Cancer care

Concern over drop in cancer patient referrals and investigations

Medical professional groups are expressing concern about patients missing out on cancer diagnosis and treatment because they are avoiding seeking medical attention during the COVID-19 pandemic.

The AMA has expressed concern that doctors are seeing a significant fall in people presenting to have possible cancer symptoms investigated or to have screening.

“It is clear that people are putting off seeing their doctor, or not going at all,” said President Dr Tony Bartone.

“We are already seeing particular concerning significant reductions in investigative diagnostic tests, including skin cancer biopsies and cervical cytological screening.

“This means we are missing the vital diagnosis of conditions such as cancer,” he said.

“The consequences of not seeing your doctor for usual care could be life-threatening for many patients .. [and] the failure to be able to monitor patients with existing conditions could lead to their conditions getting much worse.

His comments were echoed by oncologists, with centres such as the Peter MacCallum Cancer Centre in Victoria and the Chris O’Brien Lifehouse in NSW saying they are  experiencing a significant drop in new cancer patient referrals.

“We certainly have seen a reduction in the number of referrals coming through the door, probably of the order of about 20%,” Professor Declan Murphy, director of genito-urinary oncology at Peter MacCallum Cancer Centre, told the ABC .

“Some of these patients who would be coming back for a regular check up and we’ve pushed back their appointment or we’re not seeing them. But what we are also seeing is a flow on from people not going in to primary care to have a routine check up or get that symptom checked out because they’re trying to stay at home.”

Professor Murphy said centres such as Peter Mac were still fully open and staffed for seeing patients, with a significant amount of work done via telehealth.

“As of today there is lots of surgery happening, lots of chemotherapy and radiotherapy happening. It’s in the outpatient department waiting areas that we’re seeing a big difference – it’s ghostly quiet. But in the back end there is this huge telehealth environment running. We’ve gone from doing 5% of consultations by telehealth last month to around 80% this week.”

Professor Murphy added that it was important for oncology service to have good communication on deferred appointments, to give patients a set date and provide reassurance on safety rather  than just say they had been deferred indefinitely.

Meanwhile the radiologists are warning that cancer patients are not attending their required consultations or discontinuing their treatment after making incorrect assumptions about the safety, availability or capacity of clinical services.

“The Royal Australian and New Zealand College of Radiologist (RANZCR) want to express that oncologists should be communicating to their patients that every precaution is being taken to ensure infection control and it is safe to continue treatment,” the College said.

“Radiation therapy services are essential and still accessible. Radiation oncology teams are making special provisions for patients in the current situation. It is also important that all healthcare professionals remind cancer patients about the importance of continuing their treatment,” said Dr Madhavi Chilkuri, Director of the RANZCR Faculty of Radiation Oncology.

Dr Debra Graves, CEO of the Royal College of Pathologists Australasia said path labs had seen a 40% drop in testing for cancer and heart disease.

“This is a very serious issue. Just because there is a pandemic doesn’t mean these diseases go away,” she said..

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