While the pandemic has undermined public health in countless ways, a new report warns that the pandemic has been particularly hard on cancer patients and cancer research alike.
"As much as so many people have been vaccinated, and we continue to find new and exciting treatments [for COVID-19], it's been an exhausting and difficult year," Sen. Amy Klobuchar said in a videotaped message presented during a media briefing on the American Association for Cancer Research (AACR) report this week.
On the question of cancer in the context of COVID-19, Klobuchar spoke from personal experience: In the middle of the pandemic, she was diagnosed with stage 1A breast cancer, following a routine mammogram.
Her diagnosis came early, her treatment went well, and her risk for recurrence remains low, she noted. "[But] I share my story to call attention to the fact that because of the pandemic many people have been delaying physicals, routine exams, including the kinds of tests that can help people catch cancer early," she said.
Indeed, the AACR report indicates that between January and July of 2020 alone, the pandemic prompted 10 million missed cancer screenings.
A case in point: Wenora Johnson, a cancer survivor from Joliet, Ill. She was first diagnosed with colon cancer in 2011, and then genetic testing showed she had Lynch syndrome, a genetic condition that predisposes a person to hereditary colon cancer. Then, she was diagnosed with early-stage endometrial cancer; Johnson opted for a hysterectomy to cut her chances of more cancer. She was later diagnosed with basal cell carcinoma. For her, cancer screenings are now paramount.
Speaking at the media briefing, the 55-year-old recalled how the pandemic forced a four-month delay in getting the annual colonoscopy screening that she relies on, both for her health and for her peace of mind.
When Johnson did finally have the procedure, it turned out she had three precancerous polyps. They were removed, she said, but the experience "really brought home to me the effects of what COVID has done."
And screening cancellations are but one of many direct threats and dilemmas the pandemic has posed to cancer patients, the report found. Others include major delays in treatments; a higher-than-average risk for COVID-19 infection; twice the risk for related complications and death; and a poor immune response to vaccines.
Pandemic put cancer trials on hold
Dr. Larry Saltzman, a 68-year-old from Sacramento, Calif., with a blood cancer known as chronic lymphocytic leukemia, spoke to the latter concern.
In the midst of his fourth clinical cancer trial when COVID-19 first struck, Saltzman explained that for someone with a weakened immune system like him, COVID-19 has endured as a constant mortal threat, even after vaccines came to the fore.
"I know through some blood testing that the vaccines have not produced an antibody response in my system to COVID," he noted. That left him "essentially an unvaccinated person," despite having had four shots.
As a result, he said, "Even now, I don't go to a movie theater, I don't go to restaurants, even though the recommendations are lifting to go out. I can't do it, because I am afraid."
"I rely on people around me to get with it and protect themselves, and ultimately that protects me from this infection," he added.
Johnson and Saltzman typify just how tough COVID-19 has been on the cancer community, said AACR report team member Dr. Ana Maria López.
Speaking at the briefing, López, a medical oncologist from Jefferson Health in Sewell, N.J., said that from the start, "patients with cancer are at increased risk for infection, and are at an increased risk for getting sicker" from COVID-19.
That heightened risk was compounded by the hit the pandemic took on diagnosis and treatments. Particularly, said López, among elderly cancer patients and those from minority communities who are already "medically underserved" due to longstanding health inequities.
She noted, for example, that during the first wave of the pandemic, prostate cancer surgeries declined 17% among white (non-Hispanic) patients, compared with a 91% drop among Black patients.
Early cancer research also slowed by COVID
Yet the new report warns that it's not only today's patients who have been impacted by COVID-19, but tomorrow's patients as well, given widespread pandemic-triggered study interruptions and science lab closures that, at least temporarily, pulled the rug on efforts to develop new and better cancer treatments.
Dr. Antoni Ribas, report chair, past president of the AACR and director of the tumor immunology program at University of California, Los Angeles, said that the disruption to cancer research "is estimated to result in thousands of additional cancer deaths in the coming years."
"The pandemic has caused significant challenges for cancer researchers," Ribas added, noting that a survey of AACR-funded cancer researchers found that nearly all had experienced significant negative impacts to their productivity and careers.
Still, the report is not all bad news.
For example, Ribas noted that "decades of NIH-funded research into mRNA vaccines for cancer paved the way for developing COVID-19 vaccines at an unprecedented speed, [and] in turn, the tremendous success of COVID-19 vaccines has renewed enthusiasm for mRNA cancer therapies, which could revolutionize cancer treatment."
At the same time, the move to telemedicine has increased dramatically, López noted, jumping 38-fold by July 2021, compared to pre-pandemic levels. Over the long haul, the move could serve to even out the playing field when it comes to access to health care, López added. And meanwhile it already appears to be popular with patients: AACR statistics indicate that cancer patients actually prefer televisits over in-person meetings, 45% to 34%.
Ribas did emphasize that getting cancer care and research back on solid footing will take time and money, and he highlighted the report's call for an infusion of federal funds to bolster the U.S. National Institutes of Health, the U.S. Food and Drug Administration, and the U.S. Centers for Disease Control and Prevention in a post-pandemic world.
"While the pandemic has certainly strained cancer care and research, it has also provided valuable lessons for the future of cancer science and medicine," said Ribas, encouraging researchers to find innovative ways to streamline their efforts and reduce costs, while placing a greater premium on patient needs and convenience.
There's more on cancer and COVID-19 at U.S. National Cancer Institute.
SOURCES: Feb. 9, 2022, American Association for Cancer Research (AACR) media briefing with: U.S. Sen. Amy Klobuchar; Antoni Ribas, MD, PhD, past president, AACR, and director, tumor immunology program, University of California, Los Angeles; Ana Maria López, MPH, MD, medical oncologist, Jefferson Health, Sewell, N.J.; Wenora Johnson, cancer patient, Joliet, Ill.; Larry Saltzman, MD, cancer patient, Sacramento, Calif.; AACR Report on the Impact of COVID-19 on Cancer Research and Patient Care, Feb. 9, 2022