The incidence of mind most cancers in kids in Canada is three in 100,000. Mind cancers are treatable when they’re localized however prognosis worsens they usually change into much less treatable as they develop bigger, unfold all through the mind and in some circumstances metastasize via the cerebrospinal fluid down the backbone and across the mind. They’re aggressive, as mind cancers are the second most typical explanation for childhood cancers after leukemia however the most typical explanation for childhood most cancers mortality.
Many aggressive mind cancers happen earlier than the age of 5, and are tough to diagnose in younger kids. Additionally, kids can not verbalize loads of advanced or refined neurological signs like dizziness or double imaginative and prescient.
Fairly often within the final 12 months or so, I’ve seen kids for the primary time once they have already reached the top stage of mind most cancers. These are kids whose sickness is dreadfully obvious. They’re kids whose lives we may have saved if they’d been identified even six months earlier.
I do know why that didn’t occur: the COVID-19 pandemic, and its results on our health-care system and its sufferers. Generally households have been too reluctant to take their kids to see their household physicians, or common care was solely accessible via on-line appointments, the place a lot much less info is obtainable to the clinician. This consists of the important observations that may solely come from a bodily examination.
Seeing a affected person on a display screen is nothing like inspecting a toddler in individual. There are cues we get from muscle tone, eye readability and subtleties in respiratory, for instance, that when taken along with different info can flag critical issues in time for us to deal with them.
The concern and distraction generated by our strategy to the pandemic drowned out different considerations, with dreadful penalties. So whereas these youngsters haven’t been dying from COVID-19, they’ve definitely been dying due to it.
Sadly, I’m sure that these preventable deaths are occurring all through the health-care system, amongst kids and adults alike. Sufferers have delayed looking for prognosis and therapy as a result of they have been extra afraid of the virus than of no matter else was occurring.
Collateral harm: The unmet health-care wants of non-COVID-19 sufferers
My colleagues speak about grownup sufferers who skipped diagnostic procedures like colonoscopies, ignored chest pains or failed to research different critical considerations. Folks affected by different situations have change into the collateral harm attributable to the continuing pandemic.
That is heartbreaking and irritating. Public-health messaging throughout North America meant to maintain folks secure from the pandemic. Primarily based on what I see in my very own follow, I fear that it was too alarmist and too unfavorable. The messages could have deterred sufferers and brought on them to keep away from hospitals and clinics for concern of getting COVID-19. And the media deal with the pandemic created a vigilance for COVID-19 on the expense of expecting signs of different ailments.
I concern that after the total extent of those preventable deaths is understood, it’s going to far exceed the variety of deaths because of COVID-19.
Well being care after the pandemic
As we look like rising from the worst levels of the pandemic, I’m bracing myself to see extra kids with superior terminal most cancers, understanding they might have lived if not for this well-meaning however misguided strategy.
It was encouraging to see the Ontario authorities’s latest announcement about including sources to non-COVID-19 care to assist with backlogs, however the reality is that for too many sufferers, any care they obtain now will come too late.
Definitely, the general public wanted to learn about and defend itself from the specter of the pandemic virus — the collective motion of clinicians, scientists, front-line staff and others outdoors the medical system has helped mitigate the harm.
For the reason that spring of 2020, although, it’s nearly as if there have been no different well being downside however COVID-19. Whereas within the foreground we’ve been assiduously washing our fingers, sporting our masks, protecting our distance and getting our vaccines, the drumbeat of different critical well being issues has continued as steadily as ever.
Had all of us had a selection about strategy the brand new disaster, I dare say we’d have most well-liked a extra balanced, nuanced message about caring for all well being considerations concurrently, reasonably than changing nearly the whole lot else with a single public well being challenge that’s in the end worse than the one we have been attempting to forestall.
Even in well being care, I believe too many have been too able to pinch off in-person contact with sufferers in household docs’ places of work, neighborhood clinics, in imaging and different diagnostic providers, all of that are important conduits for earlier prognosis of signs that sufferers can’t determine themselves.
I dread what my colleagues and I’ve but to find as extra sufferers emerge from COVID-19’s fearsome shadow. There will probably be months, even years of catching up as we attempt to look after folks with superior diseases and situations, whereas new circumstances of the ailments and situations that normally maintain our system full proceed to develop.
As a doctor, I wish to assist folks be as wholesome as they are often. I do the most effective I can with the circumstances however at residence, late at evening, I mirror on the struggling of my sufferers and their households and my coronary heart fills with sorrow. I really feel powerless.
The obstacles have been unintentional, however the impression is horrible.
We’ll doubtless see extra pandemics, and before we’d like. Once they come, I hope we’ll face them with the wants of all sufferers in thoughts.
Sheila Singh receives funding from CIHR, Genome Canada and Mind Most cancers Canada. She is a scientific advisor to and holds shares in Century Therapeutics Inc. and Stem Pharm Inc.