22 CASTLE CONNOLLY TOP DOCTORS IN QUEENS • NOVEMBER 19, 2020 FOR BREAKING NEWS VISIT WWW.QNS.COM
Getting Candid About Lung Cancer
Diagnosis in the Age of COVID-19
(BPT) - The COVID-19 pandemic has
caused a significant disruption in cancer
care and treatment.1 As the leading cause
of cancer death in the US, the potential
impact on lung cancer is especially alarming.
2,3 Recent studies predict a significant
increase in the number of cancer deaths
over the next five years due to missed
screenings, delays in diagnosis and reductions
in oncology care caused by COVID-
19.3,4
While part of this disruption is due to
the reduction and suspension of screening
programs and diagnostic services caused
by the reallocation of medical staff and
resources to fight the pandemic, there
are also other important factors at play.1
Nationwide stay-at-home orders, job and/
or insurance loss and general fear of exposure
to the virus during a doctor visit have
resulted in people postponing care for
non-COVID-19 health concerns, or foregoing
it altogether.1,6 As a result of these
factors, although individuals across the
US are still getting lung cancer, more people
are going undiagnosed until the cancer
has reached an advanced stage.5
“What we are seeing in our practice is
that people are not coming in for anything
unless they absolutely have to,” said Joyce
Knestrick, PhD, FNP-BC, FAANP. “They
don’t want to go to any screenings. They
don’t want to go to any hospital settings to
be exposed to COVID.”
Many medical conditions, including
lung cancer, will not “wait” for the pandemic
to end. Putting off diagnosis and
treatment may have significant negative
effects on patient outcomes.5
“In my experience, if they don’t know
they have a diagnosis they are not going
to seek it out unless they are really sick
anyway. That’s why I am really worried
about the burden on the system when
people come in at different levels,” Joyce
continued.
Lung Cancer: There’s No Pause Button
Cancer does not discriminate, and its
consequences are not pausing even if the
world is.
Despite relatively stable lung cancer
diagnoses rates for 13 months prior to
the pandemic,7* states with a particularly
high prevalence of lung cancer where the
decline is most notable and severely affected
by COVID-19- New York, California,
Texas, Tennessee, Pennsylvania, Illinois,
Michigan and Ohio- have since seen a
30-60% reduction in such diagnoses as of
May 2020.
This sharp decline does not mean
fewer people are developing lung cancer.
Instead, quite the opposite: more individuals
are going undiagnosed and delay
treatment until their cancers advance.8
While some individuals with early lung
cancer can have symptoms, many do not
until the disease spreads. An added challenge
is some symptoms such as coughing,
shortness of breath and fatigue may
mimic those of COVID-19.10,11
If lung cancer symptoms are noticed
sooner rather than later, or people at
known risk seek medical care, it might be
diagnosed and treated more effectively at
an earlier stage.
“I think this is a challenging time for all
of us, but we are all in this together,” said
Nanette Alexander, DNP, APRN, FAANP.
“We want to minimize what they need for
care, and early intervention does that.”
Reassuring Patients: The Time Can
STILL Be Now
It is critical for people at risk for lung
cancer, or with potential symptoms, to
stay connected with their health care providers
and learn how to best seek care
given the situation. Even in the face of a
global pandemic, concerns should not be
put on hold.
Hospitals and clinics are doing all they
can to ensure the health and safety of
patients during the pandemic. Ultimately,
the risk of COVID-19 must be balanced
against the risk to the patient of lung cancer
progression, and in most cases, lung
cancer still represents a greater risk of
mortality for patients.3,12
“When your providers say it is safe to go
back, go back,” Nanette concluded.
For more information on cancer and
COVID-19, visit covid19cancerresources.
com.
*Compared to the average lung cancer
diagnosis rates from Jan ‘19 to Feb ‘20.
References 1. Richards M, Anderson
M, Carter P, Ebert BL, Mossialos E. The
impact of the COVID-19 pandemic on
cancer care. Nat Cancer. 2020;1:565-567.
2. American Cancer Society. Key
Statistics for Lung Cancer. Available at
https://www.cancer.org/cancer/lungcancer/
about/key-statistics.html. Accessed
August 2020.
3. Amit M, Tam S, Bader T, Sorkin A,
Benov A. Pausing cancer screening during
the severe acute respiratory syndrome
coronavirus 2pandemic: Should we revisit
the recommendations? Eur J Cancer.
2020;134:86-89.
4. Maringe C, Spicer J, Morris M, et al.
The impact of the COVID-19 pandemic
on cancer deaths due to delays in diagnosis
in England, UK: a national, population
based, modelling study. Lancet
Oncol. 2020;21:1023-1034.
5. Kaufman HW, Chen Z, Niles J, Fesko
Y. Changes in the Number of US Patients
With Newly Identified Cancer Before and
During the Coronavirus Disease 2019
COVID-19 Pandemic. JAMA Netw
Open. 2020;3(8):e2017267.
6. Woolhandler S, Himmelstein DU.
Intersecting U.S. Epidemics, COVID-19
and Lack of Health Insurance. Ann Intern
Med. 2020;173:63-64. doi:10.7326/M20-
1491
7. This is based on information licensed
from IQVIA Oncology Real World
Insights for the period of January 2019
to May 2020 reflecting estimates of realworld
activity. All rights reserved. Study
details and information maintained by
AZ.
8. Sharpless, NE. COVID-19 and cancer.
Science. 2020;368(6497):1290.
doi:10.1126/science.abd3377.
9. American Cancer Society. Signs and
Symptoms of Lung Cancer. Available at
https://www.cancer.org/cancer/lung-cancer/
detection-diagnosis-staging/signssymptoms.
html. Accessed August 2020.
10. Centers for Disease Control and
Prevention. Older Adults. Available at
https://www.cdc.gov/coronavirus/2019-
ncov/need-extra-precautions/olderadults.
html. Accessed August 2020.
11. Centers for Disease Control and
Prevention. Symptoms of Coronavirus.
Available at https://www.cdc.gov/
coronavirus/2019-ncov/symptoms-testing/
symptoms.html. Accessed August 2020.
12. Singh AP, Berman AT, Marmarelis
ME, et al. Management of Lung Cancer
During the COVID-19 Pandemic. JCO
Oncol Pract. https://ascopubs.org/doi/
full/10.1200/OP.20.00286
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