In her early 20’s, Mackenzie Alleman lost her mother to breast cancer. Then, at 28, she herself underwent a preventative double mastectomy after learning that she carried the mutated BRCA1 gene. This gene gave her an 87% chance of developing breast cancer, and a 53% chance of developing ovarian cancer. Normally, Allemen is screened for ovarian cancer every year with an ultrasound and blood test. But in the time of COVID-19, nothing – including cancer screenings – is normal.
The extremely infectious and harmful viral pandemic had contributed to nearly 4.5 million diagnoses, and hundreds of thousands of fatalities, across the globe. But for people like Mackenzie, this is not only frightening but adds a layer of complexity to medical treatment. Read Mackenzie’s full story in Inquirer.
Breast & Ovarian Cancer
Breast cancer occurs when cancerous cells form in breast tissue. Although it can affect both males and females, it is the 2nd most common cancer in women. There is no definitive cause of breast cancer. However, 10% of breast cancer diagnoses are caused by mutated BRCA1 or BRCA2 genes. Symptoms include lumps in breast tissue, a change in the breast’s size or appearance, skin dimpling or redness, flaking or scaly skin, and changes in the nipple. Breast cancer is usually diagnosed through an exam, mammogram, biopsy, ultrasound, and MRI. Learn more about breast cancer.
Ovarian cancer occurs when cancerous cells form in ovarian tissue. The ovaries are female sex organs which store eggs and produce hormones called estrogen and progesterone. There are four types of ovarian cancer: small cell carcinoma of the ovary, stromal carcinoma tumors, epithelial tumors, and germ cell carcinoma tumors. These differ based on what tissue the cancer forms in. Ovarian cancer has four stages and can spread to other areas of the body.
In rare cases, mutated BRCA1 or BRCA2 genes can lead to ovarian cancer. In fact, women with BRCA mutations are up to 30x more likely to develop ovarian cancer than those without. Symptoms include bloating and pelvic pain, menstrual irregularities, loss of appetite, abdominal swelling, changes in vaginal secretions or urination, and tender breasts. A pelvic exam is used to diagnose ovarian cancer.
However, those with BRCA mutations should participate in frequent breast and ovarian cancer screenings to assist with early detection and treatment. Learn more about ovarian cancer.
Why The Reduction in Cancer Screenings is Worrisome
Cancer screenings, like mammograms, Pap smears, and colonoscopies, help with early cancer detection. This is especially important for at-risk patients, where early detection can save their lives, allow for earlier treatment, and mitigate any potential risks.
In Mackenzie Alleman’s case, her doctor said it was necessary to postpone her appointment. But she’s not alone. According to the Epic Health Research Network (EHRN), cancer screenings dramatically fell in March after COVID-19 was declared a pandemic. In fact, preventative cancer screenings fell by 96% compared to previous years. Outpatient visits fell by 60% by April.
Says gastroenterologist Austin Chiang:
“On a global scale, it’s a lot of screening procedures being deferred — and maybe some cancers that could develop in this time, as well.”
Some tumors may not be found until later stages. Ultimately, this will lead to worse patient outcomes. However, doctors are also concerned that patients may view these screenings as unnecessary. If a colonoscopy, mammogram, or other procedure can be put off by a few months, why not longer?
For many of these procedures, doctors do acknowledge that it’s okay to wait until the COVID-19 impact is a little lighter. Or until medical providers have adequate resources and PPE. But continuing to delay cancer screenings puts patients at risk. So, patients should make appointments with their doctors to ensure there is no lapse in care.