Physician surveys and anecdotal reports suggest dramatic declines in cancer patients seeking medical care since the coronavirus pandemic began.
A July 2020 study in the journal JCO Clinical Cancer Informatics addressed this issue. It’s the largest study to date to measure normal cancer care activities in the midst of the pandemic.
It’s a sobering picture…
Senior author of the study, Christopher McNair, PhD, and his team searched a database of 20 healthcare organizations. The database contains information on 28 million U.S. patients, including e-medical records detailing diagnoses, procedures, lab tests, and patient demographics.
They compared data from January through April of 2019 with data from the same four months in 2020. The found a shocking change in cancer care.
Large drop in demand for cancer services
Professor McNair’s team reported a precipitous decline in patient care for cancer-related diagnoses and treatments. This included a 50 percent drop in visits for patients with existing malignancy and a 65 percent drop in visits for patients with new incidence of malignancy.
There was also a steep drop in the United Kingdom, though those findings were from a single hospital.
Prof. McNair and his team also broke down the decreases in patients seeking medical treatment by type of cancer. The greatest decreases were for patients with:
- Melanoma (-51.8 percent)
- Prostate cancer (-49.1 percent)
- Breast cancer (-47.7 percent)
- Colorectal cancer (-39.9 percent)
- Hematological (blood) cancers (-39.1 percent)
Prof. McNair was stunned by the magnitude of the decrease, saying, “While it is not surprising that the pandemic has had a significant impact on patients seeking care… the results have important implications for future cancer patients and the potential burden on hospitals moving forward.”
But the problem doesn’t only lie with cancer patients avoiding treatment and medical services. Cancer patients who do try to receive care reported delays.
Breast cancer patients forced to wait for care
Researchers surveyed 609 breast cancer survivors about their medical care. Almost half, 44 percent, reported experiencing delays in routine care during the pandemic.
79 percent reported experiencing a delay in routine follow-up appointments, followed by 65 percent experiencing a delay in breast cancer reconstruction surgery.
Third on the list, 60 percent of patients reported a delay in receiving diagnostic imaging such as mammograms, followed by 50 percent experiencing a delay in receiving lab tests.
In addition, about 30 percent of breast cancer survivors noted delays in hospital or clinic-based therapies including infusion therapies (32 percent), radiation (30 percent), and surgery (26 percent).
The researchers expected ethnicity to influence the delay in care, with black women or women of color experiencing greater delays than Caucasian women. This turned out to be false. Instead, their research revealed delays across the board, regardless of patients’ ethnicity.
But there was one demographic difference.
Younger women experienced more delays in receiving breast cancer care than older women. The authors surmise that it has to do with certain types of breast cancer that skew younger and might not be considered as big a risk as other types that attack older women.
They also noted that doctors had modified some cancer treatments rather than cancelling them altogether. For example, the frequency of hormone therapy visits decreased, presumably to reduce the number of clinic visits.
“If I’m only using natural
treatments, why does this matter?”
You might be asking why this story matters, especially since we advocate for alternative cancer treatments. But the diagnostic and screening tests used by alternative practitioners are largely the same as those used by conventional medicine. You’re still enmeshed in the system.
And whether you’re seeking conventional or alternative therapy, the pandemic can keep you from seeking professional help when you need it. For example:
- Many fear going to a doctor, clinic, or hospital because of COVID-19. To be sure, the virus is a significant threat for certain high-risk populations (including cancer patients)… but remember that cancer is still far more deadly than COVID-19.
- If you start experiencing symptoms of cancer, you owe it to yourself to get checked out sooner rather than later. Same goes if you start experiencing inexplicable new symptoms. Some cancers are very aggressive, and an early diagnosis allows you a greater variety of treatment options, including natural ones – and a much higher chance of survival.
- For a time, it was almost impossible to schedule an appointment for any reason deemed “non-essential.” Don’t forget about your intentions now that things are opening back up. Follow up on what you were thinking of doing then.
- This is as good a time as any to think about cancer prevention, including healthy home-cooked foods, exercise, sleep, lowering stress, and other health strategies.
If you started cooking and eating at home during the pandemic, why not continue? You’ve already been doing it for five months – you’re almost an expert now.☺
Cancer screening plummets
On the screening front, Prof. McNair’s team found that mammograms declined 89.2 percent in April 2020, versus April 2019. Colorectal cancer screenings dropped by 84.5 percent during that same period.
It’s important to point out that these decreases do make sense when you consider the ban on “non-essential” medical services in nearly every state during that time period.
The screening delay could be a mixed bag since many routine cancer screenings can pose their own risks. For example, PSA tests for men are unreliable and lead to overtreatment. I’m also not a fan of frequent mammograms to look for breast cancer, as long-time readers know.
Mammography often leads to false positives, overtreatment, and emotional trauma. Many studies show that mammograms do not save lives, and may do more harm than good.
In 2011, the Cochrane Database of Systemic Reviews conducted a meta-analysis on mammography. It revealed that mammography cancer screening led to 30 percent overdiagnosis and overtreatment of breast cancer. This equates to an absolute risk increase for breast cancer of 0.5 percent. Meaning that you might want to rethink the standard mammogram advice.1That’s why we often advise women to get a thermogram instead.
Colonoscopies likewise have a bad reputation. They can expose you to pathogens from dirty equipment and perforation of the colon wall — both of which are more common than you might think, and can even be deadly. To say nothing of risks related to pain, anesthesia, dysbiosis, and more. Add to that, the tests are frequently wrong, either missing existing disease, or yielding false positives for people who are disease-free.
International experts now recommend routine colonoscopies only if you have a three percent or greater chance of developing a growth over the next 15 years.2 Otherwise, turns out the risks are greater than the reward.
One workaround is to opt for a fecal immunochemical test (FIC) or sigmoidoscopy instead of colonoscopy to detect precancerous growths.
Whether you plan to get conventional or alternative diagnoses or treatments for cancer, it pays to be informed about risk versus rewards. Then make the necessary lifestyle adjustments to gain, maintain, or regain your health.