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

Writer's picture: Megan OgilvieMegan Ogilvie

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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