Canadian doctors say they are seeing patients suffering from more advanced stages of cancer than usual, a phenomenon they attribute to the effects of COVID which led to a nationwide shutdown and delays in medical reviews and postponements of family doctor appointments across the country.

Dr. Helmut Hollinhurst, Chief Medical Officer of the Cancer Patient Care Program in Nova Scotia, says he believes cancer patients are experiencing more advanced disease due to the pandemic and missed or delayed medical appointments.

Hollinhurst said in a recent interview, referring to the Cancer Patient Care Center at the QEII Health Sciences Center in Halifax: "From my own practice, we see patients with more advanced disease."

He added, "And we are not alone; this is happening now across the country, unfortunately."

On the other hand, Hollinhurst said that confirmed data proving this trend is not yet available, but he hears cases from colleagues across Nova Scotia and Canada about an increase in patients with more serious cancer.

He said, "We expect with the readiness and availability of data that we will be able to quantify this effect."

Dr. Tim Hanna, a dermatologist in Kingston, Ontario, says he also began noticing a sharp increase in advanced stage cancer at his clinic in January 2021.

Hanna said in a Wednesday interview, "I have noticed more advanced cancers among patients I have seen than I have personally seen at any time before." "This trend continued for about a year at the Kingston Health Sciences Center clinic, where rates of advanced cancer approached normal levels in early 2022."

Most types of cancer treated by Hanna cannot be evaluated on the four-stage cancer grading scale, but he said many of his patients between January 2021 and January 2022 had cancers that were more advanced than what his patients usually have.

Both doctors attribute the increase in advanced diseases to how healthcare and people's habits changed when the pandemic broke out. Hollinhurst said access to primary care became very difficult for many people, adding that public health restrictions directed Canadians to stay home and avoid public places.

The doctor added: "Even when primary care was available, patients were worried about leaving home or going to the hospital." He said this meant, in his words, that people delayed visiting their family doctor or outpatient clinic to check symptoms.

While cancer treatment continued during the pandemic in most parts of the country, many diagnostic tests and cancer screenings were temporarily stopped when COVID-19 first hit Canada.

Hanna said the temporary halt of these tests sent "somewhat an implicit message that cancer could wait." He said this is a problem because in some cases, "missing the screening can turn into a disaster."

Hollinhurst said that people with advanced cancer usually require immediate and complex treatment, which means more harmful side effects for the patient. He said some types of cancer, when detected early, can be treated with a single surgery. And the same cancer, if diagnosed later, may require surgery along with chemotherapy and radiation therapy.

Hollinhurst said these pandemic-related effects have caused significantly greater burdens, distress, and struggle for patients, and a much greater burden on the healthcare system."

Hanna said for many types of cancer, more advanced disease means the cancer has spread to other parts of the body. This makes it "more difficult to treat, with greater risks of side effects and less chance of success."

He added that the cost of late cancer diagnosis is also a financial cost, adding that cancer drugs can cost around $10,000 a month. The health system must cover the costs of staff and medical equipment to increase surgeries and treatments.

A study published in the International Journal of Cancer by Talia Malagon, a cancer researcher at McGill University in November 2021, modeled the potential long-term impact of COVID-19 disruption on cancer patient care. Malagon's study predicted that the disruption in cancer care caused by the pandemic would lead to 21,247 additional cancer deaths in Canada between 2020 and 2030, a 2% increase in the mortality rate.

The two doctors then mentioned that they hope intensive diagnostic screenings will reduce the expected number of additional cancer deaths in Malagon's study.

Hanna added that he would like to see Ontario Province provide greater compensation to family doctors for performing cancer biopsies. On the other hand, Hollinhurst said Nova Scotia, which ranks among the highest cancer rates in Canada, should focus its efforts on cancer prevention and speeding up cancer screenings.

He then added: "We need early detection and clinical screening, then to accelerate the work on diagnosing suspected cancer so that the disease is diagnosed at an early stage and enters the treatment system faster."

Edited by: Dima Abu Khair