by Mona Jhaveri - December 13, 2021

The COVID-19 pandemic is a global health crisis of a magnitude and severity not seen in at least a century. It has caused the near-collapse of healthcare systems worldwide, resulting in a massive disruption to patient care of all kinds.

As of November 2021, over 256 million people worldwide have been infected by the novel coronavirus. Over 5 million have died from the COVID-19 disease caused by this virus. With such staggering numbers, it is no wonder that healthcare institutions are experiencing a disruption. The sheer number of people wrestling with health care needs is unprecedented in the modern history of humanity.

This blog post will explore the impact of the COVID pandemic on cancer care and how healthcare communities worldwide are reacting to them.

COVID-19 Regulations

The cancer care disruption directly results from the regulations put in place to slow down the spread of the novel coronavirus. The virus spreads mainly through droplets and aerosols exhaled or otherwise emitted from the respiratory system through the nose or mouth. When people breathe, talk, sneeze, or cough close to each other, they can be infected with COVID-19.

Due to these facts, some of the established new regulations are meant to limit face-to-face interactions among people and prevent gatherings of large crowds. The regulations include:

  • Lockdowns
  • Quarantines
  • Social distancing
  • Mandatory face masks
  • School closings, work closings
  • Travel bans and border restrictions, and more

To make matters worse, global healthcare systems were not prepared enough (or at all) for a pandemic of this type and scale. The sudden need for healthcare workers, respirators, and other life-saving equipment to battle COVID-19 has placed a tremendous strain on already struggling healthcare institutions.

Even now, almost two years since the start of the COVID-19 spread and with a variety of COVID-19 vaccines to choose from, we still haven’t seen the return of a pre-pandemic level of patient care, especially cancer care.

Here is how the pandemic impacted the cancer diagnosis and treatment lifecycle around the world.

Cancer Screening Limitations

Since it is relatively easy for the virus to spread within hospitals and other institutions with large numbers of patients, these institutions have tried limiting patient contact and their COVID exposure as much as possible.

Screening tests for cancers have been delayed or even temporarily paused in many countries. For example, the Australian government temporarily suspended cancer screening programs, such as breast cancer screening. According to research, in the United States, at the peak of the pandemic in April 2020, there was a significant reduction of cancer screenings as follows:

  • Breast cancer by 85%
  • Colon cancer by 75%
  • Prostate cancer by 74%
  • Lung cancer by 56%

These percentages are in comparison to the baseline numbers of the same time the previous year (2019).

In England, urgent referrals for suspected cancer were down by 16% compared to the previous year.

The Brazilian Society of Surgical Oncology declared that, in the first semester of 2020, mammogram rates dropped by 47%, and colorectal cancer diagnoses also fell by 46%.

The suspension of these programs has caused a tremendous backlog in the diagnosis of cancers, especially when it comes to more difficult-to-diagnose forms. Overall, a prolonged delay in cancer diagnosis and treatment leads to many problems such as increased tumor size, increased metastasis rates, and poorer health outcomes.

Due to cancer screening delays and suspensions during the pandemic, we will likely see an increase in the number of avoidable cancer deaths in the future.

Cancer Treatment Limitations

Healthcare systems worldwide were forced to reroute their resources – equipment and staff – to combat the pandemic, and cancer treatment became almost an afterthought. In Iran, there was a prevailing sentiment among pediatric cancer patients and their families that COVID-19 prevention was taking precedence over cancer care.

Aside from restricted screenings and tests, health institutions have also been forced to limit access to treatments of all kinds. In May 2020, in the United States, 79% of patients in active cancer treatment reported a delay in their health care. All forms of treatments were postponed:

  • Surgeries, many of which were labeled as ‘elective surgery’
  • Chemotherapy
  • Radiation therapy, and more

In Mexico, at least 50% of cancer surgeries were postponed due to COVID-19.

Due to their delays in surgeries marked as ‘could wait’ in the height of the pandemic, Chilean healthcare providers now face a backlog of patients. “For cancer surgeries, we are now operating at roughly 50% more volume than we used to before the onset of the pandemic,” says Augusto Leon, MD, Professor of Surgery in Santiago.

There will be a long time before we see the return of cancer treatment capabilities that existed before the pandemic.

Fear of Infection

Another significant barrier in cancer care that has emerged in the pandemic is the fear of infection. Patients have been afraid to go into hospitals for cancer screenings and treatments, fearing they will contract the virus.

With thousands dying every day from COVID-19 in different parts of the world, it is not surprising that people avoid contact with hospitals. However, this fear of infection hinders the care that cancer patients need and deserve to survive their disease.

At the pandemic’s start, there were still many unknowns about the way and rate of COVID-19 transmission. Furthermore, it was quickly evident that vulnerable populations, such as the elderly, those with pre-existing conditions, and immunocompromised individuals were most at risk. This only added to the feelings of fear and anxiety that patients were already experiencing.

There is no telling how many cancer patients have skipped or postponed their treatment in fear of contracting COVID-19. However, it is estimated that the numbers are likely to be higher than we realize.

Cancer Clinical Trial Limitations

Cancer clinical research also suffered from the pandemic. In the first half of 2020, many cancer clinical trials were postponed as a result of COVID-19. The main goal was to reduce the chance of infection among trial participants and staff. At the same time, global medical research resources were diverted to COVID-19 trials instead to find a cure (or a vaccine) as soon as possible.

In Canada, ongoing cancer trials continued for patients already enrolled in them; great efforts were made to continue their treatment schedules as planned. However, the enrollment of new patients in open trials was suspended, as well as activation of any new cancer trials.

That being said, expedited emergency COVID-19 trials brought potentially revolutionary changes in the research landscape, such as more streamlined processes, pragmatic trials, international registries, and virtual care.

As of 2021, clinical cancer trials have mostly resumed as normal worldwide, and many cancer research institutions are back to full capacity.

Conclusion

There is no doubt that the COVID-19 pandemic will leave a lasting impact on humanity in more ways than one. Nations were not prepared for a crisis of this magnitude, and the world is still limping.

The immediate impact on cancer treatment was palpable: from screenings to treatments, patients have been forced to endure weeks and even months of delays as health institutions wrestled with the pandemic. Due to COVID-19 regulations, even cancer trials have been limited. Patients have had to skip potentially life-saving treatments, and research institutions are still recovering from the loss of invaluable research time.

The long-term effects of COVID-19 will be felt for years to come as people adjust their lives around this new reality. The loss of life and fear that has accompanied the pandemic will continue to influence health care practices.

What is important now is that cancer patients continue to receive the treatment they need. We must all work together, both nationally and internationally, to bring back the pre-pandemic level care.

Donate now to help fund cancer care. With new research and technologies, we can hope to see fewer deaths each year from this deadly disease.

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