A recognition of the extraordinary efforts by healthcare professionals, caregivers, and researchers supporting cancer patients during the dual crises of cancer and COVID-19
The year 2021 presented an unprecedented challenge in global healthcare. As the COVID-19 pandemic entered its second year, another health crisis simmered in its shadow—the ongoing battle against cancer.
World Cancer Day observed under the theme "I Am and I Will"
Healthcare professionals stood on the front lines of both COVID-19 and cancer
On February 4, 2021, the world observed World Cancer Day under the powerful theme "I Am and I Will," which took on profound new meaning. This theme served as a rallying cry, embodying the determination of healthcare professionals and caregivers who stood on the front lines of dual crises 6 7 . The day was dedicated to the courage and achievements of people living with cancer and their families, as well as the nurses, doctors, researchers, volunteers, and advocates who cared for them amid a devastating pandemic 1 4 .
"This year, more than ever, it is appropriate that we celebrate their achievements on World Cancer Day."
This article explores how the cancer community demonstrated remarkable resilience, adapting to unprecedented circumstances to ensure that cancer care would not become the forgotten 'C' during COVID-19.
The COVID-19 pandemic severely disrupted cancer care worldwide, creating what many termed "a crisis within a crisis." The World Health Organization (WHO) conducted a Global Pulse Survey revealing that between 5% and 50% of essential cancer services, including screening and treatment, were disrupted across all countries 2 .
Illustration of cancer service disruption levels across countries 2
A survey conducted by the Union for International Cancer Control (UICC) among its members revealed staggering financial challenges:
| Impact Area | Percentage of Organizations Affected | Nature of Impact |
|---|---|---|
| Reduced Income | 77% (83 of 108 respondents) | Income reductions of 25% to 100% in 2020 1 7 |
| Reduced Activities & Services | 80% (86 of 108 respondents) | Significant cuts in operational capacity 1 |
| Projected 2021 Impact | Nearly three-quarters of organizations | Expected continued financial pressures 4 7 |
"Cancer civil society organizations are holding up the end of the line, struggling to maintain life-saving services amid resource constraints and safety measures."
Cancer patients faced significantly higher risks during the pandemic due to their immunocompromised status 2 . Several biological factors explained their vulnerability:
Research consistently showed that cancer patients experienced worse outcomes when infected with COVID-19:
| Patient Group | Risk of Severe Illness | ICU Admission Rate | Mortality Rate |
|---|---|---|---|
| Cancer Patients with COVID-19 | Significantly higher | 38% required ICU care 2 | 7% died from COVID-19 2 |
| General Population with COVID-19 | Standard risk | Lower comparative rate | Lower comparative rate |
One study of 131 cancer patients infected with COVID-19 revealed the sobering reality of their clinical course, with nearly 40% requiring intensive care support 2 . The lethal combination of COVID-19 and cancer led to these patients being described as "doubly unlucky" 2 .
The adaptations represented a "silver lining" to the COVID-19 crisis, potentially permanently improving cancer care delivery.
Across the globe, the cancer community demonstrated extraordinary resilience and creativity in maintaining essential services.
The Prostate Cancer Foundation of Australia fast-tracked a Prostate Cancer Specialist Telenursing Service, the first of its kind in Australia 4
Developed technologies to reduce time spent in care settings while maintaining treatment quality 5
Oncologists worldwide adjusted treatment protocols to minimize COVID-19 risks while maintaining anti-cancer efficacy:
The SOAP (Sars-CoV-2 for cancer Patients) study provided crucial insights that directly influenced clinical practice during the pandemic. This research revealed that cancer patients with solid tumor types, including those with advanced disease, had an immune response to COVID-19 similar to that seen in the general population 8 .
The study followed a cohort of cancer patients with COVID-19 infection, monitoring their:
The critical finding was that these patients developed lasting antibodies, making it possible to safely resume their cancer treatments after COVID-19 infection 8 .
"These results implied patients with solid tumor types being treated with immune-suppressive therapies would likely respond well to COVID-19 vaccines."
A registry analysis conducted on the COVID-19 and Cancer Consortium provided crucial evidence guiding treatment decisions during the pandemic.
30-day mortality rates by treatment type based on CCC19 analysis 8
This data helped oncologists make better, evidence-based treatment decisions for patients during the pandemic, potentially helping them avoid delays in receiving or continuing their care 8 .
Vaccination emerged as a critical strategy for protecting cancer patients during the pandemic. Special considerations included:
With fourth doses suggested if anti-SARS-CoV-2 S titers fell below 1000 BAU/mL 2
The pandemic accelerated research with benefits for both fields:
mRNA vaccine technology, previously studied for cancer applications, provided a blueprint for rapid COVID-19 vaccine development 8
COVID-19 vaccine success is now informing and accelerating cancer vaccine research 8
BioNTech CEO Ugur Sahin predicts the first mRNA cancer vaccine approval within 2-3 years 8
The pandemic exacerbated existing inequalities in cancer outcomes worldwide:
Illustration of maternal orphans created by breast cancer deaths in sub-Saharan Africa 9
Different regions developed context-specific solutions:
Focused on maintaining awareness about cancer despite pandemic constraints 7
Emphasized prevention and primary care adaptations 5
Demonstrated cancer advocacy success despite overwhelming challenges 5
Implemented lessons learned and innovations specific to its healthcare context 5
World Cancer Day 2021 served as a powerful reminder that even in the darkest times, human ingenuity and dedication persevere.
The rapid adoption of telemedicine and creative networks represent lasting improvements to cancer care systems worldwide
The heroes of this dual crisis have not only navigated unprecedented challenges but have emerged with new tools and hope
While the disruptions to cancer services will likely lead to later-stage diagnoses and potentially higher cancer-related mortality in coming years 7 , the innovations born from necessity have permanently enriched the cancer care landscape.
"COVID-19 has impacted cancer control globally and the response by the cancer community has been extraordinary—heroic, even."