In New York City, the first epicenter of the COVID-19 pandemic in the United States, calls for people to stay home were crucial to flattening the curve and saving lives. But, while New Yorkers secluded themselves at home, other diseases did not. One of the most worrying is the disease I face every day: cancer.
It is a simple biological fact that cancer continues to develop in our region right now, despite COVID-19. That means that a growing number of cancer cases remain hidden. In January, the American Cancer Society predicted there would be nearly 118,000 new cancer diagnoses in New York in 2020. In an ideal world, many of those cases would be found early through preventive testing. This would help cancer doctors to act quickly to treat patients and increase the chances of a cure.
But COVID-19 radically affected cancer prevention: cervical cancer screening appointments, colon Y mom fell by as much as 94% in March, according to a analysis conducted by Epic, an electronic medical records company. The medical community is rightly concerned that due to its special characteristics this is an imminent crisis.
It is true that in the early days of the pandemic we are recommending patients postpone cancer screening appointments a bit, largely to help our hospitals and clinics focus on the expected increase in COVID-19 cases. But, now that we have flattened the curve in New York City we must make up for lost time, and we encourage patients to return to the doctor for cancer screenings and treatments. Despite the rapid drop in COVID-19 numbers across the city, New Yorkers continue to postpone scheduled exams and ignore symptoms, which is causing a marked – and alarming – reduction in the number of new case diagnoses.
What are the consequences of these delays in diagnosis? For most types of cancer, disease progression (which will occur if tumors grow without treatment) often implies a worse prognosis and that more aggressive therapy is necessary to achieve the best outcome. This is a reality that particularly concerns the Hispanic people in our community.
Breast cancer is the most commonly diagnosed cancer among Hispanic women, and the least invasive treatment relies on early detection. For example, a tiny breast cancer detected by mammography may require the removal of a small part of the breast tissue (and radiation therapy, depending on the age of the patient) and then some pills to inhibit recurrence. But less than half of Hispanic women age 40 and older had a mammogram last year, based on 2015 data. If the cancer is not found until it reaches a size that can be felt, or grows despite being felt, this could mean that the woman should have to chemotherapy and a mastectomy. The difference can also be seen when we compare the removal of a polyp by colonoscopy, which prevents cancer, with the management of invasive colon cancer that could result from an undetected polyp.
In October, Breast Cancer Awareness Month is recognized. It’s another reminder for New Yorkers to consider breast cancer (and all cancers) screening and therapy essential. We have almost fully reestablished our ability to provide comprehensive cancer care throughout the region. Many hospitals, even the hospital where I work, Memorial Sloan Kettering Cancer Center, have transformed their facilities. They have equipped their staff with full protective gear and have taken precautions to allow them to be as safe as possible to visit. And for those who still feel unsure about going to a healthcare facility, the ability to communicate with patients through telehealth.
The truth is that the figures show that each week, on average, hundreds of New York City residents are diagnosed with cancer. If you have symptoms or are due for a cancer screening test, let us take care of you. We can do it safely. Cancer is not confined.
Cancer is serious. It cannot be put on hold and ignored without consequences. My dear New Yorkers, it’s time to go back to the doctor.
-Dr. Diane Reidy-Lagunes is a medical oncologist specializing in the treatment of patients with gastrointestinal cancer and neuroendocrine tumors, and a chief deputy physician for Memorial Sloan Kettering’s Regional Care Network.