The incidence of brain cancer in children in Canada is three in 100,000. Brain cancers can be treated when they are localized but the prognosis worsens and they become less curable as they get older, spread throughout the brain and in some cases the spinal cord. Metastasize through the cerebrospinal fluid under and around the brain. They are aggressive, as brain cancer is the second most common cause of childhood cancer after leukemia, but childhood cancer is the most common cause of mortality.
Many invasive brain cancers occur before the age of five, and are difficult to diagnose in young children. In addition, children cannot verbalize many complex or subtle neurological symptoms such as dizziness or double vision.
Many times in the past year I have seen children for the first time when they have already reached the final stage of brain cancer. These are children whose illness is terrifyingly obvious. These are the children whose lives could have been saved had they known even six months earlier.
I know why it didn’t happen: the COVID-19 pandemic, and its impact on our health care system and its patients. Sometimes families were too reluctant to take their children to see their family physicians, or routine care was only accessible through online appointments, where little information is available to the physician. This includes important observations that can only come from a physical exam.
Watching a patient on a screen is nothing like examining a child in person. Signs that muscle tone, eye clarity and breathing are finely tuned, for example, when taken with other information can lead to serious problems in time for us to treat them.
The fear and distraction created by our approach to the pandemic outweighed other concerns, which had dire consequences. So while these children are not dying of COVID-19, they are certainly dying because of it.
Sadly, I am convinced that these preventable deaths are occurring throughout the health care system, among children and adults alike. Patients have delayed seeking diagnosis and treatment because they feared the virus more than what was happening.
Read more: Collateral damage: Unmet health care needs of non-COVID-19 patients
My colleagues talk about adult patients who skipped diagnostic procedures like colonoscopies, ignored chest pain or failed to check for other serious concerns. People suffering from other conditions have become collateral damage due to the ongoing pandemic.
This is heartbreaking and depressing. Public-health messaging across North America aims to keep people safe from the pandemic. Based on what I see in my practice, I worried it was too dangerous and too negative. The messages scared patients and caused them to avoid hospitals and clinics for fear of getting COVID-19. And the media focused on the pandemic creating a vigil for COVID-19 at the cost of noticing symptoms of other diseases.
I fear that once the full extent of these preventable deaths is known, it will exceed the number of deaths due to COVID-19.
post-pandemic health care
As we emerge from the worst of the pandemic, I find myself forcing myself to look at more children with advanced terminal cancer, knowing that they are not for the sake of this well-meaning but misguided view. could live.
It was encouraging to see the Ontario government’s recent announcement about adding resources to non-COVID-19 care to help the backlog, but the fact is that for many patients, the care they get now is too late. will come from
Certainly, the public needs to learn about the threat of the pandemic virus and protect themselves – the collective action of physicians, scientists, frontline workers and others outside the medical system has helped minimize the damage.
However, since the spring of 2020, it is almost as if there was no other health problem but COVID-19. While in the foreground we are washing our hands, wearing our masks, keeping our distance and getting our vaccines, the intoxication of other serious health problems continues as ever.
If we all had a choice about how to approach the new crisis, I dare say that we would all have preferred a more balanced, nuanced message about taking care of health concerns together. , instead of being replaced by almost everything with a single public health issue. Ultimately worse than what we were trying to stop.
Even in health care, I think many people were willing to have personal contact with patients in family doctors’ offices, community clinics, imaging and other clinical services, all of which It is an important means of early diagnosis of patients’ symptoms. Can’t identify myself.
I fear that my colleagues and I are yet to find out as more patients emerge from the sinister shadow of COVID-19. Months, even years, will go on as we try to care for people with advanced diseases and conditions, while new cases of diseases and conditions that usually keep our systems full continue to develop.
As a physician, I want to help people be as healthy as possible. I do what I can with the circumstances but at home, late at night, I contemplate the suffering of my patients and their families and my heart fills with sadness. I feel powerless.
The odds were unintentional, but the effect is terrifying.
We will likely see more pandemics, and sooner than we would like. When they come, I hope we will deal with them keeping in mind the needs of all patients.