“Delays in care have a major and lasting impact for cancer patients”



The cross : As early as spring 2020, you warned of the consequences of delays in the diagnosis and treatment of cancer linked to the pandemic. Today, what is the magnitude of the loss of opportunity for these patients?

Jean-Yves Blay: These delays have a major and lasting impact on cancer patients. For the first wave alone, they could cause 1,000 to 6,000 additional deaths. Some patients have been operated on and saved, sometimes in advanced stages. Others did not have time to arrive and are already dead. Now, specialists agree that excess cancer mortality in the decade to come will be at least 5%.

→ INVESTIGATION. Covid-19: life on hold for “deprogrammed” patients

Although preserved because exclusively dedicated to this disease, the 19 centers for the fight against cancer (CLCC), which take care of nearly 25% of patients in France, are also forced to deprogram certain operations, in particular preventive or preventive surgeries. repair, for example in breast cancer.

What are the rates of deprogramming within these centers?

J.-YB: 5%, maybe 10%. It’s much less than in hospitals, but it’s already too much. The fifth wave has brought about an unprecedented difficulty in terms of human resources. Between the accumulated delays, the reception of patients who cannot find a place elsewhere and the natural increase in the number of cancers, activity in our centers increased by 13% in 2021. But the number of staff fell by 10%. In addition to being exhausted, some of the caregivers are absent for Covid. This has a significant impact, particularly in the Paris region, where certain services must close, leading to operation cancellations.

What are the consequences of postponements for patients?

JY. B.: They are sometimes dramatic. I am thinking in particular of this 21-year-old young man from Lyon, suffering from a brain tumour, whose operation at the hospital has been postponed three times. Once again, the centers for the fight against cancer, which only treat this disease, are more spared than the public hospital. Despite this, the increase in our activity pushes us to make choices.

Our first concern is to operate on people who are at risk of dying, regardless of the type of cancer they suffer from. But the deprogrammings, if they do not put the life of the patients at stake, are sources of suffering. This is the case of patients waiting for breast reconstruction, a wait that is often extremely difficult to live with and very destabilizing.

Once again, this crisis highlights in a rather cruel way the fragility of our health system. As an oncologist and president of Unicancer, my judgment is inevitably biased, but it seems to me that this confirms the importance of sanctuaries for the treatment of a single disease, such as cancer centers. Without these structures, the toll would undoubtedly be heavier.

Are certain cancers more affected?

J.-YB: What I notice is that women are mostly affected. They are the first concerned by preventive surgery, in particular patients with genetic predispositions for certain cancers. The same applies to reconstructive surgery, mainly aimed at breast reconstruction. Unfortunately, women pay the heaviest price for these deprogrammings.

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