OTTAWA - For several months now, mask mandates and social distancing have become somewhat routine for much of society. The spread of COVID-19 is mostly isolated to a few areas around the region to the point where society remains vigilant, but also independent of government restrictions outside of long-distance travel.
That isn’t to say that COVID-19 is a disease of the past like the black plague or smallpox.
With the seventh wave of COVID’s Omicron subvariants gripping in the back of everyone’s throats and looming like a nagging cough, immunocompromised patients are still heavily at risk of COVID-related death.
A new survey from the Canadian Cancer Survivor Network shows that despite the calming of COVID mandates throughout the nation, anxiety among cancer patients persists.
The survey, "Impact of COVID-19 Crisis on Cancer Patients," is a national online survey, conducted between April 13 and May 12, 2022. The survey was the fourth in a series of research studies conducted by Léger for the Canadian Cancer Survivors Network. The fourth study focused on cancer patients' and caregivers' levels of anxiety about receiving cancer care after COVID-19 restrictions have been lifted. The respondents comprised 1100 people with a cancer diagnosis and 253 caregivers for cancer patients.
"The survey results tell us that many cancer patients and caregivers still believe that COVID-19 poses a serious risk for them and that they feel the weight of responsibility for keeping themselves and their loved ones safe," says Jackie Manthorne, President and CEO of the Canadian Cancer Survivor Network.
For immunocompromised cancer patients, the negative impact is even greater.
Just over one in four patients in CCSN's survey 26 per cent are immunocompromised, and 41 per cent of caregivers care for the patient.
During the last two years, hospital overcrowding of COVID patients made it impossible for cancer patients to receive proper treatment. These disruptions include cancelled and postponed in-person appointments, and suspension of elective surgeries and other procedures.
“During the first wave, my cancer clinic was almost 'shut down,' in effect,” wrote an ovarian and esophageal cancer patient in Quebec. “My regularly scheduled appointment was cancelled and not rescheduled. Instead of every six months, it was over a year before I was seen, and by then my cancer marker had tripled, when for 1.5 years it had been stable.”
For most cancer patients, waiting in line to see a specialist or an outright suspension of surgeries because of the overwhelming plight of COVID patients taking precedence allowed their cancer to continue to eat away at the patient's body, as well as, their mental health.
“At first I was confused and thought it was a hospital scheduling error - when I realized it was due to covid I was very anxious,” said an ovarian cancer patient in remission from Ontario, referring to a cancelled appointment. “I depend on my checkups to make sure my bloodwork is stable and if the cancer returns, we catch it in time to be proactive. The anxiety of living with cancer is unexplainable to someone who has not experienced it.”
The cancellation of elective surgeries across Canadian hospitals in the early stages of the pandemic had a massive impact on cancer patients.
According to the Canadian Cancer Survivor Network survey, for those who did have rescheduled appointments, wait times tended to be 30 days on average to get a new appointment date; however, some patients had the experience of waiting several months.
As of July 2021, 12 per cent of all respondents, or just under one in eight, have had their surgeries cancelled or postponed during the pandemic.
“It's quite devastating to me,” wrote a cervical cancer patient in Ontario about her postponed surgery, “as this surgery would have relieved many of my worst symptoms.”
During this time, cancer patients had to live with their pain and debilitating symptoms. This added to the burden of stress, anxiety, and despondency.
Canadian Cancer Survivor Network survey does acknowledge that postponement of surgeries is in decline: nevertheless, the backlog of surgeries from earlier in the pandemic remains. Because of this, there are still patients who do not know when their surgery will be rescheduled.
“Having my endoscopy procedure postponed has increased my worries,” said a stage 2 stomach cancer patient in Quebec. “Now I have to wait, and I have no idea when it will be rescheduled. I want to know that my cancer treatment was successful and that the cancer has not returned. This uncertainty is affecting my quality of sleep. I need to know if my cancer has come back.”
With the added stress of not knowing if cancer has returned and is wreaking havoc on a patient's body only worsens with the knowledge of waiting months for confirmation. These delays allow symptoms to worsen or cancer to spread further; therefore, when the patient has the opportunity for surgery, cancer may be more difficult to remove than it should have been.
“Because of the delay in getting an appointment with my surgeon and then another delay for surgery, my cancer quadrupled in size causing a simple surgery [to be more complicated,” wrote a lymphoma and melanoma patient in Ontario who has experienced these consequences firsthand.
To read the full report, all four studies conducted from 2020 to 2022, are available on the CCSN website. In June 2022, the CCSN also published a report summarizing the first three of these studies, titled 'Thrown Under the Bus! Disruption of cancer care in Canada during the COVID-19 pandemic'.