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Tags: Cancer | cancer | coronavirus

Cancer Doesn't Wait During a Crisis

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By Monday, 11 May 2020 10:31 AM Current | Bio | Archive

There is never a "good" time to get cancer. It's scary and overwhelming as any cancer patient or cancer survivor will tell you. Now imagine a novel virus from China has closed down many clinics preventing thousands of cancer patients from either getting their treatments or cancer screenings, which could go on for quite some time.  That's even more frightening.

Unfortunately, this scenario is actually happening and all too real. And cancer isn't concerned about a viral pandemic. Cancer doesn't quietly retreat, waiting until a crisis has passed. Cancer only knows one thing — to grow and expand until it takes over completely.

Record drop in cancer screenings

We know routine cancer screenings saves lives, but beginning already in March, an astonishing drop transpired as these tests were cancelled and put on hold. What we didn't quite expect, was just how bad it was. According to a white paper released by Epic, the electronic medical records vendor, screenings for cancers such as cervical, colon and breast, all took a nosedive. When compared to 2017 average numbers, these disrupted screenings were down between 86% and 94% in March. Even federal health officials and cancer societies strongly recommended Americans should cancel or delay routine cancer screenings.

As a prostate cancer surgeon, I have grave concerns over deadly cancers that could and likely will go undetected due to this significant fall off of cancer screenings. I've performed numerous prostate cancer biopsies on men. Occasionally, a biopsy result will come back with a very concerning Gleason score of 9, indicating a high-grade prostate cancer likely to grow and spread quickly. To have put that type of cancer screening off indefinitely would be a certain death sentence for that man. 

We know that the earlier a cancer is found and dealt with, the better the chances of survival for the patient. Cancer screenings have revolutionized oncology, helping find this disease at a more treatable stage, extending the lives of patients.

I also understand that like any medical procedure, there is no foolproof cancer screening. False positives and false negatives can and do happen, unnecessarily subjecting patients to sometimes uncomfortable medical procedures or undue worry and anxiety until test results return. But, when anything is amiss such as finding a lump or experiencing rectal bleeding, to forego screening for cancer as soon as possible, is not considered practicing good medicine.

The harmful ripple effect on cancer screenings

Just like Sir Isaac Newton's third law of physics reminds us, "for every action, there is an equal and opposite reaction." COVID-19 has created a very bad reaction of a wide and ever expanding ripple effect in the healthcare system ultimately harming innocent patients caught in the fray of its deadly path.

As the viral pandemic began to wind up back in late February/early March, hospitals and clinics main concern was to prepare as swiftly as possible, the anticipated oncoming crushing influx of patients infected with the virus. This meant curtailing all non-urgent elective surgeries (joint replacements, gallbladder removals, breast augmentations, etc.) abruptly including cancelling routine screenings for diseases such as osteoporosis or cancer. The idea was all hands were needed on deck — and now — to help care for these victims.

Because of vast population differences throughout the U.S., there were some hospitals that did continue performing elective surgeries and routine screenings, but they were the exception and not the norm. Many small hospitals in areas with no hotspots of the outbreak and who had a much smaller number of patients hospitalized with COVID-19, could not financially have absorbed the tremendous blow to operating expenses if they called off these important surgeries and screening exams altogether.

Since then, most hospitals have experienced anywhere from one-third to one-half of beds devoted to patients with the virus. As beds filled to capacity in certain hotspots, non-COVID-19 patients were forced to wait their turn before getting the procedures they had been waiting on.

Even major surgeries in some instances, have been delayed for the time being, all because of COVID-19. Then there has been the problem of patients needing immediate care such as someone having a stroke or a chest pain or possible heart attack, fearful of going to the emergency room and  contracting the virus and then being isolated from their family.

Advice for cancer patients who've experienced treatment disruptions

I'm a believer in continuity of care. Disruption in that chain of care necessary for treating cancer patients should be avoided at all costs, even in pandemics. Limiting or completely stopping care only leads to anxiety and confusion among patients. They may sense a feeling of abandonment if they suddenly are no longer being seen for follow-up appointments or are unable to get in for a cancer screening.

But I don't want patients to feel disconnected or that they lack power. My advice is to make sure they are staying connected with their healthcare cancer team. Right now, with concerns of COVID-19 and keeping cancer patients free of the virus, a phone call or virtual meeting online is a safe and prudent way to for an appointment or to discuss any concerns or issues they need answers to.

Now that many areas of the country are beginning to reopen, clinics and infusion centers have begun making changes allowing cancer patients to return for continuation of their treatment. It's important to know everyone will still be required to wear a mask and answer COVID-19 screening questions ahead of their visit. Waiting rooms will likely have proper spacing of chairs and appointments to prevent overcrowding.

Any patients needing a mammogram, prostate specific antigen (PSA) test, colonoscopy or any other cancer screening exam should check with their healthcare team about rescheduling their routine screening.

In conclusion

Thankfully, catastrophic pandemics are far and few between. All of us hope to never again see the likes of this situation having such a monumental effect on our healthcare system.

However, we are far from being out of the woods yet. There is much work to be done repairing and fixing the damage we've been through. Many hospitals and clinics may not be able to sustain the hit they've taken and may have to close for good. This will be the ultimate disruption of providing quality healthcare throughout the nation.

Most of all, we need to remember that patient care always comes first. Because, even in the worst of times cancer doesn't wait.

Dr. David Samadi is Director of Men's Health and Urologic Oncology at St. Francis Hospital in Long Island. He is a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City. He is regarded as one of the leading prostate surgeons in the U.S., trained in oncology, open, laparoscopic, and robotic surgery. He has vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Read Dr. David Samadi's Reports – More Here.

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There is never a "good" time to get cancer. It's scary and overwhelming as any cancer patient or cancer survivor will tell you.
cancer, coronavirus
Monday, 11 May 2020 10:31 AM
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