COVID-19: UK Cancer Care Facing 'Time Bomb' Warn Charities

Liam Davenport

June 05, 2020

'COVID protected spaces' and systematic testing of patients and clinical staff on a huge scale will be required if the enormous backlog of cancer screening and treatment that has built up due to the COVID-19 pandemic is to be quickly cleared, says Cancer Research UK.

The charity estimates that the enormous disruption to cancer services caused by the pandemic has left 2.4 million people across the UK waiting for cancer screening, further tests, or cancer treatment, and tens of thousands of cases left undiagnosed.

While there have been improvements since Cancer Research UK first sounded the alarm over cancer care in April, the numbers are not yet back up to pre-COVID-19 levels.

'Forgotten C'

Similarly, a survey by Macmillan Cancer Support showed that almost half (45%) of cancer patients have seen their cancer treatment delayed, cancelled, or altered as a result of coronavirus, leaving many living in fear.

They called cancer “the forgotten C” of the pandemic, and warned of a potential cancer “time bomb” when, as the number of deaths from COVID-19 falls, cancer returns as the leading cause of death in the UK.

The charity Breast Cancer Now also found that a significant number of women with secondary breast cancer have seen their chemotherapy or targeted therapy changed or paused.

Monitoring scans have also been delayed by up to 3 months for some, and the recruitment of patients to clinical trials has been put on hold, which the charity warns not only limits access to novel medications but also could stall the development of novel medications.

All three charities are united in calling on the Government for a “clear” plan for restoring cancer care to pre-pandemic levels, through the creation of COVID-19-free “hubs” and regular testing for patients and NHS staff.

Cancer Research UK calculates that to test patients ahead of hospital appointments, and cancer staff every week, between 21,000 and 37,000 COVID-19 tests must be performed each day across the UK.

'Devastating Impact'

"My colleagues and I have seen the devastating impact this pandemic has had on both patients and NHS staff," said Professor Charles Swanton, Cancer Research UK's chief clinician.

"Delays to diagnosis and treatment could mean that some cancers will become inoperable. Patients shouldn't need to wait for this to be over before getting the treatment they need."

He continued: "We can create a safer environment for both staff and cancer patients if testing efforts ramp up quickly with test results delivered back within 24 hours or less.

"We know that carrying COVID-19 while asymptomatic or pre-symptomatic is a major concern where healthcare worker staff and patients can transmit infection."

Michelle Mitchell, chief executive of Cancer Research UK, commented: "The enormous strain COVID-19 has placed on cancer services is of great concern to us.

"The NHS has had to make very hard decisions to balance risk, and there have been some difficult discussions with patients about their safety and ability to continue treatment during this time."

She added: "But we're over the peak of the pandemic now, and cancer care is starting to get up and running again as 'COVID-protected' spaces are being set up."

Lockdown

Cancer Research UK estimates that due to the COVID-19 pandemic, around 2.1 million people have been left waiting for breast, bowel or cervical screening, which would ordinarily have led to 3800 cancers being diagnosed.

Up to 290,000 people have also not received urgent referrals for further testing, as a result of which approximately 20,300 cancers would have been detected.

Since the start of the lockdown, up to 12,750 (40%) fewer patients have undergone cancer surgery, while 6000 (30%) fewer have received chemotherapy and 2800 (10%) fewer have had radiotherapy.

Furthermore, a survey of 100 cancer patients by Macmillan found that 45% had had their cancer treatment delayed, cancelled or changed due to the COVID-19 pandemic.

Stephen McIntosh, Macmillan Cancer Support policy director, said that the virus has "wreaked havoc on the progress we were making in the UK to improve cancer care".

"It has created a ticking timebomb of undiagnosed and untreated cancer, which is leaving people with cancer living in fear."

He added: "We need urgent action to address the uncertainty of delayed cancer services and prevent coronavirus resulting in a serious spike in cancer deaths.

"UK governments must rapidly restore cancer care and deal with the backlog in treatment whilst keeping staff and patients safe during the pandemic."

Breast Cancer Now gathered information from its help services, which have experienced a huge surge in enquiries since the pandemic hit, and a survey of more than 580 people affected by breast cancer in the UK.

Among 190 women living with incurable secondary breast cancer, they found that 24% had experienced delays or cancellations to their potentially life-extending treatment, while a further 10% had monitoring scans delayed or cancelled.

"It's extremely concerning to hear of the major impacts the pandemic continues to have on thousands of people affected by cancer," commented Baroness Delyth Morgan, chief executive at Breast Cancer Now.

"Governments and the NHS across the UK must now turn their attention to recovering cancer services and we need to see clear plans to ensure that cancer referrals and diagnostic and treatment services can return to pre-pandemic levels."

She said: "We have to ensure all those patients whose appointments, screening, and treatments have been delayed are seen as soon as possible in COVID-free hubs or sites, to prevent the current changes to care from affecting patients' chances of survival in the long-term.

"But to catch-up on this backlog, we urgently need to see short- and long-term plans to ensure there will be sufficient capacity in the workforce to meet this huge influx in demand."

Similar concerns have been raised by the British Heart Foundation over delays in patients accessing cardiac treatment and care. 

No funding declared.

No conflicts of interest declared.

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