By Fazila Seker

As the COVID-19 pandemic continues to overwhelm Canada’s healthcare system, its long-term consequences on hospital care are becoming clear. The massive surgical backlog that has built up in Canadian hospitals since 2020 – particularly in cancer care – has come with a profound cost for patients and their families.

In Ontario alone, hospitals are facing a backlog of 327,800 surgeries. According to a recent report, some provinces are facing wait times of up to 36 days for breast cancer, 46 days for lung cancer, 55 days for colorectal cancer, 84 days for bladder cancer, and 112 days for prostate cancer, in contrast to the national goal of 10 days.

We’ve known since the beginning of the pandemic that delays in care can have life-or-death consequences for patients – particularly for people living with cancer. According to the Canadian Cancer Society, delaying cancer care by just a few weeks can increase the risk of death by around 10 per cent. However, as we have all seen, COVID remains unpredictable – and even a small surge in patients in an already overwhelmed system can have profound effects on wait times. Canadian healthcare leaders need to find new ways to help make hospitals more resilient – which means having the right people and the right resources in place to manage sudden surges in admissions.

To create that resilience, it’s important to understand that the current cancer surgery backlog is not only because of the shortage of beds caused by waves of COVID, but also because hospitals have adjusted workflow and scheduling to minimize overcrowding and ensure physical distancing. More physical distance means that more time needs to be set aside for appointments to reduce the possibility of overlapping procedures and to properly clean and disinfect areas after use. While all of this is necessary to help reduce the risk of infection, these safety measures have also led to fewer patients being seen and fewer procedures being performed.

One way to help solve the backlog is for hospitals to adopt newer and better technology that can help make surgeries more efficient while improving the patient experience.

For example, many hospitals still use wire-guided localization, a way to mark the location of a tumour before surgery, by inserting wires into the patient’s breast. It’s a technique that hasn’t changed much in 50 years. Wire-guided localization demands a lot of coordination among the patient, radiologist, surgeon and pathologist because the procedure has to be done on the same day as the surgery. This can create scheduling challenges for all the people involved as well as for the hospital itself.

Wire-guided localization is particularly challenging and anxiety-inducing for patients. Because the tumour has to be marked on the same day as the surgery, it can mean a long day spent waiting at the hospital between the two procedures. As part of the wire-guided procedure, the patient needs to fast the whole time, which can sometimes lead to fainting. Patients often need to sit around in a hospital gown as they wait for an operating room to open up, while also trying to avoid accidentally snagging their gown on the protruding wire. And finally, the wire has also been known to become displaced or transected during surgery, which can lead to inaccuracy and additional procedures.

Instead of relying on this method, hospitals should consider a new wire-free technology where the marker can be implanted on the same day or a few days before surgery as a way to ease backlogs in a way that is much more patient-centred and efficient.

One such wire-free technology is MOLLI Surgical’s Health Canada-approved MOLLI,® which is designed to put the breast cancer patient first by creating a better experience over traditional wire and other localization options. The sesame-seed sized MOLLI Marker® can be implanted several days ahead of the surgery – meaning the patient doesn’t need to have their radiology appointment on the same day as their surgery. During the surgery, the MOLLI Wand® tells the surgeon the exact position of the marker, which is a much easier way to locate the tumour, more precisely remove it, and produce better cosmetic results for the patient – because it allows for smaller incisions to be made, even in hidden areas.

From a hospital perspective, wire-free technology allows for a more flexible approach when it comes to scheduling surgeries, reduces the impact of unforeseen delays in radiology, and increases the number of surgeries that can be performed in a day. Just by “decoupling” localization from surgery, care teams can improve their workflows to make care for patients more timely and create a better overall experience. When hospitals take this step, it leads to a 34% increase in the scheduling capacity of radiology departments and a 41% increase in breast-conserving surgery programs. In short, wire-free localization provides a better experience before, during, and after surgery for patients, for the radiologist who helps to locate the tumour, and for the surgeon who has to remove it.

The COVID-19 pandemic has had a devastating impact on the healthcare system as a whole, and cancer care in particular. For people who work in hospitals, improving their workflows, clearing cancer surgery backlogs and making sure people can continue to have faith in their local hospital are all vital concerns.

As hospitals and administrators explore new ways to increase efficiency in the face of these wait-time challenges, it’s important that the changes that are ultimately adopted are not just efficient for the hospitals, but centred on the patient, too.

Fazila Seker Ph.D. is CEO and co-founder of MOLLI Surgical.