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From the start of confinement, doctors had hammered home the importance for cancer patients to continue their treatment, but the consequences on management were very real. Now there is an emergency, warn specialists.
“My last treatment was postponed for six weeks. With a phone call to tell me that it was less dangerous than being exposed to Covid, “worries Roger (*), 62, still in immunotherapy following lung cancer.
Adèle, 40, was in full treatment for breast cancer diagnosed in September when the epidemic spread to France. This Parisian then decides to confine herself to the family home in the provinces.
The transfer of her treatment finally went well and she is now waiting to start radiotherapy, but “at one point, I asked myself:” Where will I be followed? Am I going to be in the wild? ” “
The number of cancers diagnosed has been halved
Between processing delays and those in the detection of new cases, it is the whole system that risks being destabilized. “During these two months, the number of diagnosed cancers was halved,” says Professor Axel Kahn, president of the League against cancer, citing the feedback from the hospital field.
“Obviously, it was not the coronavirus that scared the cancer. Cancer is still there. On the other hand, the coronavirus frightened the patients who were dissuaded from being tested, from consulting ”.
The president of the League against cancer warns of “very damaging delays” in screenings pic.twitter.com/QMZgxVnqyR
– BFMTV – Matinale (@PremiereEdition) May 5, 2020
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“We risk a very big traffic jam”
The figures are simple and worrying: with nearly 400,000 new cases of cancer per year in France, some 30,000 patients will not have been diagnosed. Even if the multiplication of pulmonary scanners to confirm coronavirus infections could allow the detection of certain tumors.
A “very worrying” situation for Axel Kahn, who points to two consequences: taking care of patients too late and the risk of saturation during normal resumption of activities. “If the postponements of check-ups, chemotherapy, radiotherapy and scheduled surgeries add all the late screenings, there is a risk of a very large traffic jam,” he warns.
“We must quickly resume treatment”
Another consequence: interruptions of treatment. In addition to deprogramming by hospitals, some patients – cancer being an additional risk factor against Covid – preferred to “stay very cautiously confined to protect themselves”, notes Éric Solary, president of the scientific council of the ARC foundation for research on the cancer. “We must quickly resume treatment.”
A prepublication study by British researchers, coordinated by Professor Clare Turnbull of the London Cancer Research Institute, is examining these different questions.
Decreased survival
According to their models, survival at six months could be reduced by 30% by “even a modest delay” in surgical management for certain aggressive stage 2 cancers (bladder, lung, stomach, etc.). Survival at three months would be reduced by 17%.
“The priority should be to avoid delays in cancer surgery. (…) In the short term, to avoid cascading effects, the immediate mobilization of additional resources is necessary to make up for the delay in the first months of the pandemic in terms of detection and surgical procedures, ”warn these specialists.
Another concern is the possible coronavirus-cancer interactions. The CRA has launched an appeal to fund research projects on these issues (70 are already in the running). “It is a question of measuring the impacts on the management and seeing how to quickly help the clinicians to adapt the treatments, how to use the drugs in this context which little is known”, explains Pr Solary.
“Collapse of donations”
For all these specialists, it is urgent to relaunch the fight, even as Axel Kahn regrets a “collapse of donations” since the start of the pandemic.
* First name changed at his request.
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