MANILVA – Experts in the province of Málaga warn in the newspaper SUR of the need to get rid of the care phobia caused by the coronavirus so that timely diagnosis is possible again. Two in ten people with cancer are wrongly undiagnosed.
In Malaga, 9,309 cancers were diagnosed in 2020. Statistically, according to the experts, there should have been more: up to twenty% more. “In our province, namely 17.6% more,” says oncologist Emilio Alba: “There are many people who have cancer without knowing it.” Nearly two in ten patients are undetected.
In a recent report, the Ministry of Health also acknowledges there has been “a reduction in diagnoses”. It attributes this to several causes derived from the pandemic:
- the suspension of screening programs
- difficulties in accessing primary and hospital care
- the delay in appointments for medical tests
- fear of contamination.
“They have focused on curing the coronavirus. But have forgotten to prevent other diseases,” criticised Paloma Gómez, one of the most experienced volunteers of the Spanish Association Against Cancer (AECC) in the province. It considers it necessary to ban the imposed telephone filter in health centres. “We have the right to be seen by a doctor. Many people do not know how to express over the phone what is wrong with them. There are symptoms that seem mild, such as back pain or fatigue, which could be something completely different.”
Patients diagnosed with cancer in the last year and a half had to be treated alone, without family or friends. The first wave was devastating for early detection programs. As such, the various health care facilities realised the importance of restoring the treatments of chronic patients with other pathologies, who no longer went to their health centres. In some cases, however, it was already too late.
The Department of Health admits “delays in diagnosis or initiation of treatment will be relevant”. Emilio Alba believes “it is not yet possible to measure the magnitude of the problem”. Furthermore, he predicts “we will have to wait 2-3 years to know what the impact will be” of underdiagnosis. Fortunately, he points out many screening tests, including mammograms, colonoscopies, and cytology’s, are back on the calendar of health centres.
Surgeon César Ramírez, who specialises in cancer surgery, confesses “fewer cancers have been diagnosed for surgery in recent months than in any other year”. It is a terrible indicator! if there is no possibility of surgical treatment, it means that the disease has already progressed too far.
Ramírez has seen the consequences of stopping the screening tests in his immediate environment. “A close family member spent four months unable to undergo a colonoscopy, despite the fact that he was bleeding. We eventually diagnosed him with colon cancer. The scenario is worrying, to say the least: “Under normal circumstances, 33% of colon cancers are diagnosed in stool test screenings, in preventive campaigns. Now that figure has dropped to 5%. And at the same time, the number of colorectal cancers entering the emergency room has multiplied by four, when there is already a perforation or obstruction and thus an acute complication and even a vital emergency.”
The Spanish Society of Medical Oncology (SEOM) speaks of a “diagnostic limbo”. Chairman, Álvaro Rodríguez-Lescure, believes the pandemic is “behaving like a black hole absorbing human, therapeutic, technological and technical resources”. This situation urgently needs to be reversed because the delay in the detection of other pathologies assumes “a very negative impact” on the survival of patients.
The AECC also points out the drama extends beyond diagnoses: the pandemic has exacerbated the “unequal” situation of the sick, who are more vulnerable to poverty and to conditions such as depression and anxiety.
The healthcare phobia the coronavirus has caused in much of the population is another obstacle to early detection. “An acquaintance recently told me: ‘I will not remove the lump until the Covid is over.’ People are still afraid to go to the doctor, we must make sure they get rid of that fear,” says Paloma. Because cancer, often silent and insidious, doesn’t wait. And at least two out of 10 cases have yet to be diagnosed.
The pandemic has not only affected the diagnosis of the disease, but also the profile of patients. The economic crisis triggered by the coronavirus has “severely” worsened the economic situation of 20% of the population with cancer, according to the Spanish Cancer Association.
Social divide wider
President, Ramón Reyes, explained: “Cancer is the same for everyone, but not everyone is the same when it comes to cancer”. The epidemic has widened the social divide that causes cancer between those with and without resources. The disease still drives one in four new patients into poverty and causes symptoms of depression. And anxiety is diagnosed in nearly half of cancer patients.
Cancer causes family costs of more than €9,000 on average and reduces income from sick leave, unemployment, and disability claims. The association, with nearly seven decades of experience in the fight against cancer, emphasises many patients have difficulty paying “rent, mortgage, food or electricity, water, and gas bills.”