, allowing for early, less costly interventions.
To address this, Breast Cancer Canada has helped create the REAL Alliance (Research Excellence and Active Leadership), a coalition of volunteer oncologists and specialists dedicated to establishing consistent, evidence-based care standards nationwide. This year, the REAL Alliance released its first guideline on HER2 biomarker treatment, providing uniform care recommendations across Canada.
