The lack of face-to-face care and the fact that many ailments were resolved over the phone has altered the early detection system. Doctors recognize that various symptoms that may be compatible with serious diseases have been left out of the diagnostic systems during these months, which is why they now receive patients who present an advanced stage of some ailments, including cancer. To this is added that other people did not consult their discomfort to avoid having to go to a hospital.
Margarita Font, president in Asturias of the Spanish Association Against Cancer (AECC), had already warned last January of the impact of the pandemic on the healthcare side. “According to our information, patients who were already in the testing and treatment circuit have received correct care. The worst has been with the new diagnoses. In fact, at the national level, diagnoses have dropped by 21 percent, and that means that people now arrive in more advanced stages ”.
At the Cabueñes hospital, a reference center for Health Area V (Gijón, Villaviciosa and Carreño, with almost 290,000 inhabitants), the figures for new cancer cases that are arriving at the center have been worrying for a few months. The pandemic has led to a late diagnosis in some types of malignant tumors, and this circumstance, together with the fact that it is necessary to regain the pulse of postponed treatments and operations, could generate problems when carrying out the work accumulated in the months ago, with a hospital taken over by the covid and with activity reduced to the essentials to minimize infections and safeguard patients from the coronavirus. Many patients, directly, did not pay attention to the symptoms that they may have had, or have been diagnosed late simply because the annual check-ups were not done for fear of contagion.
Explain it Jose Carlos Fernandez, Chief of the General Surgery and Digestive System at the Hospital de Cabueñes: “The most obvious tumors, such as those of the breast or colon, have not suffered from this problem, because they are tumors that are noticeable; a woman goes to the doctor when a breast lump is noticed when there is rectal bleeding, but other tumors go unnoticed. Many people who feel tired or who have other less obvious symptoms may not go to the doctor in time, “he says. And that is what is beginning to be seen, although there are still no official statistics.
The most obvious tumors, such as breast or colon tumors, have not suffered delays, but others go unnoticed and are the ones that present the greatest problems
In Gijón there is concern right now that this profile will increase, which in some areas is being noticed more than in others. “In cases of breast or colon tumors, they have been brought more up to date, especially in the breast because more than 90 percent of women have surgery and go home during the day, they do not need resuscitation bed, and thus we have been saving with a lot of effort ”, explains Fernández.
In the case of colon tumors, attempts are being made to speed up so that no more than two months elapse between diagnosis and operation, but what is important and most worrying right now are tumors that do not face up, the ones that take longer to manifest. or have they just been overlooked. For example, recalls Fernández, cases such as hematological ones, in which there could also be an increase because they are among those that do not show palpable evidence except when the disease is more advanced.
To this is added that in the case of Gijón the pandemic devastated when the expansion of the center was most needed, “a hospital, Cabueñes, which is not up to par”, many professionals who work there agree. “In addition to delays in the waiting lists for surgeries, although the most urgent ones continued to be performed, what worries us is to update treatments for diseases that arrived with a delayed diagnosis and other pathologies that also need prompt attention; what is clear is that there are not enough operating rooms, there weren’t any before and now we are worse off with all the pending work ”, the doctor also explains Carlos Laso, digestive system surgeon.
And all this at the beginning of the summer, when the holidays will begin and the activity was traditionally reduced. Doctors “do what we can, and now the colors are coming out in the hospital. The expansion of Cabueñes is so urgent that it cannot be ignored. There is no excuse for not starting as soon as possible and with a good financial endowment “, he concludes.
However, many doctors call for caution because “we are talking about sensations rather than concrete numbers that will have to be analyzed”, but it is clear that “there are diseases that could have been detected earlier, perhaps with a better prognosis, and that it is foreseeable that they begin to arrive from now on, with the recovery of normal activity ”.
In the sanitary area of Nalón, its manager, Bernabé Fernandez, he assured that “during the pandemic we have maintained oncological and urgent surgeries.”
This has been the general trend, it is concluded from the conversations with other health sources, who also agreed to highlight the effort made by all health personnel to care for covid patients, but also all the others, despite the enormous difficulties they faced every day. “To the postponed appointments we must add the new ones that were incorporated and those that will have to be added before we can catch up,” they assured.
Patients who underwent cancer treatment during the pandemic indicated that they had not noticed changes in care, although they did not hide the fear that it caused them to be infected.
The Central University Hospital of Asturias (HUCA) receives an average of 2,100 first visits from cancer patients per year. According to the sources consulted, the statistics for 2020, the year of the coronavirus pandemic, do not show an avalanche of new cases, but rather the index of first visits remains in the same range of influence as in the previous year.
And is that avalanche expected to occur this year? The same sources indicated that “it is unpredictable. At the moment there has not been a noticeable increase in cases compared to previous years either, but we will have to wait until the end of the year and to know the final official statistics ”.
Another matter of concern is the incidence that the pandemic may have had in the death of cancer patients during the last year. The specialists consulted pointed out that “no one can dare to make statistical forecasts right now about the incidence of covid in the mortality of people with cancer. We will have to wait more than a year to be able to speak with real figures and not with sensations ”, they point out, because to find out it will be necessary to study the cases in detail. “Now it is very premature. We will have to wait to see the regional figures and also the national ones ”.
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