The COVID-19 pandemic has altered lives in many ways, but one of the most potentially perilous is through the delay in diagnostic testing and treatment for cancers. A survey by the American Cancer Society Action Network found that half of the respondents had experienced changes, delays or disruptions in their care: Among those folks, 50% had changes to in-person provider visits and 20% in supportive services and imaging procedures to monitor tumor growth, and 8% said their treatment, including chemotherapy and immunotherapy, had been affected. That's backed up with another new report that found 50% of breast cancer patients have had their treatments postponed.
The head of the National Cancer Institute, Dr. Norman Sharpless recently pointed out that cancer care has declined in part because there is confusion about what elective treatment is. "It doesn't mean that it's not needed, just that it's not an emergency and doesn't need to be done today. But if we're talking about chemotherapy and surgery, we don't think they can be delayed for too long — maybe a week, but not for several months." Writing an editorial in the June 19 issue of Science, he added, "There can be no doubt that the COVID-19 pandemic is causing delayed diagnosis and suboptimal care for people with cancer."
Where we're headed: As a result of the delays in diagnosis and treatment, a model created by the NCI predicts there will be more than 10,000 excess deaths from colorectal and breast cancer over the next decade — deaths that could have been prevented. And that's just for those two most common forms of the disease. Excess deaths are also likely to occur in other forms of cancer.
As Dr. Amy McNally, chair of The US Oncology Network's Surgery Advisory Council, says: "When the dust from the COVID-19 pandemic settles, we will almost certainly see a silent and underrepresented casualty of the crisis: Patients with cancer whose diagnosis, access to care, and treatment have been negatively affected due to the pandemic response."
Questions to ask yourself and your doctor: What should you do about getting your regularly scheduled colonoscopy or mammogram — or any other cancer screening test? Can you safely delay or modify treatment if you've been diagnosed with cancer? What are the risks of exposure to COVID-19 because of interaction with the health care system versus benefits of timely and thorough cancer treatment?
Answers to those questions are highly individualized depending on your age, overall health and known risks for cancer or stage of diagnosed cancer. What's known about the flexibility of any given treatment approach also must be considered, as must the prevalence of COVID-19 in your area and the amount of cases being treated in local hospitals.
That means we cannot tell you what you should do, but we can offer guidance so you and your doctors can make the smartest decisions possible. As Dr. Sharpless wrote in his editorial: "Ignoring cancer for too long is an untenable choice and may turn one public health crisis into another. If we act now, we can make up for lost time."
Three smart moves:
1. Ask the doctor who is postponing your care to explain specifically what the known risks and benefits of the delay are. If that information isn't provided or seems insufficient, get a second opinion, advises the Mayo Clinic.
2. Request a specific timetable for providing you with needed care. "Wait and see" is not an answer.
3. Together, you and your doctor might use a remarkable app from Michigan Medicine-University of Michigan that's called OncCOVID. It employs all available data to create individually tailored "integrated survival estimates from immediate versus delayed cancer treatment." It is available at http://onccovid.med.umich.edu.
If you stick up for your health, you and your care team can determine the best way to provide you with cancer screening and/or treatment that offers the optimal outcome.
Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer Emeritus at Cleveland Clinic. To live your healthiest, tune into "The Dr. Oz Show" or visit sharecare.com.
(c)2020 Michael Roizen, M.D. and Mehmet Oz, M.D.
King Features Syndicate