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  • Writer's pictureMegan Ogilvie

The emergency department is no place to be told you have cancer

Patients are ‘routinely’ being diagnosed with cancer in busy Canadian emergency rooms, doctors warn

“It’s not just a local issue,” said Dr. Keerat Grewal, an emergency medicine physician at Mount Sinai Hospital. “My colleagues across Canada are seeing this as well.” Nick Lachance/Toronto Star

On a recent 12-hour shift, Dr. Kyle Vojdani diagnosed three patients with cancer.

Like most evenings, it was busy in Michael Garron Hospital’s emergency department: A crowd of patients waiting to be seen. Physicians and nurses rushing between cases. Sick patients, some critical, waiting in hallways for a hospital bed.

Amid the bustle, Vojdani, chief and medical director of the department, had to find the time — and the words — to tell each of the three that their tests pointed to cancer.

One of the patients, a man who had no family doctor and who could no longer wait to get care for his symptoms, had metastatic disease — the cancer had already spread to other parts of his body.

“You’re looking at the CT scan and it doesn’t say somebody has a treatable diagnosis like appendicitis,” Vojdani said. “Then you’re thinking, ‘How do I sit down with this person and their family in this unbelievably busy space and provide them with a life-altering diagnosis.’”

Across Canada, doctors are reporting a similar troubling trend, saying an increasing number of patients are receiving a cancer diagnosis in emergency departments in yet another symptom of a health system under pressure. Patients, they say, are forced to go to emergency departments for help because a family doctor shortage means they cannot easily get care anywhere else.


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