Yarmouth County resident, Damon d’Entremont and Dr. Karen Howlett, General Practice Oncologist

By Christine Smith

Cancer was the last thing on his mind when Damon d’Entremont, a lobster fisherman from Yarmouth County, was preparing for the 2021 season, but in October he began having symptoms he couldn’t ignore.

The right side of his body was weak; he was dropping things and was unsteady on his feet. He also noticed blood in his urine. He was assessed at the local emergency department and tests were ordered.

By early November, he was diagnosed with two different cancers – brain and kidney.

It turned his life upside down, but his journey has been easier because other than two trips to Halifax, for specialized surgery to remove the brain tumour and then radiation therapy after surgery, d’Entremont has been able to receive his treatment in Yarmouth.

“It’s been good, only a fifteen-minute drive to the hospital,” he said. “I have immunotherapy once every three weeks. It takes an hour and then I’m in town and can do whatever I want. The cancer care staff are A-1. They are professional, funny, and treat you with respect.”

Although some cancer care has been available in Yarmouth for many years, patients often had to make multiple trips to Halifax, and deal with traveling when not feeling well, time away from loved ones and work, and the expense for gas, accommodation, and meals.

In fall 2017, residents and community leaders raised concerns about the many burdens of traveling for cancer treatment.

Their concerns prompted an extensive community and local staff engagement process, led by the Cancer Care Program. Patient experiences and other data were gathered through in-person conversations, surveys, focus groups and staff meetings.

A steering committee including patients and community groups, medical ethics, and cancer care, considered the evidence gathered and recommended that government fund an enhanced bundle of services to improve access to cancer care.

Following the submission of a detailed request, government announced almost $1 million more in annual cancer care funding (July 2021) for the Yarmouth area, enabling the recruitment of a registration and booking clerk, a nurse educator, a registered nurse, a drug access navigator, a pharmacy practice assistant, and a pharmacist.

Recruitment of a nurse practitioner and a social worker are also underway.

The newly strengthened cancer care team has one goal: to support patients in receiving quality cancer care, as close to where they live as is safe and possible.

They are doing this, one patient at a time: improving coordination of appointments and using new treatment protocols (e.g. radiation therapy) when travel is necessary to minimize time away from home, working with patients who don’t have private drug plans to register them for available funding, supporting more video appointments, when appropriate, and providing more support to patients who are experiencing distress because of their diagnosis.

d’Entremont and others like him are benefiting from these new investments. A day prior to having treatment d’Entremont sees a General Practice Oncologist (GPO) who is part of the local cancer care team. Dr. Howlett reviews his blood work and assesses his general health to ensure treatment can continue.

A drug access navigator has worked with him to register for programs to help with the cost of oral drugs. Follow-up appointments with the radiation oncologist to monitor the effectiveness of the radiation for the brain cancer occur via telephone and Zoom.

“Patients tell us they understand the need to travel to the cancer centre in Halifax for specialized treatment and procedures,” said Pam Robichaud, Western Zone Oncology manager. “But traveling for more than three hours for short appointments or having to travel two or three separate times for tests that could have been done in one trip takes a toll.

“We are listening to and working with patients, and cancer care teams in Yarmouth and Halifax. We’re getting there, but there is more to do. We will continue to engage patients and our cancer care teams in Yarmouth and Halifax to ensure we get it right. We’ll use what we learn in Yarmouth to guide the evolution of care in other community cancer clinics as we continue our work to provide care as close to home as is safely possible.”

As for d’Entremont, he is looking forward – to completing his treatment, fishing for bass with his nephew this summer and perhaps planning a trip south for next winter.