Doctors worry that they will not be able to help every cancer patient who is diagnosed and treated late due to COVID-19

Around the end of June last year, Karen Townsend started experiencing abdominal pain.

At that time, she could only make phone appointments with her family doctor in London, Ontario. He suspected that she might have irritable bowel syndrome (IBS), so he prescribed medicine and gave her a special diet.

When her symptoms did not relieve, her doctor ordered an ultrasound examination. But the test is too late. Townsend felt a lump in her abdomen, and her husband insisted that she go to the emergency care center immediately, where a large lump was found during testing, which was later determined to be stage 2 ovarian cancer.

“This is absolutely devastating,” she told CBC radio host Dr. Brian Goldman White coat, black art.

Townsend said that when she asked the emergency care doctor what would happen next, “he said,’Karen, we run as fast as possible.'”

Karen Townsend was diagnosed with stage 2 ovarian cancer a few months after the phone appointment, and her doctor said she was likely to have irritable bowel syndrome. (Submitted by Karen Townsend)

When she received a definite diagnosis, about two months had passed since Townsend first asked for help.

As Canada begins to get rid of the third wave of the COVID-19 pandemic, experts working with cancer patients said that they are worried that they will not be able to help all people whose serious cancers are undetected or diagnosed late because of the crisis.

There is a need to change the way that patient care is managed to improve capacity and treat as many people as possible, including extending operating room time and continuing full participation by medical staff who are tired of COVID, the doctor said. Tony Eskander, head and neck surgery oncologist at the Sunnybrook Health Sciences Center in Toronto.

The backlog is expected to take years to resolve

Although Townsend was able to undergo surgery only a few weeks later, followed by chemotherapy and radiotherapy, she said she wanted to know if her cancer could be detected earlier if she was able to accept an on-site appointment at first, and her abdomen might have been censored .

“Of course I think there is a delay in my diagnosis, you know, especially by going through the gate and having my primary care doctor help me through it.”

Townsend rang the bell at the London Regional Cancer Center to commemorate her completion of chemotherapy in January. (Submitted by Karen Townsend)

Through treatment, the five-year survival rate for Townsend cancer types and stages is about 70%.

Eskander said data on the number of patients with more advanced cancers due to the COVID-19 delay will be unavailable for a year or more.

But he told Goldman Sachs that among his colleagues in oncology, “there are many stories about patients who did not seek medical care because they were afraid of coming to the hospital to contract COVID,” or patients who could only receive virtual care.

Escander said, therefore, doctors are seeing patients with more advanced cancers.

Although there is no estimate of the size of the nation’s surgical backlog, only in Quebec, The provincial government announced a plan last week to resolve its long waiting list. Approximately 145,000 people are waiting for surgery. The Minister of Health, Christian Dubé, stated that this number will not be reduced to 100,000 until March 2023.

“It broke my heart,” said Dr. Lucy Gilbert, director of gynecological oncology at the McGill University Health Center in Montreal.

Dr. Lucy Gilbert, director of the Department of Gynecological Oncology at McGill University Health Center in Montreal, said that surgeons met with hospital leaders to allocate limited operating room capacity to the most urgently needed patients, calling the situation “shocking.” (Canadian Broadcasting Corporation)

She said that surgeons met with hospital leaders to allocate limited operating room capacity to the most urgently needed patients. “I present my case, then the head and neck [surgeon] Say that this person has tongue cancer near obstruction, and then the vascular surgeon said, you know, this person may lose a leg. “

The Ontario Medical Association said last week that the pandemic has left An estimated backlog of 15.9 million operations, diagnostic tests, screenings and other medical treatments program In the province. “We are talking about recovery in a few years, not weeks or months,” Escander said.

Once the COVID-19 crisis is alleviated enough to release more resources, this work will not only need to deal with the current backlog of surgery, but also need to identify patients who are currently ignored due to the lack of CT scans and ultrasound examinations. He said, colonoscopy, breasts X-rays and Pap smears.

“I am really worried. I don’t know where these patients are. I hope the message is clear. They should go to the hospital for medical treatment. We are open for business. It is safe here.”

Once the pandemic is relieved enough to free up more resources, not only will the current backlog of surgeries need to be resolved, but patients who have been neglected due to the lack of access to procedures such as CT scans and mammograms will also need to be identified, one doctor said.

Recommended for follow-up care outside the main center

Eskander presented ideas to the federal government to improve the efficiency of cancer care Parliamentary Health Research Caucus in May.

One of the changes he hopes to see that will help resolve the backlog related to COVID is the establishment of a place outside the main cancer center, allowing patients to receive follow-up care closer to home, thereby freeing up the main cancer hospital. Ability to treat more patients.

“Many types of cancer… require very professional care in designated centers,” Escander said. “The problem is that patients often come to designated centers from far away, which is very suitable because that is where the expertise lies.”

In a colonoscopy, the doctor inserts a small camera into the patient’s large intestine and checks for possible tumors. This is another screening procedure that has been scaled back during the COVID-19 pandemic. (Jean-Paul Pelissier/Reuters)

But when they need to deal with issues such as pain management or feeding tube issues, it is better and more effective for patients to deal with these issues outside of a large cancer hospital, he said.

“I like to use the collision center analogy. So if you enter the fender bend in Sudbury, you won’t drive all the way to Toronto to the nearest collision center… You must go to the nearest collision center near Sudbury ’S collision center reported the accident.”

He said that this method provides free beds in a large cancer hospital for people who have been waiting for surgery.

Dr. Tony Eskander, an oral, throat, and neck surgical oncologist at the Sunnybrook Health Science Center in Toronto and Michael Garron Hospital, presented his ideas for improving the efficiency of cancer care to the federal government’s Parliamentary Health Research Caucus in May. (Brian Goldman/Canadian Broadcasting Corporation)

Eskander said he would also like to see referrals taken centrally and assigned to capable surgeons.

“What’s happening right now is that certain family doctors tend to refer to a very specific group of specialists, who then manage these patients, some of whom have longer waiting lists than others.”

Although Eskander said that he thinks he and many of his colleagues are willing to spend some time to resolve the backlog, there will be some human resource limitations-including the professionals needed to perform cancer screening tests and those needed to keep the operating room. Drive longer. There have been labor shortages in some of these areas before, and many health care workers have been exhausted due to the pandemic.

He said: “What I miss most is indeed our nursing colleagues. They have been hit hard during this pandemic. Their working hours and conditions are very challenging.”

Watch | The backlog forces patients to wait for surgery that can save their lives:

The COVID-19 pandemic has created a backlog of more than 250,000 surgeries in Ontario, including cancer surgeries, forcing patients to wait for surgeries that can save their lives. 2:03

The “important part” of COVID-19 in late diagnosis

Anna Whitely couldn’t help wondering if the situation would be different if COVID-19 did not change the care of her father, Mark French. Mark French passed away on April 1 after being diagnosed. Had pancreatic cancer for only five weeks.

Whiteley said that when he started feeling unwell last fall, the phone appointments he was able to receive didn’t get to the bottom of it. When her father saw it in person, visitors to the clinic and hospital were restricted, which meant that his wife or daughter could not defend the 88-year-old.

Mark French (left) was photographed in Lake Takla, British Columbia in 2018, and his wife Hazel French died of pancreatic cancer in April 2018. His daughter, Anna Whitely, said she believes that his late diagnosis was delayed only five weeks ago, limiting face-to-face appointment visits. (Submitted by Anna Whiteley)

“Sometimes he can’t understand what they are talking about, after his test or his doctor visit, we never get the full story,” she said.

“My mom will have to try to follow up with the doctor’s office over the phone and try to get updates to see what the next steps are for him.”

In November last year, a Frenchman who was a native of Lake Takla who lived in Prince George, British Columbia, was finally hospitalized for 17 days to treat lung problems.

But it wasn’t until Whitely suggested that her mother and her father send him a note on their next date requesting him to be tested for pancreatic cancer-she used to lose a supervisor for this deadly disease and noticed the similarity of symptoms- The test was carried out.

The Frenchman, taken in 2019, lives in Prince George, British Columbia, and is a member of the First Nations in Lake Takla. His daughter said that due to COVID-19, he was unable to have his family defend him during his appointment or hospital stay in November. (Submitted by Anna Whiteley)

“I think COVID played an important role in his late diagnosis,” she said.

“I’m sure that if my mother or someone can join him in advocating for different tests, it can be done. I think an early diagnosis will definitely change the results or prolong his life, at least for a while.”

Written by Brandi Wicker. Produced by Amina Zafar and Jeff Goodes.

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