The Covid-19 pandemic has affected all areas of the health service and resulted in the most dramatic reorganisation of care in living memory. These rapid changes have taken place against a backdrop of uncertainty with no way of knowing exactly how Covid-19 would affect a health care system that is already under pressure.
With so much focus on the virus, we fear that other conditions, like pancreatic cancer, are being considered less of a priority. Researchers and clinicians are beginning to warn of a potential “cancer epidemic” with late diagnosis and delayed treatment leading to excess cancer deaths during and after the pandemic.
Urgent cancer referrals from GPs to hospitals have fallen by up to 80% in some areas during Covid-19. Some trusts have adjusted referral criteria to prioritise patients with the most severe or persistent symptoms to attempt to manage cancer patients alongside the virus at a local level.
Despite this huge decrease in primary care presentation and referral, there has been no increase in emergency presentation of disease with A&E departments. This raises the question are people more afraid of Covid-19 than they are of cancer?
The government has acted to remind the public that the NHS is open for business. Patients with classic symptoms of cardiac problems, stroke and cancer are being reassured that services are still open and available. However, this campaign is clearly not reaching patients with early stage symptoms of pancreatic cancer who have vague and non-specific symptoms like abdominal pain or indigestion. Pancreatic cancer diagnosis often requires multiple visits to a GP with symptoms that patients often don’t want to trouble their doctor with. Reaching these patients now will be more challenging than ever before.
Primary care providers
Pancreatic Cancer Action is working hard to communicate the importance of early presentation and the steps that primary care providers are taking to reduce the risk of Covid-19 from attending appointments. However, the scope of the challenge means we cannot do this alone. The government needs to do more to highlight vague but serious symptoms such as those of pancreatic cancer. Weare keen to see a public awareness campaign to remind the public that cancer remains as important now as at any time before the pandemic.
The risk to patients with pancreatic cancer symptoms during this pandemic is not just Covid-19. It is late diagnosis due to delay in presentation, referral, diagnostics such as endoscopy and treatment. A delay in any stage of this pathway could be the difference between patients being eligible for life saving surgery or only able to receive palliative care. It is vital that patients present to primary care and safety netting is in place for those at an increased risk or who decline diagnostics due to Covid-19. More transparency in this process is important for public trust in services to continue.
As the NHS adjusts to providing cancer services alongside the reality of Covid-19, and begins to consider recovery, flexibility in the system must be found to diagnose and treat cancers like pancreatic as fast as possible. We welcome trials of cancer hubs which could represent an opportunity to streamline cancer diagnosis and treatment.
At Pancreatic Cancer Action our priority is to continue to advocate for patients along every step of their journey, placing them at the heart of everything we do.
By Becky Rice, Health and Policy Manager at Pancreatic Cancer Action