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Topic: New to the medical system here in Canada

Forum: Canadians Affected by Breast Cancer —

Canadian health care, clinical trials, and life in general in the north.

Posted on: Mar 27, 2021 06:37PM

txstardust wrote:

Hi everyone,

My cancer diagnosis was in Texas in 2009. I went through the whole gamut - multiple surgeries, chemo, rads, reconstruction...

When I moved here in 2017, my MO told me I did not need to be followed by an oncologist here, just to see my regular doctor if I had any concerns.

So, now I'm having concerns. I have been having leg and hip pain for a while now. I called my family doctor who ordered an X-ray. I was happy that I was able to have the x-ray taken the next day (Thursday). But now I'm waiting. It's only been two days (and it's the weekend now) but I have not heard back from the dr about any results. Is it typical to have to wait several days to get results, or do they tend to call sooner if there's something on the x-ray? I'm not familiar enough with the system to know if the waiting means there's no major problem, or do they wait no matter what?

My other fear is that x-ray is not very sensitive to bone mets, and there could be something there but can't be seen on x-ray. What's the likelihood that I could have a bone scan done if the x-ray is negative or inconclusive?

Thanks in advance for your help navigating and understanding the system!

~ Shelby

Dx 8/10/2009, IDC, Right, 2cm, Stage IIB, Grade 3, 2/21 nodes, ER+/PR+, HER2-
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Mar 27, 2021 06:54PM - edited Mar 27, 2021 06:57PM by canadaliz

Well Hi Shelby,

First off, welcome to the north!!

Second--don't worry about what hasn't happened. You are right to get an X-ray out of an abundance of caution but don't jump right from ache to mets. (Lord knows I've done it 8,352 times myself but don't do as I do, do as I say.)

Now, as for the Canadian system it is awesome! Are you in a rural or urban area--that may make a difference. Call your doctor on Monday for the results. At the latest I would say Tuesday morning. If there is even a suspicion of a doubt you will have access to any and all tests without delay. That is if you are in a large city centre. If you are rural you may have to both travel and wait.

As none of us are getting any younger your hip pain can be down to good old aging. In the unlikely event you need a cancer centre Canada excels in care delivery from coast to coast. My sons are in BC and one in Vancouver. Trust me, Vancouver 'does' breast cancer treatment well and as for medical treatment-- Canada has your back....and front.

Cheers, Liz (Orillia/an hour north of Toronto)

Letrozole Dx 1/11/2018, IDC, Right, 2cm, Stage IIA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 3/13/2018 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy Whole-breast
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Mar 27, 2021 06:56PM - edited Mar 27, 2021 06:59PM by Beesie

While there are overriding principles guiding healthcare across the country, healthcare in Canada is run by the provinces, and there are differences from one province to another. Which province are you in?

As for not having heard yet from the doctor, if you only had the x-ray on Thursday, the report from the radiologist probably wasn't signed off until Friday, and you don't know when it was released to your doctor, or if your doctor has even had a chance to see the report yet. This would be true anywhere in the U.S. too.

Whether in Canada or the States, how long it takes to get results depends on the imaging/testing facility. How and when the doctor notifies you depends on the doctor. Just as there is no consistency with this in the U.S., there is no consistency in Canada. It has nothing to do with the healthcare system. It's all up to the doctors involved. It would be nice if there were rules and consistency on all this so that we'd know what to expect, but doctors are individuals who each operate in their own way.

The same would be true on the bone scan. Some doctors are very responsive and proactive and recommend and order lots of tests. Other doctors are more hesitant to order tests. Again, this is no different than what you would find with doctors in the U.S. (and there you also have to deal with the possibility of your insurance denying the doctor's requisition).

The advice I've given many times on this site, whether to someone in Canada or the U.S., is to always ask your doctor and the testing facility what their process and timelines are for notifying patients about results.

Does either your doctor's office or the imaging facility have a patient portal?

Hope that your x-ray shows something like arthritis or bursitis... not that I want you to have those conditions, but it would be good to have a clear explanation for the pain, something that isn't mets!


Edited to add: I see that as I was typing,you just changed the location under your user name from Texas to B.C.. There are lots of BC people on this site who can help you navigate the BC system.


Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole
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Mar 27, 2021 07:14PM - edited Mar 27, 2021 07:16PM by txstardust

Thanks for your input, Liz and Beesie! They did say it would be 1-2 days for them to file the report with my doctor. I know I'm just looking for reasons to either worry or not worry - but I'm going to worry regardless. It's a little disconcerting to be navigating a new healthcare system and not know what to do. I haven't been terribly successful trying to get help with mental health (just like in the US!!), so I'm hoping it's easier than that. I'll just keep breathing until I hear back from the doctor next week.

I live in the Lower Mainland, close to Vancouver, so hopefully that will streamline things a bit.

I am grateful to be here in Canada where I do not have to worry about being bankrupted by cancer like I was in the US!

Dx 8/10/2009, IDC, Right, 2cm, Stage IIB, Grade 3, 2/21 nodes, ER+/PR+, HER2-
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Mar 27, 2021 08:40PM Sadiesservant wrote:

Hi Shelby,

I live in BC and have done my entire life. You have no reason to worry that you have not heard back yet, in fact, it may be the opposite (no news may be good news). However, I agree with Beesie that a call to your doctor would be a good idea, late Monday or Tuesday, as you are worried. It often takes a few days for the results to get to your GP unless something is clearly ominous.

In terms of a bone scan, that will depend a great deal on your symptoms, the results of the x-ray and your doc. Our system is great and I have always had excellent care. The one thing you do need to be prepared for, if there are indications that further investigation is required, you may not get the second scan instantly. It’s been my experience that scans ordered by a general practitioner, in the absence of a compelling diagnosis, usually take longer to be scheduled. If my MO orders it I get pushed to the front of the line. Hope this helps put your mind at ease

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/11/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/22/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/29/2017 Arimidex (anastrozole) Targeted Therapy 4/20/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/21/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/19/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/10/2019 Verzenio Radiation Therapy 11/3/2020 External: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine)
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Mar 28, 2021 02:34PM txstardust wrote:

Thank you Sadiesservant, I appreciate your input! It's helpful to hear from someone who has experience with the system. I'm hoping I'll be able to report nothing serious this week!

Dx 8/10/2009, IDC, Right, 2cm, Stage IIB, Grade 3, 2/21 nodes, ER+/PR+, HER2-
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Apr 1, 2021 03:03PM Elderberry wrote:

txstardust: hi and a belated welcome to the True North. One thing I didn't have to worry about when I was diagnosed was "OMG - how can I afford this?!" Our system is pretty good, although there are flaws. Waiting lists can be long. I attribute that to the fact that everyone is entitled to the same care not just rich people or those with good insurance who can move to the front of the line. I could be wrong. Urgent care is speedy but people might have to hobble around in pain for months for a knee replacement. That is the downside to "free" treatment.

A regular x-ray result usually comes back pretty fast, PET/CT etc results can seem like an eternity when you are spiralling around in scanxiety. New West is a good place to be. Royal Columbia is an excellent hospital. I started off at BCCA but really disliked my MO right at the start and tranferred to Lions Gate Hospital where I have the most fabulous MO I could ever hope to have. The infusion centre isn't as swanky as BCCA but the care is excellent. I live in Burnaby, about nine blocks from the Cassiar Connector to the Iron Workers' bridge.

You may get scheduled for CT if there are reasons for concern. It might turn out to be arthritis or something less scary than mets. Let us know!!


De Novo - this isn't a "brave battle" - it is a "furious struggle" Dx 3/6/2019, IDC, Left, 5cm, Stage IV, metastasized to liver, HER2+ Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel) Targeted Therapy Perjeta (pertuzumab)
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Apr 1, 2021 05:28PM moth wrote:

txstardust, I'm your neighbour - I'm in Coquitlam :)

just fyi, my xray of my lung (which turned out have a met in it) led to the radiologist calling my dr while I was driving home & giving a verbal report & my GP called me just as I walked in my door to say I would need a CT and she booked it STAT. Now, from experience I know I have a super proactive GP and this isn't everyone's experience but I would say that no news is good news.

It's annoying that it's the long weekend. Can you book a telehealth appt for next week for the results? Also, you can get your medical records - pretty much every place I've been to has a medical records department where you can get the written report released to you for free. They sometimes charge for the actual images (if you need them for 2nd opinions etc.)

hth!



I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Jun 26, 2021 01:07AM txstardust wrote:

Thanks all, my x-ray turned out to be normal, thank goodness.


Now I'm dealing with heart issues that appear to be related to prior chemo. Found out I have two leaky valves and something called abnormal global strain, which I'm reading up on. Can this end please?

Dx 8/10/2009, IDC, Right, 2cm, Stage IIB, Grade 3, 2/21 nodes, ER+/PR+, HER2-

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