My dad was diagnosed in Dec 2024, staged in Jan 2025 (4b), and got his first Eligard injection in Feb 2025 (prescribed by a urologist). Eligard is the only drug he is on when I know for his situation he should be on triplet therapy.
I have called and called again but there is a waitlist to see a Med Onc in my province (MB) and we are still 8 weeks out from an appointent. I am trying everything I can to get him on a second gen hormone since he has aggressive cancer with distant bone mets, but this waitlist seems to be throwing a wrench in things. I have left messages to hopefully have the urologist prescribe something until a Med Onc can take over but haven't heard back. There are very few Med Oncs in my province and going to a different province isn't an option. Has anyone else in Canada dealt with this kind of wait? I am nervous if we wait 8 more weeks to be prescribed more meds he could be castration resistant by then.
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SeaSlug204
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SeaSlug, I asked ChatGPT a question, because of your situation. Here it is, and maybe you have already taken advantage or pursued some of the angles suggested. Also see my comments at the end for what may be a powerful argument as to why your father should be pushed to the front of the line.
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FROM CHATGPT
I'm sorry to hear about your friend's father's diagnosis and the challenges he's facing in accessing timely oncology care. In Manitoba, initiatives like the "In Sixty" Cancer Patient Journey aim to reduce the time from cancer suspicion to treatment to 60 days or less. This strategy emphasizes prompt referrals and coordinated care to ensure patients receive timely interventions.
0. **Question** - What are the standard wait times for oncology consultations in Manitoba, and is there a policy for prioritizing urgent cases?
Manitoba has implemented initiatives like the Cancer Patient Journey Initiative to reduce the time from cancer suspicion to treatment to 60 days . While specific wait times can vary based on factors like cancer type and healthcare system capacity, patients with aggressive or advanced cancers are typically prioritized to ensure timely access to care. If there are concerns about the current wait time, it's advisable to communicate directly with the healthcare providers or contact CancerCare Manitoba to discuss the possibility of expediting the appointment.
* Canadian Cancer Society
* Canadian Partnership Against Cancer
* CancerCare Manitoba
1. **Contact the Patient Representative:**
CancerCare Manitoba offers a Patient Representative service to assist patients and families with concerns about care delays. They can provide information on policies, help navigate the healthcare system, and address any issues related to treatment timelines.
- **Phone:** 204-787-2065
- **Toll-Free:** 1-866-561-1026
- **Email:** [email protected]
2. **Reach Out to Cancer Navigation Services:** These services offer support from suspicion of cancer through diagnosis and treatment. Nurse Navigators can provide information, coordinate tests and appointments, and may assist in expediting care when delays occur.
For immediate concerns or advice on appropriate services, patients can call the Cancer Helpline. This line offers guidance on urgent care needs and can direct patients to the appropriate resources.
- **Phone:** 204-787-8900
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MY COMMENTS
For our American friends who have such high regard for Canadian healthcare, this situation is not uncommon.
As for accelerating an appointment an oncologist, where your representation has only been a urologist, there is the urgency from a treatment perspective as follows. (Forgive me if I'm restating things you already know.)
You already know that triplet therapy is very likely something your father would likely benefit from enormously. And triplet therapy of course includes the Docetaxel chemo. The chemo is especially effective against cells that are active and fast dividing. (That's why sometimes hair falls out when a person takes chemo because the hair is the fastest dividing cells in the body.)
But, if ADT is initiated, then maybe the cancer cells will be tamped down a little bit and might not be quite so active. Which is a sort of a win. But then the chemo might not work as well. Because cancer cells are a little bit asleep. And not so vulnerable to the chemo.
And maybe your urologist or other people in the prioritization chain aren't thinking about this. Maybe timing is of the essence and your father should be pushed and prioritized to the top of the wait list.
Okay forgive me for suggesting things you've already considered and pursued. And I'm just a lay person sharing information. And everything I said about, even with a little emotion, might not in fact be the right advice.
I am in British Columbia. There are pros and cons with both the Canadian and American health care systems. Personally I prefer ours where every citizen has equal access and where the prescribed treatments don't have the potential to bankrupt the patient.
I wouldn't worry too much about the eight weeks of wait time. The Eligard should rapidly shrink his cancer during that time. I was diagnosed almost seven years ago. Gleason 9, PSA 103.0 I was given ADT by the urologist just like your father. I met my oncologists a few weeks later and started chemo a few weeks after that. It all worked out well and my PSA was below 0.02 after a few months. Remember that prostate cancer, even aggressive Gleason 9, is a much slower growing cancer compared to most other types.
MarkBC I live in Ontario . Getting a Urologist to requisition a PSMA PET CT Scan is like pulling teeth -- even if you pay privately, as I wished to do - the cost $ 5000.00 Can . For some unknown reason they refuse to consider this advanced scan . Even at the top hospitals Princess Margaret , Sunnybrook etc . Yes you can get a Bone & CT Scan no problem covered by OHIP . Additionally ,Canadian Urologists poo,poo any suggestion if you want a Biomarker Test . Again it's like pulling teeth - almost never requested by any Urologist . In the states you are forever hearing about the Decipher or similar tests .
PSMA PET scans are great tools for specific purposes. They are also expensive compared to regular CT and bone scans. Americans with "gold plated" health insurance get them all the time even though regular scans would provide enough information for the oncologist.
I have never had a PSMA PET scan in my seven years of treatment. I have three tumours that are visible with regular scans. It's possible that a PSMA PET scan will find more tiny tumours but that additional knowledge will not change my prescribed treatment.
There are two important uses for PSMA PET scans which the province will pay for.
1. The oncologist wants to know if small bits of cancer have spread beyond the prostate or if the cancer is still contained within the prostate. That information will help determine a treatment path.
2. The patient is suffering pain or has other issues related to the cancer and regular scans cannot pinpoint the tumour causing the problem.
If you don't need a PSMA PET scan, the government won't pay for it. If the oncologist needs it done, the government will pay for it. Remember that some health-care institutions in the USA are driven by profits. They will order many unnecessary procedures and tests to help generate more profit. That is especially true for patients with "gold plated" insurance plans.
Regarding PSMA PET Scans, I live in B.C. I was fortunate to get into a research project with regard to the scans so the cost was borne by the medicare system. The scan was of critical importance to me as it identified sites that were not otherwise detected. In B.C. PSMA PET SCANS are, with referral, about to be made available in Kelowna this June. I noted someone referenced $5,000 for private scans. They are offered privately by INITIO Medical in Burnaby B.C. at a cost of $3,200. Prior to receiving mine from the B.C. Cancer, I was booked with them, but cancelled when my public one became available. They were very professional. Of course it is strictly diagnostic, but can aid in devising an effective treatment for some cases.
They also use it if they are unsure whether or not it has spread beyond the immediate prostate area. If it has, it will be treated as stage 4. If there is no indication of distant spread, they will attack it with the goal of trying to eradicate it.
Thank you for this post. Socialized medicine is second rate but Canadians will defend it to the end. Canada’s system almost killed me. I know so many people who have suffered egregiously for months and months while they wait. But go ahead Canadians keep defending it. It is becoming two-tiered because it’s impossible to sustain.
With respect, I believe we should limit our discussion about the pros and cons of our public health care system versus the U.S. as it does not assist individuals to debate pros and cons of each. Perhaps in another forum.
[For those on long waitlists, if you have the means you may want to consider another country such as Poland, India or Mexico but always by a reputable health care provider. The best of many countries is top notch, as long as you are careful to find the best. ]
With respect it’s only a couple of posts and it’s an issue that impacts our care. I won’t keep posting but the state of healthcare in Canada is an additional antagonizer in our care
Yes, there are many procedures that have long wait lists. It’s not acceptable, I agree. But I have had a very good experience here in BC. BC Cancer is really good. I am getting a PSMA PET scan next week to determine if I have a low enough amount of Mets to do SBRT. This was my suggestion and I was scheduled in about six weeks of asking. I also asked to be switched from Abi to Enza and , no problem. I know it doesn’t always work but it’s been good for me. And nothing out of pocket in 7 years.
Philosophy; Illegals , as with the U.K. and USA etc, have drained the treasury in Canada . Lots of money for 4 Star hotels , free meals and on - and-on .-- BUY NO MONEY FOR HEALTH CARE , teachers salaries , doctors , police , firemen etc.etc .
I am sharing this with you in hopes it eases your mind just a bit. I began treatment May 2022 with extensive bone mets, nodes and lungs. I started casodex for 30 days and after 15 days I had my first one month Lupron injection. Psa at start was 5664 and 278 after 3 weeks. Pain which was very bad immediately started to subside. I held off on abiraterone until psa bottomed and started to rise which was about 16 months at which time we added abiraterone. Psa dropped for 7 months and started to climb a year ago. Just switched from prednisone to dexamethasome which has benefit for many. I guess what I am saying is that your dad has already started treatment and by the time he sees a MO his psa will probably have dropped considerably and mets should be shrinking already at which time you can make more long term dicisions. If you notice my timeline shows I didn’t jump on another treatment as soon as my psa began to climb because I like to run each treatment as long as possible. One of the biggest enemies of the cancer patient can be fear. Don’t read the survival statistics because they are totally outdated. You will read about horrible side effects of drugs but many have few or mild side effects. Now in closing, your dad is probably not curable but can have many good years with the proper treatments. QOL depends on accepting the right treatments for your dad and passing on the ones that will not improve quality of life. Slow down, take a deep breath, spend some time on your knees with God and count each day as the precious gift that it is. God bless.
At least that is better than the post I saw yesterday from a young lady that had to wait for an MRI brain scan to confirm brain tumor, for 13 months! Her appointment is in Jan 2026.
It seems incredulous. But I’ve experienced Canadian socialism and actually used to be a socialist myself. Socialists like to brag about our healthcare. I did. It’s a great talking point. Free … At least everyone has to wait a year. I’m so thankful they are going to see her for free … 😊
I believe that our member Radtech suggested that in a St Louis Jewish hospital in a case of her 90 years old father. MRI is better if you are young and they don't know much about the condition. I would prefer MRI. Even my sisters are getting MRI in my little home town Sombor in Serbia and Canada is a rich western capitalist country with lots of mineral resources.
For all of you who think the Canadian Medical System of socialized healthcare is politically the right way to go please read SeaSlug’s experience again. You have no idea what socialized medical care is like. I almost died waiting for a stent in my heart. I know many people who die after waiting literally years and years for simple procedures like knee replacements. We have great incentive here in Canada to let people die because our socialized system is so overwhelmed. You all talk about best treatment — you make so many excellent suggestions. In Canada we are restricted. If you are an emergency they get you in after waiting hours or days in Emergency Rooms, but other than that you … wait. You have NO idea. I almost died waiting. And that’s not an exaggeration. I almost died in my late 40s because it took forever to diagnose and stent me. So please don’t tell me ever how great our healthcare system is. You can always say it’s wonderful that everyone gets the same treatment and Canada is so compassionate. That is 100% crap. Everything happens under the surface. Can you get good care? Yes. And there are many excellent doctors. But don’t ever tell me it’s a great system. Try asking a doctor what they think I have asked many . The very competent young doctors I’ve had have left the country. And don’t ever try to get a proper convalescence in a hospital. It’s like a MASH unit. In and out . BC is thoroughly socialist always so they always see the rosy side of socialism. Sea Slug is the norm wait until it’s too late. That’s what pays for our socialism.
Please don't use my comment to speak against the healthcare system. Our system is absolutely flawed, and there is so much that can be and should be better. But I am infinitely grateful we are not in life long debt after my dad's diagnosis. Plus with all the other health stuff that has come up for my family in the past few years, we have received great care.
Sorry but Canadian Healthcare is in shambles. Try being sick. It’s in terrible shape. We just don’t see all the people who die waiting. I have. Huge swaths of people can’t even get a primary doctor. Our healthcare system is abhorrent.
Just Google it. Everything from left to right say the same thing. And they are right. This one is about emergency rooms. But it’s everything . It’s a terrible system in ways you don’t even know. Lack of options in treatment. Burned out doctors and staff What is most symptomatic is — the alternative is rising against the socialist despite government socialism
This is my last comment. I would really like you to understand but you won’t. I came extremely close to death waiting for our healthcare system. That is not hyperbole. 99.9% blocked. Months. Months. Months. In my 40s. I ran 5-7 km every day. They didn’t want to spend the money on diagnostics. I had a stress test only. After a passionate plea I got more. Then I WAITED. I almost died once while waiting. You cannot convince me it’s a good system. There are good people in it. I’ve talked to many of them. But the system is crappy. Tommy Douglas was a good man. And it might have worked at one time. But it’s a shambles. Anyway best wishes.
You’ve told me with respect not to talk about this yet you do. A second tier is developing in Canada. That shows how good it is if you don’t believe my heart story — which gets into all the other people I’ve met regarding this issue. But my intention was to stop. I’m sure you’ll need the last word. Canadians are propagandized so much about our healthcare we always say we’re thankful for it. Anyway I would’ve stopped before … when someone says they’re waiting in Canada it’s a bit of an issue for me because I was very close to being one of those statistics. 74,000 since 2018 is underreported.
My urologist is a top-notch urologist. Every time I see him he is so frustrated. So I ask. The Canadian Healthcare System is killing him. I have seen it over the last ten years. And he HATES working here. Hates it. My surgeon who gave me a Hoffman’s apparatus when I broke my pelvis — is gone. Moved to the states. Told me it’s almost impossible to work under the conditions. My family doctor — oh that’s another issue. You can’t get a family doctor in pathetic Canada. And what kills me? Canadians think we’re so much better than Americans. Canadians are arrogant and so many of them put down the USA — especially the south. Anyway that’s it. Please don’t tell me how great the healthcare system is in anything other than MAID. (Medical Assistance in Dying) They do that quickly for almost anything.
We are in Manitoba too. The 3 months hormonal shots are done by MO in my husband’s case. That is when we talk to him and ask as many questions as possible. Also he has OR. Also both of those have nurses you can call with questions. We don’t do anything with urologist anymore. Family doctor is looking after all other issues too. To get DXed and staged took 9 months for my husband.
Our diagnosis and staging was similar, but a bit longer due to the holidays being in the middle of it all. Thank you for sharing, glad to know this is just how it goes.
No sense discussing who can piss the furthest....Try pushing some damn buttons so your Dad can be seen by a qualified "Ca" doctor before the US takes over Canada or vice versa.
More than 74,000 Canadians have died on health-care wait lists since 2018: report
At least 15,474 Canadians died in 2023-24 alone before receiving various surgeries or diagnostic scans. The true number is likely double. National Post Jan 2025 Try reading the Star or Globe and Mail or The Fraser Institute or — yes — even the CBC. All say the same. The head of the Canadian Medical Association a few years back said something will give — patient lives.
There's lots to be said for and against Canada's so-called socialized healthcare system. And a really important item is of course that people aren't bankrupted here and lose their house or whatever because of healthcare costs, compared to the US. And the enormous amount of time spent finagling with insurance in the US seems crazy, for patients and doctors and administrators and hospitals and everything is a huge cost, and a waste, and stressful.
All that said, and acknowledging myself that I'm alive because I got what at the time under Canadian healthcare was non-standard care on the leading edge and am alive 3 years later because of it, all the dysfunctions in Canadian healthcare that people have listed above in this form are very real.
Tiny example: we went in to emergency a little while ago for some concern for a family member that was something that was indicated, and we spent half a day in various rooms, waiting. And eventually we found out that no one had visited us because we had been discharged. They lost us. Go figure. Fortunately everything was fine.
But here's the kicker. The Canadian population life expectancy at birth is several years longer than the American population life expectancy at birth! And at the same time we spend a smaller proportion of our GDP on healthcare! Weird huh?
Canadians think Americans are stupid and Americans think Canadians are stupid. Maybe there's a lot of stupidity in healthcare on both sides of the border, only different kinds of stupidity. And maybe some incompetence and laziness too. The best thing to do is to avoid the healthcare system if at all possible. And all things being equal, there's one answer to that: exercise 💪.
Communication is very important and we should check and double check everything.
I went to the emergency department when I started my firmagon injections because my first medical oncologist professor Richard Epstein sad if I experience any reaction to the drug to go to the emergency department.
I developed 38.5 C temperature during the night and I decided to do what I was told. In the emergency doctor was Scottish and it was difficult to communicate with him. I refused the strong wind spectrum injections which could be harmful to my hearing. And I was prescribed capsules and discharged. They gave me a paper what I didn't read until I arrived home and from the paper I realised that I refused hospitalization.
Thanks for the discussion. My best wishes as you continue with your father. I won’t be talking Canadian Healthcare anymore on this forum. There are great things that happen in Canadian hospitals every day and I hope your father’s care is the best.
People dont die in the US from not being able to afford emergency medical care. They just show up at the ER and get treated. See all the illegal aliens in every ER. They know they will be treated and cost spread to us payers. And yes, people with more money have more options. That is why we work to build successful businesses and employ people and offer health insurance. There is no free lunch in life. As my mother-in -law always said: "Fair, what kind of sissy word is fair? This is the real world, not a Kindergarten." She was a tough fighter.
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My Dad
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