Cancer Services in COVID-19: 40,000 Fewer People Start Treatment-Cancer Research UK

Since the beginning of the pandemic, the flow of numbers has been steadily progressing.

COVID-19 Number of cases. Number of hospitalizations. The number of people waiting for screening, testing or treatment. The number of cancer surgeries that have been postponed or canceled.

Each number reveals what many cancer patients have seen directly. The devastating impact of COVID-19 on cancer patients, healthcare capacity, and recovery efforts.

“Medical services throughout the UK have endeavored to ensure that the services function properly throughout the pandemic, a major challenge that could not have been achieved without the efforts and dedication of staff, especially when the number of COVID-19 cases declined. “We did,” said Jon Shelton, Senior Gun Intelligence Manager at Cancer Research UK.

However, the persistent turmoil caused by the pandemic throughout 2020 left a deep rift in cancer treatment, with 40,000 fewer people starting cancer treatment across the UK last year.

This figure focuses specifically on treatment, mainly due to a decrease in the number of people diagnosed with cancer in 2020. As Shelton explains, it’s a concern.

“The number of people diagnosed or started treatment for cancer each year in the UK is usually relatively predictable. Unless major changes are introduced, such as in a new screening program, significant changes are seen each year within the cancer site. No. ”According to Shelton, fluctuations can occur. For example, after being diagnosed with Stephen Fry and Bill Turnbull’s high-profile prostate cancer, there was an unusually large increase in about 10,000 prostate cases in 2018, but the overall figure is usually in the thousands each year. “So the 40,000 drop is huge.”

So where are the 40,000 people who were hoping to start cancer treatment but didn’t? The majority live in the community, live with the cancer without knowing it, and the tumor can grow and spread, so it needs to be diagnosed and treated as soon as possible.

This can pose challenges for healthcare services.

“How are medical services struggling to deal with before the pandemic now dealing with this influx of people? Most of those 40,000 are above those who are usually diagnosed in 2021. Because I still have to go through. “

Cancer diagnosis

Written earlier About the effect of COVID-19 on the early cancer diagnosis of the pandemic.

The number of people going to the GP after noticing any changes in the body at the beginning of the first blockade has dropped dramatically.

After a plunge at the beginning of the pandemic, urgent cancer referrals increased throughout the year, reaching pre-COVID-19 levels in England and Wales by the fall. However, the recovery was not entirely the same, so there was still work to be done. The number of urgent referrals with suspected lung cancer remains the most affected nationwide, followed by suspicion of urinary cancers such as prostate cancer and kidney cancer.

Suspected referrals for urgent cancer are only part of the picture, and usually two in five people are diagnosed with cancer by this route. However, these are good indicators of the number of people complaining of symptoms and the status of cancer services across the UK, along with the numbers that examined the tests used to diagnose cancer when someone was referred. ..

Most of the diagnostic test numbers are not cancer-specific. However, by monitoring commonly used tests for diagnosing cancer, such as endoscopy, CT scans, ultrasound, and MRI, how many people are secondary to how cancer services are performed. You can see if you are referred to medical care.

Again, it’s a complicated situation. Endoscopy services are particularly affected by pandemics, with about 600,000 fewer endoscopy performed in the UK between March and November, and the number of endoscopy performed in November. I haven’t returned to the pre-pandemic level yet.

Also, the longer it takes to recover, the larger the backlog. The number of patients awaiting endoscopy reached 200,000 in the UK in November 2020, an increase of 49% over the previous year. Similar photos can be seen in Northern Ireland, Wales and Scotland, with 12,000 more people on the endoscopy waiting list in September compared to the previous year.

And that’s before the second wave of COVID-19 peaked in the UK. The latest data will take us in November, when regulations in the UK countries began to tighten as the number of cases of COVID-19 increased. Since then, the pressure on medical services has only increased. The concern is that this can lead to an even greater waiting list for endoscopy.

“There are concerns about the waiting list for endoscopy and what delay means for patients with cancer and tumor growth. Using tests such as the Fecal Immunochemical Test (FIT), which There is great interest in seeing if a patient needs to be seen most urgently, but not all people with cancer have good FIT results. It is important to pay attention to the risks and see the people on the waiting list as soon as possible. “

Impact on cancer treatment

There is less timely data on cancer treatment. But the biggest confusion was cancer surgery. This is true at the beginning of the pandemic and also in the last few weeks.
The last few weeks have suggested that hospitals in London and eastern England have had the greatest impact, but pandemic tensions are felt throughout the UK.

Cancer surgery has been the most affected for many reasons, but the biggest one is the intensive care unit. “For certain cancer surgeries, surgery cannot be started unless the intensive care unit is guaranteed to be available,” says Shelton. “Therefore, hospitals that are undercapacity due to the number of COVID-19 cases may delay these major surgeries.”

Another big thing is the number of staff. “Surgery involves a significant team of surgeons, as well as nurses, anesthesiologists and support staff. And people are not infected with COVID-19, are self-isolated, or have COVID. -19 It is difficult if the number of staff is small due to relocation to the ward. “

Other cancer treatments (eg, radiation therapy or chemotherapy) do not require as much staff to deliver. And overall, these services continue to run during the second wave.

Government and healthcare service leaders have plans to ensure that critical cancer surgery is underway. In the United Kingdom, the NHS England has told hospitals to give cancer the same priority as the coronavirus. Healthcare services are also looking to independent departments for additional capabilities.Scotland has Announcement of partnership There are several independent hospitals in Scotland that help with some surgery. A similar arrangement has also been made in the United Kingdom, with NHS England instructing hospital confidence to use up to 100% of the capacity of independent hospitals as needed.

In addition to allowing important cancer services to continue, the additional benefit of using a separate hospital is the lack of A & E or emergency rooms. This allows you to limit the spread of COVID-19 in hospitals. However, if you are not careful, the types of operations you can perform are also limited.

“It’s primarily surgery that is unlikely to require intensive care,” says Shelton. “Many breast and prostate cancer surgeries fall into this category, while more invasive or brain surgery, including opening the chest to reach the lungs, is performed where intensive care is available. need to do it.”

Another concern is that independent hospitals are not evenly distributed across the country and are concentrated in southern England, which can lead to service inequality.

Another option used by many cancer professionals is to provide people with alternative treatment options-for example, radiation therapy before surgery or instead of chemotherapy.

A Study by Professor Eva Morris Oxford University has shown the impact of COVID-19 on cancer treatment in patients with intestinal cancer. This not only confirmed that the number of patients with intestinal cancer undergoing surgery from April 2020 has decreased significantly, but also that the proportion of patients who have undergone minimally invasive laparoscopic surgery with excellent patient recovery is low. Shown. For rectal cancer, which is a type of colorectal cancer, the use of radiation therapy before surgery has increased significantly, and as a result of COVID-19, the treatment methods that patients receive have changed.

However, while these decisions were made in the best interests of the patient, normal service should be resumed as soon as possible. “For solid tumors, surgery is often the best way to treat someone’s cancer, so it’s imperative to get this treatment at the best time for the patient.”

Building better cancer services

Even now, ten months after the start of the pandemic in the UK, things are changing every day. But things have progressed. The COVID-19 vaccination program has been launched and more than 10% of the UK has been vaccinated at least once. Cases of COVID-19 and hospitalization are also decreasing.

Last year’s figures also show that cancer services can be restored thanks to the dedication of healthcare staff and the work of healthcare planners in all four UK countries. But there is still a lot to do.

It’s time to not only rebuild cancer services, but make them world-class.

Governments across the UK have the bold ambition to improve the survival rate of cancer in one in two of us diagnosed with the disease. We must return as soon as possible to promote a faster and earlier diagnosis of cancer at the earliest stages of survival. That way, everyone can get the cancer treatment that suits them.

Katie

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