It all started with a stomach problem.
That’s what Cheryl-Anne Labrador-Summers thought, anyway. It was October 2020, shortly after she moved to the quiet, lakeside community of Georgina, Ontario, and instead of relaxing with her family as planned, three children were struggling to figure out why he continued to experience strange and inexplicable. stomach cramps.
Labrador-Summers tried to visit his family doctor, but the office was closed due to the COVID-19 pandemic. So he looked for another clinic, only to offer him a phone appointment instead of an in-person evaluation. She was told that her large digestive system was probably caused by a mild gastrointestinal illness.
In January, the 58-year-old woman had a distended stomach, resembling, in her own words, “about nine months pregnant.” Again, he contacted a doctor, had some tests done, and then went to the nearest emergency department.
After finally seeing a doctor face to face for the first time in months, he learned the real cause of his discomfort: a bowel blockage caused by cancer.
“It ended up being a nine-inch tumor and it had completely blocked my lower intestine,” he said.
An emergency surgery left Labrador-Summers with 55 staples along his torso and a recovery months before he could start oral chemotherapy. His question is now unquestionable, but it is painful to consider: could this ordeal have been prevented, or at least minimized, with a previous diagnosis?
“If I could have seen the doctors before, I wouldn’t be in stage 3,” he said. “It could have been a stage 2.”
The photos show Labrador-Summers with his stomach distended before his emergency surgery, left, and the 55 staples along his torso after the procedure. (Provided by Cheryl-Anne Labrador-Summers)
951,000 fewer cancer screenings in Ontario
More Canadians could be diagnosed with advanced cancer diagnoses in the coming years, warn medical experts, who predict an impending crisis linked to the ongoing COVID-19 pandemic.
“We expect to see more advanced stages of presentation over the next two years, as well as impacts on cancer treatments,” said oncologist Dr. Timothy Hanna, clinical scientist at Queen’s University Cancer Research Institute in Kingston, Ontario.
“We know that time is of the essence for people with cancer. And when people are waiting for a diagnosis or treatment, this has been associated with increased risk of advanced stage and worse survival.”
A review of Ontario’s breast, lung, colon, and cervical cancer screening programs showed that by 2020, 41%, or more than 951,000, fewer screening tests were performed compared to the previous year.
Detection volumes recovered after May 2020, but were still 20% lower compared to pre-pandemic levels.
TARGET | Canadian ER is diagnosed with late-stage cancer:
Emergencies face advanced cancer diagnoses in mid-pandemic
Hospital emergency rooms are seeing a surge in patients diagnosed with late-stage cancer after the COVID-19 pandemic forced many clinics to close or switch to virtual appointments, leading to fewer cancer screenings.
This drop in screening tests translates into fewer diagnoses of invasive cancer, including approximately 1,400 to 1,500 fewer breast cancers, wrote Dr. Anna N. Wilkinson, an assistant professor in the Department of Family Medicine at the University of Ottawa. in a May comment for Canadian Family Physician magazine.
“The impact of COVID-19 on cancer is far-reaching: delay detectiondelayed study of symptomatic patients and abnormal screening results, and delays in cancer treatment and the investigation, all aggravated by the patient’s apprehension of being seen in person, “he wrote.
“Clearly, not only is there a lost cohort of patients examined, but also a subset of cancer diagnoses lost due to delays in patient presentation and evaluation,” which makes these cancers diagnosed at a later stage. .
Difficult access to care “in a timely manner”
The slowdown in colonoscopies may already be leading to more severe cases of colorectal cancer in Ontario, for example, proposes a role published in the Journal of the Canadian Association of Gastroenterology.
“Patients who were treated after the onset of the COVID-19 pandemic were significantly more likely to be rushed to the hospital. This means they were more likely to have a bowel perforation or obstruction. severe bowel movements, which require immediate life-saving surgery, “the study’s lead author, Dr. Catherine Forse, said in a call to CBC News.
“In addition, we found that patients were more likely to have large tumors.”
Dr. Lisa Salamon, an emergency physician at Scarborough Health Network, is pictured outside Birchmount Hospital in Scarborough, Ont. (Evan Mitsui / CBC)
In some cases, such as the Labrador-Summers situation, Canadians heard alarming news about their health in the hospital’s emergency departments after struggling to receive hospital care in other ways.
Closed family physician offices, a shift to telemedicine, and the fears of some patients around COVID-19 may have played an important role.
“It became more difficult for patients to access care and access it in a timely manner,” Hanna said.
“At the same time, there were real risks, and there are real risks of leaving home to go anywhere, especially to go to an outpatient clinic or a hospital for a checkup.”
Dr. Lisa Salamon, an emergency physician at Scarborough Health Network in Toronto, said she is now diagnosing more patients with serious cancers, including several in recent months alone.
“So previously, it may have been localized or something small, but now we’re seeing metastatic cancer that we’re diagnosing,” he explained.
Lessons for future pandemics
Health policy expert Laura Greer faces fourth stage, metastatic breast cancer after waiting more than five months for a routine mammogram to be performed initially in the spring of 2021 , a precautionary measure given that her mother also had breast cancer.
Unlike an early-stage diagnosis, Greer’s cancer is only treatable, not curable.
“It was an example of what happens when you don’t have the usual screening or wellness visits,” said the Toronto resident and mother of two.
“Most likely he would have had cancer at an earlier stage if he had been earlier.”
Health policy expert Laura Greer faces stage 4 metastatic breast cancer after waiting more than five months for a routine mammogram to be performed in the spring of 2021. (Esteban Cuevas / CBC News)
Pausing access to care and screenings for other health conditions can have serious impacts on patients, according to Greer, who offers lessons on how policymakers address future pandemics.
“We need to make sure we have enough capacity in our healthcare system to be able to flex, and that’s what we really didn’t have in that,” he said.
For Labrador-Summers, it’s hard to forget the time when her life changed while she was alone in an emergency room, learning a terrifying diagnosis from a doctor she had just met. Her mind raced with questions about the future and worries for her family.
Labrador-Summers’ husband and one of her children kiss her on the pier near her lakeside home in Georgina, Ontario. (Ousama Farag / CBC News)
“My eldest son had just told us they were expecting a baby, and I just wanted to be there for them. And I didn’t know what the next steps were. And we had lost my mother to cancer a few years ago, so us, cancer was always terminal, “he recalled.
“So again, I’m alone, trying to process all this.”
Detection after surgery and chemotherapy treatment in Labrador-Summers ended up finding more cancer.
“It’s life threatening now,” he said.