What is the Impact of COVID-19 on CANCER? A Surgeon’s View…

2020 has certainly been unprecedented for all of us. Every aspect of our lives has been affected. The country’s economy has taken a knock, our tourism and entertainment industry has suffered. We are still living through the punch in the face called CORONA.

Anyone who ventured to our malls, offices, schools and hospitals over the last few months described these desolate spaces as ghost towns, most people were terrified to leave their homes.

It would’ve taken a real medical emergency to coax the general population into a healthcare facility. 

Cancer is Perceived as Less Urgent

The problem with cancer and other chronic life-threatening diseases is that they don’t usually present as outright emergencies.

Cancers are usually diagnosed in the elective out-patient setting, diagnostic scans and biopsies are booked, surgery for cancers are planned semi-elective procedures, adjuvant therapies for advanced cancers are usually administered in day-wards. 

Another problem with cancers and chronic diseases is they do not wait for COVID-19 before they attack. They don’t slow down their evolution in a patient’s body because of this new virus that is captivating the world’s attention. 

Now that we are on level one restrictions I have been confronted with a few patients who are seeking surgical help for advanced stage cancer.

The stories are all similar- the patient noticed a lump earlier this year, then lockdown happened, they were preoccupied with the instability of their lives during COVID-19 and they ignored growing symptoms.

Delayed Diagnosis can be Avoided

Now that it is safe to venture into hospitals they decide to get the problem checked out, only to be hit with the devastating news that what they put off as just a small niggling problem is actually advanced stage cancer. 

Delayed presentation due to social and societal circumstances is not a new concept to African physicians. What is new to us is a case of delayed presentation in a patient who lives a few minutes away from a well-equipped private hospital, a patient who has an all-inclusive medical aid, a patient who has been exposed to cancer education and screening campaigns.

This is the unexpected rebound effect of the CORONAVIRUS on our cancer statistics, which I fear we have yet to fully realize.

Will cancer mortality rates go up?

Will we see a delayed spike in new cancer cases?

Will our cancer prevention and screening strategies digress?

The reality is we won’t realize the full impact of COVID-19 on cancer in South Africa for a few years.