Urgent Cancer Treatments for Mari Ruti

Mari Ruti was told that she had a year to live . . . four and a half years ago. Since her diagnosis of Stage 4 metastatic breast cancer in September 2018, the Canadian healthcare system has failed her thoroughly and repeatedly. She quickly realized that if she wanted to stay alive, she needed to seek help from outside this system. Through an incredible amount of research, advocacy, and travel, she has assembled a team of experts in Boston and London, in addition to Toronto, to help her stay ahead of her illness. She is currently in London, hoping the receive a treatment—ablation, which destroys cancer tumors when operating is impossible—for two life-threatening tumors in her liver. The problem is that the cost of this treatment is almost USD40,000.

Our goal is to raise USD80,000 for the next two years, not only to pay for the urgently needed ablation to Mari’s liver but also to ease the financial burden of her ongoing cancer treatments in three countries. During the first six weeks of 2023 alone, Mari has spent around $25,000 on travel and treatments. She is therefore in desperate need of your assistance.

Mari’s cancer story consists of a long string of disasters, most of which could have been avoided with swifter and more effective care. The moment she realized that she had cancer, she clearly and forcefully asked for a double mastectomy. Her male surgeon refused to perform the operation, claiming that she would regret it later. No amount of reasoning managed to change his perspective, which seemed to be that the worst thing that could ever happen to a woman would be to lose her breasts. Mari felt that she had no agency over her body. After all, they were her breasts. She should have been able to do whatever she wanted with them. The surgeon’s decision was all the more difficult to understand given that we live in a culture where women have cosmetic breast surgery all the time and where women with genetic mutations that make them prone to breast cancer—and it turned out that Mari has one of these genetic mutations—are allowed to do preventive surgery. Why, then, was Mari denied this potentially life-saving procedure? She can only think of one reason: a dinosaur of a male surgeon who insists on knowing better than the women he treats.

More than a year later, Mari sat in ER for nine hours to get a referral to a female surgeon, who immediately agreed to perform the surgery on the premise of “your breasts, your decision.” Unfortunately, by then it was too late: the cancer had spread to Mari’s bones, lungs, and liver. While cancer is a complicated illness, and it is impossible to retroactively know if an immediate intervention could have made a difference, Mari is psychologically haunted by the possibility that the metastatic spread of her cancer could have been prevented by faster action (her diagnosis alone took five weeks to procure).

Mari was also made to wait a year and a half for radiation to her sternum even though she lived in agony from a large tumor in the area. When radiation was finally granted, she was denied stereotactic body radiotherapy (SBRT)—a precise and effective form of radiation—on the idea that using such an expensive treatment on a terminal patient was not cost-effective. At this point, Mari’s friends raised an impressive USD70,000 to enable her to receive SBRT at the Dana Farber Cancer Institute in Boston. The treatment prolonged her life and made a big difference to her quality of living.

Mari ended up in London because she found out about a new technology that tests cancer tissue against different cancer drugs to determine which drug might work best. (A treatment that Mari feels all cancer patients should have access to.) In the context of getting the necessary biopsy, she met an ablation specialist, who told her that he could destroy the two largest tumors in her liver as well as definitively get rid of the pain that still lingers in her sternum. However, the price tag is high for the three lesions, excluding accommodations, travel, and additional fees for the different doctors involved.

After she returns to Canada, Mari has to fly from her home province of Nova Scotia to Toronto every three weeks for infusions. This is because Nova Scotia is not yet set up to administer the medication she will need to receive, which was just approved for her kind of genetic cancer at the beginning of 2023. This alone is a considerable burden on her finances. However, the larger problem is that the Canadian public health system is rigid in the sense that anything “off-protocol”—no matter how life-prolonging—is met with immovable resistance. For instance, the ablation that Mari hopes to receive in London would be completely out of the question in Canada. Indeed, trying to persuade the Canadian system to deliver reasonable treatment has drained Mari psychologically. Too much of her energy has gone into advocating for basic care, such as radiation.

For many of us, Mari is a beloved friend, mentor, professor, or colleague. She is the author of fifteen academic and general interest books on living a good life within the inevitable human condition of grief and suffering. She is still fully functional and hopes to be able to complete the numerous books that currently crowd her brain. Writing is the activity that most sustains her during her health crisis. Besides writing, what matters to her is time with her mother and her friends, who want nothing more than to spend more time in her radiant and brilliant presence. Mari has a strong inner conviction that she is not yet meant to die - that it is not yet her time. But she needs your help.

This time we are reaching our fundraising efforts beyond Mari’s intimate circle of friends. If you know Mari or her work, or you know of people who might be willing the help so that she can continue to inspire with her profound writing, sharp intelligence, and compassionate presence, please spread the word about this campaign. Likewise, if you know potential donors with a special interest in cancer care, please consider sharing this message.

Direct deposit or wires for larger sums are also welcome by contacting the organizers.