The Challenges of Cancer Research and Cancer Care During the Pandemic

The recent COVID-19  pandemic has disrupted many aspects of cancer care and cancer research, including ongoing therapies, clinical trials, laboratory work, and research funding.

Data shows elevated mortality rates amongst cancer patients who are more vulnerable to infections as their immune system is weakened by the disease and its treatment. It is not the only issue they have to face as treatments and surgeries might have been delayed or treatment pathways have been modified. Understandably many patients are worried to get exposed to the virus during cancer care. Oncologists needed to assess the risk of delaying therapy and exposing their patients to the virus. Cancer patients were not the only ones who are reluctant to visit hospitals, people, in general, have skipped regular screenings, and emergency-department visits. In parallel, many institutions canceled their screening programs and prepared for admitting COVID patients. According to the NHS in March emergency-department visits decreased by a third, meanwhile, another study shows routine screenings dropped by 85-90%. Less screening means delayed diagnosis and worse long-term prognosis. Furthermore, clinical trials can be lifesaving, yet only in the UK 60% of the 15 000 trials have been suspended and 10%, 1500 clinical trials have been closed down according to The Guardian. Shutting down clinical trials narrows the therapy options for patients, also slows down medical research and scientific advancement.

Covid affecting cancer research
In the UK alone 60% of the 15 000 trials have been suspended and 10%, 1500 clinical trials have been closed down

“Over the past several months the entire globe has had to learn what isolation, mask-wearing and constant concern around contamination is like. For cancer patients, this has always been their reality. Today a cancer patient is 16 times more likely to die from COVID-19 than another person who acquires the virus. This means concern for their health is even more intense.  At Livestrong, we’ve seen cancer patients effectively go into high levels of quarantine as they distance from anyone who ventures out. Many stopped treatment or opted not to go for follow up appointments with their physicians. We will see the effect of this in the coming months as cancer experts predict a rise in mortality linked to the COVID outbreak and ensuing isolation. Important clinical trials have all but ceased as patients are unable to come in for surveillance. As funding and focus slowly begin to shift back to work which was on-going prior to the lockdown, we will likely see substantial delays in study results and ultimately potentially life-impacting treatments.” says Suzanne Stone, Chief Strategic Solutions & Programs Officer of the Livestrong Foundation.

Laboratories also have been suffering from the effects of the pandemic, in many countries laboratory work was not regarded as essential work. During the lockdown, many researcher teams had to suspend their projects. Simultaneously research institutions, private laboratories, and biotech companies repurposed their resources to aid the fight against the virus.

RUBYnanomed, a Portuguese startup developing non-invasive cancer progression monitoring, is part of our 2020 cohort. The team of RUBYnanomed shared their story with us and the challenges they had to face after Portugal went on lockdown.

„RUBYnanomed is a Portuguese startup that spun-off from INL – International Iberian Nanotechnology Laboratory.  In March, Portugal implementing a general lockdown, causing that most of the activities in the lab were put on hold for over two months and all operations had to be performed remotely. Like everyone, we were heavily affected: experimental work stopped, meetings were canceled, contracts were delayed, and all family members were at home struggling to get some work done (many times until very late hours). Also, once we retook onsite activities, supplies were delayed, and services were affected.

Moreover, we feel that for a small company that is starting to flourish, attracting attention from investors, possible licenses, and finalizing the first industrial test-batch of our product, this situation had an even more detrimental effect than that for established companies. At RUBY we feel the area in which COVID-19 had more impact is funding. We applied to funding that, during the evaluation, attributed half of the budget to COVID19-related projects with no previous notice, reducing the budget available to non-COVID-19 projects and thus, our chances to be funded. We feel there has been some pressure to shift focus towards COVID-19, in detriment to other relevant diseases. We fully understand that some funds and efforts may be reallocated, however specific calls and private funding were already allocated to these efforts. In some cases, we perceived this interest as merely economic. This brought us to the reflection of how to balance the business opportunity COVID-19 brought for many with the real impact those many can actually provide.  Is COVID-19 going to a new asset bubble?

In more practical terms, another aspect that had an impact on our activity strongly relates to hospital functioning. In the framework of the European H2020 project PERSIST, in which we are partners, there are ongoing preparations for a clinical study to be launched in early 2021. Yet, there is uncertainty in the air and clinical partners are worried about patient recruitment as visits to hospitals are reduced and communication with patients faces new challenges.”

Even though there are challenges, we see the light at the end of the tunnel. After the initial shock, scientists got back on their feet and adapted to the new circumstances. Radical and devastating changes can fuel scientific research and innovation. This time is no different and it holds tremendous opportunities for those who are quick to adapt.

Special thanks to the contributors, Suzanne Stone and the team of RUBYnanomed who helped to create this unusual piece, and gave us insight into the challenges organizations fighting cancer face during the pandemic.

cLAB Ventures - November 16, 2020