My colleague Paul Howell recently wrote an excellent post about prostate cancer mortality rates, specifically how they are predicted to fall by nearly 10% this year. This is very welcome news, although no one really knows the true impact of COVID-19 on patients waiting for treatment.
Indeed, Cancer Research UK says we are now in “unchartered waters for delivering cancer care” because of the ongoing coronavirus pandemic. The problem is that cancer patients have a significantly higher risk of severe illness when infected with COVID-19. This inevitably puts them, in turn, at higher risk of requiring intensive care – particularly if they have recently had surgery or chemotherapy.
We’ve already seen more than 2 million NHS operations cancelled as the health service battles to fight the COVID-19 outbreak. But these are predominantly non-emergency procedures.
Oncologists, however, find themselves between a rock and a hard place. Do they under treat their cancer patients and reduce the chances of them contracting SARS-CoV-2 while in hospital, or do they continue with their treatment regimes as before, but possibly put vulnerable patients at risk?
Doctors have warned that cancer treatment has become a postcode lottery, with many patients not getting the vital care they need at the moment because of the impact the coronavirus outbreak is having. In fact, even some patients classed as category one and two priority are not undergoing chemotherapy right now.
Despite NHS England stating that cancer services should continue to deliver care during the ongoing pandemic, it has also called for “local solutions to continue the proper management of these cancer services while protecting resources for the response to coronavirus”.
Prof Karol Sikora, the chief medical officer at Rutherford Health, which operates oncology centres, said the guidelines were sensible, but being “implemented inconsistently” around the country.
Perhaps the saddest consequence right now is that patients with curable cancers are missing appointments and, therefore, treatment. As Paul pointed out in his article, prostate cancer mortality rates have been falling. This is fantastic news, especially when you consider that prostate cancer is the most common form in men in the UK. But what will the impact of COVID-19 be on this trend?
I personally have a lovely neighbour in my village that was diagnosed early with prostate cancer in December 2019. However, his planned operation wasn’t scheduled until March 2020, which was far too long a wait. Following this, the appointment was cancelled again and rescheduled for early April. Now, due to the pandemic, the operation has been cancelled until further notice. It is very worrying that more people like my neighbour are in a similar situation and it may be a while before anyone really knows the impact the delay in treatment will have.
Fortunately, there have been talks between NHS trusts and authorities and independent health care providers over how the latter can help by providing private beds for the use of patients suffering from COVID-19. Hopefully, this will help alleviate some of the pressure being placed on the NHS and possibly lead to cancer patients continuing the treatment they so vitally need.