ON the eve of February 4, World Cancer Day, Pan American Health Organisation (PAHO) Director, Carissa F. Etienne, called for ensuring diagnosis and treatment of cancer in the Americas, where services have been seriously disrupted during the COVID-19 pandemic.
“We must not forget other grave illnesses while we combat COVID-19,” Etienne said. “We must fight the pandemic while continuing to make advances against other diseases, particularly cancer. For cancer patients, lack of diagnoses, treatments, and medications can be deadly,” she remarked.

In the Americas, cancer is the second leading cause of death, with an estimated four million people newly diagnosed in 2020. An estimated 1.4 million people died from cancer in 2020. And approximately 57 per cent of new cancer cases and 47 per cent of cancer deaths occurred in people 69 years of age or younger, in the prime of their lives. Among men, prostate, lung and colorectal cancers are most common whereas among women, breast, lung and colorectal cancers are most common.
Pandemic-related disruptions to cancer services arose due to multiple causes, according to a PAHO/WHO survey of non-communicable diseases (NCDs), including cancer, in seven countries in the Americas. They resulted from cancellation of elective medical procedures, closure of services, reduction in demand due to lockdowns, and the need to channel resources into COVID-19.

In addition, some cancer patients have been reluctant to show up for office visits or go to hospitals for treatment where COVID-19 patients may also be receiving care. Cancer patients are at increased risk of developing the most serious and potentially fatal forms of COVID-19.
“We must ensure that people who are already sick with cancer do not miss life-saving diagnosis and treatment because of the pandemic,” said Anselm Hennis, director of PAHO’s Department of Non-communicable Diseases and Mental Health. “There are tools for prevention, diagnosis, and treatment that can show us how to achieve this.”

PAHO/WHO provides guidance on how to adapt services for cancer patients amid the pandemic. These are: Prioritise treatments for cancer patients, taking into consideration the safest and most effective interventions, the speed at which the cancer is progressing, and the effects of delayed treatment on clinical outcomes and quality of life; minimise the number of in-person visits to health centres, especially in areas where there may be more patients with suspected COVID-19; lower risk of exposure by providing services and clinical trials at alternate healthcare facilities; provide follow-up counselling, psychological support or palliative care by telephone or remotely; facilitate home delivery of drugs and in-home testing and sampling; move practitioners’ offices to locations with lower risk of exposure; and delay personalised follow-up visits for several months when feasible, for example, when patients have completed treatment, have a good prognosis, and can be seen in telehealth consultations.

WORLD WITHOUT CANCER
World Cancer Day works to save millions of lives each year by raising awareness and education about cancer and by calling on governments and people around the world to take action against the disease. From 2019 through 2021, the theme of World Cancer Day is “I am and I will” – a collective call to action to reduce the global impact of cancer. This global day invites people to express who they are and what actions they will take to create a world without cancer. Between one-third to one-half of cancer cases could be prevented by reducing risk factors such as tobacco use, harmful use of alcohol, unhealthy diet, and physical inactivity. The human papillomavirus (HPV) vaccine also prevents Cervical Cancer. “Cancer should never be a death sentence, even during a pandemic,” Dr. Hennis said.