Paying the Price Because of Gauteng’s Radiation Oncology Crisis

Public sector cancer patients bear the brunt of Gauteng’s Radiation Oncology Crisis. The implications of long radiation oncology waiting lists in Gauteng’s public hospitals are devastating. The cost of waiting too long for radiation therapy comes at a price far exceeding the mere financial implication. Too many cancer patients on the lists are dying, with dire consequences facing large numbers of those who don’t.

Increased chances of local cancer recurrence go hand-in-hand with delayed radiation therapy. All too often, the potential for metastasis increases. Chemotherapy treatments have to start all over again and oncology patients end up in life-threatening situations. Ultimately, the only solution for patients on public waiting lists is to seek treatment in the private sector. But is this a solution? For most public patients this option is out of financial reach and those who do somehow manage it end up facing massive, life-altering debt. Unemployed patients, or those without medical aid, rely on the Gauteng Department of Health to receive treatment. For too long, this just hasn’t happened on time, if at all.

The Financial Implications

Let’s examine why there is very little financial chance for a government patient to switch radiation therapy to the private sector:-

Radiation Oncologist Consultation

A private consultation with a radiation oncologist could cost a patient between R1200 and R2000. Some doctors may charge discounted rates or even forgo a consultation fee depending on the patient. As it is important to provide an oncological history at a consult, patients may have to fight yet another battle to obtain this information from public institutions.

Radiation Oncology Planning

Radiotherapy planning itself varies depending on the type of planning to be administered. Prices can vary dramatically. A manual procedure with a single region of interest can cost around R3000 while Intensity Modulated Radiotherapy Planning procedures (IMRT) cost a lot more. Over-and-above the procedure charges, Radiation Oncologists also charge once-off planning fees (R4000+).

Depending on the region of the body that needs scanning, a CT scan could cost anything from R3500, with the average being a higher price.

Radiation Therapy

When taking the type of cancer and its severity into account, the duration and treatment plans of radiation therapy differ a great deal. Some patients may only need short course treatments (ranging from R7000 to R14000 each), but prescribing a three to six week daily course (5 days per week) is more common. Prices for these courses can range from around R9000 to R25000 per week.

A radiation oncologist also charges a rate on top of these prices – potentially R4000 per week or more.  All the above prices depend on the type of radiation therapy administered and the number of regions of interest involved.

Travel and Accommodation

The cost of travel to a radiology centre or, if a patient lives far away, accommodation close to the centre can vary from patient to patient. Patients should keep travel to a minimum during radiation therapy as side-effects, including extreme tiredness, vomiting and diarrhoea, are common.

Patients who live in outlying regions should try to book lodging in a guesthouse or care home while having treatment, and travel home only on weekends . There are facilities that offer accommodation to cancer patients only. CANSA care homes situated in five provinces provide beds, two basic meals a day and transport to and from treatment centres for nominal daily rates. The average private radiation oncology treatment is five weeks which is likely to cost a patient at least R6250, excluding weekends and weekend travel.

The Minimum Cost of Going Private

Taking into account the lowest-mentioned estimates for the above sections of the radiation therapy process, a five week treatment schedule could cost a patient at least R80000. It is not likely that this minimum would be practically applied across all sections of the treatment journey, so the total is likely to be higher.

Considering the financial situation of most public patients, such a figure would be out of reach, leaving their remaining options lying somewhere between the power of prayer and a positive attitude. It is tragic that the Gauteng Department of Health has allowed the radiation oncology crisis to reach this point. Most public patients do not have further options and nowhere else left to turn.

Please note: All estimates quoted in this article are meant as informed guidelines only, and actual prices may fall outside of the parameters given.

Examples of How Patients Pay the Price for a Failing Public Health System

Cancer statistics get released often. These statistics give an idea of the state of the disease in the country. The problem with statistics is that they are impersonal – viewing a bunch of numbers on a page never actually tells the full story. Patients struggle daily to keep their positivity because of the manner in which the public health system is failing them. These patients are not statistics. They are real people with real lives and very real diseases. It is time for the Gauteng Department of Health to start viewing them as such. What follows are examples of real people who have been neglected by the GDoH because of its inability to solve the ongoing Radiation Oncology crisis.

A Breast Health Foundation Video Showing the Impact of the Long Radiation Oncology Waiting List

Sadly, information has been received that a brave warrior featured in the above video clip passed away from her cancer in January 2022. Allegedly, the only radiation therapy she ever received from the Gauteng Department of Health was once she was already a palliative patient. Whether fact or not, whenever radiation therapy did occur, it happened too late.

The majority of public patients cannot afford private radiation therapy nor are they in positions to loan money for this purpose. If public patients were receiving the prescribed public radiation therapy from the Gauteng Department of Health on time, many tragic outcomes could be very different. They SHOULD be different but the system is failing too often. Much too often.

Jennifer Van den Berg

Jennifer Van den Berg in 2022

The system has also failed Jennifer Van den Berg. Jennifer is an Inflammatory Breast Cancer survivor who has had to pay for many R5000 treatments of the targeted chemotherapy drug, Trastuzumab. Due to exclusionary South African Department of Health treatment protocols, she didn’t qualify for public supply of the only drug that would save her life prior to surgery. And she still has to cover another five treatments to keep metastasis at bay. Added to this, the Gauteng radiation oncology crisis has forced her to seek private radiation therapy too, which she really cannot afford.

Long waiting lists left Jennifer with no chance to receive timely and effective public radiation therapy. Any further wait would have meant that radiation would have held little to no benefit, and that she would be open to increased chances of local cancer recurrence. Inflammatory Breast Cancer holds a higher risk of this happening than most other breast cancers.

As a public patient, Jennifer has since been reliant on the help and guidance of empathetic private specialists and facilities to keep the financial cost of radiation therapy within reach. An angel friend, and her family, have helped her to pay for treatment but she is obligated to repay the debt.

Jennifer is a warrior and a survivor. Her battle against IBC would have been much easier if she had received the help she needed and deserved from the Gauteng Department of Health and National Health Breast Cancer Policy. Without the financial assistance of loving friends and family, at their own initial expense, Jennifer would have ended up, as too many public patients do, paying the ultimate price.

Read more about Jennifer’s journey here.

Please visit Jennifer’s BackaBuddy campaign here to read more and show your support.

Conclusion

Real people. Real lives. Real problems. Real disease. Real Debt. Real tragedies. There are real inadequacies in public oncology treatment and protocols and the Gauteng Department of Health needs to find real solutions urgently, before more people needlessly struggle, suffer and die.

Header image courtesy of flickr.

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