By Sana Al Sukhun, MD, MSc

Over the past year, the world has been devastated by the COVID-19 pandemic. It was a wake-up call to remind us how vulnerable and alike we human beings are! The virus simply does not choose, does not care for religion, culture, customs, or country, whether we are poor or rich. To the virus, we are all equal. I am an oncologist, and I will take this opportunity to emphasize that this is also the case for cancer.

Cancer didn’t and will not slow down. It was responsible for the death of 10 million patients worldwide in 2020 in addition to 19.3 million newly diagnosed patients with cancer.¹ Compare that to 1.9 million patients who died from COVID-19 in 2020!² World Cancer Day 2021 is our opportunity to call upon all stakeholders—physicians, patients, survivors, their families, advocacy groups, pharma, government, and, most importantly, mainstream media—to remind the world of a more challenging pandemic to come, the cancer pandemic. A pandemic with no potential for vaccine. A pandemic that needs consistent measures to decrease incidence and persistent collaborative efforts to improve access to treatment worldwide. Together, all our actions matter.

I am an oncologist, and I will be, I am, and I have been caring for my patients during the pandemic. Like all of you, I have been overwhelmed by the COVID-19 storm, the cases I have helped to care for, the stories I have heard from friends, colleagues, and patients battling this common, mysterious enemy. Dealing with the unknown, however, has been the cornerstone of my practice. Cancer, like COVID-19, is another mysterious diagnosis feared by people worldwide. Patients with cancer, and with other diagnoses, still need treatment and follow-up care while the dreadful attack of COVID-19 on our society goes on without giving anyone a break. They still need proper guidance and support while in their treatment journey, a journey that cannot be put on hold pending the pandemic control. I am an oncologist, and I will help my patients balance their treatment needs while maintaining safety. Deep inside I know that patients with cancer are more vulnerable to worse outcomes from the infection—most already know that.³ Therefore, the emphasis has been, and should continue to be, on stressing physical distancing and personal protection measures—wear a mask and wash hands—while supporting and encouraging them to adapt to a changing care pattern: more telemedicine, less family support.⁴ That simple message can affirm and spread important protective practices among patients, their families, and societies. Together, all our actions matter.

I am an oncologist, and I will speak about the importance of early detection and prevention of cancer even during the COVID-19 pandemic. The pandemic is an opportunity to remind societies of the importance of a healthy lifestyle to combat both COVID-19 and cancer. The financial challenges, together with lockdown restrictions, have had a negative impact on lifestyle: more smoking, more sedentary behavior, greater obesity, and poor diet. All not only increase the risk of death from COVID-19, but also from cancer. People are more attentive these days to focusing on what helps decrease the risk of COVID-19. Let us all talk about the negative impacts of these risk factors, especially smoking, on our health. Not only does smoking increase the risk of death among patients with COVID-19, it also is responsible for 25% to 30% of cancer-related deaths.⁵ A recently published study demonstrated the negative impact of the pandemic on cancer therapy and research globally. The study projected a significant decline in screening with a subsequent predicted increase in cancer-related deaths by 4% to 17%.⁶ A decrease in preventative care could mitigate the positive impact on survival recently achieved by modern therapeutics and also negatively impact research funding and the flow of clinical trials. We need to encourage patients to report symptoms even if they cannot go for screening. After all, the earlier the presentation, the better the outcome.

On the bright side, the COVID-19 pandemic offered proof that illness is a common enemy that can be defeated only if we all unite and cooperate at all levels. Of course, cancer is no exception; to the contrary, the only way to combat cancer is through cooperation of all stakeholders. Together, all our actions matter.

Dr. Al Sukhun is the director of oncology practice at Al Hyatt Oncology Practice in Jordan, and she is the past president of the Jordanian Oncology Society and chair-elect of ASCO’s International Affairs Committee. Follow her on Twitter @SanaAlSukhun. Disclosure.

References

1. International Agency for Research on Cancer. World Health Organization. Latest Global Cancer Data: Cancer Burden Rises to 19.3 Million New Cases and 10.0 Million Cancer Deaths in 2020. Accessed Feb 1, 2021.
2. COVID stats. Accessed Feb 1, 2021.
3. Lee LYW, Cazier JB, Starkey T, et al. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020;21:1309-16.
4. American Society of Clinical Oncology. ASCO Special Report: A Guide to Cancer Care Delivery During the COVID-19 Pandemic. Dec 15, 2020.
5. van Zyl-Smit RN, Richards G, Leone FT. Tobacco smoking and COVID-19 infection. Lancet Respir Med. 2020;8:664-5.
6. Bakouny Z, Hawley JE, Choueiri TK, et al. COVID-19 and Cancer: Current Challenges and Perspectives. Cancer Cell. 2020;38:629-46.