A Dangerous Mix for Cancer Patients

Feb. 4 is World Cancer Day. This disease is the second main cause of death in Latin America taking the lives of almost two million people a year. In Mexico, around 190,667 people suffer from cancer and records point out that 14 percent of the total deaths in the country are due to a type of cancer.

Patients with cancer have been one of the most affected groups regarding treatment continuity as a result of the pandemic. During Mexico Health Summit on Jan. 27 and 28, Héctor Martínez-Said, President of the Mexican Society of Oncology, talked about the challenges facing cancer patients during COVID-19. “In terms of care, both in the public and private sectors, we have had to reassess priorities. In many cases, we could not halt treatment and we used all precautions, including isolation, to continue the cancer treatment.” Martínez-Said says that hospital conversion was another issue, which displaced patients to other centers. He explains that while this might not have a transcendental impact on urban areas, for people living in rural areas this means not having access to a hospital at all. “The result is that people were not diagnosed and assisted at an early stage, which means they will have more advanced cancers by the time they are treated. Mexico’s cancer-related deaths currently stand at 85,000 a year.” According to Martínez-Said, research has been affected too. “The pandemic has shifted CONACYT’s focus from cancer, as well as resources, toward COVID-19.”

A study by Colegio de Mexico from 2020 showed that in fact, social inequalities have a decisive influence on cancer incidence and mortality and are related to the level of development of the country's regions, even within a COVID-19-free scenario. States with higher incidence and mortality rates tend to have high levels of development: Sonora, Chihuahua, Mexico City, Baja California, Nuevo Leon and Baja California Sur. On the contrary, the lowest incidence rates are registered among less developed states like Guerrero, Oaxaca, Hidalgo, Guanajuato and Michoacan. However, the quality of care for those who suffer from cancer seems to have an inverse relationship with socioeconomic development: the probability of dying from cancer is higher in the states of the southern region of the country, the least developed (Chiapas, Oaxaca, Guerrero, Yucatan and Veracruz), while the states of the northern region, the most developed and the capital of the country have the lowest ratios (Mexico City, Nuevo León, Sinaloa and Baja California). Colegio de México reports that the institutional response to the cancer problem has been uneven and fragmented. The distribution of financial, material and human resources to control cancer in Mexico is very unequal due, in part, to lack of resources in the public health system and its fragmentation and highly uncoordinated operation. People with cancer face a very dire outlook when they must move to other cities or entities to receive care or when they bear high costs associated with treatments that insurance does not cover.

According to what Martínez-Said said during Mexico Health Summit, “the average expenditure of a cancer patient in the last year of their life is US$5,000, a very large amount for a large segment of the Mexican population.” Martínez-Said believes the real burden of this will manifest this year and he called on both private and public sector insurers to create more accessible coverage, while also reducing waiting times.

Global studies warn that people suffering from cancer are also at risk of not receiving the COVID-19 vaccine. According to the New York Times, ideally, cancer patients are to receive the vaccine at a cancer center, following a doctor’s approval and with a close follow-up. However, with already saturated health systems and complicated vaccine rollouts, this increases difficulty. Safety of the vaccine must not be questioned. COVID-19 vaccines have been proven to be safe and according to CNN, “many cancer experts, medical groups and doctors are making a big push for vaccinating most cancer patients, especially those at most risk during the pandemic.”

In Mexico, delays and limited vaccine doses have already been a complication in general terms. While it is yet early to see the impact of vaccination in cancer groups, these patients should be seen as a priority as long as components of that vaccine are not contraindicated, says a CDC clinical guidance.