Patients have been waiting for up to three months to undergo urgent surgery from the day of their diagnosis with breast cancer, with surgeons’ operating lists slashed by more than half.

The “worrying” delay in potentially life-saving breast cancer surgery was flagged by support groups at the start of Breast Care Awareness Month.

They highlighted the “intolerable” wait – the standard time frame is four to six weeks after diagnosis – for the start of curative treatment and the removal of “seriously malignant tumours”.

Action for Breast Cancer Foundation and Europa Donna Malta Breast Care Support Group wrote to the health authorities in August to express “serious concerns” about the current situation, urging them to resolve the problem “as a matter of urgency as soon as possible”.

Their letter was addressed to Health Minister Chris Fearne, the director general of health care services, Clarence Pace and Mater Dei Hospital’s medical director Walter Busuttil.

The patients were being told the reason for the delays was lack of manpower, including nurses and anaesthetists at hospital, as well as a lack of theatres, due to the pandemic.

The result was that the monthly five operating lists, with around six to seven patients on each, dwindled to two over the last few months.

The patient advocates have now been told by the hospital authorities that weekly lists will return from October 4, so the backlog should eventually be tackled. The situation is expected to return to normal by the end of the year.

“By the first week of October, we should be back to the pre-COVID-19 theatre situation, with added resources to tackle the backlog both inside and outside Mater Dei,” the support groups were told.

However, this is subject to not having “unexpected surges of COVID-19 patients, which will upset our plans”.

From the Facebook page of the Action for Breast Cancer Foundation.

Pandemic changes

Since the coronavirus pandemic broke out, working practices at hospital have changed continuously and there was even a time when cancer and urgent cases were prioritised and these patients were operated on faster than usual.

“Mater Dei has done its utmost to offer treatment to emergency, urgent and cancer cases in as timely a manner as possible during the last 18 months of the pandemic,” the hospital’s medical director said in his correspondence with the support groups.

“We have had to deploy anaesthetists and nurses to extra intensive care units in a similar fashion to other countries,” Busuttil explained, assuring them that “we have now redeployed staff to theatre and are in the process of training staff for theatre work”.

He added: “We are acutely aware that all health matters, be it infective, breast cancer or other illnesses.”

Cancer patients unaware of support 

Action for Breast Cancer Foundation chairperson Esther Sant and Europa Donna Malta president Gertrude Abela both pointed out that the country’s reputation of high standards of healthcare for cancer patients and achieving good statistical outcomes as a result is now being “placed in a precarious balance”.

They maintained it was “impossible to keep up such positive outcomes if it was taking too long to surgically remove malignancy from patients’ bodies”.

This would lead to more spread, requiring more complex treatment post-surgery and possible metastasis, which meant a lifetime of treatment, a low quality of life and premature death for patients.

“It is surely not what a healthcare system with high standards should be aiming for,” they told the health authorities.

The organisations plan to reassess the situation shortly.

“I do not understand how patients do not go mad in these circumstances,” Sant, a breast cancer survivor herself, said.

“Cancer needs that quick and big first hit and timely surgery is crucial.

“Imagine your surgeon tells you that you have cancer and that you have to remain idle for three months... with a ticking timebomb,” she added.

She noted that cancer patients are still unaware of the groups set up to assist and lobby for them.

It is important that patients remain alert about their health  and that family and friends are checked on during the pandemic, she advised.

It has also been suggested that in Breast Cancer Awareness Month, the local health authorities should be pushed to establish acceptable timeframes for the treatment of the disease and, if these are not followed, they should be held to account for not sticking to the rules they themselves wrote and answers sought.