[Cathya]

Man sought treatment in Netherlands

Board rules he was right to do so because therapy was unavailable in Ontario

LISA PRIEST


The Ontario government has been ordered to reimburse a cancer patient who travelled to the Netherlands after repeated treatments in Canada failed to rid him of his bladder tumours.

Ontario's Health Services Appeal and Review Board, which hears from patients seeking to recoup out-of-country treatment costs, agreed the provincial government should reimburse Warren Sutherland for the cancer therapy he received.

The Hamilton man had been suffering with superficial bladder cancer for five years, but none of the treatments rid him of the disease. His last option, doctors told him, was to remove the bladder and prostate, an option Mr. Sutherland characterized as having a "questionable hope of long-term survival."

Instead, the former insurance company executive did his own research on the disease. He learned that there was an effective treatment pioneered in the Netherlands and commonly used in Europe that shrinks tumours using a mixture of chemotherapy and hyperthermia (a type of heat therapy).

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On Mr. Sutherland's behalf, his family doctor applied to the province's insurer, the Ontario Health Insurance Plan, asking it to cover the costs of the procedure. On the application form, the doctor said the treatment was not experimental, is not performed in the province and is appropriate for a patient in Mr. Sutherland's medical circumstances.

In rejecting the request, Dr. Jude Coutinho, medical consultant for the Ministry of Health, wrote in a Nov. 16, 2004, letter, entered as an exhibit at the board hearing, that the procedure was rare.

Consequently, "I am unable to conclude that the service requested could be considered generally acceptable by the medical community in Ontario," he wrote.

Believing it was his best option, Mr. Sutherland, then 62, went to the Netherlands in fall of 2004.

There, he stayed in Nijmegen, near the German border, where he received weekly treatments for six weeks.

"They put the chemotherapy into the bladder, stick a microwave probe into you and they heat it up at unbearably high temperatures," Mr. Sutherland said in a telephone interview. "Then they take the chemical out."

When he returned home to Ontario, Mr. Sutherland launched an appeal to the Health Services Appeal and Review Board, arguing that the treatment was not experimental. He wrote that it is commonly used in a number of European countries, including France, Germany and Switzerland.

"I have paid premiums to OHIP my entire life, run in the Terry Fox fundraisers, contributed annually to the cancer drives and now find out that I am ineligible for funding for my cancer treatment for bladder cancer," he wrote in a Nov. 9, 2004, letter to the board. ". . . I think it is grossly unfair to deny my request for funding for the medical treatment."

Mr. Sutherland said he spent $20,000, which included a long stay in the Netherlands while undergoing medical care. The actual treatment cost about $5,000.

Ultimately, the appeal board agreed with him, saying that the treatment is not experimental, that it is generally accepted as appropriate for a person in the same medical circumstances, and that an identical or equivalent treatment is not available in Ontario.

The board cited a 2004 study published in Urology, which concluded that three-quarters of all patients who received the treatment achieved a "complete response," which means that all signs of cancer disappeared, based on symptoms, physical exams, radiology and laboratory tests.

While Mr. Sutherland is glad he sought the treatment, it was later found that he had another recurrence, which necessitated the removal of his bladder and prostate at St. Michael's Hospital in Toronto.

"Since I've come back, I've had the surgery and six months of chemotherapy," he said. "I feel pretty good right now."