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Nurse exposes inequity in prostate cancer tests

Author
Nathan Morton, NZ Herald,
Publish Date
Wed, 19 Apr 2023, 10:53AM
Photo / File
Photo / File

Nurse exposes inequity in prostate cancer tests

Author
Nathan Morton, NZ Herald,
Publish Date
Wed, 19 Apr 2023, 10:53AM

A South Island clinical nurse has spoken of the “iniquity in health” South Island men face in battling prostate cancer compared to their northern counterparts.

While Auckland and Northland men can receive vital scans to monitor prostate cancer free of charge, men down south must fork out thousands of dollars and jump through hoops for its access.

The nurse, Jason* told the Herald he felt “deeply concerned” that men in the South Island are being disadvantaged when it comes to tackling the country’s most common form of cancer.

Prostate cancer affects 4000 men across New Zealand every year, according to Cancer Society NZ. The diagnosis is most common among men over 50 developing it in a small gland below the bladder.

For men who have had either surgical or radiotherapy treatment, close monitoring and surveillance of the cancer is critical, as health experts will look to identify any recurrence of cancer after treatment.

A Prostate Specific Membrane Antigen (PSMA) Pet scan is the most sensitive test to identify whether the cancer is returning or fighting back.

The scan in question is fully funded for anybody receiving treatment in Northland or Auckland. But for Christchurch, health providers won’t cover its cost.

South Island men in desperate need of the scans, who Jason pointed out are commonly in their 60s or 70s and on a pensions, must find $3800 to cover the cost.

They must then travel at their own expense to Christchurch for the scan.

Jason called the process for South Island residents to follow “draconian” as he described the complexity of applying to the Variance Committee for consideration of the scan.

“The appellant has to submit a PowerPoint presentation outlining the clinically significant benefit with appropriate evidence-based studies for each case, and invariably these are declined,” he said.

South Island men in desperate need of the scans must find $3800 to cover the cost, then often travel for a scan. Photo / George Heard

South Island men in desperate need of the scans must find $3800 to cover the cost, then often travel for a scan. Photo / George Heard

“So it is a futile exercise that is never pursued.”

The process has caught out numerous people that Jason has worked with, as he’s witnessed locals grapple with the unfair requirements.

“It’s an awful proposition to see the initial hope on the patient’s and their family’s faces as they understand that something could be done to help them, only to then realise it will be at a significant personal financial cost,” he said.

The nurse also pointed out those living in the rural South Island also hail from low socio-economic backgrounds, making it hard to afford the cost of a scan that could potentially save a life.

“There are many men who miss out on the opportunity for PET altogether,” he said.

Te Whatu Ora acknowledged the variation in funded scans across the country’s districts, citing “many factors” that influenced the variations.

“The aim behind the health reforms is to ensure equity and reduce the ‘postcode lottery’ that used to exist between districts,” said Fionnagh Dougan, national director of Hospital and Specialist Services.

“We are currently working through a process to identify these variations and will then prioritise the work required to ensure equity of access across Aotearoa.”

*Names have been changed for privacy reasons

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