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The COVID-19 pandemic has had a major impact on people with existing medical conditions, including cancer.

The Centers for Disease Control and Prevention (CDC) considers cancer patients a high-risk group for COVID-19. Cancer patients are likelier to have complications like severe illness, hospitalization, and death.

The indirect impact of COVID-19 on cancer patients is delayed care.

Because of COVID-19, many people have put off or canceled routine screenings and other cancer care. This has led to negative outcomes like later-stage cancer diagnoses and delayed treatments.

At UPMC, we urge people to maintain their cancer-related care. This includes getting routine screenings, paying attention to cancer warning signs, and getting all of your necessary care.

“Cancer doesn’t stop growing,” says Rushir Choksi, MD, assistant medical director, Medical Oncology Network, UPMC Hillman Cancer Center. “The screening guidelines were put into place to catch cancer early so it could be as curable as possible.”

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Cancer Care and COVID-19

People with cancer are considered high risk for complications from COVID-19. The CDC recommends that all Americans ages 12 and older get the COVID-19 vaccine, including people with cancer.

While it is important that people with cancer avoid COVID-19 infection, it is also important for them not to delay cancer care.

A March 2021 survey from the American Society for Radiation Oncology reported the impact of COVID-19 on cancer care.

  • 66% of doctors surveyed said new cancer patients were presenting with more advanced disease.
  • 73% of doctors surveyed reported that patients were missing cancer screenings.
  • 66% of doctors surveyed said their patients experienced disruption in care.

Other reports offer similar accounts. According to The Journal of General Internal Medicine, mammogram and colonoscopy screenings dropped more than 95% during March and April 2020. A November 2020 study in JCO Clinical Cancer Informatics reported sharp declines in screenings for several different cancers among American seniors.

There may be different reasons for delayed care. During the pandemic, many cancer centers had to adjust care options, including adapting to virtual visits. People may have delayed cancer screenings or treatments due to fear of getting COVID-19.

But later diagnosis of cancer can have long-term effects. It can make cancer more difficult to treat and cure. The National Cancer Institute predicted there would be 10,000 excess deaths from breast and colorectal cancers over the next decade because of delayed care during the COVID-19 pandemic.

“We’re seeing later stages of cancer,” Dr. Choksi says. “We’re seeing breast cancers that have now gone to lymph nodes or other places in the body, where sometimes they cannot be curable. They can always be treatable, but not curable, as they potentially could have been if they had been diagnosed last year.”

Routine Cancer Care to Maintain

Depending on factors like your age, sex, and medical history, you should get regular cancer screenings.

  • Breast cancer: Breast cancer is the second leading cause of death in American women. A mammogram can help detect breast cancer early, leading to earlier treatment and a higher chance of cure. At UPMC Magee-Womens Hospital, we recommend women get yearly mammograms beginning at age 40. If you have a family history of breast cancer or other risk factors, you may need to begin routine mammograms at an earlier age.
  • Colorectal cancer: At UPMC Hillman Cancer Center, we recommend regular colonoscopies beginning at age 45. We also recommend regular screenings if you have a family history of colorectal cancer or certain risk factors.
  • Prostate cancer: Men over 50 or who have a family history should talk to their doctor about prostate cancer screenings.
  • Lung cancer: Regular lung cancer screenings are recommended if you are between the ages of 55 and 77 and meet risk factors from your smoking history.
  • Cervical cancer: Pap tests and HPV tests can help detect cervical cancer. Women should have their first Pap test within 3 years of starting sexual intercourse, or at age 21. Women under age 30 should have a Pap test every 1 to 2 years. Women over age 30 have the option of only the Pap test or both the Pap and HPV tests.

Cancer warning signs to watch for

In addition to maintaining your screenings, you should also be mindful of potential cancer warning signs. It may be as obvious as a lump on your breast or on your testicles, or it could be something more subtle.

“If you experience anything abnormal, you should see your doctor,” Dr. Choksi says. “Stomach pain, nausea, vomiting, trouble swallowing, can be signs of cancer and should be checked out.”

If you notice new and unusual lumps anywhere on your body, call your doctor.

Other warning signs to watch for, according to the American Cancer Society, include:

  • Extreme fatigue that doesn’t go away with rest.
  • Unexplained weight loss or gain.
  • Unexplained pain.
  • Skin changes (i.e. yellowed skin or non-healing sores).
  • Unusual, unexplained bleeding/bruising.
  • Cough or hoarseness that doesn’t go away.
  • Change in bladder or bowel habits (blood in the stool/urine, pain when urinating, needing to go to the bathroom more or less often).
  • Fever/night sweats.
  • Headaches.
  • Vision/hearing problems.
  • Mouth changes (sores, bleeding, pain, numbness).

If you notice any of these symptoms or anything else unusual, talk to your doctor for more guidance.

COVID-19 Prevention Efforts at UPMC Hillman Cancer Center

Although worry about COVID-19 is understandable, Dr. Choksi says all UPMC Hillman Cancer Center locations take every step to limit the risk of COVID-19.

At UPMC, we follow key COVID-19 prevention methods like facemasks, physical distancing, COVID-19 screening, and sanitizing. Adults and children over 2 years old who come to UPMC hospitals or facilities must wear facemasks.

“The clinics are extremely safe,” Dr. Choksi says. “We take the proper precautions. The hospitals are very safe. Our screenings ā€” mammograms, colonoscopies ā€” they’re taking the proper protocols to minimize the risk of COVID.”

Although many cancer appointments require a physical examination, we also offer video visits.

At UPMC Hillman Cancer Center, we are here for you. We are committed to providing care for all your cancer needs while keeping you and your loved ones safe from COVID-19.

For more information or to schedule an appointment, call 833-791-7122 or visit us online at Hillman.UPMC.com.

“Our doors are always open,” Dr. Choksi says.

Sources

American Cancer Society, Signs and Symptoms of Cancer. Link

American Society for Radiation Oncology (ASTRO), COVID-19 and Radiation Oncology. Link

Centers for Disease Control and Prevention, COVID-19, People at Increased Risk, People With Certain Medical Conditions. Link

Ryan K. McBain, PhD, Jonathan H. Cantor, PhD, Anupam B. Jena, MD, et al, Journal of General Internal Medicine, Decline and Rebound in Routine Cancer Screening Rates During the COVID-19 Pandemic. Link

Debra Patt, MD, Lucio Gordan, MD, Michael Diaz, MD, et al, JCO Clinical Cancer Informatics, Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors. Link

Norman E. Sharpless, MD, Science, COVID-19 and Cancer. Link

About UPMC Hillman Cancer Center

UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, New York, and Maryland, with more than 200 oncologists. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment.