Dear Minister Holland,

As a patient who has been negatively impacted by difficulties accessing a mammogram in Canada due to task force guidelines, I would like to thank you for your care and your words on this issue.

Hearing you speak truth and the value placed on the lives of young women had me feeling seen and heard. Through treatment, I heard many stories of the trauma fellow patients and their friends and families experience due to delayed diagnosis. Many Canadians have lost a young woman in their life.

When I was 39, my doctor told me that she had been reading and that since screening at 40 was a shared decision she wanted me to start thinking about it. She suggested a benchmark at 40 so that we could watch for changes and be proactive. I agreed, sounded wise.

Unfortunately, within the year, she suddenly retired and closed her practice. It took me some time but I eventually found a young doctor accepting new patients. One of my first requests was for a screening mammogram and she refused, saying it was not recommended. I insisted but again she refused. I would ask again the following year, but again, no.

I knew I couldn’t get a second opinion as I had to sign a contract that I would not use walk-in clinics. I knew my doctor would remove me from her roster and knowing the doctor shortage had worsened, I would be unable to find another.

Then I found a lump. At first, I dismissed it. I felt that since she was so firm on not authorizing a mammogram that the appointment would be challenging. Eventually I did go and 2 weeks after my 43rd birthday, I was diagnosed with a locally advanced cancer with lymph node involvement. My family doctor called me between appointments; she was crying on the phone but I didn’t have time or energy to comfort her. I think the guidelines cause harm to the doctors who follow them too.

Sure the biopsy, scans, and all the processes of diagnosis were stressful, but so was trying to advocate for care from my doctor in the first place. I wonder what if my first doctor had retired just a year later, or if I had taken the risk and gone to a walk-in clinic to ask for a requisition.

The consequences of delayed diagnosis for me may not end my life prematurely; however, the treatment effects are harsh and my quality of life has been impacted. I underwent harsh chemotherapy which may have damaged my heart and other organs, a surgery to remove the tumour and the affected lymph nodes, 29 consecutive days of radiation, and a full year of targeted therapy infusions. I am on my fifth year of a hormone treatment which causes achy joints, mood changes, brain fog, and other unpleasant side effects. I was lucky. I may live to old age. I may even live the rest of my life without a breast cancer re-occurrence.

When I was undergoing chemotherapy, I read the Pulitzer Prize winning book The Emperor of all Maladies and there are four pages on the Canadian breast screening RCT from the 80s. I was so saddened to learn that it is widely known that the study was sloppy or maybe even fraudulent, that people involved explained the problems with randomizing patients and STILL there is no indication that the scientists, the University of Toronto or the journal where it was published are planning to retract this RCT.

If you’re interested in reading the pages I posted them to my Twitter/ X profile here. https://x.com/ladyscorcher/status/1577091283658547200?s=46

I know this is long and you are busy. I hope my story helps you in your important work. I sincerely appreciate your words and actions. It reassures me that someone in power cares about the lives of women like me.
Cheryl White

DBC Note: When Cheryl sent this letter to Health Minister Mark Holland, she shared it with DBC. She has given us permission to share it with you. Thank you Cheryl for telling Minister Holland what is happening in doctor’s offices. The Task Force can talk 24/7 about a mammogram being a woman’s choice but until that message gets through to family docs and women themselves, then women will continue to be dismissed or talked out of having mammograms in their 40s. Thank you Cheryl for also telling the Minister what you went through and what you still experience on a daily basis. These are the harms no one talks about. Breast cancer can be a lifelong sentence. If you would like to write to Minister Holland about your experience, his email is hcminister.ministresc@hc-sc.gc.ca