The Concern for Cancer Care as Pandemic Takes Priority

Kate Byng-Hall laments as the UK could face 60,000 premature cancer deaths as the coronavirus pandemic limits diagnosis and treatment.

Photo by Hush Naidoo

Estimates by experts have predicted that around 60,000 people could die of cancer prematurely as a result of lack of diagnosis and treatment due to Covid-19 restrictions.  Routine cancer screenings, such as mammograms for breast cancer and endoscopies for gastrointestinal cancers, have been severely hampered or even scrapped together due to pressures on health services because of coronavirus.

As of June 2020, over two million people were waiting for cancer screening, tests and treatments, mainly for breast, bowel, and cervical cancers.  This led to approximately 2000 fewer cancer cases being diagnosed every week in the UK as of May 2020.

Cancer screening programmes lead to around 5% of cancer diagnoses per year, meaning that an estimated 380 cancer cases aren’t being diagnosed every week through screening programmes.  This means symptom-based diagnosis is more important than ever, but it’s much less reliable than screening.

Vague cancer symptoms such as fatigue, change in bowel habits, and weight loss might be dismissed by patients as trivial without scans to back them up, and respiratory symptoms like persistent coughs could be put down to the effects of coronavirus rather than their true origin.  People are less inclined to book face-to-face appointments with GPs about concerns due to the possibility of coming into contact with the virus, so symptoms are being neglected.

“Delays to diagnosis and treatment could mean that some cancers will become inoperable. Patients shouldn’t need to wait for this to be over before getting the treatment they need.” – Professor Charles Swanton, chief clinician at Cancer Research UK

Moreover, approximately one in five cancer cases are discovered as a result of emergency situations, such as fainting because of brain tumours, but admittances to A&E dropped by a third at the beginning of lockdown, meaning a substantial number of such cases are being missed.

As of June 2020, there were an alarming 6000 fewer cancer patients undergoing chemotherapy than usual.  Some of these are elderly and comorbid patients whose treatment has been postponed indefinitely, leading to earlier deaths. 

The number of cancer-related surgeries currently being performed is down 60% compared with normal figures, leaving around 12,750 people waiting for cancer surgery across the UK.  Some surgeries are being replaced with temporary radiotherapy, but the delay in drastic treatment may be negatively impacting people’s prognoses. 

The effects are also being felt keenly by newly-diagnosed or long-term cancer patients who suddenly have to deal with their illness without the normal support services such as face-to-face counselling, and even sessions teaching chemotherapy patients how to put on wigs and apply make-up while dealing with hair loss.  This has led to crippling feelings of isolation and mental health implications for many who are already having to struggle with so much.  

The increased risk of Covid-19 for patients receiving chemotherapy, radical radiotherapy and immunotherapy has also added to this anxiety, with Macmillan Cancer Support reporting that a quarter of calls to its support line were from patients with cancer who are concerned about the virus as of April 2020.  As a report by Nature states, “the psychological stress of receiving a diagnosis and treatment for cancer will be exacerbated in current circumstances”.

Furthermore, about 12,000 clinical trials for cancer treatment advancements are currently ongoing, but the majority have been suspended, leading to long-lasting developmental and financial implications, and loss of potential benefits for participating patients.  The pandemic is even having a detrimental impact on the progression of pioneering treatment alternatives.

One we are over the hill with coronavirus, which will hopefully be sooner rather than later, cancer needs to become a healthcare priority.  Some have even suggested that the largely empty Nightingale hospitals, purpose-built for Covid-19’s peak, be used to accommodate cancer patients during screenings and treatment.  

Whatever the answer, these patients cannot be overlooked anymore, or we’ll face a heart-breaking surge in deaths – this country needs some good news, not more sorrow.

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