Cancer diagnosis and treatment is delayed due to lack of oncologists


Archive image of the Doctor Negrín hospital in Gran Canaria, the most affected by the difficulty in filling the vacancies for oncologists. / JUAN CARLOS ALONSO

The Canary Islands have 2.7 medical oncologists per 100,000 inhabitants, compared to 3.5 for the state average. The Doctor Negrín hospital is the most affected by the deficit

Carmen Delia Aranda

The “enormous structural deficit of oncologists” that affects the health system, as recognized a month ago by the Canarian Minister of Health, Blas Trujillo, is reflected in the Canary Islands, an unattractive professional destination for highly demanded specialists throughout Spain. This shortage of professionals is suffered by cancer patients on the islands in the form of delays in consultations, diagnoses and check-ups.

“The lack of oncologists fundamentally affects delays in visits, in diagnosis, in dispensing the first treatments and in reviews. Obviously
four oncologists cannot do the same as eight. Until this is resolved, the Ministry is trying to do everything possible to comply with the procedures, "explains the president of the Spanish Association Against Cancer of Las Palmas, Fernando Fraile.

Despite attempts to alleviate this deficit, «
all the processes of oncology patients are being delayed which is serious”, recognizes the representative of the group of patients. This situation, in addition to worsening the prognosis of the disease, generates great uncertainty and anxiety in patients who see how the days go by pending a test or a consultation that does not arrive. "A cancer caught early is cured, fortunately, most of the time, but
a cancer that is delayed can become serious and the situation changes completely», recalls Friar.

In the Canary Islands, the national health system has 60 medical oncologists and 39 specialists in radiation oncology, according to the
Supply-Need Study of Medical Specialists 2021-2035 recently published by the Ministry of Health.

This document reflects that
The Canary Islands have 2.7 medical oncologists for every 100,000 inhabitants, compared to the national average, which is 3.5 specialists for every 100,000 inhabitants.

In the case of Radiation Oncology, the islands maintain a ratio similar to that of the rest of the State with 1.7 specialists per 100,000 inhabitants, compared to the national average of 1.5 doctors per 100,000 inhabitants.

In any case,
these places are more theoretical than real because the Canary Islands are an unattractive destination for specialists who prefer to work in hospitals closer to their place of residence, that is, on the peninsula.

A) Yes,
Hospital Doctor Negrin of Gran Canaria is the most affected of the archipelago due to the lack of oncologists, since, between the past months of October and December, there were three casualties because the specialists decided to move to the peninsula. Currently, there are seven professionals in the Medical Oncology Service and 17 in Radiation Therapy Oncology, according to hospital sources.

In numerical terms,
The Canary Islands are within the margins recommended by the Spanish societies of Medical Oncology and Radiotherapy Oncologywhich recommends having around 20 professionals in each specialty for every million inhabitants, explains the president of the National Commission for Radiotherapy Oncology, Ministry of Health, Pedro Lara, aware of the lack of oncologists in the Canary Islands.

Each year, university hospitals in the Canary Islands offer resident doctors six places in Medical Oncology and another four in Radiation Oncology, which are not covered every year. "Under normal circumstances,
this amount could meet the needs of the autonomous community, but some circumstances must be taken into account that prevent it», Lara points out. The first, she says, is that they are positions convened at the national level and many times,
doctors, upon finishing their training, opt for other centers or return to their city of origin. In addition, the also president of the Radiotherapy Oncology Group of the European Union of Medical Specialties (UEMS) maintains, «
it is difficult to attract professionals who are in hospitals on the peninsula to come work here. That puts us at a disadvantage compared to other parts of the peninsula.”

Thus, Lara attributes the shortage of oncologists to the return of doctors trained in the Canary Islands to their cities of origin, the departure of specialists upon finding attractive job offers abroad, and the increase in the needs of patients, aggravated by the traffic jam generated by the pandemic.

Fraile agrees with the oncologist in pointing to this cluster of causes as the origin of the shortage of specialists. “Medicine students should be asked why this specialty is not as in demand as others.
There is more demand for oncologists than supply", it says.

A year and a half waiting for a review

Hadith Perea is one of those affected by the delays.
After overcoming breast cancer in 2018 in Gran Canaria, she had to wait a year and a half for a mammogram to review your health problem. When they did it, in 2021, the cancer had reproduced.

The patient believes that her problem did not arise due to the lack of oncologists, but due to the delay in carrying out a review of her oncological problem and the lack of a genetic test that was never indicated.

The truth is that this delay is explained, in part, by the
lack of specialists suffered by the province of Las Palmas, aggravated by the outbreak of the pandemic.

“In 2018 I was treated for triple negative breast cancer.
They should have done a genetic test to find out if it was hereditary. I asked for it. If I had had this test, I would have had a bilateral mastectomy to prevent a new cancer.
They didn't do it to me. After three years, the cancer reappeared, ”explains this patient who is still receiving chemotherapy for a second tumor that could, perhaps, have been avoided with this genetic test.

In addition, between the recovery from his cancer in 2018 and the mammogram to check his condition, a year and a half passed. Enough time for the new tumor to emerge, detected in June 2021.

After diagnosis,
Perea waited two and a half months to be operated of the new cancer due to the lack of operating rooms, converted into critical care units for cases of severe covid.

Now,
after his second chemotherapy treatment, everything is more complicated, even a mastectomy to prevent it from reproducing again because it has damaged tissues. That's why he hopes to be prescribed Olaparib, a drug that reduces the risk of relapse. "It is very expensive. They are not giving it », she laments.



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