Cancer Care for Seniors Delayed During COVID-19 Pandemic

Cancer Care for Seniors Delayed During COVID-19 Pandemic

COVID-19 has had a large impact on the cancer community. Patients have faced new challenges, particularly when seeking health care. The pandemic has negatively affected cancer care as a whole, especially for elderly patients.

Researchers recently studied the impact of COVID-19 on American seniors in need of cancer care. According to their findings, there were decreased diagnoses and delayed treatment. This may create challenges for aggressive cancers such as mesothelioma.

COVID-19 and the Drop in Cancer Diagnoses

Researchers partially attribute a drop in cancer diagnoses to fewer screenings. In one recent study, researchers focused on cancer screenings from March 2019 to July 2019 in comparison to March 2020 – July 2020. At the April peak of the pandemic, screenings dropped by:

  • 85% for breast cancer
  • 75% for colon cancer
  • 74% for prostate cancer
  • 56% for lung cancer

This study focused on Medicare participants. Most Medicare participants are people 65 years of age or older. Younger individuals with disabilities or certain medical conditions may also participate. This particular study included more than 6 million Medicare beneficiaries.

Doctors may recommend patients with a known history of asbestos exposure undergo frequent checkups. These can involve screenings for any signs of mesothelioma, lung cancer or other asbestos cancers. Without these screenings, individuals may not receive diagnoses until the later stages of the disease.

For mesothelioma, patients may not experience symptoms until decades after their exposure. This places further emphasis on the importance of screenings.

COVID-19 and Mesothelioma Misdiagnosis

Mesothelioma is a rare cancer that may be misdiagnosed as a more common condition. Some mesothelioma symptoms are also similar to symptoms of COVID-19. Mesothelioma and COVID-19 patients may experience coughing, shortness of breath or a fever.

Patients may not seek additional care if they attribute their symptoms to COVID-19. However, it’s crucial to speak to a medical professional as soon as possible. Specialists can rule out other conditions and pursue a cancer diagnosis if it is suspected after evaluation.

One of the main factors signaling a mesothelioma diagnosis is asbestos exposure. Patients should inform their doctor of any possible exposures. This knowledge can help guide doctors toward an accurate diagnosis.

COVID-19 and Delayed Treatment for Cancer Patients

Many cancer patients also saw their doctors less and experienced delayed cancer treatments. There was a sharp decrease for Medicare participants in April for:

  • Hospital outpatient evaluation and management visits (E&M visits)
  • New patient E&M visits
  • Established patient E&M visits
  • Billing frequency for the top physician-administered oncology products

There was also a decrease in:

  • Mastectomies (April through July)
  • Colectomies (April and May)
  • Prostatectomies (April and July)

Some surgical procedures may be crucial to prevent cancer from metastasizing (spreading) to other areas of the body. For cancers such as mesothelioma, beginning aggressive treatments early may help improve prognosis.

At-risk elderly patients urged to stay home and transition to telehealth have lost the in-person care they may need to monitor and manage their condition.

Particular Concerns for Elderly Cancer Patients

Elderly cancer patients may be more at risk of serious complications due to their age or poor overall health.

The median age for a mesothelioma diagnosis is 74 years old. These patients may be ineligible for aggressive treatments and reliant on clinical trials for treatment. Many clinical trials have paused enrollment during the pandemic. This means some patients may be unable to receive the form of care provided by the trial.

Researchers have found elderly cancer patients can also be at a higher risk of serious complications or death from COVID-19. Moffitt Cancer Center identified three major risk factors for cancer patients:

  1. Advanced age
  2. Progressing cancer
  3. Poor performance status*

*Poor performance status refers to patients who can care for themselves but can’t perform most work-related tasks.

Many patients are encouraged to use telehealth appointments to avoid potential exposure. However, this is difficult for those in need of surgery, chemotherapy or radiation. These treatments could greatly extend patient survival.

Programs such as Moffit’s Senior Adult Oncology Program continue to study the relationship between elderly cancer patients and the COVID-19 pandemic. This is to ensure elderly patients receive the cancer care they need.