Fewer check-ups on potential lung cancer cases as people delay seeing doctors in pandemic

Medical experts are reporting an emerging and alarming side effect of the Covid-19 pandemic.

Cancer Research UK has found that during the pandemic fewer people are going to their GPs with symptoms of suspected cancer.

Doctors and cancer NGOs are concerned that people who should come forward for lung cancer screening are not doing so because they think their symptoms indicate they may have Covid-19.

November is Lung Cancer Awareness Month and consultant cardiothoracic surgeon Dr Anand Sachithanandan tells MalaysiaNow that a persistent cough can be a symptom of Covid-19 but may equally be an early sign of lung cancer.

Anand, who is Lung Cancer Network Malaysia president, emphasises that early detection of lung cancer can lead to more effective treatment and longer survival for patients.

Lung cancer affects two million people globally each year. In Malaysia, it is the highest cause of cancer-related death in men, while for women it is the second highest cause, after breast cancer.

“The world is still learning about the Covid-19 virus,” Anand says. “We know it predominantly attacks our airways and lungs, but also other organs.”

He explains that the big emerging danger lies in people interpreting coughing as a symptom of Covid-19 or some other infection without taking into account how long the cough has lasted.

“If you have a recurring, persistent and troublesome cough for at least two weeks you should see a GP or a lung specialist,” he says.

In Malaysia, lung cancer is the highest cause of cancer-related death in men, while for women it is the second highest cause, after breast cancer.

While there is insufficient local data in the Malaysian medical community to support calls to give equal priority to lung cancer screening during the pandemic, reports from the UK contain figures substantial enough to compel specialists such as Anand to bring this issue up.

“With the movement control order, there are restrictions on hospital visits and admissions, and patients are understandably reluctant, but if you have suspicious symptoms that are worrying you, then you should seek treatment,” Anand says.

“Doctors and hospitals should not defer these cases, because this pandemic is likely to be with us for another year. We cannot put other diseases on hold,” he says.

“Because if you do have lung cancer, by this time next year it will have spread.”

Globally, over 80% of Covid-19 cases are asymptomatic or only mildly symptomatic, which underscores Anand’s advice that a check-up of any cough that has persisted for more than two weeks should not be deferred until the pandemic has subsided.

Persistent coughing is far more common than other symptoms associated with lung cancer, such as unexplained weight loss, breathlessness or coughing up blood, which usually appear at more advanced stages.

The problem with lung cancer, Anand explains, is that in its early stages it is usually a “silent killer” displaying no symptoms or only very mild non-specific symptoms.

“The majority of coughs are benign,” he says. “But for smokers, who typically have a phlegm-rich cough in the mornings, I urge them to go for cancer screening if they notice a change in the nature of their coughs.”

In the UK, a third of lung cancer patients have died since the start of the pandemic because they were told by doctors to stay home out of fears they had contracted Covid-19.

Experts are now worrying that such numbers could roll back hard-won improvements made in cancer treatment and survival, simply because the pandemic is driving down the number of cancer sufferers coming forward for treatment.