Hamilton missing hundreds of cancer patients as COVID postpones screening

Eleanor Wood was diagnosed with cancer five months later than she should have been because of COVID-19.

The 74-year-old Troy woman was supposed to get a colonoscopy in April as part of regular cancer screening. But she was among hundreds of thousands of Ontarians to have screening cancelled in the first wave of the pandemic. It wasn't until Sept. 3 that she got the exam showing she had colorectal cancer.

It was quite a shock, I really had no symptoms," said Wood. I was awake for the colonoscopy so I could see the problem right away. It was different than all the rest of the pictures so there it was plain as day."

By the time Wood was diagnosed, her cancer was more advanced at stage 3.

If you come with a stage 1, it's a very short little bit of treatment," Wood said doctors told her. When you come with stage 3, it's five times that so that's what I'm doing."

The massive amount of cancelled screening in Ontario is staggering - nearly 155,000 missed mammograms from March 15 to May 31, nearly 193,000 pap tests to screen for cervical cancer and more than 103,000 fecal tests.

The result is a troubling trend of missing cancer patients across Ontario including Juravinski Cancer Centre.

Compared with previous years, the number of new patients with cancer that are being detected is lower," said Dr. Ralph Meyer, vice president oncology and palliative care at Hamilton Health Sciences (HHS). We think patients are not entering the system."

Hamilton saw 17 per cent fewer cancer surgeries from March 17 to Nov. 10 compared to 2019, representing 666 patients.

Poop tests flagged for further exam decreased to 65 in August compared to 273 in January in Hamilton Niagara Haldimand and Brant region, which includes Burlington. Patients with symptoms of colorectal cancer being checked plummeted to 321 in May from 1,239 in January.

We have most certainly seen a fall off in referrals," said Hamilton gastroenterologist Dr. Barry Lumb. As that builds up overtime ... you develop a backlog. Patients who have symptoms we might consider very high risk and need to be examined don't get found."

Cancelled screening isn't solely responsible for the drop off.

It's for a number of reasons not the least of which is patients' reluctance to agree to come to a hospital for a procedure which of course is tragic," said Lumb. The other is that during the early phases of the pandemic the family doctors weren't operating at the same pace that they normally would so patients weren't having the opportunity to have their symptoms dealt with."

In addition, HHS reports about 5,000 more people skipped scheduled diagnostic tests between April 1 and Aug. 31, compared to last year.

Wentworth-Halton X-ray and Ultrasound clinic also raised flags about patients not showing up for appointments at its 14 clinics in Stoney Creek, Hamilton, Waterdown, Burlington and Oakville.

We're seeing backlogs created by the shutdown back in the spring that's caused great delays in imaging people and we're trying to work our way through that - it's in the thousands of ultrasounds alone," said chief radiologist and CEO Dr. Brian Birchenough. The problem is we're still booking more people so we're pushing the backlog further down the road. We'd have to be running more than 100 per cent of our previous capacity to catch up."

But the clinic can't even get up to 100 per cent because of staff shortages due to COVID and cancellations.

We get about 15 no-shows per day." he said. Before the pandemic, it would be very rare. Maybe a couple a week. It has drastically gone up. We can only blame it on the COVID-19 situation."

On top of the 15 no-shows are those who call and cancel.

We're missing a few breast cancers a week, we know that," says Birchenough. The purpose of mammography is to diagnose lesions at an earlier stage before you can actually feel them. Once they are palpable generally they're at a more advanced stage which can be harder to treat."

While there's no data yet to show those diagnosed are at a later stage of cancer, there is anecdotal evidence from surgeons and pathologists.

There is a sense there is more patients presenting with ... more advanced cancer," said Meyer. It's a concern."

Wood doesn't focus on what could have been if she was diagnosed back in April.

You can't go back and cross that bridge again," she said. We're just moving ahead."

Her treatment was expedited as soon as it was found and she hopes COVID doesn't interfere with her care for a second time.

I'm worried we could have a shut down again because this is only the beginning of my treatment," she said.

Wood had no choice to get her colonoscopy earlier and she urges others to learn from the delay in her care.

You need to keep your appointments. It's just a travesty to have those machines sit there that can save your life."

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com