Qld Health horror: Cancer survivor waiting 614 days for breast reconstruction

A Queensland woman is still waiting for reconstructive surgery more than 600 days after a mastectomy for breast cancer.

Sharyn Washington has been waiting over 600 days to hear back from Queensland Health about reconstructive surgery. Picture: Brian Cassey

It has been 614 days since Sharyn Washington had a mastectomy – and she is still waiting for reconstructive surgery, accusing Queensland Health of hiding information about unacceptable delays.

Mrs Washington, 40, struggles daily with anxiety over her “incomplete treatment”.

“I am not ashamed of my scar or flat chest – I just want what was promised to me so I can move on with my life,” she said.

The mother of three and long-serving librarian at St Thomas’ Catholic primary school in Mareeba, Far North Queensland, said she was not one to make a fuss but contacted The Sunday Mail after being brushed off by Queensland Health.

She has been repeatedly trying to ascertain a date for the reconstruction of her right breast – removed due to grade-three aggressive cancer on November 2, 2021 – but continually referred to the Cairns Hospital Performance website, which provides no information on her case.

“They hide things so we don’t know how long the wait actually is,” she said.

Mrs Washington has not even had an initial consultation, the first step before her referral to a specialist qualifies her to be put on the specialist outpatient surgery waiting list.

The Queensland Health website states this first consultation should be done within 365 days.

Mrs Washington’s referral was sent on November 15, 2021 – a lapse of 534 days.

Mrs Washington, who is battling other complications from her breast cancer treatment, has been deemed a category 3.

Sharyn Washington and children

This is the least urgent, for “a condition unlikely to deteriorate quickly or to require more complex care, if assessment is delayed”, according to the Queensland Health website.

Mrs Washington said she was happy to wait the recommended 365 days to see a specialist because there were women in greater need.

“But I’m not even on the list yet, and this is unacceptable,” she said.

“I’m not just speaking out for me, but for all women – people in a Facebook group I’m in say they have been waiting up to five years for their reconstructions.”

Mrs Washington said engaging a private surgeon, even with private health insurance, could “run into tens of thousands of dollars” so most women had no choice but to go public.

“The government must improve the equity of access to breast reconstruction,” she said.

“None of the doctors at Cairns Hospital can tell me when I might be eligible, and they pass me to the breast cancer care nurse. She’s been kind but can only point me to this useless website.”

The Cairns Hospital Performance website shows that since January 2023, only 43.1 per cent of category 3 plastic and reconstructive surgery patients have waited within the clinically recommended 365 days for their first specialist consultation.

In category 2, that number plummets to 11.5 per cent, while in category 1, it’s 80 per cent, with most people waiting an average of 113 days, despite the recommendation for this most urgent category being 30 days.

Sharyn Washington in treatment

Notably, however, when it comes to the days people in categories 2 and 3 are kept waiting, there is no data published.

“Why are these numbers withheld – where is the transparency?” Mrs Washington said.

On April 20 this year – 534 days after her unilateral mastectomy – Mrs Washington had a standard annual check-up with a breast surgeon at Cairns Hospital.

In a text message later that day to her breast cancer nurse, she said the doctor “was amazed I hadn’t had my initial consultation with the plastic surgeons as my referral was received on November 15, 2021. She (the doctor) was going to speak with you about it”.

On April 24 at 9.44am, the nurse said she had “emailed the plastics referral team and asked them to contact you and let you know. I don’t have access to their information and am not in a position to give you the correct information”.

At 10.06am, the nurse sent Mrs Washington another text – also seen by the Sunday Mail – saying she had received a reply from “referrals” and “unfortunately they are not allowed to give information about wait times anymore and are told to direct patients to the link below (to Cairns Hospital Performance)”.

Four days later, Mrs Washington was excited and relieved to receive a call from the Cairns and Hinterland Hospital and Health Service.

“A woman was checking my contact details and if I still required the surgery,” she said.

“I asked whether this meant I would be receiving information regarding an appointment soon, and she brushed me off, saying she does not have that information, she is just employed to ask these questions.

Cairns Hospital Specialist Outpatient Performance data, showing percentage of patients waiting for an initial consultation, across categories 1, 2 and 3, and the average number of days most have waited. Source: Queensland Health

“It was only later when I researched online that I realised the HHS is required to conduct audits of patients who have waited longer than recommended.

“That was crushing,” Mrs Washington said.

“I honestly was so pleased to finally have had contact with someone regarding surgery. I had rung my family and friends to say I must be getting closer, then had to contact them to say no.”

Increasingly desperate for answers, on July 1 Mrs Washington wrote to Health Minister Shannon Fentiman, federal Member for Kennedy Bob Katter and state Member for Cook Cynthia Lui.

All responded, with Mrs Washington receiving notification from Ms Fentiman’s office on July 4 that her correspondence would be sent to the hospital and health service “for investigation”.

Ms Fentiman told the Sunday Mail women’s health was very important to her and she had been in touch with Mrs Washington and would follow up her correspondence.

“I understand reconstructive surgery is an important step in the journey for patients who have undergone significant procedures, like mastectomies,” Ms Fentiman said.

“Getting wait times down across our hospitals is one of my top priorities.”

A Queensland Health spokesperson said its clinicians were “committed to delivering specialist outpatient appointments within clinically recommended times”.

“We will always prioritise patients requiring urgent care (category 1). Unfortunately, this means people requiring non-urgent care may experience delays.

“In these situations, the treating hospital communicates with specialist outpatients about all aspects of their care.”

Mrs Washington has a “no evidence of disease” clearance following her mastectomy, however, her health remains compromised.

She has signs of osteoporosis, linked to early menopause triggered by hormone suppressant drugs to reduce the risk of her oestrogen-positive cancer returning.

Regular bone density infusions are making a limited difference. She is also on heart medication, following damage incurred during treatment.

But Mrs Washington remains grateful to be alive.

It was March 30, 2021, when she noticed a painful lump in her right breast. The GP she saw the next day “dismissed it as a pulled muscle”.

But by April 20 when Mrs Washington was able to see her regular GP, who had been on leave, she was sent for a mammogram, ultrasound and biopsy.

Mrs Washington’s husband Benn, a laws officer with Mareeba Shire Council, was due to go away for work and she told him “there is no point sitting around waiting”.

“I thought I’d be fine; so many friends have had cysts that were benign and I have no family history.”

When her GP called with the result – grade three aggressive malignant tumour and ductal carcinoma in situ measuring 7.5cm – Mrs Washington was devastated.

“My greatest fear was not being around for my kids, who were eight, six and four at the time,” she said.

A gruelling regime of neoadjuvant chemotherapy, combined with immunotherapy, began.

The treatment caused severe nausea, exhaustion and heart damage, requiring three emergency hospital admissions for dehydration, low potassium levels and fevers.

“The original plan to complete my reconstruction at the time of my mastectomy was thwarted by the damage to my heart,” Mrs Washington said.

She was advised to wear an external prosthesis to limit postural control changes while awaiting reconstruction. But she said the prosthesis was hot, uncomfortable and required a mastectomy bra with wide straps and high cups, making wardrobe choices difficult.

“I have been a bridesmaid twice since my mastectomy and it’s really hard to find dresses, plus my son thinks the prosthesis is a soccer ball and has tried to kick it around our deck,” she said.

“I say, ‘stop, do you know how expensive this thing is?”

Mrs Washington said a positive attitude and sense of humour, but most importantly, the love of her family – including Benn, 41, Amelie, 11, Oscar, 9, and Daisy, 6 – and the tight-knit Mareeba community had carried her through.

“I wasn’t worried about losing a breast – I said ‘get rid of it, it’s going to kill me’ – and I shaved my long hair for charity before I’d watch it fall out.

“But the fact my treatment is incomplete causes enormous anxiety; my body is still looking different.”

Email Kylie Lang

Sharyn Washington and children

TIMELINE OF TRAUMA

2021

Mar 30: Sharyn feels pain in right breast.

Mar 31: A GP dismisses it as a pulled muscle.

Apr 20: Sharyn’s regular GP refers her for mammogram, ultrasound, biopsy.

Apr 29: Sharyn has scans, first available date.

Apr 30: Grade-three cancer diagnosis confirmed; bone scan shows cancer has not spread.

Jun 15: Chemo and immunotherapy begin at Atherton Hospital oncology clinic.

Sep 28: Chemo ends, immunotherapy stops due to abnormal heart function.

Nov 2: Unilateral mastectomy at Cairns Hospital.

Nov 15: Referral lodged for reconstructive surgery by GP with Cairns Hospital.

Dec 3: Immunotherapy resumes as heart improving with medication.

Dec 24: Hormone suppressant medication starts.

2022

May 31: Cairns Hospital cardiology clinic check shows heart normal.

Aug 18: Immunotherapy ends.

Sep 28: Routine check-up with Cairns Hospital oncologist, bone density infusions begin.

2023

Mar 3: Mareeba Hospital cardiologist confirms Sharyn’s heart still normal.

Apr 20: Check-up with Cairns Hospital breast surgeon reveals no evidence of disease. Surgeon “amazed” Sharyn not yet contacted by plastic surgeons to book breast reconstruction. Sharyn contacts breast care nurse for help.

Apr 24: Nurse texts with a reply from plastic referrals – wait times are “not allowed” to be given anymore, patients to be directed to Cairns Hospital Performance website.

Apr 28: Cairns and Hinterland Hospital and Health Service calls Sharyn for audit, asks if she still needs surgery.

July 1: Sharyn writes to Health Minister Shannon Fentiman, federal MP Bob Katter, Cook MP Cynthia Lui.

July 4: Ms Lui responds. Health Minister’s office tells Sharyn her correspondence will be sent to HHS “for investigation”.

July 6: Bob Katter says he’s forwarded Sharyn’s letter to federal Health Minister Mark Butler.

July 7: Health department tells Sunday Mail when delays occur, “treating hospital communicates with specialist outpatients about all aspects of their care”.

July 8: Ms Fentiman says she appreciates Sharyn “reaching out and we have been in touch to follow up her correspondence”.