AN UNSEEN DANGER
Andrea Redway, who has never smoked, has Stage 4 lung cancer but is stable thanks to treatment. She is part of a campaign encouraging people to get checked, treated and screened for cancer during the COVID-19 pandemic — which recent falling rates of diagnosis suggest fewer people have been doing.
Fewer Canadians have been diagnosed with cancer during the COVID-19 pandemic compared with previous years. But far from being something to celebrate, it is part of a global trend that is raising alarm bells.
Across Canada, diagnoses are down about 16 per cent overall and as much as 25 per cent in some cancers, information from the Canadian Cancer Survivor Network shows. In addition, some oncologists are seeing an increase in late-stage cancers in newly diagnosed patients.
The missing cancer cases are leading to fears of an eventual double wave of patients needing treatment, many of them sicker than if they had been diagnosed earlier.
“We think that is because there is a group of patients sitting on silent cancers that have not yet been diagnosed,” said Dr. Sandeep Sehdev of The Ottawa Hospital Cancer Centre.
That is partly because appointments have been delayed and cancelled during the pandemic, and partly because fear of COVID-19 is keeping some patients from seeking health care. During the first wave of the pandemic, all but urgent surgeries and some treatments were delayed, leading to a backlog.
Canadian physicians, health organizations and patient groups are among those urging people to get timely cancer screening and care as part of a global campaign called New Normal, Same Cancer.
“When the pandemic began, our health-care system went into acute crisis response in order to limit COVID-19 transmission, but the ripple effect it has had on cancer care is alarming, and we are already seeing the profound impact,” said Dr. Shady Ashamalla, an oncologist and assistant professor of medicine at the University of Toronto.
“Delays in diagnostics, evaluation and treatment can lead to more advanced cancers, limited therapeutic options and access to clinical trials, and ultimately lead to poor patient outcomes,” he said. “That is why it is absolutely critical that patients don't wait.”
Ottawa's Andrea Redway is among those urging people not to delay seeking medical advice and treatment for symptoms and concerns. She knows firsthand the difference treatment can make.
The 53-year-old lawyer was diagnosed five years ago with Stage 4 lung cancer. The diagnosis “came out of nowhere” for Redway, who doesn't smoke and has no risk factors for lung cancer. She sought medical advice for a persistent cough after she began experiencing pain and other symptoms.
She was able to receive a new immunotherapy treatment which eliminated the cancer that had spread outside her lungs and has stabilized her condition. Throughout the pandemic, she has continued to undergo regular monitoring and testing, although she faced some appointment delays at the beginning.
“I would encourage anyone who thinks they have something strange going on with their body that they can't explain to have it
checked out as quickly as possible and to not hesitate because of COVID,” Redway said. “The hospitals are safe and are taking all precautions to keep people safe.”
Redway also encouraged people to be their own advocates to make sure they get the tests they need for a diagnosis.
Early in the pandemic, medical officials put out pleas for people to seek treatment because so many — even those with critical medical conditions such as heart attacks — were staying away or delaying. Meanwhile, many patients had procedures and appointments postponed or cancelled.
While many Canadian patients continue to face long waits for appointments, which has further delayed testing and possible diagnosis, there are some signs of improvement.
Sehdev said he hasn't had any patients whose urgent surgeries have been delayed significantly in the Ottawa area. He said doctors and health centres have learned from the first wave of the pandemic.
But a survey by the Canadian Cancer Survivor Network found that many cancer patients across the country continue to have appointments and tests postponed and cancelled.
“This is very troubling,” said Conrad Eder, a public policy analyst with the survivor network.
Meanwhile, the fear of contracting COVID -19 is still keeping some patients, especially older patients, from getting timely medical care or even cancer screening.
“I think a lot of it has to do with the kind of psychological fear people have,” Sehdev said. “This kind of campaign is meant to help remind people that COVID is important — by all means, protect yourselves with masks and hand hygiene — but don't neglect your health.”
Sehdev said many appointments can be done virtually — but not all of them. In-person appointments and treatments are safe, he said.
It is absolutely critical that patients don't wait.