THE U.S. COULD BE MISSING 25,000 CANCER DIAGNOSIS PER WEEK DUE TO COVID19
But apparently most people are too obsessed with whether Trump said to inject Clorox or not to even notice or care about this massive elephant in the room.
I’ve had multiple people reach out to me over the past few weeks with worrying symptoms that they might have testicular cancer, but have been unable to find doctors to see them with everything being locked down from the COVID19 pandemic. These have mainly been from outside of the U.S., but combined with a report out of the UK that cancer diagnosis have dropped 75% in the midst of the pandemic when we know cancer doesn’t stop happening because of this, this is a very big problem.
Granted, much of this has to do with people just being afraid to go see their doctors and skipping cancer screenings out of fear, and perhaps a bit less because of availability of doctors to check them, but I’m hearing a lot of different things and this is worrying nonetheless. I have a lot of readers reach out to me from far away places, where finding a good doctor that can successfully treat cancers such as testicular can be a challenge even in ordinary times, and these are far from ordinary times.
Delayed Cancer Diagnosis is a problem
From an article in the Daily Mail:
2,700 cancers MISSED every week: Coronavirus crisis causes urgent GP hospital referrals to plummet as patients are reluctant to visit their doctor
“Cancer Research UK said the numbers being referred by doctors for urgent hospital appointments or checks had dropped by 75 per cent since the start of the coronavirus outbreak.
Sarah Woolnough, from the charity, said about 2,300 cancers were being missed every week as a result, and many patients' operable cancers would become inoperable if they remained undetected.
Separate figures estimate that another 400 cancers a week are being missed because screening for breast, cervical and bowel cancer has been suspended.”
2,700 missed cancer diagnosis per week is a lot, and that’s just the UK. What about the rest of Europe? What about the U.S.? What about the rest of the world? Cancer doesn’t care whether someone is too afraid to go see their doctors because of the pandemic, or if they can’t find doctors that are able to see them and screen them appropriately with the needed tests or scans.
Via another story in the The Sunday Times, Richard Sullivan, professor of cancer and global health at King’s College London, says: “Deaths due to the disruption of cancer services likely to outweigh deaths from the coronavirus itself over the next five years.” He added that, “The cessation and delay of cancer care will cause considerable avoidable suffering. Cancer screening services have stopped, which means we will miss our chance to catch many cancers when they are treatable and curable, such as cervical, bowel and breast.” (See a bit more here.)
The same applies to testicular cancer. Although no official screenings are recommended, a point of contention with both testicular cancer advocates and experts, it’s crucially important to get prompt medical attention when testicular cancer is suspected, because of the fact that it’s a fast and aggressive type of cancer.
People will die not just from COVID19, but because they’re missing cancer diagnosis
Per the National Cancer Institute, there are 1.7 million cancers diagnosed every year in the U.S., and around 600,000 people will die from cancer annually. If we assume for the sake of argument that a similar 75% drop in appointments for cancer diagnostics aren’t happening here as well, that’s around 25,000 cancers that could be missed per week here in the U.S. I don’t see why conditions would be drastically different here versus the UK, and I know for a fact that it’s happening from what I’m seeing in my Inbox.
Around 25,000 cancers could be missed per week in the U.S. due to skipped screenings or delayed diagnosis, because of either patient fears and COVID19 lockdowns, or inability to timely access medical care.
Missed or delayed cancer diagnosis are going to cause excess cancer deaths. At the same time, evidence has been emerging that suggests that the coronavirus is not nearly as deadly as had been thought. What are we truly achieving with these lockdowns, and will we just end up with more deaths elsewhere? I don’t know the answers, but I’m asking the questions, and pointing out that secondary costs considerations such as these need to be factored into public policy.
What’s Really Happening on the Ground in the U.S.
Nobody is really reporting on this so it’s tough to know, so I’ve done some of my own investigating.
Surgeon friends of mine tell me, and it’s been widely reported that elective surgeries are all on hold. In some cases, tumors that are discovered in patients may have been present for years, and so can be perfectly safe to monitor for another few months as the COVID situation stabilizes. Dr. Phil Pierorazio, a testicular cancer expert at Johns Hopkins University, said that: “Most ‘diagnoses’ are coded with pathology from an orchiectomy [referring to testicular cancer.] If surgery is being postponed (safely), you will see a lag in the # of diagnoses... may not be a bad or dangerous thing at all.”
So it’s likely there will be a surge in new cancer diagnosis that have simply been backlogged in the coming months but had been monitored, and this doesn’t necessarily mean outcomes will be any different. Cases that are deemed safe to monitor or postpone surgeries for will be punted down the road a few months, but nobody presenting with a testicular cancer or other aggressive tumor is going to be denied surgery for several months, as a cancer that’s known to be very fast growing and aggressive is allowed to spread.
The trouble is, getting people to their doctors in the first place! What is actually coming into oncology practices? I asked my former oncologist, Dr. Paul Thambi at Maryland Oncology Hematology, who treated me 9 years ago in 2011 for his feedback.
“In terms of new cancer patients, there has been a decline although this is from my observations, [but] have not seen our monthly numbers yet. My experience is closer to 50%, but this is just a guess.
Elective procedures are on hold (ie colonoscopies, screening mammograms, pap smears, etc.), so this is not surprising. Urgent procedures such as colonoscopies done for patients with bleeding, are being done.
Your concerns about delays in diagnoses causing increased mortality is well founded.” (emphasis mine)
Whatever the drop is in new cancers being treated, there is certainly a drop happening in the U.S. because of COVID19 lockdowns.
The last time I saw Dr Thambi in 2016, and I hope to keep it that way!
As for the approximately 50% drop in new patient referrals for a local group oncology practice, Montgomery County, Maryland where this practice is located is a very affluent area. It has a high concentration of households with at least one Federal government employee, or employees of large government contractors and associated businesses, and so is generally more sheltered from economic downturns. If there’s a 50% drop in new cancer patient referrals at a major group oncology and hematology practice here, I think it’s probably a safe assumption to make that the drop could be far worse in many other areas of the country where there’s been far more severe economic devastation and job loss, and that the 75% drop reported in the UK could easily apply across much of the U.S. as well.
While we’d like to think that the cancer surgeries and treatments that are deemed safe to delay are being delayed, and that the ones that need immediate attention are being taken care of, the truth is that when screenings aren’t happening, new cancers aren’t being found, and this is going to cause delays in diagnosis, and possibly outcomes.
The lives of either undiagnosed or untreated cancer patient lives are on the line here.
Is this Virus Really As Deadly As They Say?
Months into this crisis, we still don’t know what we don’t know about this novel coronavirus, but it’s not hard to find reports of antibody testing showing that the true number of infections versus the number of reported cases are easily orders of magnitude higher than what’s been understood. Most people know when they get the common flu because they have symptoms, but many people are getting SARS-CoV-2 without ever realizing they’d had it!
In Santa Clara County, CA, the true infection rate from antibody tests suggests that the number of cases has been underreported by a factor of 50 to 85, which drops the corresponding mortality rate to 0.12 to 0.20%.
In New York City, it’s estimated that 25% of the city currently already has antibodies for the coronavirus. In a city of 8.55 million, that means 2.1 million already have antibodies, but with only 160,000 cases reported that represents an 11-fold increase in true number of infections. This drops the mortality rate from 7.4% down to just 0.5% in a city with an extremely high population density.
Nobody is going to argue that the novel coronavirus clearly isn’t something above and beyond the common flu, which has a mortality rate of around 0.1%, but the true mortality rates and hospitalization rates of the novel coronavirus are nowhere close to what models had predicted. This is incurring a real and potentially deadly cost against other people that have life-threatening health conditions, while the world is forced to stop to deal only with COVID-19.
The Hill: The Data Is In — Stop The Panic and End The Total Isolation
Fact 4: People are dying because other medical care is not getting done due to hypothetical projections.
Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.
But WE Still Don’t KNow What We Don’t KNow Yet Part “Eleventy Seventy-Three”
I’m NOT arguing that what’s been done to date hasn’t been necessary but is it still necessary, and for how much longer? I’m well aware that silent morbidities are a concern, as are concerns about just how immune people testing positive for antibodies are. Still, these questions need to be asked, and public policies, re-evaluated, challenged, or even protested if warranted, as it’s our right to do, because people don’t stop getting cancer or developing other health problems just because COVID19 is here.
Thanks to Big Tech and social media, that debate is not happening to the extent it should, when anything that questions the status quo is deemed “harmful disinformation” and removed! Although the coronavirus is most certainly being politicized, the right to speak out about policies that people feel are wrong is not a left versus right issue. Tucker Carlson’s segment on this very issue is worth watching for all.
The message is very clear that Big Tech companies like Facebook and YouTube (Google) are NOT our friends. Obey or else, while other people’s lives are on the line from not being able to get cancer and other health screenings done, while the authoritative sources they say cannot be questioned have been wrong plenty of times throughout this. This is totally unacceptable, and just one of many reasons why I’m abandoning platforms such as Facebook for the free and open-source Gab, which actually respects our 1st Amendment rights and our values here in America.
Nobody gets to tell Americans what they can and can’t protest period. Full stop. I don’t necessarily agree with what exactly is being protested in some cases, but these lockdowns are creating huge secondary issues, massive economic loss, and will start to cause excess cancer deaths. We have a right to question and protest our government at all levels. It is our 1st Amendment right, and this is non-negotiable in American life.
Excess cancer deaths due to covid19 are going to be a thing — Please Do Not Skip Your Cancer and Other Health Screenings
While it’s difficult if not impossible to predict what the numbers will be, some of the estimated 25,000 missed cancer diagnosis per week in the U.S. are going to translate into excess cancer deaths, rather than cancer survivors. For many others, it could be far more intensive treatments in order to be cured, with additional post-cancer morbidities (side-effects, dysfunction, etc.) that might have been avoided otherwise.
Please follow through with cancer and other health screenings as soon as possible, especially if you’re in a range for elevated risk. Don’t just blow them off or skip them, which is what I think many people are going to do this year. Nobody ever wants to believe that they’re going to get cancer, but that’s not how it works. Nobody ever thinks they’re going to get cancer until it happens to them. How do you know you’re not going to be one of them? Please don’t skip your screenings.
If you have signs or symptoms of cancer, or strange things going on with your bodies such as lumps, bumps, or other strange symptoms or pain, please do not let this go or brush it off as nothing. Please follow through, be your own advocate, and keep making calls if necessary in order to get yourselves checked.
Skipping screenings and delaying getting checked when there are signs and symptoms of cancer can all lead to a poorer outcomes. Early detection is important not just for survival, but for maintaining quality of life after cancer by minimizing the amount of treatments needed. As a survivor of a Stage II cancer who had signs and symptoms for at least two months prior to being diagnosed, I could have spared my body significant exposure to extremely toxic treatments and post-cancer morbidities had I been able to detect my cancer a month or two prior when it might have still been at Stage I.
Skipped screenings or delayed diagnosis could cost you your life, or your quality of life down the road. We all might have to delay a bit, but please do make sure you get those cancer and health screenings done. I know we’re going to start hearing about terminal cancer cases where if only cancers had been detected a few months earlier. Please don’t be one of them, and do everything that you can to avoid this.
StevePake.com
