I will never forget the third week of March 2020. At the time, I was completing my radiation oncology training in Detroit, Michigan. Detroit was an early COVID hot spot.
Over the course of the week, I saw our hospital scramble to collect as much personal protective equipment as possible. I also saw our emergency department swell and then overflow onto the floors of the hospital and eventually into the intensive care unit.
Before the pandemic, I had become accustomed to hearing codes called over the hospital speakers for severely ill or dying patients about twice a day. Over the next few weeks, I became accustomed to a new normal: codes called every 20 minutes, haunting me as I tried to care for our cancer patients. Among the physicians, nurses, trainees and other staff in the department, I saw fear, but I also saw a determination to continue caring for our patients.
As I reflect on those first weeks of the pandemic, I realize how lucky I was. Cancer care was considered an essential health care service, so I was allowed to continue caring for my patients. Because I was not pulled to the front lines, I did not suffer the same stress and burnout as the providers in the emergency department, inpatient floors and ICU, who were overwhelmed with severely ill COVID positive patients.
It has been 18 months since those first nightmarish weeks. Only now am I seeing the true toll COVID has taken on cancer patients. I have cared for numerous patients who were diagnosed with an early stage, curable cancer in early 2020, but due to their fear of COVID, they did not seek health care and returned with incurable, metastatic disease.
I have also seen dozens of patients who delayed cancer screening or missed screening entirely during 2020 and then came to me with advanced disease. It is impossible to know which of these individual patients would have been cured. What I can say with certainty is that for a number of our cancer patients, we missed the vital window in which curative therapy would have been an option.
The American Society for Radiation Oncology recently surveyed 117 cancer centers and clinics nationwide regarding the impact of COVID. Two-thirds of radiation oncologists noted that new patients are presenting with more advanced-stage cancers, and 73% reported patients are delaying or missing cancer screenings. While it may be years before we have comprehensive data showing how this global pandemic has affected cancer outcomes, for those of us caring for cancer patients on a daily basis, the devastating impact of COVID on these patients has become clear.
As a physician, I encourage my patients to take steps to reduce their risk of contracting or spreading COVID. I do everything I can to limit my personal risk of contracting or spreading COVID to my patients.
Thousands of cancer survivors call Cheyenne their home. Many of my patients remain active members of the community during and after their cancer treatment. For these friends, family members and neighbors, the consequences of contracting COVID could be dire.
As you decide what precautions to take – to mask, vaccinate, social distance or not – I urge you to consider the impact that these decisions are having on these resilient and remarkable – but also vulnerable – members of our community.