The College of Physicians and Surgeons of B.C. is seeking a permanent injunction to prevent the founder of a popular online “personalized cancer care and precision oncology service” from assessing patients and dispensing medical advice.
A petition filed in B.C. Supreme Court this week claims Alexander Rolland is violating provincial health regulations through the operation of Cancer Treatment Options and Management Inc.
The petition claims that “taken as a whole,” Rolland’s websites and a YouTube channel where he calls himself “The Cancer Guy” all work to imply that he and his colleagues “are able or willing to conduct activities that may only be provided by a regulated health practitioner.”
The petition claims Rolland and his consultants are “conducting activities that are within the scope of the practice of medicine or are restricted activities by diagnosing, assessing the health of patients, recommending treatments, managing treatments, preventing disease, advising on physical health, and designing therapeutic diets.”
‘Our goal is to work ourselves out of a job’
Rolland has not responded to the petition.
In a phone call with CBC News, Cancer Treatment Options and Management co-founder Michelle Morand said the company has not been served with the court documents.
Morand, who is also named in the petition, said the company is doing nothing wrong.
“We don’t treat and we don’t prescribe. We just help people access things that the health-care system doesn’t give them. And we’ve been doing it for 15 years. And every couple of years, the B.C. College of Physicians and Surgeons comes around and complains,” she told CBC News.
“There’s no evidence whatsoever to support a claim that we are treating or prescribing. It’s just not a thing that happens. What we do is an incredible amount of diagnostics and then an incredible amount of advocacy with patients for their doctors to be able to provide them with more current technologies and more current treatments.”
According to an online press kit, Rolland holds a bachelor of science from the University of Victoria and completed a PhD in medical genetics at the Terry Fox Laboratory in Vancouver.
Cancer Treatment Options and Management (CTOAM) is described as a “private company that works as a supportive arm within mainstream health care to enhance the quality of care that cancer patients receive.”
The company’s media material claims “time and budgetary constraints within the health care system” mean that doctors “miss out on the latest advancements in new, effective diagnostic measures and treatments.”
“Significantly, when the most recent developments in cancer research and technology fail to reach doctors and health care teams on the front lines, they fail to reach patients like you,” the company’s website reads.
“In a nutshell, CTOAM offers a bridge between leading edge cancer research and front line cancer care. Our goal is to work ourselves out of a job.”
Fees ranging from $2,000 to $20,000
But the College of Physicians and Surgeons of B.C. claims Rolland has overstepped the bounds of the regulations governing medicine in the province, playing “a pivotal role in monitoring treatment plans and recommending treatment to clients” described as “patients” in reports shared with doctors.
“Rolland has also provided clients with his opinion on what aspects of their cancer they should, or should not, be concerned about and whether their cancer is likely to spread,” the petition reads.
The court documents note that the cost of services provided by Rolland and his colleagues ranges from $2,000 to $20,000, depending on the services.
“On top of this fee, if clients have to pay out of pocket for medications that are recommended … the client may pay upwards of an additional $10,000 a month,” the college claims.
“Clients are required to pay up front for the services … and [Rolland and his associates] recommend, amongst other things, that the client create a GoFundMe page to raise money.”
According to their online biographies, some of the other consultants named in the petition are licensed to practise medicine in other jurisdictions, but the petition notes that they are prohibited from giving medical advice in B.C. unless licensed in this province.
‘How about if it was your family member?’
The petition is backed by affidavits from two medical oncologists with B.C. Cancer — both of whom claim to have patients who sought second opinions from Rolland’s company.
Dr. Adam Fundytus claims a patient with brain cancer presented him with a report from Cancer Treatment Options and Management that allegedly cost about $25,000.
The report recommended the patient start taking a drug that was only in the first phase of testing and would not have been covered by B.C. Cancer.
The doctor’s affidavit includes his email correspondence with Rolland.
“I was hoping to have a conversation with you about the way that information is provided to patients who have in many cases incurable cancers,” Fundytus wrote.
“The packaging of the report is very unfair to people with low levels of scientific literacy and the strength of the recommendations is somewhat discordant from the quality of the evidence provided in the report.”
In the responses attributed to Rolland, he cited successes his company has had recommending treatments for patients in New Zealand and Saskatchewan.
“Perhaps you can answer me this … do you think part of the goals of a treatment team should include educating a patient on what can be done for them regardless of if it is not offered locally? How about if it was your family member?” Rolland asked.
“Do you know how many Canadians go to the USA (or elsewhere) every year for cancer treatments that they can’t access here?”
Fundytus claims his patient requested to switch oncologists after the doctor said he “would not be taking instructions from Mr. Rolland.”
The patient is currently in palliative care.
‘Therapeutic relationship had been damaged’
Another oncologist, Dr. Richard Gagnon, claimed a patient with ovarian cancer got a second opinion from Rolland’s company advocating against a promising drug that was in the process of approval from Health Canada at the time.
“The follow up conversation was long and Patient A and their spouse acted very frustrated. They told me that they did not know who to trust given the conflicting information they were receiving … and they accused me of holding back on effective treatment because of ‘red tape,'” Gagnon wrote.
“The conversation left me feeling that our therapeutic relationship had been damaged.”
Gagnon claims Cancer Treatment Options and Management recommended unnecessary tests and scans without meeting the patient in person.
“I have never spoken to anybody at CTOAM directly,” Gagnon wrote.
“All contact was through the patient and the reports that CTOAM sent.”
Morand told CBC News the business is very clear with clients about the services they provide.
“Every patient signs a form that says, these guys aren’t oncologists. They’re not treating me. They’re not going to prescribe anything. My doctor doesn’t even have to look at their report if the doctor doesn’t want to,'” Morand said.
“Patients are very well informed. But they also sign the same document that says, I want to know all my options, and I’m open to travelling if I need to. Or I’m open to paying out of pocket for drugs or to going into a clinical trial.”
“These are people who have been given a life sentence and they want to do everything they can to extend their life and have better options,” she said.
“And science can do a lot more for them than our health-care system is doing in almost every single case.”
None of the allegations in the petition have been proven in court.
