COVID-19 took over news headlines for a year but, while the virus had been spreading across the world and infecting millions of people, other illnesses continue to threaten the lives of many more. Worse, because hospitals were overwhelmed with patients and strict nationwide lockdowns, so many diagnoses were not made. Patients could not visit a doctor to get aches and pains, bumps, rashes, and other potentially serious symptoms checked out.

Experts have been warning about a hidden crisis that has been brewing for the past year. While governments and healthcare facilities focus on COVID-19, those who live with chronic health conditions, rare diseases, and cancer have been unintentionally ignored.

The Non-COVID Crises

Every year, 18 million people receive a cancer diagnosis. Cancer is one of the leading causes of death in the world. Advancements in the medical field made cancer a treatable disease, but it has to be spotted in its early stages to ensure the patient’s survival. The efficacy of treatment decreases as cancer becomes more aggressive and develops into later stages.

However, because of the pandemic, many patients delayed visits to the doctor to get checked.

A research letter published in JAMA Network Open in 2020 revealed that, as COVID-19 was spreading, fewer cases of the six most common cancers – breast, colorectal, lung, gastric, pancreatic, esophageal – were identified. From March 1 to April 18, new diagnoses for these six cancers decreased by 46 percent. The number of diagnoses for breast cancer had the biggest drop.

Patients did not have opportunities to come into the hospital for routine screening. The disease could have been spotted earlier in a normal year. Because there is a pandemic, patients waited longer to get a diagnosis and begin treatment.

The decline of Skin Cancer Diagnoses in 2020

Dermatologists also sound alarms over the steep decline of skin cancer diagnoses during the first six months of 2020. The American Academy of Dermatology reported that, from March 2020 to May 2020, the cases of skin cancer found dropped by an average of 46 percent compared to the same period in 2019. The largest decrease of diagnoses happened in April 2020, when the United States was being ravaged by COVID-19.

Cancer of the skin occurs when skin cells grow abnormally, often after frequent and prolonged exposure to the sun or through the use of tanning beds. Common forms of skin cancer include basal cell carcinoma, squamous cell carcinoma, and melanoma.

Telemedicine Improves Detection

An important factor that led to a decline in diagnosis is access. People cannot as easily go to a doctor.

In some places, medical practitioners were forced to step back as the pandemic worsened. In Northern Ireland, four out of 10 general practice doctors were unable to practice because of the lockdowns.

Patients, too, were not ready to step inside a hospital. A survey by the American College of Emergency Physicians found that 70 percent of respondents were very or somewhat concerned about entering a health facility because of fear that they will contract COVID-19.

Telemedicine helped, but there were limitations. The stability of internet connection was a barrier for many patients and doctors. Dermatologists, in particular, need to see the problem area clearly to identify and recommend the appropriate treatment.

For some cases, such as skin cancer diagnosis, the patient will be invited to the clinic for a closer, hands-on examination. Telemedicine has limitations. Dermatologists need tools to investigate serious symptoms and conditions.

The use of electronic health records (EHR) will help dermatologists, too, to identify a person’s risk of skin cancer. While the disease is mostly caused by the sun, it can also run in the family. According to the Skin Cancer Foundation, one out of 10 patients has a family member diagnosed with the disease.

Skin Cancer Diagnosis and Treatment

Diagnosis cannot be made over telemedicine alone. The specialist will want to closely examine the skin and ask the patient about changes in its appearance over time and their lifestyle or family health history.

The attending physician will also likely extract a sample of the suspicious patch of skin for biopsy. A lab test will confirm if the patient has skin cancer and which type. Once confirmed, the doctor will suggest further testing to see the extent of the disease, whether it is still in its early stages or it has spread.  

The severity of the skin cancer will determine possible treatment options.

For skin cancers in their early stages that are superficial or limited on the surface, removing the entire growth might be sufficient. Those who were lucky to find the disease immediately will not require further treatment aside from the biopsy.

The doctor might also recommend freezing to destroy actinic keratoses and early skin cancers. When the skin has thawed, the dead tissues will be removed.

Patients in advanced stages will have to go through chemotherapy or radiation therapy to kill the cancer cells.

COVID-19 is a public health emergency, but the pandemic response should involve patients struggling with other diseases. Ignoring non-COVID diseases will only lead to more severe cases and deaths later on. Telemedicine is one tool that enables patients to access medical aid despite lockdowns and fear of catching COVID-19.