The Impact of the Coronavirus on Cancer Care

As the coronavirus pandemic continues to overwhelm health care systems in the UK, patients suffering from other illnesses are struggling to find treatment. In particular, the lockdown announced by the UK government on March 23 has drastically impacted cancer care—in terms of diagnoses, urgent referrals, and treatment.

The coronavirus has slowed down progress at every stage of the cancer treatment pathway. This has led to suggestions that cancer could be the UK’s “next big crisis.”

The State of Cancer Care in the UK

According to the World Health Organisation (WHO), cancer is responsible for 1 in every 6 deaths—making it the world’s second leading cause of death. Despite considerable improvements in prevention, research shows that the number of cancer diagnoses in the UK is set to grow in the coming years. Cancer Research UK estimates that 50% of people born within the last 6 decades are at risk of getting the disease.

But regardless, cancer care has been improving steadily—drawing on greater public awareness, more investment, better reporting, and effective national strategies. Even so, a population-based study appearing in The Lancet Oncology shows that the cancer survival rates in the UK are lower than other OECD countries.

The COVID-19 pandemic threatens to disrupt the progress made. In its directives on managing cancer patients during the pandemic, the NHS notes that “We should seek the best local solutions to continue the proper management of these cancer services while protecting resources for the response to coronavirus.” While this is sensible, Prof Karol Sikora from Rutherford Health told The Guardian that the directive is often implemented inconsistently on the ground—with some hospitals suspending cancer treatment altogether for a few weeks.

This disruption in the level of cancer treatment, in addition to a drastic drop in referrals and diagnoses, casts a bleak outlook on cancer care in the UK.

Delayed Referrals and Diagnosis

While observing social distancing and self-isolation are an important facet of managing the pandemic, it also means that fewer people are coming forward with suspected signs of cancer—citing risks of infection and the stretched capacity of health facilities. As of April, the number of new referrals had reduced by an average of 70%. This seems to negate the decade-long public awareness efforts made to encourage people to get tested as soon as possible.

The reduced rate of referrals is a major cause for concern since early diagnosis has been shown to be an important determinant of successful cancer treatment. According to researchers from the Institute of Cancer Research, London:

Any delay in cancer treatment has the real risk of patients’ tumours progressing from being curable (with near-normal life expectancy) to becoming non-curable (with very reduced life expectancy).

They went on to suggest a need for clearer protocols to address the diagnostic backlog that could put overwhelming pressure on the healthcare system. A government campaign encouraging people with symptoms of serious non-coronavirus conditions to seek medical care is perhaps a step in the right direction.

Disrupted Cancer Treatment

Since the coronavirus started sweeping across the globe, cancer patients were identified as a population subgroup at an increased risk of infection and death.

A recent study by authors affiliated to the University College London estimates that an extra 18,000 cancer patients could die due to the reluctance to seek NHS care and suspension of treatments. This is a 20% increase in the estimated annual mortality rates of 89,576. An additional 6,270 newly diagnosed could also lose their lives within a year due to the disruptions caused by the pandemic.

Another study by DATA-CAN, the Health Care Research Hub for Cancer claims that extra cancer deaths in the UK due to the coronavirus could rise to 35,000 in the worst-case scenario. The reasons for this worrying statistic revolve around the disruption of treatment in hospitals. One oncologist to the BBC that:

The guidelines for radiotherapy and Covid-19 advised people to delay and avoid radiotherapy in some circumstances…the machines are here but we haven’t been allowed to switch them on properly.”

But new research shows that the susceptibility of cancer patients to COVID-19 is not uniform across the board. In particular, patients with myeloma, lymphoma, and leukaemia are at a greater risk of infection and death. The findings also showed that people with breast cancer, prostate cancer, and even lung cancer were under-represented.

Treatment plans are also greatly affected. For example, most medical facilities are operating at 50% capacity—meaning they cannot offer the needed level of cancer care. Additionally, there’s the concern over treatments that make patients more vulnerable to the coronavirus. With this in mind, NHS England recently facilitated the use of “COVID-friendly” drugs and cancer treatments that have fewer side-effects, reduced damage to the immune system, and can be administered from home.

In a statement, Sir Simon Stevens—CEO of the NHS—noted that:

Since the first case of COVID in England six months ago, NHS staff have fast-tracked new, innovative ways of working so that other services, including A&E, cancer and maternity could continue safely for patients and it is thanks to these incredible efforts that 65,000 people could start treatment for cancer during the pandemic.”

The loss of funding is another major blow to the UK’s cancer-fighting efforts. A large portion of cancer research and medical research is funded by charities—which also provide financial aid and support to patients.

Major Concerns and Increased Anxiety

Understandably, a lot of people are confused and concerned about the impact of the coronavirus on cancer services. Both patients and health care providers face psychological and emotional challenges that cannot be underestimated.

For those with possible signs and symptoms of cancer, the fear of COVID-19 infection may be holding them back from seeking diagnostic services. In addition to reduced survival rates, delayed diagnosis risks overstretching the health care system when services resume due to an influx of appointment requests.

Patients on cancer treatment are increasingly anxious and concerned that interrupting their treatment plan could affect its efficacy. The initiatives advocating for the use of oral chemotherapy treatment options at home also put immense pressure on the users. People who already feel vulnerable due to their illness may also face significant challenges due to a lack of support—facilitated by lockdown measures.

Doctors and other medical practitioners are not sparred either. Despite the lack of good evidence, medical experts are forced to make difficult treatment decisions that could change a  patient’s life. They also face major concerns over their own safety while working on the frontline to help with cancer care.

Developing New Approaches to Treatment

As highlighted earlier, the main challenges facing the UK health care system revolve around the drastic drop in the number of urgently referred cases and the inadequate capacity of hospitals to effectively treat cancer. Regarding the latter, the NHS has facilitated the setup of hubs that are designed to offer medical care—while minimizing the risk of COVID-19.

On a more optimistic side, the COVID-19 crisis can be seen as a catalyst to innovations and adoption of new approaches to treatment. New technologies have emerged out of the need to help manage cancer care at these trying times. Health tech that would have ordinarily taken years to develop is being rolled out in mere months.

For example, the use of telehealth as a solution for healthcare has skyrocketed. Cancer doctors and data scientists from the University of Michigan have also developed a web-based mobile application that’s designed to calculate the risk of delayed cancer care.

The OnCOVID app assesses the risk posed by the coronavirus versus the long-term risk of postponing care. According to Holly Hartman, the lead researcher, “each time a cancer patient goes to the hospital to receive care, they’re also putting themselves at higher risk of contracting COVID-19. So, it’s essential to balance the need for treatment for this very serious disease and the extra risk that COVID-19 poses for cancer patients.”

The pandemic has sped up the adoption of simplified and more targeted therapies—including a new life-saving type of radiotherapy and chemotherapy treatment. It has also resulted in partnerships with private health facilities. As highlighted in the latest NHS Confederation report, the profound impact of the coronavirus necessitates a rethinking or a reset of the UK’s health care system.

Effective Cancer Care

The coronavirus has undoubtedly hindered the UK’s already lagging cancer-fighting efforts. The current state of affairs regarding the significant drop in the number of urgent referrals and the suspension of treatments suggests the possibility of disappointing news and results going forward.

Governments and relevant bodies must come up with clear guidelines to deal with COVID-19 while offering effective cancer care. This is the time when we should turn to technology as a way to bridge the gaps in the health care system. The faster we implement them the better the chance of saving more lives and avoiding the ‘ next big crisis.’

How to Claim Compensation For the Late Diagnosis of Cancer

Delays in cancer diagnosis can have a serious impact on your recovery from the disease.

If you are unsure if what happened to you was an act of medical negligence, contact our cancer misdiagnosis claims team who will take the time to listen with empathy and advise if you have a valid claim.

Devonshires Claims’ highly experienced cancer misdiagnosis solicitors will support you through the whole process of obtaining compensation if you have experienced negligent care or treatment relating to cancer.  For more information or to start your free case evaluation, contact our experts today on 0333 577 9444, email cn@devonshires.co.uk or complete our online form.

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