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Could COVID-19 be causing delays to BIA-ALCL and other cancer diagnoses?

Solicitor Zahra Nanji, who represents women with the rare cancer BIA-ALCL, discusses the dangers incurred by delays in diagnosis and treatment of cancer as a result of the COVID-19 pandemic.

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Zahra represents people who have been seriously injured and who have turned to her for her technical expertise and approachable manner. She has a special interest in complex and catastrophic injuries, including those caused by medical devices.
As a lawyer, I represent women who have been diagnosed with Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare form of blood cancer which has been linked to textured breast implants.

In my experience, when women are diagnosed with this rare form of cancer, time is of the essence and swift treatment is vital, just as it is for most other cancer patients.

However, right now the NHS is grappling with the COVID-19 pandemic and all the strains that the virus has put on its resources.

Although the NHS was told on 30 March to continue with urgent cancer surgery, the ability for them to carry on as normal has not always been possible as wards and theatres have been turned into intensive care units to tread COVID-19 patients. 

Another factor has been that many cancer patients may have been too scared of becoming infected with the coronavirus to go into hospitals during the pandemic.

We have found that information surrounding BIA-ALCL is not necessarily reaching those who require it particularly in light of extraordinary and challenging times facing our NHS frontline clinicians.  

So it is worrying that researchers at the Institute of Cancer Research (ICR) have warned that delays in diagnosis and treatment of a range of cancers as a result of coronavirus could lead to a rise in cancer related deaths or early deaths as many hospitals have suspended surgery while the NHS battles the coronavirus.

The study entitled ‘Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic’ involved researchers from the ICR analysing data from Public Health England in respect of the impact of delays in cancer surgery on patients’ five-year survival rates.  

The researchers estimated the effect of a three-month or six-month delay caused by the pandemic to the cancer care and diagnosis pathways. The research revealed that surgery for cancer adds on average 18.1 years onto the life of each patient, of which on average 1 year is lost for a three-month delay or 2.2 years are lost with a six-month delay. 

The study leader Professor Clare Turnbull, Professor of Cancer Genomics at the ICR, said: “Our findings should help policymakers and clinicians make evidence-based decisions as we continue to deal with the effects of the pandemic on other areas of medicine. We have to ensure that both patients with COVID-19 and also those with cancer get the best possible care. That means finding ways for the NHS to get back to normal service on cancer diagnostics and surgery as soon as possible, prioritising certain cancer types in particular.”

The study concluded that cancer surgery is highly impactful in respect of life-years gained when accounting for the resources used.  

The study acknowledged that the COVID-19 pandemic has placed an unprecedented strain on health care provision and to avoid a deferred public health crisis of unnecessary cancer deaths, urgent ringfencing of substantial resources is required to address cancer treatment.

Professor Clare Turnbull also commented that while a delay in surgery would make no difference to the chances of survival of patients with certain forms of cancer, others would die sooner than if they had undergone their procedure as planned.  

We know that there are NHS staff and medics working untiringly to protect and treat the nation as it battles the COVID-19 pandemic. These are of course challenging and testing times for all who work healthcare. Nevertheless, it is vital that valuable time is not lost in diagnosing and treating all cancers, including BIA-ALCL, to ensure that otherwise preventable deaths do not occur.  

We have produced a booklet for patients and an information leaflet for GPs which we hope will be useful for any person who has breast implants and who is suffering from potential symptoms, but is unclear as to what they can do to report and have their concerns investigated.  

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