Transportation safety experts will tell you that speed kills. The faster a vehicle is traveling at the time of an accident, the more severe and potentially lethal the impact may be. That’s just science.
When it comes to medical care, the reverse is often true. Speed to care saves lives, especially when dealing with serious or life-threatening conditions like cancer.
The earlier a patient is diagnosed and the sooner she or he gets treated, the better the chance for a positive outcome. Conversely, a late diagnosis and delays in treatments may result in challenging consequences for patients.
Researchers at Queen’s University at Kingston in Canada have concluded that even a four-week delay in cancer treatment may increase the risk of death by up to 13 percent.
In this article, we’ll explore:
- What the research says about treatment delays
- Chart: When a diagnosis is delayed
- Why do treatments get delayed?
- What can you do?
If you’ve been diagnosed with cancer or are experiencing symptoms, call us or chat online with a member of our team. Appointments may be available in as little as 24 hours.
What the research says about treatment delays
The Queen’s University report was the result of an exhaustive analysis of 34 studies on delays in cancer treatments. Researchers focused on data for:
The 34 studies documented in the Queen’s University report reviewed the impact on patient mortality from delays in chemotherapy and other systemic treatments, as well as surgery and radiation therapy.
Among the report’s findings:
- The Veterans Administration of the Greater Los Angeles Healthcare System found that delays of more than 12 weeks in radical cystectomy surgery was associated with an increased risk of “disease-specific and all-cause mortality” among patients with stage 2 bladder cancer.
- Researchers in Toronto, Canada, found that delays in postoperative radiation therapy was associated with a greater risk of cancer recurrence.
- Scientists at Fox Chase concluded that delays in breast cancer surgery were associated with lower overall and disease-specific survival, and a shortened time to treatment initiation was associated with benefits comparable to some standard therapies.
After reviewing these and dozens of other studies on cancer treatment delays, researchers concluded:
- A one-month delay in cancer surgery resulted in a 6 percent to 8 percent increase in the risk of death.
- A one-month delay in radiation therapy for patients with head and neck cancer resulted in a 9 percent increased risk of death.
- A one-month delay in systemic treatment for colorectal cancer resulted in a 13 percent increase in the risk of death.
- An eight-week delay in breast cancer surgery increased the risk of death by 17 percent, and a 12-week delay increased the risk by 26 percent.
- If all breast cancer surgeries were delayed 12 weeks for a year, it would result in an estimated 6,100 additional deaths in the United States.
Researchers acknowledged that their findings don’t account for how treatment delays affect quality of life for those who survive delays. Some patients may have more health complications and financial burdens as a result of delayed treatment.
“Therefore, the impact of treatment delay is probably far greater for patients and society than that reflected in our results,” the study says.
Chart: Outcomes when a cancer diagnosis is delayed
It’s only logical that the more time cancer is allowed to grow and the more it spreads, the more difficult it is to treat. This bears out in the survival statistics for most cancers and the fact that cancer metastasis is the primary cause of death for cancer patients.
The chart below helps to illustrate the dramatic difference in potential outcomes for patients diagnosed with these common cancers, depending on when they’re diagnosed. It breaks down the five-year survival rates for patients when the cancer is considered:
- Localized, or hasn’t spread from its area of origin
- Regional, or has spread to nearby lymph nodes or tissue
- Distant, or has metastasized to organs or tissue elsewhere in the body
| Type | Localized | Regional | Distant |
|---|---|---|---|
| Breast cancer (female) | 99.6% | 86.7% | 31.9% |
| Prostate cancer |
100% | 100% | 36.6% |
| Lung cancer |
63.7% | 35.9% | 8.9% |
| Colorectal cancer |
91.1% | 73.7% | 15.7% |
| Melanoma | 100% | 74.8% | 35% |
Why do treatments and diagnoses get delayed?
The Queen’s University study didn’t pinpoint all the causes for cancer treatment delays, but the list for potential reasons is long.
“While there are a variety of reasons for a delay in the initiation of cancer treatment, including the need to improve the nutritional status of a patient prior to major surgery, existing evidence strongly suggests the potential negative impact on survival of an excessive delay,” says Maurie Markman, MD, President of Medicine & Science for City of Hope® Cancer Centers Atlanta, Chicago and Phoenix.
The study lists several potential reasons, including:
- A primary care physician did not recognize or act on early cancer symptoms.
- Local hospitals may be short-staffed or experiencing supply-chain challenges.
- People may not have adequate insurance because they’re unemployed or under-employed.
- In some cases, patients may ignore their symptoms or diagnosis or delay treatment out of fear.
Diagnoses may also be delayed for a variety of other reasons, including a lack of awareness of symptoms or screening guidelines or knowledge of your family history or other risk factors.
For people in underserved or rural communities, access may be an issue, says Peter Baik, Thoracic Surgeon at City Hope Cancer Centers in Chicago and Phoenix.
“There are now a lot of facilities that have low-dose CT scans, but for the underserved population, it may be difficult to get access,” Dr. Baik says. “For example, what if they work during the day? How many imaging centers offer low-dose CT after hours? They may have transportation issues, or maybe they don’t have insurance, a primary care physician or don’t have access to good health care in general.”
What can you do?
It’s common to think you have no control over cancer. But you have control over making lifestyle decisions to reduce your risk and get screened. And if you’ve been diagnosed, there are steps you can take to ensure you are involved in your treatment plan.
Here are some steps to consider before and/or after a diagnosis:
Get screened. It’s important to know the recognized guidelines for cancer screening and whether you meet criteria to get screened. Screening tests, such as mammograms and colonoscopies, are often covered by insurance.
Know your family history. Up to 10 percent of all cancers can be traced to genetics. If your family has a history of cancer, especially if an ancestor was diagnosed at a young age, talk to your doctor about screening or genetic testing.
Be alert to symptoms. Cancer shares many symptoms with other conditions and less-serious illnesses, such as the flu. But if you’re experiencing ongoing symptoms, such as fatigue, unexplained weight loss, excessive bleeding, pain or ongoing digestive issues, you should see a doctor.
Ask questions. The more you know about your cancer and your treatment options, the better equipped you are to make education decisions about your care plan. The National Cancer Institute (NCI) suggests several questions to ask your doctor about your diagnosis and treatment.
Understand your emotions. It’s normal to experience a dramatic wave of emotions after a diagnosis. Consider reaching out to a counselor, chaplain or someone you feel comfortable confiding in about your feelings.
Take care of yourself. Many of the lifestyle choices you make to help reduce your cancer risk are just as important after you’ve been diagnosed. Behaviors like eating well and exercising regularly may help your treatments work better and improve your quality of life.
The American Cancer Society and NCI offer more suggestions to help patients take control of their care.
If you’ve been diagnosed with cancer or are experiencing symptoms, call us or chat online with a member of our team. Appointments may be available in as little as 24 hours.
