RELATED MEDICAL ISSUES RIGHT NOW! #4: Breast Cancer and the Global Pandemic…

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

The immediate crisis that was Breast Cancer and Alzheimer’s have passed. There are, however ancillary issues like testing and treatments that may not be directly related to BC or A but intersect with them. Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: “Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US”

We all know that the pandemic, through the twin incidence of overflowing hospitals and lockdowns, had an impact on the diagnosis and treatment of breast cancer.

But how MUCH of an impact? According to the article, “[We expect that there will be] 2487 excess breast cancer deaths…([an] increase over breast cancer deaths expected) by 2030 in the absence of the pandemic’s disruptions.”

Twenty-five hundred people doesn’t…seem…like a lot over a ten year period. Statistically, it’s a bit more than a half-percent increase (“0.52% (model range = 0.36%-0.56%”).

In the study, “Each model estimated the effect of COVID-19 disruptions on breast cancer deaths among all women aged 30 to 84 years between 2020 and 2030 in the United States.” The scenarios they looked at range from NO COVID19 all the way to “Hybrid delayed and skipped screening and delayed diagnosis and reduced chemotherapy treatment” – which is to say a person skipped BC screening because they just didn’t think it was safe to go out AND when they were screened, they delayed getting diagnosed AND once they were, they had a shorter than average chemotherapy treatment.

This seems like a bunch of unlikely events all piled on top of each other, but I can (and I imagine you can as well) imagine EXACTLY this scenario happening to someone we know or love.

Another study found that “Patients were more likely to be diagnosed with late-stage breast cancer [during relaxed mandates that opened various businesses and services]. Patients with lower income and medical comorbidities were disproportionately affected. These data raise significant concerns regarding the impact of [COVID19] on cancer diagnoses and long-term outcomes, especially in vulnerable patient populations.”

Also, mammography screening has seen a negative impact, “Our radiology department is going to be slammed just catching up with routine mammography screening. Patients who have been waiting for cancer surgery for 2-4 months are not going to want to wait any longer than needed if they have to go and be localized prior to surgery.”

From screening to diagnosis to surgery to chemotherapy, COVID19 has changed how quickly breast cancer can be treated. It has changed how patients can come to the hospital and it has changed because now, an already stressful situation is made doubly so by COVID concerns – both in patients and doctors.

Looking at the number of people expected to die from breast cancer – who would NOT have died if there had been no pandemic – over a ten year period is about 2500. Current numbers for 2021: The American Cancer Society's estimates for breast cancer in the United States for 2021 are: about 281,550 new cases of invasive breast cancer will be diagnosed; 49,290 new cases of ductal carcinoma in situ (DCIS); and ultimately, about 43,600 women will die from breast cancer in 2021.

Without any kind of change then, some 436,000 women are expected to die from breast cancer between 2020-2030. An additional 2500 women will die as well.

But, living in Minnesota right now, we find ourselves with increasing numbers of infections. In fact, the “now” report from data tracked by Johns Hopkins reports that, “COVID-19 cases up in 29 states, down in 18, flat in 3”. I wonder if the estimate of the increase in deaths due to breast cancer was perhaps too optimistic. Did they notice that the Spanish Flu Epidemic which lasted from February 1918 through April of 1920 continued to affect the planet for over two YEARS? The population at that time wasn’t even two billion; there was virtually NO international travel, and people pretty much died where they lived; except for the soldiers who were the main vector for the flu. With a current population well over SEVEN billion we might well expect the pandemic to last THREE AND A HALF TIMES AS LONG AS the first modern pandemic – or something like EIGHT YEARS…

Dark? Grim? Yep. I sure hope someone smarter than me has got plans in place, because 3.5 x 2500 = 8750…

Resources: https://academic.oup.com/jnci/article/113/11/1484/6319940, https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.528, https://www.beckershospitalreview.com/public-health/17-states-with-rising-covid-19-cases.html
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