It takes 21 days to form a new habit, and to mark World Cancer Day on 4 February, international organisations are urging people around the world to pledge the next three weeks to fighting cancer.  The ‘I am and I aill’ campaign is a call to action for all, encouraging cancer survivors to overcome not only their personal struggles, but the unique challenged the Covid-19 pandemic has brought.

Heeding the call

In Mulima village, outside Louis Trichardt in Limpopo, Nomsa Tshingowe has taken up the challenge. Diagnosed with osteosarcoma, a type of bone cancer at 23 years old, Tshingowe knows how cancer can impact one’s life.

“When a person is diagnosed with cancer, it does not only affect them physically, psychologically, emotionally and socially but it also affects them financially. And for families already living in poverty, the struggle is often multiplied,” she tells Health-e News. “When I was diagnosed with cancer I was already working as a social worker and with medical aid but there were a lot of co-payments and other stuff I needed and due to that I lost my financial freedom.”

Cancer survivor Nomsa Tshingowe is embracing the campaign. (Facebook)

In 2019, Tshingowe co-founded Cancer0Thirty5, a non-profit organisation which assists cancer survivors and their families with food parcels and other essentials through donations. The Covid-19 pandemic has shown how vulnerable cancer survivors are.

“We almost postponed all our activities in 2020 but we realised that those families of children living with cancer need us now more than even and we vowed that we will continue with our work no matter what challenges we may encounter along the way,” she said. Her organisation has lost donors, many of whom are struggling to meet their own financial needs, but Tshingowe has continued to support families in any way she can. In particular, the 30-year-old wants survivors to stay positive during this difficult period.

“Being a cancer survivor with a compromised immune system it is very challenging to lead a normal live as one is always scared of contracting the virus. I encourage all other cancer survivors to stay positive and protect themselves from this virus,” says Tshingowe “Always practice safety measures and most importantly stay at home and only go out when it is necessary to do so.”

Global campaign

Around the world, the Union for International Cancer Control (UICC) is driving the 21-day campaign.

“So, for 2021, whether you’re committing to improving your personal health, supporting someone you love with cancer, educating yourself about cancer, speaking out against cancer or making history by helping to eliminate cervical cancer, sign up to one of the five challenges to receive daily inspiration and practical guidance,” the UICC said in a statement.

The UICC supports nurses, doctors, researchers, volunteers, advocates and other caregivers in oncology from around the world, as well as government agencies. This last year has been particularly difficult. The union conducted a survey of more than 100 member organisations in 55 countries showed cancer support structures were under strain. Almost three quarters of the organisations showed a drop in income, ranging from 25% to 100%. Their projections for this year were equally grim.

The Cancer Association of South Africa (CANSA) warned that the global pandemic has reduced the focus on the fight against cancer.

“Cancer continues to claim unnecessary lives. It’s important that despite the Covid-19 pandemic we do not lose sight of the needs of cancer patients, helping them to live a balanced lifestyle to safeguard their health and of the importance to continue raising awareness of the signs of cancer, early detection through screening and educating to lower cancer risk,” said the group’s CEO Elize Joubert.

Joubert urged cancer patients currently in treatment and those living with the disease to stay informed about Covid-19. They must be educated about what can be done to lower the risk of infection and what to do if they contract Covid-19.

Pandemic putting cancer support under pressure

Globally, the pressure is growing on health services, according to the results of a survey conducted by the UICC. Civil Society Cancer Organisations (CSCOs) around the world say they will have to cut their support to survivors. Thirty-nine CSCOs surveyed expected further temporary reductions and almost a quarter anticipate making permanent reductions in staff in the coming year.

Another study, by medical journal Lancet, reported at least 67% of respondents expect further falls in income. While the toll is growing, there have been positive signs too.

“In many ways, the pandemic has underlined the resilience of the cancer community and the pioneering spirit of UICC’s members. It has driven innovation and collaboration, as well as the need to run more efficient organisations,” said the report. “Many CSCOs have adapted business operations, provided remote support to patients, strengthened governance arrangements, adopted remote working, and invested in the health and wellbeing of staff.”

Disruption in diagnosis

Around the world, the pandemic has also disrupted cancer diagnoses. Frontline health staff also have to cope with shortages of both resources and staff. As a result, cancer prevention and treatment programmes are delayed or interrupted, particularly in low and middle income countries.

Cancer specialists are also exposed to the coronavirus, along with other frontline workers. At the same time there is also a growing confusion about what constitutes an essential worker. In some places for example appointments for cancer checks are being pushed back, while surgery, chemotherapy and radiotherapy are continuing as planned. Some of those who are not being treated as essential are patients with mouth sores as a result of chemotherapy.

South African hospitals have reduced the risk of contagion by creating separate wards for Covid-19 sufferers and those suffering from cancer, but this has changed depending on the pressure experienced at individual hospitals.

“It appears quite certain that disruptions to cancer services in the past year will lead to diagnosis at later stages which in turn will translate into higher cancer-related mortality,” UICC President Professor Anil D’Cruz.

“Worse still the wider economic impact of the pandemic on cancer care in all probability will be felt for many years to come, even in high-income countries – in low- and middle-income countries, the impact is unfathomable,” said D’Cruz. “However, it is heartening to see the incredible response of the cancer community to mitigate these consequences both in India and elsewhere. Their stories are inspiring and these organisations need all the support we can provide to keep doing their incredible work.”

Rallying to support each other

Organisations and healthcare workers rallying across the globe to support patients and resuming screening and diagnosis for cancer. In South Africa for example, the private sector is developing innovative technologies to reduce the time spent in care settings while maintaining quality of treatment with digital technology facilitating a sharing of knowledge.

“Covid-19 has impacted cancer control globally and the response by the cancer community has been extraordinary, heroic even,” said UICC CEO Dr Cary Adams

Kenya-based breast cancer surgical oncologist Dr Miriam Mutebi agrees.

“There has been notable progress in cancer care in recent years. In high-income countries, we have seen drops in incidence and mortality rates for certain cancers,” she said. “In low- and middle-income regions such as Africa, we are seeing a promising increase in awareness about cancer as well as moves towards the implementation of national cancer control plans.”—Health-e News