Digby woman faces cancer a 2nd time, told wait to see dermatologist could be 9 to 12 months
'I just want to see a doctor,' says Robin Blecker, who had a cancerous growth recently removed
Robin Blecker first noticed something growing on her face in December 2023.
When the Digby, N.S., woman brought it up to her family doctor, they told her it could possibly be basal cell carcinoma, the most common type of skin cancer with a high survival rate.
When the growth hadn't disappeared months later, Blecker insisted to her doctor that it be removed. Blecker, a cervical cancer survivor, was reminded of what an oncologist told her in 1995.
"My oncologist, the first time I had cancer, told me if you get cancer again, it'll be a different kind of cancer and you probably won't survive," Blecker said in an interview. "Those words — you never forget. You never forget."
The growth was removed last October, and a couple of weeks later, Blecker's family doctor confirmed it was basal cell carcinoma.
She was referred to a dermatologist in Halifax for followup screening to determine if any cancerous cells remain, but soon discovered she'd have to wait between nine and 12 months for an appointment.
"I probably cried for two days," said Blecker.
Dermatologist shortage
That wait time is a side effect of a chronic, national shortage of dermatologists. That shortage is especially acute in Nova Scotia, where there are only 19 or so practising dermatologists, said Dr. Kerri Purdy, head of the division of clinical dermatology and cutaneous science in Dalhousie University's department of medicine. Most of those dermatologists are based in Halifax, she said, and four work only part time.
According to online data from Nova Scotia Health, 50 per cent of new patients were seen in person by a dermatologist within 176 days between July 1 and Sept. 30 of last year. Ninety per cent of new patients were seen within 459 days.
Purdy said patients with basal cell carcinoma, like Blecker, would ideally have to wait no longer than four to six months to see a dermatologist. But she said thousands of patients are waiting for appointments.
Cases considered more urgent, such as more aggressive skin cancers like melanoma, are seen within one to two weeks.
"You just have to prioritize the limited time that you have to ensure that things that are life-threatening are seen first," said Purdy. "But it means, unfortunately for many other people, they're left waiting for really long periods of time despite us doing the best that we can to see them."
In January, the Canadian Dermatology Association released a paper with five solutions to what it calls a "critical shortage" of dermatologists. Among the recommendations is increased funding for education.
Nova Scotia has just one or two dermatology residents a year, noted Purdy.
Dr. Mark Kirchhof, president-elect of the Canadian Dermatology Association, said the province should bring in or train more dermatologists to decrease wait times.
"There hasn't been really a large significant increase in the number of training spots in quite some time," said Kirchhof in an interview. "That'd be one of the things that governments can certainly change relatively quickly and that would result certainly in more dermatologists being around to help patients."
When asked about dermatology wait times in the province, Nova Scotia Health said in a written statement that it is "working to respond to the challenges of patient access to dermatology" as part of its ongoing efforts to recruit specialists.
The statement noted the province has a growing population of older adults with "chronic skin conditions or more serious complications," leading to more referrals to see dermatologists who already have limited availability.
'Can somebody please fight for me?'
While booking an appointment at a private dermatology clinic is an option, Blecker said she can't afford to go that route. In the meantime, new growths have emerged.
Blecker doesn't know whether they're a symptom of lichus planus — an inflammatory skin condition she's been diagnosed with — or basal cell carcinoma.
"I feel like I'm just complaining. I'm not complaining, I just want to see a doctor," she said. "I just want to see the right person that can make sure that all these other things that are popping up, because of my skin disorder, that they're not cancer, too."
While caring for a husband with a brain injury and ailing parents, Blecker said she is not ready to "leave this Earth."
"I'm so stuck. I just sat and cried the other day and thought, can somebody please fight for me?"
ABOUT THE AUTHOR
