With Hospitals Strained, Some Cancer Patients Face Delays In Treatment
LULU GARCIA-NAVARRO, HOST:
Hospitals are being forced to delay all kinds of treatment to handle the surge in coronavirus patients. But as reporter Will Stone explains, there are some people, including cancer patients, for whom waiting is not an option.
WILL STONE, BYLINE: Christine Rayburn was diagnosed with breast cancer six weeks ago. Coronavirus was in the news, but she was focused on getting surgery fast.
CHRISTINE RAYBURN: The cancer tumor seemed to have attached itself to a nerve. And so I feel pain from it on a regular basis.
STONE: Rayburn is 48 years old and taught school for many years. She and her husband live in Olympia, Wash., an hour south of Seattle. Her cancer is aggressive. It's already spread to her lymph nodes.
RAYBURN: I guess I cried a little bit off and on, but, you know, you're told to stay positive.
STONE: Her husband, David Forsberg, hurried to get everything in order, scans and appointments. Meanwhile, the outbreak was getting worse. Then just two days before her surgery, it was canceled.
DAVID FORSBERG: Our surgeon called up pretty livid, and she said, look. They've canceled it indefinitely.
STONE: Hospitals were calling off elective surgeries, trying to prevent patients and staff from getting infected and to conserve supplies.
RAYBURN: It just felt like one of those really bad movies, and I was being sacrificed.
STONE: They were told that in a few weeks, the hospital would review the decision. Rayburn's surgeon said they needed to go to plan B.
FORSBERG: She instantly went into that's too long to wait. We need to start chemo.
STONE: Chemo was supposed to happen after the surgery. Flipping it wasn't ideal because for this type of breast cancer, chemotherapy doesn't shrink the tumor significantly, but it would help stop the cancer from spreading. Rayburn discovered that inside the statewide ban on elective procedures, there were exceptions.
RAYBURN: And it actually said that it excluded removing cancerous tumors.
STONE: The hospital is run by Providence Health and Services, where Elaine Couture is a senior executive. She says to help figure out which surgeries can be delayed, they use algorithms and a team of physicians. Couture wouldn't talk specifics, but she assumes other cases were more urgent.
ELAINE COUTURE: Were there other patients that even had more aggressive types of cancer that were completed?
STONE: Couture says the hospitals are burning through the supplies of masks, gowns and gloves.
COUTURE: There are no perfect decisions at all in any of this. None.
STONE: At the American Cancer Society, Dr. Len Lichtenfeld is hearing lots of stories. Like this one...
LEN LICHTENFELD: There is no single national standard that can be applied. And a lot of decisions are being made on the fly.
STONE: Lichtenfeld says patients are losing precious time.
LICHTENFELD: Someone who had a brain tumor who was told they would not be able to have surgery, which was basically - and appears to be - a death sentence for that patient.
STONE: Lichtenfeld says it's not just the delays. Cancer patients everywhere are at high risk of serious illness if infected. Christine Rayburn in Olympia was steeling herself for months of chemotherapy, and she can't even see her daughters. Last week, her surgeon called again. She had convinced the hospital to allow the surgery after all.
RAYBURN: We just need to make sure that in these situations - that everyone is taking care of.
STONE: Rayburn never imagined she would be getting cancer treatment in the middle of a worldwide pandemic. Still, she feels fortunate it's happening at all. For NPR News, I'm Will Stone in Seattle.
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