Some cancer surgeries, treatments in Nova Scotia postponed due to COVID-19

The COVID-19 pandemic has led to some dramatic changes in the way Nova Scotia treats cancer patients, including delaying some surgeries.

The Nova Scotia Health Authority's cancer care program is making decisions daily, trying to best balance the safety of its patients with existing resources.

"We're in unprecedented times," said Dr. Drew Bethune, medical director of the provincial cancer care program.

"We're doing our best at being as innovative as possible, so this is extremely necessary, regretfully."

The changes include:

• Delaying some surgeries.
• Suspending the colon cancer prevention program.
• Cancer patients can no longer bring a support person to most appointments.
• Radiation therapy patients are now receiving higher doses, less often.

"It's really, very, very difficult. Cancer patients are at a time of their greatest need," Bethune said.

He points out cancer patients have compromised immune systems, putting them at an extremely high risk of developing serious medical complications if they contract COVID-19.

"Cancer surgery is not elective ... but a lot of surgeries have to be delayed," he said. "There is no option because we have to preserve our equipment not knowing how many COVID-19 cases we're going to be dealing with in a week or two or three or four."

One of their big focuses is minimizing contact and in-person appointments. By doing that, Bethune said it limits the number of chances a cancer patient could be exposed to the virus. All patients are called in advance of their appointments to ensure they're not showing any COVID-19 symptoms.

The pandemic has also pushed the cancer care department to expedite changes that were already in the works. Doctors are meeting with their patients virtually as much as possible.

The radiation program was testing a new treatment model called hypofractionation.

"It's higher doses per fraction and with our new high-precision radiotherapy machines, it's possible to do that," Bethune said. "We're doing this cutting-edge therapy now and we were doing that before the COVID-19 pandemic, but we're accelerating it."

Bethune said the department has meetings on a daily basis to see if changes will be implemented. All updates are posted on the Nova Scotia Health Authority's website.

One of the changes will mean patients cannot bring a support person to their appointments, unless it's an initial appointment where they're receiving a diagnosis.

Patients who are having treatments such as chemotherapy will have to use digital devices to connect with their loved ones.

It's unclear when the changes will be reversed.

Bethune acknowledges the changes are hard, and even said the visitation rules are draconian, but they have no other option.

He's asking for patience as they continue to make difficult decisions and said physical distancing has played an important role in protecting the lives of Nova Scotians, especially cancer patients and front-line health-care workers.

The Canadian Cancer Society said it has seen a 25 per cent increase in the number of people asking for advice and support.

"That raises lots of questions and concerns around, 'What does this mean for me? What does this mean for my diagnosis?' Is this becoming the sort of collateral damage of COVID-19?" said Kelly Cull, the Atlantic director of public issues for the Canadian Cancer Society.

'Such a difficult time for all of us'

She said health-care workers have had to make "impossible" decisions in the last few weeks.

"There are no good solutions here," she said. "This is such a difficult time for all of us, but for people who are living with cancer, there's just a different and particular level of vulnerability."

She said the organization is busier than it has ever been, trying to provide as much phone and online support as possible. 

"We're doing our best to reduce anxiety and limit those feelings of isolation in these really challenging times," Cull said.

There are more than 400 confirmed cases of the coronavirus in Nova Scotia.