The Canadian Cancer Survivor Network (CCSN) held its Manitoba All-party Cancer Caucus (APCC) at the Manitoba Legislative Building in Winnipeg, Manitoba on October 28, 2024. This was CCSN’s first ever APCC in Manitoba, and their fourth for 2024, with a spring APCC held in Saskatchewan, and two APCCs in Ontario.
The Caucus meeting was facilitated by CCSN Staff members Lindsay Timm, Community Engagement Manager, and Trevor Smith-Millar, Communications Manager. Jackie Manthorne, CCSN’s President & CEO, was unable to attend the Caucus because of the death of her wife in September 2024.
Lindsay Timm: “When survivors and patients are empowered, they become our strongest partners who bring the practical, real-life perspective to the discussion.”
The presentation began with a land acknowledgement from the Government of Manitoba. Manitoba is situated on the treaty territories and ancestral lands of the Anishinaabeg, Anishininewuk, Dakota Oyate, Denesuline and Nehethowuk Nations. These nations, along with the Metis and the Inuit peoples paved the way for the creation of the province.
Timm opened her remarks by introducing CCSN to MLAs to familiarize them with the organization. During her speech, she shared information about some of CCSN’s programs, such as the 10-module Science of Cancer e-education course, CCSN’s flagship webinar series, which offers up to 20 webinars a year, and previous All-party Cancer Caucuses held in other provinces.
Timm then encouraged MLAs to work together to establish a lung cancer screening program that covers the entire province, stating that lung cancer screening results in earlier diagnosis when treatment is possible rather than late diagnosis, when treatment is often prolonged and complex.
Timm also showcased CCSN’s bilingual aggregate Canadian Prostate Cancer Guide website, which the organization launched in early 2024 as a resource for prostate cancer patients, caregivers, and families. “There is a coast-to-coast directory of support groups and an info quiz to help you navigate the site if you don’t know where you would like to start. There is a link provided in the package for anyone who would like to take a look at the website or if you know someone who would benefit from its existence.
“We look to work with governments, all political parties, and other decision-makers to educate and promote positive and considered policy that will support patients, caregivers, and survivors in the healthcare system. When cancer survivors and patients are empowered, they become our strongest partners who bring the practical, real-life perspective to the discussion.”
Two cancer organizations were invited to present at the APCC. The first, Ovarian Cancer Canada (OCC), is a national charity dedicated to funding research and raising awareness of the disease. Vice President of Programs and Policy, Cailey Crawford, was joined by Alexandria Tadman, Associate, Government Relations and Advocacy; Dr. Lesley Roberts, MD, FRCSC, Gynecologic Oncologist, Assistant Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Manitoba and Health Sciences Centre; Dr. Mark Nachtigal, Ph.D., Professor, Department of Biochemistry & Medical Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rady Faculty of Health Sciences, University of Manitoba; Senior Scientist, Manitoba Ovarian Cancer Research Program, Paul Albrechtsen Research Institute, CancerCare Manitoba.
Patient advocates for OCC included Cindy Sanchez, Nurse Practitioner, Gyne-Oncology at CancerCare Manitoba, Previvor, Member of OCC Prevention Task Force, Co-Chair of Winnipeg’s OCC’s Walk of Hope and Christa Slatnik, Clinical Resource Nurse and Certified Diabetes Educator, Previvor, Member of OCC Prevention Task Force, Co-Chair of Winnipeg’s OCC’s Walk of Hope
Dense Breasts Canada was the second group in attendance, and was represented by Jenny Borgfjord, Manitoba Director of Advocacy, Dense Breasts Canada. She was joined by Dr. Scott Gregoire, President of the Manitoba Association of Radiologists.
Cailey Crawford: “Research holds the key to better understanding.”
Timm introduced Caily Crawford, the Vice President of Programs and Policy of Ovarian Cancer Canada, who oversees programming, education, support and advocacy. OCC is the only charity in Canada focused solely on the eradication of ovarian cancer, and advocates for more research into the disease.
Ovarian cancer is more deadly than most cancers. In Manitoba, of the 80 women expected to be diagnosed in 2024, 45 will die within five years. “It’s more fatal than breast cancer, and the five-year survival rate is only 44 per cent. One in two women diagnosed today will not live for five years, and unlike so many other cancers, survival outcomes haven’t changed significantly in 60 years. This has created an incredibly urgent situation.”
Crawford said that there are many reasons why the survival rate is so low. There are no screening tests for ovarian cancer (PAP tests, she noted, are only for cervical cancer). “The only way to diagnose ovarian cancer is by being admitted into a cancer centre and having a biopsy, and yet there are a lot of people who think that a simple blood test, the CA-125, will diagnose ovarian cancer. That is not the case.
“I also want to talk to you about the challenges of symptoms, first that the symptoms are very general.” Crawford explained that the most common ovarian cancer symptoms are bloating and abdominal discomfort. These are symptoms that are often explained by less serious conditions, and they often do not grab the attention of a doctor or the patient. With ovarian cancer, there is no unique symptom that alerts the doctor, so it’s often overlooked or ignored.
The second factor that makes ovarian cancer so deadly is that it doesn’t behave like a lot of other cancers. “It spreads very quickly right out of the gate,” Crawford said. “So, if you think about cancer cells on the surface of the ovary or the fallopian tube, they simply slop off into the abdomen or pelvis, and they don’t cause any symptoms for most women until they have grown into an advanced stage cancer before anyone really notices what’s going on.”
Crawford said that the late-stage diagnoses, combined with the lack of research funding, means that there are few treatments for the disease. She added that many of the challenges associated with ovarian cancer are in finding it at its earliest, more treatable stage. Ovarian Cancer Canada is committed to research to find an early detection test. However, she added, results globally have been disappointing. This means that the focus for OCC has instead shifted to prevention.
“With an estimated one in five ovarian cancer cases being linked to inherited genetic mutations, prior knowledge of a mutation can actually helps patients in Manitoba determine if they are at high risk of developing this disease and can therefore take preventative action.”
Crawford laid out a pathway to effective prevention. First, by identifying people who might be at high risk of developing ovarian cancer by investigating family and medical history. If there is reason to believe that there is a high risk of ovarian cancer developing, then the patient will be tested for the full suite of cancer genes. If genetic testing confirms that a person does have a genetic mutation related to ovarian cancer, like the BRCA mutation, then the primary care provider should discuss risk-reducing surgery and make the appropriate referrals. Crawford refers to people who have the genes for ovarian cancer, but not the actual disease, as “previvors.”
While Crawford called this the optimal pathway, she also said that it is not being implemented properly. “Research conducted by Ovarian Cancer Canada and published in Current Oncology found that there was a lack of discussion on family history between primary care providers and their patients, and physicians aren’t always referring patients to genetic counselling and testing when it’s appropriate.”
In addition to this, Crawford said that there is a wide variation in wait times and eligibility criteria for genetic counselling and testing, and there is even variation across not only the country but also within provinces. In Manitoba, the full suite of genes is not tested, as it is in Ontario and several other provinces. There is also very poor access and navigation to risk-reducing surgery and aftercare. Lack of research investment in these areas compared to other cancers compounds this issue.
“Given these missed opportunities, Ovarian Cancer Canada convened the Ovarian Cancer Prevention Task Force with financial support from the AstraZeneca/Merck Alliance. We brought together patients, previvors, gynecological oncologists, genetic counsellors, family physicians and researchers, all to focus on how we can optimize the ovarian cancer prevention pathway,” Crawford stated.
The Task Force is creating and disseminating resources to educate and engage primary care clinicians and their patients. While primary care doctors are busy, they are also the gateway to the prevention of ovarian cancer, and doctors and patients must be educated about the disease. This includes handouts to primary care providers, waiting room posters, and interactive tools available on Ovarian Cancer Canada’s website.
The Task Force is also identifying gaps and barriers in healthcare systems related to prevention opportunities, advocating for change, and investing in prevention research that relies on the lived experiences of patients aimed at improving the prevention landscape in Canada. One example Crawford gave was OCC funding for a project investigating equity and cancer genetics, including identifying racial disparities in cancer services.
“But beyond improving prevention, I want to stress that research holds the key to better understanding the complexities of ovarian cancer leading to the discovery and the developments of a screening test and early detection tool as well as novel and innovative treatments. And this is why Ovarian Cancer Canada funding is driving collaborative and innovative research across the country.”
Hon. Uzoma Asagwara: “It is important for us to champion cancer care in this province.”
At this point in the presentation, Manitoba’s Minister of Health, Uzoma Asagwara, asked to speak. Minister Asawara’s background was as a psychiatric nurse and addiction specialist. They were also the first non-binary MLA elected in Manitoban history.
Minister Asagwara highlighted the importance of cancer care in their province, an issue they said crossed party lines. “As you can see there’s a lot of folks in this room that showed up from government and the opposition caucus, because this is something that we recognize affects everybody across the province. You are probably not going to find a single person in this room who hasn’t been touched in some, way, shape or form by cancer. We are, as a government, more than happy to work with you to get the information out there.”
Minister Asagwara said that not everyone has access to the information they need to self-advocate and to know what their risks are. They said that it is their government’s responsibility to work with patient groups to get that information out to Manitobans. The Minister said that because of this, there are a few priorities their government is working towards to improve access to care in the province.
“Research is huge, and issues that affect women specifically are highly under-researched, under invested, and that is a huge problem. So as a government, it is important for us to champion cancer care in this province and we invest in strengthening it.” Minister Asagwara went on to say that Manitoba is in a unique place to invest in research in ways that provinces with larger populations like Ontario are not.
Minister Asagwara expressed their thanks to the advocates present, and their work in advancing cancer care in the province. “It’s the survivors that we centre, the advocates that we centre, alongside the experts, that we keep at the heart of the work that we do. As Health Minister, I very much support you, as does the government and opposition MLAs, who are working with you as well. It’s important for us to work together to move our province in a much better direction.
“We look forward to working closely with all of you and the experts that have the information and tools that we need to make sure that, across Manitoba, we’re getting the information in the hands of people who need it, we’re making intentional, strong investments, taking steps like lowering the breast cancer screening age to 40, and we’re doing that in a way that centres the voices previvors and survivors across the province.”
Dr. Roberts and Dr. Nachtigal: “Getting diagnosed as a high-risk patient is where we struggle in this province.”
Crawford then introduced Dr. Lesley Roberts. She is a Gynecologic Oncologist, Assistant Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Manitoba and Health Sciences Centre.
Dr. Roberts said that often by the time patients see her, they are already at a late stage. However, she also works at a hereditary cancer care clinic, which educates, treats, and supports women at high risk of ovarian cancer. “About 20 to 25 per cent of women who develop ovarian cancer will have a mutation of some description that puts them at high risk. And if you identify that mutation before they develop cancer, medical intervention is possible.”
This includes medical management, like taking birth control pills that lower the risk of getting ovarian cancer, or more invasive strategies like surgery, which significantly improves outcomes for those at high risk.
“The women I see in my clinic, generally speaking, have had a hard time accessing this pathway,” Dr. Roberts said. “Getting to me in the clinic is not very challenging, but getting diagnosed as a high-risk patient is where we struggle in this province. And that’s primarily because we lack the resources and support for genetic testing, lab testing, the blood testing that need to happen.”
She also stressed that patient-centered support is key, especially for something as medically intensive as removing tubes and ovaries, which includes a lot of discussion and long-term support. The lack of long-term support is the largest gap in treatment. Dr. Roberts also noted that once a patient is diagnosed with ovarian cancer, Manitoba is recognized one of the top places internationally to get treatment.
While in absolute numbers ovarian cancer doesn’t seem to affect many women, Dr. Roberts said that each woman diagnosed has a huge impact. “It’s a major diagnosis that carries a lot of professional, emotional, caregiving and obviously potential mortality associated with it. But there is a very large financial burden as well. It takes between $150,000 to $200,000 dollars per patient to treat over their lifetime.” Dr. Roberts stressed the need for more support, more funding, more education, and more research into prevention.
Dr. Mark Nachtigal was then invited to speak about research. He is a Senior Scientist at the Manitoba Ovarian Cancer Research Program, the Paul Albrechtsen Research Institute, and CancerCare Manitoba.
Dr. Nachtigal said that they include patient groups as part of their research to make sure that it is patient centric. They are working to elevate their group nationally, which Ovarian Cancer Canada is helping to do. This has also allowed them to access national grants that would not be available to them otherwise. These grants have also allowed them to conduct research in areas like novel therapeutics that can help treat cancers that are immune or resistant to chemotherapy.
Dr. Nachtigal said that his group is also focused on bringing in talent to work in the province to help advance ovarian cancer research. He added that these experts will train the next generation of experts. In collaboration with experts like Dr. Roberts, they have developed genetic counselling programs and prevention clinics.
However, Dr. Nachtigal said that they hope to expand their laboratory to include a tissue bank, which helps catalog ovarian cancer cells and tumours for use in research. “For the past 25 years in my lab, we have been using patient samples to do the most clinically relevant research. I’ve had patients at different lectures and conferences come up and tell me how angry they were because their sample wasn’t used for their research. This tells me about the passion of the individuals who were affected by this disease, and so we want to do everything we can to enhance tissue banking in this province.”
Cindy Sanchez and Christa Slatnik: “What do you think mom would have done?”
Crawford then introduced Cindy Sanchez and Christa Slatnik. Sanchez and Slatnik are co-chairs of the Canadian Ovarian Cancer Walk of Hope and members of the Ovarian Cancer Task Force. Slatnik is a nurse practitioner, gyne-oncology at Cancer Care Manitoba, and Sanchez is a clinical resource nurse and a registered diabetes educator. They are also identical twins.
In 1998, Sanchez and Slatnik’s mother was diagnosed with ovarian cancer, and two years later she passed away at the age of 53. Sanchez and Slatnik said that after graduating from their respective nursing programs, they had the opportunity to work at the oncology unit where their mother was diagnosed. They both worked there for over a decade. Slatnik obtained her Masters degree and went to work with Dr. Roberts at her clinic.
“It was nice to be able to work at Women’s Hospital and really try to help people in similar situations, but unfortunately, we found too often that there were too many people in very similar situations. So, when Ovarian Cancer Canada came to Winnipeg in 2004 looking for someone to lead the Walk of Hope, Christa and I jumped on it.”
The pair have been organizing the Walk for 21 years, where they met several other patients and families. Many, they say, have similar stories as their mother, where the symptoms are vague and often ignored. When Sanchez and Slatnik entered their mid 40s, they started to become concerned that they would face a similar challenge as well.
“Even if the symptoms did present themselves, we would be stage 3C ovarian cancer by then, and we know that the statistics are all too devastating. In 2017, we learned about a research project that was Canada-wide called the Screen Project. Previously, we couldn’t get that testing in Canada or Manitoba. Unfortunately, to qualify for testing, because our mom had passed away, we couldn’t use her ovaries to test, so I would have had to wait for Christa to get ovarian cancer or she would have to wait for me to get ovarian cancer for us to qualify.”
Sanchez and Slatnik paid for two gene-panel testing and the test came back negative. However, since they both worked in cancer care, they discovered there were more than just two genes that determined ovarian cancer, and they were personally offering more genetic testing to their patients. Eventually the Screen Project was able to offer a 45-screen panel, meaning that they were testing up to 45 different genes for risk of ovarian cancer. Because this test was more expensive, Slatnik got tested, assuming that because the sisters were identical twins, their genetic makeup was similar.
Slatnik found that she had a group 1 genetic mutation, which was a new discovery for her as her local clinic didn’t test for it yet. Slatnik told her twin that because she had the mutation, Sanchez would have it too, and Slatnik had made the decision to get her ovaries removed.
“My first thought was ‘I don’t know what I want to do,’” Sanchez said. “It’s not an easy decision for everyone to go into early menopause. My second reaction was, ‘I’m not ready!’ But then Christa said, ‘You do you. However, what do you think mom would have done if she had chosen to get those ovaries out? She would have been there to see us graduate; she would have been there to see us get married; and she would have been there to meet her grandchildren.’ And right away, I was like ‘Okay, let’s get those ovaries out of there.’”
After hosting the 2023 Walk of Hope, Sanchez and Slatnik both had surgery on September 11, 2023. After the surgery, the twins donated their ovaries to cancer research, which they say caused excitement at Dr. Nachtigal’s research centre. This officially made both Sanchez and Slatnik previvors.
Sanchez and Slatnik find that more women are worried about breast cancer, but it is ovarian cancer that is more deadly. They also find that many of those who come in with ovarian cancer have a history of breast cancer. They are looking to spread awareness and urged MLAs to have full genetic testing available in the province of Manitoba.
Jenny Borgfjord: “I urge you to support updating breast screening protocols in Manitoba.”
Timm then introduced Dr. Scott Gregoire, President of the Manitoba Association of Radiologists and an advocate for improved healthcare outcomes, especially for women. He introduced Jenny Borgfjord, Dense Breast Cancer Director of Advocacy for Manitoba, and a breast cancer survivor.
Borgfjord began by presenting the statistics for breast cancer in Manitoba. 900 women were diagnosed with breast cancer in 2023, which is 25 per cent of all cancer diagnoses for women in Manitoba. Of those, approximately 180 women died.
“Some of the deaths could have been avoided with earlier detection. We can do better for Manitobans with improved breast screening practices that save lives and reduce suffering,” Borgfjord stated. Breast cancer screening in Manitoba begins at age 50. All women that have a screening mammogram will find out if they have dense breasts or not. But for individuals with dense breasts, mammograms are not enough, and the danger is that essential additional screening is not offered. Current practices make finding cancer early difficult for women with dense breasts.
“Finding cancer later means worse prognoses and the need for harsher treatments, poorer quality of life, and it increases costs to the healthcare system.”
Borgfjord said that Canadian research shows that women aged 40 to 49 who have mammograms are 44 per cent less likely to die from breast cancer than those who do not have mammograms. Canadian and global research shows increasing incidence of breast cancer in the 40s as well as racial disparities, with non-white women, including Indigenous women, with a peak incidence in the late 40s and early 50s. Early detection also allows women to undergo less extensive breast surgery, or even avoid chemotherapy. There are also cost savings: a stage one breast cancer patient costs $39,000 to treat, compared to an amount 10 times more for a stage four patient.
“Not screening women in their 40s and not offering supplemental screening to women with dense breasts places women in Manitoba at greater risk of a delayed and advanced diagnosis. We’re happy to see that the government has announced plans to lower the screening age, but it’s not happening fast enough. Screening will only start at 45 in 15 months and 40 sometime in December 2026—this long phased-in approach will mean later-stage diagnoses. We are advocating for screening at 40 to begin as soon as possible,” Borgfjord said.
“Manitoba has begun to take steps to lower the screening age, but we need to address another crucial breast screening issue as well. That is why I’m focusing today on the critical need for Manitoba to offer supplemental screening for women with dense breasts. Thanks to advocacy from DBC’s patient advocates, in 2021, Manitoba began to directly inform women of their breast density category, A, B, C, or D after their screening mammogram. It’s important for women to learn if they have dense breasts, but Manitoba needs to take the next obvious step and give them access to the additional and essential screening they need to find breast cancer early.”
Borgfjord explained that mammograms don’t find all cancers. Having dense tissue is the most common reason for a cancer to be missed, and 43 per cent of women over age 40 have dense breasts. Dense breasts are also more common in Asian and Black women, and those at higher density like C and D are at greater risk of getting cancer. Women with dense breasts are also at higher risk of an interval cancer, which are cancers found between mammograms.
“They are discriminated against if they only have access to mammograms,” Borgfjord said. “Women with dense breasts face a double whammy: they are at increased risk of getting breast cancer, and it’s harder to detect cancer on mammograms.
“We’ve known about the risk of breast density for about 50 years. We’ve known for almost 30 years from multiple studies that ultrasounds find breast cancers missed on mammograms. Many of those cancers can be found when they are small, usually with ultrasound, but also MRI. Mammography finds four to five cancers per thousand women. Ultrasound finds at least additional two to three per thousand. MRI finds up to 16 cancers per thousand scans that are missed on mammograms. Today’s focus is on ultrasound because it is more accessible and is used in other provinces.”
However, Borgfjord says there are several barriers to accessing supplemental screening. There is a shortage of trained ultrasound technologists in Canada, which Borgfjord says can be counteracted with training incentives. There is also undue concern about false positives, that some people say are anxiety inducing. However, Borgfjord said that short-lived anxiety is not a reason to deny women the opportunity for early detection of breast cancer. Finally, the third barrier is that people believe there is not enough evidence. Borgfjord says this is not true, as there have been many studies in Canada on ultrasound as well as randomized trials underway in other countries.
“To improve early detection of breast cancer, reduce deaths, reduce suffering, and save on treatment costs, Manitoba has taken a step in the right direction by moving towards women self-referring at age 40. Let’s take another step and ensure that supplemental screening is provided to women with Category C and D dense breasts. It will save lives and reduce suffering,” concluded Borgfjord.
Borgfjord then spoke about her own experience with Manitoba’s breast screening protocols. In April 2023, Borgfjord had no concerns about developing breast cancer due to her doctor’s advice and her lack of awareness. Her physician, she said, relied on outdated information.
“In March 2023, my second mammogram returned ‘normal’ results. However, in April, I discovered a lump. At first, I wasn’t worried. My husband reminded me of the tenderness I’d felt after the mammogram, so we assumed it was just a tissue injury. After all, I had just received a ‘normal’ result. When the lump didn’t disappear, I visited the clinic on May 4th, expecting reassurance given my recent mammogram. This time, however, I was sent for an ultrasound on May 9th. During the scan, the technician became more focused and less chatty. She then brought in a radiologist. At that moment, I became terrified. They explained that further investigation was needed and recommended a biopsy, which I agreed to. I left the clinic with a throbbing breast and a sense of dread.”
Ten days later, she was diagnosed with cancer. While initially scheduled for a lumpectomy on June 13th, this was delayed after she had a breast MRI, which revealed another mass and delayed her surgery. “With less than 24 hours before surgery, I was given 20 minutes to decide whether to proceed with a mastectomy or delay for another biopsy. I chose the biopsy, and after 16 agonizing days, the second mass was confirmed as non-cancerous. Both masses were missed during two screening mammograms.”
On July 6, Borgfjord underwent a lumpectomy and sentinel lymph node biopsy. Ten weeks after that, a treatment plan was developed. “I was fortunate to have an early-stage diagnosis, but I can’t help but think about what could have happened had I relied solely on mammograms and ignored self-examinations and the lump.
“I urge you to support updating breast screening protocols in Manitoba.”
Timm closes All-party Cancer Caucus
Timm returned to the podium with some closing remarks, urging MLAs to learn from the patients’ experiences. “That is why we are here today, ensuring that our political leaders understand not only the needs and challenges of the cancer community but also the power that they uniquely hold to make the hope of becoming a cancer survivor a reality.”
MLAs had no questions for CCSN or the affiliated groups, and Government Health Critic Kathleen Cook thanked everyone who attended.
2024 Manitoba APCC Attendees
CCSN
Lindsay Timm, Community Engagement Manager, Canadian Cancer Survivor Network
Trevor Smith-Millar, Communications Manager, Canadian Cancer Survivor Network
Ovarian Cancer Canada
Cailey Crawford, Vice President, Programs and Policy, Ovarian Cancer Canada
Alexandria Tadman, Associate, Government Relations and Advocacy, Ovarian Cancer Canada
Dr. Lesley Roberts, MD, FRCSC, Gynecologic Oncologist, Assistant Professor, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Manitoba and Health Sciences Centre
Dr. Mark Nachtigal, Ph.D., Professor, Department of Biochemistry & Medical Genetics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rady Faculty of Health Sciences, University of Manitoba; Senior Scientist, Manitoba Ovarian Cancer Research Program, Paul Albrechtsen Research Institute, CancerCare Manitoba
Cindy Sanchez, Nurse Practitioner, Gyne-Oncology at CancerCare Manitoba, Previvor, Member of OCC Prevention Task Force, Co-Chair of Winnipeg’s OCC’s Walk of Hope
Christa Slatnik, Clinical Resource Nurse and Certified Diabetes Educator, Previvor, Member of OCC Prevention Task Force, Co-Chair of Winnipeg’s OCC’s Walk of Hope
Dense Breasts Canada
Jenny Borgfjord, Manitoba Director of Advocacy, Dense Breasts Canada
Dr. Scott Gregoire, President of the Manitoba Association of Radiologists
Manitoba New Democratic Party
Hon Usoma Asagwara, Deputy Premier and Minister of Health – Union Station
Hon. Renee Cable, Minister of Advanced Education and Training – Southdale
Hon. Ian Bushie, Minister of Municipal and Northern Relations & Minister of Indigenous Economic Development – Keewatinook
Hon. Malaya Marcelino, Minister of Labour and Immigration – Notre Dame
Hon. Tracy Schmidt, Minister of Environment and Climate Change – Rossmere
Carla Compton, MLA – Tuxedo – Parliamentary Assistant for Health
Mike Moyes, MLA – Riel
Mike Moroz, MLA – River Heights
David Pankratz, MLA – Waverley
Billie Cross, MLA – Seine River
Diljeet Brar, MLA – Burrows
Mintu Sandhu, MLA – The Maples
Tyler Blashko, MLA – Laginmodière
Progressive Conservative Party of Manitoba
Wayne Ewasko, Interim Leader of the Opposition – Lac du Bonnet
Kathleen Cook, Health Critic – Roblin
Carrie Hiebert, MLA – Morden-Winkler
Trevor King, MLA – Lakeside
Wayne Balcaen, MLA – Brandon West
Richard Perchotte, MLA – Selkirk
Jodie Byram, MLA – Agassiz