Alberta Health Services Logo. (File Photo)

Column: A timely cancer diagnosis matters, COVID-19 pandemic or not

We are currently trying to do the right thing – wearing masks, keeping our distance, and staying home more than we ever thought possible.

Dr. Deena Hinshaw’s messages remind us to be careful and cautious in our daily activities. For some people this means working from home, avoiding recreational activities, or seeing fewer family and friends.

For some people it also means delaying a visit to see a doctor, and this can be a potential problem if serious health concerns then go unchecked.

Cancer is the leading cause of death in Alberta.

Prior to the pandemic, approximately 2,000 Albertans were diagnosed with cancer every month, and approximately 600 died from cancer every month.

We know that early cancer diagnosis results in less advanced disease, more effective treatment options, better survival and quality of life outcomes.

However, diagnosing cancer early is a complex process that requires a person to notice a change in their body that is persistent or worsening and seek medical attention. It also requires an assessment by their family doctor or another physician in order to investigate any worrisome signs or symptoms with a series of tests.

Multiple interactions between patients and different healthcare providers are often needed to get a cancer diagnosis. Sometimes this happens quickly, but it can also take significant time. The sooner this process starts, the better.

No symptoms are specific for cancer, but it is important to see your doctor so they can investigate worrisome new, persistent symptoms such as: an unusual or growing lump; significant blood in stool, urine, or phlegm; growth or darkening of a mole; trouble urinating for men; or unexplained significant weight loss.

A more complete and detailed list of potential warning symptoms can be found on the MyHealth link: https://myhealth.alberta.ca/Alberta/Pages/Symptoms-of-cancer.aspx .

Diagnosing cancer later at more advanced stages results in shorter survival, reduced quality of life, and more hospitalizations.

Even before the COVID-19 pandemic, delays in cancer diagnosis and inadequate supports for patients and family physicians were issues facing Albertans and healthcare providers.

The Cancer Strategic Clinical Network™ of Alberta Health Services (AHS) has initiated work on the creation of a comprehensive provincial cancer diagnosis program, and will soon add diagnosis programs for lymphoma and colorectal cancer to build on those created for lung and breast cancer.

The pandemic has made these gaps in cancer diagnosis worse and has resulted in a decrease by more than 30 per cent during the first wave in the spring with some recovery through the summer and early fall.

We are seeing a reversal of that recovery through wave two and cancer diagnosis is declining again.

We find this concerning. Similar decreases in cancer diagnosis have been reported globally, including the USA, Europe, and Australia. The pandemic has not made cancer go away, but may worsen cancer outcomes.

This spring, Alberta implemented several measures to protect the public, and divert health care resources to COVID-19. This meant many people stopped seeing their family doctor for routine visits or opted to have their visit over the phone. My colleagues are meeting newly diagnosed cancer patients who first noticed symptoms or lumps in April, but did not book an appointment to see their family doctor until later in the summer because they were worried about catching COVID-19 or bothering their doctor with a non-COVID-19 issue, or thought their doctor was not seeing patients in-person. The public needs to be assured that physician offices and testing facilities are safe places to visit because of strict COVID-19 precautions such as masking, extra cleaning, distancing, and pre-screening protocols. Testing potential COVID-19 cases occurs at other specific locations.

The fact is that cancer has not gone away. Without exception, we all need to follow recommendations to safely manage and control the pandemic. However, an important part of taking care of your health during the pandemic is also seeing your doctor and going for tests when needed. As clinicians, we will always be here to help you with serious medical concerns.

Douglas Stewart is a professor emeritus of Oncology at the University of Calgary, a medical oncologist at the Tom Baker Cancer Centre and the senior medical director for the Cancer Strategic Clinical Network, AHS

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