The two deadly C’s: How COVID-19 affects cancer diagnoses and treatment

Cancer and COVID-19 are the second and third leading causes of death in the United States. COVID has led to delays in treatment of the other deadly “C,” cancer.

The COVID-19 pandemic overwhelmed hospitals, causing global delays in cancer treatments and health care, according to JCO Global Oncology.

Since the pandemic began in 2020, disruptions for cancer healthcare have slowed facility functionality by up to 77.5%, with personnel availability being stalled by about 60%, according to JCO Global Oncology. These two aspects are unable to efficiently function without ample medical products since the supply chain was disrupted by up to 79%.

While this poses a concern for existing cancer patients, undiagnosed cancer patients overall took a harder hit. Cancer Research UK estimated that 45% of people with potential cancer symptoms did not address them to medical personnel during the first wave of the pandemic in the UK.

For people seeking care for potential cancer diagnoses, referrals for “fast-track” investigations dropped by 350,000 people, according to an article published in Nature Reviews Clinical Oncology in 2020. During the height of the pandemic, fewer people sought care and primary care services were more reluctant to make hospital referrals. Many people could unknowingly have worsening cancer that could have been prevented. 

Robert Lowsky, MD of Stanford University’s Division of Blood and Marrow Transplantation and Cancer Cell Therapy, said accessibility to nonelective treatments and surgeries for current cancer patients were essentially unaffected by COVID-19. The main difficulties were for current patients attempting to get logged into the medical system for treatment, but those already scheduled into the system received the necessary care for their precarious health situations.

However, the emotional turmoil cancer patients went through exponentially increased due to lack of visitation from loved ones. Lowsky shared his experience observing the emotional welfare of his patients.

“In our field, and I imagine as with other fields in medicine, COVID dramatically changed how outpatient and inpatient care was delivered,” Lowsky said. “Throughout the pandemic we continued to perform blood and marrow transplants, this did not change because a transplant is not an elective procedure. It is done because a person has a life-threatening illness. To provide a safe environment for immune-compromised patients and health care workers severe visitation restrictions were implemented. How scary, lonely, and emotionally challenging it was for a patient to spend 2, 3, 4 and sometimes more weeks in hospital without the love and support of their family, and friends at their bedside. Our staff was proactive in trying to enhance a patient’s emotional well-being yet the support, strength, reassurance and care provided from loved ones is irreplaceable.” 

A study by the Renmin Hospital of Wuhan University about the psychological pressures of cancer patients is similar to Lowsky’s account. This study done in China, where the coronavirus originated, found that 51.2% of patients were suffering from depression, 62.8% with anxiety, 51.2% with insomnia, and 35.5% with PTSD amidst the pandemic. Aside from worries about the pandemic and the risks of their own treatments and surgeries, lack of visitation was very disheartening for patients and took a toll on their emotional wellness.

However, there is a light at the end of the tunnel — or at the end of the hospital hall. While there may have been psychological strains regarding major treatments and surgeries, increased virtual substitutions for physical meetings decreased physical strain for patients. James Chang MD of Kaiser Hospital’s Hematology/Oncology Department accounted for how the increase in virtual technology has eased on patients.

“Due to COVID-19, we increased the number of virtual visits and limited in-person clinic ones to protect the patients and staff,” Chang said. “At first, there was some hesitation with using new technology but our patients quickly embraced the ease of seeing their providers virtually. Appointments that might have taken an entire morning with commuting and parking might now only take five to 10 minutes, making it easier on our cancer patients.”

McKinsey & Company reported how 84% of physicians offered virtual telehealth options and 57% preferred to continue offering virtual care. Furthermore, in that same survey consisting of over 2,000 U.S. adults, it was discovered that almost 67% of participants favor usage of telehealth appointments in the future. McKinsey & Company also shined how telehealth service usage is stabilizing at 38 times higher compared to the pre-COVID era.

Although COVID exacerbated the emotional turmoil and physical strain of those plagued with cancer, the exceptional performance of medical teams worldwide enlightened us on key lessons for ensuring comfortable and efficient cancer care in the future. The future of telehealth services and technological advancement is flourishing, and everyone, especially cancer patients, learned the importance of close proximity with loved ones.