This Friday, February 4, on the occasion of World Cancer Day, we are interested in the impact of the coronavirus epidemic on these patients. Between screening delays, postponements of operations and late treatment, the backlash is difficult to negotiate.
Since the detection of the first cases in France at the beginning of 2020, the Covid has taken the lives of more than 130,000 of our fellow citizens. But how many indirect victims died because of this epidemic? End of 2020, a study brought to light by Unicancer estimated that the health crisis could cause “1000 to 6000 additional cancer deaths”.
In September 2021, l’Inserm explained that “successive confinements have limited access to care and have led to a significant reduction in screening, diagnosis and referral to hospitals of cancer patients”, without giving figures. More concretely, the league against cancer drew up an alarming observation, estimating that “nearly 93,000 cancer diagnoses could not be established in 2020”, as a “direct consequence of Covid”. An observation that is therefore widely shared.
A significant delay in screenings
At the microphone of BFMTV, Christophe Swiatek, Auvergne-Rhône-Alpes ambassador for the Cerhom association for cancers specifically affecting men, evokes a “very hard impact from the first confinement”. He noted a “marked slowdown in prostate cancer screening”.
For fear of catching the virus or obstructing health services, patients preferred to postpone these essential deadlines at the scale of the health system. For example, for breast cancer, the screening participation rate fell to a historic low in 2020, at 42.8% of eligible people.
Unfortunately, these screening delays are often synonymous with much more complex care, even for tumors that are usually treated very well. For prostate cancer, for example, “the importance of early diagnosis” is not negligible according to ANAMACaP (National Association of Prostate Cancer Patients). The association indeed recalls that healing is much more difficult when “men feel symptoms”.
Totally disrupted support
“As long as we have not started treatment, in terms of cancer, tumor lesions, tumors can increase”, underlines Maya Gutierez, medical oncologist and doctor at AP-HP, at BFMTV. Unsurprisingly, management will therefore be much more complex once the tumor has spread.
An example of a direct consequence mentioned by the oncologist is the mastectomy of a person with breast cancer, ie the partial or total removal of the breast. She explains that with a less late diagnosis, “we could keep the breast while operating”.
But the delays are also felt when taking care of the sick. “There are interventions that had to be postponed, there were also delays in the treatment of patients who, for example, could not have their immunotherapy session”, adds Maya Gutierez.
Deprogramming that weighs on patient morale
Hospital deprogramming which may have impacted cancer care pathways was observed almost exclusively during the first epidemic wave, according to the National Cancer Institute. However, if these staggered interventions “do not put the lives of patients at stake”, according to the president of Unicancer Jean-Yves Blay, who spoke at the end of January with our colleagues from The cross, they “are a source of suffering” for patients.
“This is the case of patients waiting for breast reconstruction, a wait that is often extremely difficult to live with and very destabilizing”, he specifies.
A call for screening
From now on, the nature of the problem has changed according to Maya Gutierrez: “Here clearly what impacts us is the lack of caregivers. I have been in a home hospitalization service for a year, and out of 11 doctors we have three positions vacant.” Resignations, fatigue accumulated during two years of pandemic or even Covid-positive caregivers do indeed pose staffing problems that the public hospital is struggling to solve.
To limit the impact of Covid on cancer treatment, the WHO and doctors are calling on the population to get tested. The World Health Organization even mentions a risk of “cancer epidemic“to provoke a stir on the part of the population.
Daniel Nizri, president of the League against cancer, also recalled this week in The world that “the best way to cure cancer is still not to develop it”. He indicated in passing that “the main environmental factors are well known: tobacco, alcohol, diet, physical inactivity, but also air quality.” With “nearly 400,000 new cases and more than 157,000 deaths each year, cancer remains the leading cause of death in France”, also recalled Unicancer in a statement released this week.