COVID and cancer make for a deadly combination, especially for Black and Hispanic people and those who are uninsured and live in low-income communities. According to the CDC:

• Black and Hispanic people are nearly twice as likely as White people to die of COVID. 
• Black cancer patients are at particularly high risk for complications and hospitalizations. 
• Black people had lower survival rates than White people for many cancers even before the pandemic. 

COVID and cancer also share certain risk factors that disproportionately affect people of color, including: 

• Higher rates of diabetes and hypertension 
• Lack of health insurance or access to a primary-care physician
• Jobs that can cause health problems (e.g., through exposure to infectious disease or environmental pollutants)

Pandemic-Related Delays Are Also Deadly

Contracting the virus isn’t the only way that COVID has wreaked havoc on cancer patients’ lives, however. Many are now seeking care for advanced cancers due to pandemic-related delays in diagnosis and treatment, doctors are saying.

Millions of cancer screenings and other diagnostic tests were canceled, and thousands of surgical procedures postponed, in early 2020 to protect both patients and providers as the pandemic surged across the U.S. 

Federally qualified health centers that usually distribute at-home tests to detect blood in the stool (an early sign of colorectal cancer) temporarily suspended distribution during the pandemic, along with follow-up colonoscopies. 

Kavita Patel, a health policy expert and primary-care physician at Mary’s Center clinic in Maryland, said uninsured patients face major delays in obtaining various tests. “I have written orders for mammograms eight months ago that have expired, and I have had to reorder,” she said.

Patients Have Faced Scary and Difficult Choices

Unfortunately, even when screenings and care have been available, the problem has been compounded by the patients themselves, most of whom have had to choose between multiple competing demands, responsibilities, and fears. 

“People have been trying to ignore symptoms for a year because they didn’t want to come in,” said Jennifer Haas, a cancer prevention expert, and primary care doctor at Massachusetts General Hospital in Boston. Hass and her colleagues have seen an unusually high number of advanced stomach cancers and esophageal malignancies over the past several months.

Many of the patients most severely affected are women, added Debra Patt, a breast cancer specialist in Austin and an executive VP of Texas Oncology. “They have sacrificed themselves to deal with the needs of the family,” she said. They’re asking, “Are my children getting schooling, how do I take care of the older adults in my life, how do I manage everything?” 

One of Patt’s patients, Christina Cook, a 44-year-old Black woman, discovered a small lump in her breast just as the pandemic was taking hold in early 2020. “It felt like a baby rock,” Cook said, “but I had bigger things to worry about.” By December, the lump had grown and become painful. The uninsured Cook sought help at a Planned Parenthood clinic where staffers helped her enroll in Medicaid and schedule a mammogram. Patt has since been treating her for an aggressive form of cancer called triple-negative breast cancer, prevalent among Black women.

So far, Cook is responding to treatment and has scheduled a mastectomy in December 2021.

“I’m terrified that I cut it too close,” she said, “That I neglected myself too long and could have easily taken myself out.”

Doctors Have Gotten Creative

Doctors and other health professionals are urging all patients, but especially people of color, to resume cancer screenings and be proactive about seeking care. “COVID put cancer and healthcare disparities on steroids,” said oncologist Kashyap Patel, chief executive of Carolina Blood and Cancer Care Associates. “I have never seen this many people presenting at Stage 3 and 4.” 

When the pandemic hit last year, Patel scrambled to continue treating patients while keeping them and his staff safe. He switched some patients from chemotherapy infusions to oral drugs to reduce the risks of office visits. When COVID vaccines became available, he and his staff persuaded more than 150 patients and their relatives to get vaccinated. He extended his two clinics’ hours while also attempting to manage the added burden and stress on his staff members. He is hoping that funding will be approved to expand his services to include mobile lung cancer screenings next year.

Looking Ahead with Both Trepidation and Hope

While physicians are being realistic about the likely long-term fallout from delayed diagnoses and treatment, the picture is not completely bleak. One of Patel’s patients, Tamaki Caldwell, started having abdominal pain last year, but she didn’t see a doctor for months due to concerns about the pandemic, and because she was taking care of her grandmother, who had COVID.

In that time, her ovarian cancer tumors grew to the size of tennis balls. Now, after six months of chemotherapy, Caldwell feels “like somebody whopped me,” but her cancer is finally in remission, and she can look to the future. “I am going to frame this,” she said, holding the results that showed her to be cancer-free. “I am going to beat this and get back to my regular life.”

*McGinley, L. (2021, Oct. 11). COVID and Cancer: A Dangerous Combination, Especially for People of Color. The Washington Post. https://www.washingtonpost.com/health/2021/10/11/covid-cancer-delayed-diagnosis/ 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.