Cancer: pandemic and wars leave patients without therapy – 09/18/2024 – Balance and Health

The Covid pandemic and the wars in Gaza, Sudan and Ukraine have left countless patients without access to cancer treatment in several countries, a scenario that is expected to be further aggravated by natural disasters caused by climate change.

The situation was discussed at the World Cancer Congress, which is taking place in Geneva (Switzerland). According to researchers, there are huge gaps in research and investment in these regions, and only a continental and global initiative will be able to address them.

An analysis by Portsmouth Hospital University NHS Trust shows, for example, that the war between Russia and Ukraine alone has caused an increase of 3,600 cancer-related deaths since the start of the conflict.

The World Bank estimates that around 1.2 billion people live in countries defined as fragile or in conflict.

“In Gaza, we have 10,000 cancer patients who are unable to get care because the hospitals have been destroyed,” said Rana Ghafary, director of advocacy and government affairs at the King Hussein Cancer Foundation in Amman, Jordan. She said more than 100 patients from Gaza have been transferred to Jordan for treatment.

The same scenario has been repeated in other conflict areas where, according to experts, there are delays in diagnosis, treatment and lack of access to health services.

The WHO (World Health Organization) has managed to organize regional coordination to monitor the most vulnerable patients since the beginning of the conflicts.

In the war in Ukraine, for example, oncologists were able to track some of the patients and monitor them remotely in Egypt and the United Arab Emirates, where a thousand patients were received in July.

Among African nations, where there are around 40 million refugees, there could also be regional coordination with a similar impact, but the difficulties are even greater.

“Africa has normalized conflict and what we have seen, unfortunately, in the last two years is that health systems are not functioning effectively, where patients will see six health professionals before they are diagnosed with cancer,” said Miriam Mutebi, an assistant professor at the Aga Khan University College of Medicine in Nairobi, Kenya.

“Now we have a worsening climate crisis, geopolitical crises and conflicts, debt and poverty affecting almost every country, including high-income countries that have been relatively spared until recently,” said Richard Sullivan of King’s College London.

According to mastologist Maira Caleffi, president of Femama (federation of philanthropic institutions supporting breast health), the floods in Rio Grande do Sul, for example, caused impacts on the journey of cancer patients that are still being measured.

According to the researchers, there are lessons being learned that deserve to be replicated. In the Ukraine war, for example, monitoring a group of cancer patients from the beginning of the conflict allowed oncologists to track them and continue their care in neighboring Egypt and the United Arab Emirates, where 1,000 patients were admitted in July.

Similar coordination among African nations, a continent with some 40 million refugees, could have a similar impact on providing urgent cancer treatment, experts said.

“Africa has normalised conflict and what we have seen unfortunately in the last two years is that health systems are not functioning effectively, where patients will see six health professionals before a cancer diagnosis,” said Miriam Mutebi, a consultant breast surgical oncologist and assistant professor at the Aga Khan University College of Medicine in Nairobi, Kenya.

“This is compounded by social and cultural barriers that already inherently diminish access. When you add a layer of conflict, it pretty much goes up in smoke.”

At a press conference organized by UICC (Union for International Cancer Control), researchers also discussed the impact of Covid on the drop in cancer diagnoses.

“We have all read, talked and experienced Covid. We are now quantifying many of the fears we had about misdiagnosis and late-stage disease as a consequence of the pandemic,” said UICC President Jeff Dunn.

A preliminary study by the International Partnership for Cancer Reference compared data on the occurrence and stage of cancer diagnosis in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the United Kingdom, before and during the pandemic.

The results show that the UK had the largest and most sustained falls in lung, breast, colorectal and skin cancer diagnoses during 2020, relative to other countries.

For Isabelle Soerjomataram, from IARC (International Agency for Research on Cancer), what makes the study truly unique is the fact that there is comparable data from high-quality databases, which include all sources of information in the country.

Although they are all high-income countries, the researcher emphasizes that the idea is not to talk about income. “The idea is to have the best quality data.”

According to her, experience shows that even developed countries responded very differently when it came to caring for cancer patients during the pandemic.

In Northern Ireland and Wales, for example, there was a 30% drop in lung cancer diagnoses. In New Zealand, it was 11%.

Although the study did not include data from Latin America, the researcher said that some studies carried out in Brazil show that the impact was significant in both diagnosis and treatment. However, there is no systematized national data.

One of the studies, by Fiocruz Pernambuco, for example, analyzed the impact on breast cancer care in the first year of the pandemic in the Pernambuco health network. There was a drop in mastology consultations (46.3%), ultrasounds (41.5%), biopsies (49.6%), new cases (34.8%) and surgery (34.6%).

According to Caleffi, from Femama, in many places the impact of the pandemic still persists. “Tracing [do câncer] It hasn’t picked up yet, people haven’t returned to the level they were at before the pandemic.”