If some patients have escaped Covid-19, they will not get out of their cancer unscathed, for lack of prompt treatment.
This is the reason why, between two waves of Covid-19, health professionals are determined to wave another wave, pink, across France.
On the occasion of the Pink October operation, doctors and volunteers intend to warn about the consequences of the late treatment of patients with cancer, invisible victims of the health crisis.
Doctors' concerns primarily relate to screening, an essential step in the care of a patient.
Throughout the confinement, all cancer screenings were canceled by the National Cancer Institute in order to stem the epidemic.
An aberration for Céline Lis-Raoux, director of the RoseUp association which publishes Rose magazine and manages two pink houses, committed to the fight against breast cancer.
"There was no reason to stop these screenings, especially in areas where the Covid-19 epidemic was not widespread. Losing even a month in the treatment of certain aggressive cancers is proving decisive, even fatal for the future. "
[#OctobRose] 3,2,1 ... Here we are on October 1st and therefore Breast Cancer Screening Awareness Month starts today!
❤️
The Cancer League reminds you that screening can save your life!
More info at https: //t.co/QkoiJSFWko pic.twitter.com/2VrjbFOofn
- the League against cancer (@laliguecancer) October 1, 2020
"Great distress"
If screenings resumed after confinement, women who showed signs of breast cancer did not necessarily return to detection centers, or to gynecology offices.
"There was such panic speech from the authorities through the media that women were more afraid of catching Covid-19 when going out than of having a mammogram," continues Céline Lis-Raoux in an interview with France 24. It is a shame because breast cancer can be treated quickly and well if caught on time. Waiting for the next year to get tested means running the risk of dying from a disease. that we could have healed. "
Interventions deemed "non-urgent" for all cancers were also postponed during the first month of confinement.
A decision taken with the aim of reserving the material and human resources of the operating theaters and anesthesia for the fight against the coronavirus.
According to a recent survey by the Patients en Réseau association, 61% of surgeries were canceled.
A strategic choice that some association managers question.
"Many women have been deprived of treatment for several months, regrets the director of RoseUp. It is precious time for patients who know that certain cancers can become metastatic in a few months."
>> To read: "Because of the Covid-19, I will not have children"
Finally, the follow-up examinations were also behind schedule.
The practices that usually perform MRIs and X-rays had to close the time to reorganize the premises with the imposed sanitary measures.
When they reopened, they had to drastically reduce the number of appointments to respect barrier gestures.
"Still time wasted for all the patients, explains Céline Lis-Raoux. And what can be said on the psychological level of this expectation! Not knowing the state of progress of your disease for nearly six months is a unbearable situation. Within our association, we were able to provide psychological support by telephone. Because many breast cancer patients were in great distress. "
2% to 5% excess mortality
A study published by researchers from Gustave-Roussy, the leading cancer center in Europe, located in the Paris region, reveals grim data.
"We estimated that the delays in care will cause an excess mortality of 2% at five years, warns Aurélie Bardet, statistician in charge of the study, in an online article from RoseUp. In other words, from here on out. by the end of the year, around 5,000 patients will be treated in Gustave-Roussy. We know that in five years, 2,000 of them will have died of their cancer. Among these 2,000 deaths, 50 will be due to delays of care due to the pandemic. "
This study is all the more alarming as it was based on a massive return of patients in September and the absence of a new wave.
"We had all the same considered a more pessimistic hypothesis in which the patients would have returned later, continues Aurélie Bardet. According to this new scenario, excess mortality would reach 4.6%. But it appears that this last scenario was still too optimistic since, today, not only is the pandemic resuming, but we have not recovered the historical flow of our patients. This means that not only have our diagnosed patients not all returned to start or continue their treatments, but neither have we no longer welcomed patients who should have since been diagnosed. "
The Covid has had a major impact on #cancer patients.
A study conducted at @GustaveRoussy estimates that, in 5 years, 2 to 5% of cancer deaths will be the result of delays in treatment.
Read our interview with Aurélie Bardet: https://t.co/EllrDQ6H55 # esmo2020
- RoseUp Association (@RoseUpAsso) September 24, 2020
When we know that cancer kills approximately 150,000 people in France each year, including 12,000 women from breast cancer, "a 5% increase in mortality is absolutely enormous," worries Céline Lis-Raoux. this study concerns only the patients followed in Gustave-Roussy, that is to say a population which has access to care and is concerned about its health. This is not the case throughout the territory. "
Consequences in four to five years
But the picture is not so dark, if we are to believe some doctors like Paul Cottu, deputy head of the medical oncology department at the Institut Curie.
“At this time, there is no evidence to support the hypothesis that Covid-19 will have an impact on breast cancer,” he told HuffPost. The only thing that can be said is 'can not be said. Yes, some patients may have postponed appointments, but with a few rare exceptions, they understood that cancer was something serious and are being followed, "he continues. .
And to conclude: "This cancer is a disease which evolves slowly", it is therefore "not at all certain" that this will have a "real impact".
Either way, it is still too early to know the real consequences for cancer patients.
"We will not perceive the effects of Covid-19 this year but in only four or five years. Because delays in screening or follow-up do not necessarily have an immediate impact but may result in less effective treatment thereafter, long-term alteration of the survival rate of some patients. "
In the meantime, according to the National Cancer Institute, patients with the disease are four to five times more likely to develop a severe form of Covid-19 if infected with the virus.
Their immune system weakened by certain treatments, including chemotherapy, makes them more fragile.
This is not the first time that cancer patients have suffered from exogenous crises.
Studies had already shown that the subprime financial crisis that occurred in 2007, which had harmed the world economy, had had dramatic consequences on the screening of patients.
According to a study published in May 2016 in the British medical journal The Lancet, the rise in unemployment and the budget cuts in the health sector, following the crisis had contributed to an excess mortality from cancer of more than half a million people around the world.
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