Cancer plan 'going to take time'

Newly appointed interim national director of cancer control Diana Sarfati. PHOTO: SYLVIE WHINRAY
Newly appointed interim national director of cancer control Diana Sarfati. PHOTO: SYLVIE WHINRAY
Diana Sarfati’s life work has been  to improve cancer treatment. Now the University of Otago, Wellington academic has six months to make a lasting difference. She talks to health reporter Mike Houlahan about her secondment as  interim national director of cancer control.

In January Diana Sarfati spoke to the Cancer Care at a Crossroads conference on "trends and disparities in cancer in Aotearoa/NZ".

Eight months on, she finds herself in a position to affect trends and address those disparities as interim national director of cancer control.

Although her role is a mere six-month secondment from her position as head of the public health department and director of the cancer and chronic conditions research group at the University of Otago, Wellington, Prof Sarfati said that afforded her plenty of time to make a lasting difference in the field.

"It is about starting a process - my role is about shaping the new systems and processes and starting the implementation of the plan," she said.

"A lot can be done in six months, and I want to get as many things set up as I can, which can then be followed through. But this is a 10-year plan - it is going to take time."

Although as recent events prove, things can happen quickly.

When Prof Sarfati organised the January cancer conference alongside Cancer Society medical director Chris Jackson, they knew the timing was promising for promoting their vision of a national, focused attack on the disease.

"We set up the conference with the explicit aim of putting cancer on the national agenda, but I wasn't expecting to take up a role leading that work."

Doing Prof Sarfati's cause no harm was a bravura performance at the conference by Winton man Blair Vining, whose battle against terminal bowel cancer has sparked a national campaign to improve cancer treatment.

At the conference, he and wife Melissa put Health Minister David Clark on the spot, demanding immediate action - last week's announcement of a national cancer action plan being the end result.

"Both Blair and Melissa are extraordinary people, and they have put a human face on this," Prof Sarfati said.

"He has limited time left, and he has chosen to spend that limited time he has on advocating for other people ... It is such an extraordinary thing to do and I have the world of respect for both of them."

Dr Sarfati has more experience than most of cancer; while she has not worked as a clinician for many years, as a public health academic and board member of organisations such as the Bowel Cancer Screening Taskforce and the Cancer Society, the disease has been central to her career.

"People with cancer are an inspiration. Every one of them has a story, every one of them has a family - they are the people we do our work for," she said.

"Patients tend to stay with you. I still remember very clearly many of the patients I treated a long time ago, and when I went into public health medicine I wanted to combine my clinical expertise with public health expertise, so it was a natural progression to work in that cancer space."

Much of Prof Sarfati's work has focused in inequities in cancer treatment, such as the poorer outcomes rural, Maori and Polynesian patients experience.

Previously, equity issues had been viewed as being partly caused by patients not recognising symptoms or proactively accessing screening or treatment, but researchers now believed systemic issues lay behind some of New Zealand's unpalatable cancer identification and treatment statistics.

"What we have had in New Zealand has been a very regional approach to cancer treatment and cancer control," Prof Sarfati said.

"That is bound to result in differences across regions, so what the national cancer plan will do is have a national approach to leading the management of cancer, so that we have much more consistency.

"There will need to be clear quality indicators, monitoring against those, then holding the system to account and supporting DHBs who are not doing so well, and seeing what DHBs are doing well and sharing examples of good practice."

Ultimately, all cancer patients no matter who they were or where they lived, should receive the same-quality treatment, Prof Sarfati said.

"Cancer control and care is complex. This will take time, but I will be doing my best to get as much in place as I can in these first six months."

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