Pancreatic cancer is an insidious disease with survival rates barely improving in the past half a century. The reason for this is that most patients are diagnosed late when their tumour is inoperable or when the cancer has metastasised. Around 44 per cent are diagnosed following a presentation to A&E, with only 22% being referred via the two week wait route.
Data from Public Health England suggests that two-week wait cancer referrals from GPs to hospitals have fallen by up to 80% in some areas, while the latest figures from NHS England show that A&E visits have halved. The two-week wait levels are beginning to improve, but this is still very concerning and spells a worrying picture for anyone who might be suffering from undiagnosed symptoms.
Not only have non-COVID treatments and procedures been postponed or cancelled, but some diagnostic tests, such as endoscopy, have been suspended except in emergencies due to the risk of aerosol transmission of the virus to staff.
The other and very concerning problem is that people are scared to visit a doctor and visit hospitals or GP practices in case they contract coronavirus. The public is also very aware of the pressures coronavirus is putting on the health service in general, and many are not wanting to be a burden and put additional pressure on the system and are therefore not presenting with symptoms.
Ultimately the consequence of later diagnosis, changes in health service provision alongside the psychological effects of social distancing and/or shielding will be seen in the excess deaths from pancreatic cancer as a direct result of the COVID-19 emergency, especially in those with multi-morbidities.
Current estimates of excess deaths for cancer are hampered by the lack of real-time data and are thought to be underestimated. Even so, in a recent study, pancreatic cancer patients are expected to suffer the 4th highest excess mortality of any of the 24 cancers studied. Very sobering indeed.
While we seem to be coming out from the peak of the pandemic in the UK, it is vital that referrals, diagnostics and treatment for cancer must be brought back to pre-pandemic levels at the earliest opportunity to minimise potential harm, and to reduce the scale of the post-pandemic surge in demand.
It is vital that people who have symptoms suggestive of cancer, and in particular, pancreatic cancer, feel reassured about safety measures being taken by GPs and hospitals to protect them from exposure to coronavirus so they seek help in a timely manner.
If not, the unintended consequence of COVID-19 will not only be the excess deaths caused by the virus itself but the excess deaths from cancer, which, without mitigation, could be significantly higher.
Ali Stunt, Founder and Chief Executive, Pancreatic Cancer Action