That’s what Cheryl-Anne Labrador-Summers thought, anyway. It was October 2020, not long after she’d moved to the tranquil lakeside Ontario community of Georgina, and instead of relaxing with her family like she’d planned, the mother of three was struggling to figure out why she kept experiencing strange, unexplained stomach cramps.
Labrador-Summers tried to visit her family physician, but the office was shuttered because of the COVID-19 pandemic. So she searched for another clinic — only to be offered a phone appointment rather than an in-person assessment. She wound up being told that her grumbling digestive system was likely caused by a mild gastrointestinal illness.
By January, the 58-year-old had a distended stomach, looking — in her own words — “about nine months pregnant.” Again, she reached out to a physician, went for some tests, then headed to the nearest emergency department.
After finally seeing a doctor face to face for the first time in months, she learned the real cause of her discomfort: an intestinal blockage caused by cancer.
“It ended up being a nine-centimetre tumour, and it had completely blocked off my lower bowel,” she said.
An emergency surgery left Labrador-Summers with 55 staples along her torso and a months-long recovery before she could begin oral chemotherapy. Her question now is unanswerable but painful to consider: Could that ordeal have been prevented, or at least minimized, by an earlier diagnosis?
“Had I maybe been able to see the doctors earlier, I would not be in Stage 3,” she said. “I might have been a Stage 2.”
Photos show Labrador-Summers with a distended stomach before her emergency surgery, left, and the 55 staples along her torso following the procedure. (Supplied by Cheryl-Anne Labrador-Summers)
951,000 fewer cancer screenings in Ontario
More Canadians could experience late-stage cancer diagnoses in the years ahead, medical experts warn, forecasting a looming crisis tied to the ongoing COVID-19 pandemic.
“We expect to see more advanced stages of presentation over the next couple of years, as well as impacts on cancer treatments,” said oncologist Dr. Timothy Hanna, a clinician scientist at the Cancer Research Institute at Queen’s University in Kingston, Ont.
“We know that time is of the essence for people with cancer. And when people are waiting for a diagnosis or for treatment, this has been associated with increased risks of advanced stage and worse survival.”
One review of Ontario’s breast, lung, colon, and cervical cancer screening programs showed that in 2020 there were 41 per cent — or more than 951,000 — fewer screening tests conducted compared with the year before.
Screening volumes rebounded after May 2020, but were still 20 per cent lower compared to pre-pandemic levels.
WATCH | Late-stage cancer being diagnosed in Canadian ERs:
ERs faced with late-stage cancer diagnoses amid pandemic
4 days ago
Duration 2:11
Hospital emergency rooms are seeing a wave of patients being diagnosed with late-stage cancer after the COVID-19 pandemic forced many doctors’ offices to close or pivot to virtual appointments, leading to fewer cancer screenings.
That drop in screenings translates into fewer invasive cancer diagnoses, including roughly 1,400 to 1,500 fewer breast cancers, wrote Dr. Anna N. Wilkinson, an assistant professor in the department of family medicine at the University of Ottawa,in a May commentary piece for the journal Canadian Family Physician.
“The impact of COVID-19 on cancer is far-reaching:screening backlogs, delayed workup of symptomatic patients and abnormal screening results, anddelays in cancer treatment and research, all exacerbated by patient apprehension to be seen in person,” she wrote.
“It is clear that there is not only a lost cohort of screened patients but also a subset of missed cancer diagnoses due to delays in patient presentation and assessment,” leading to those cancers being diagnosed at a more advanced stage.
Tough accessing care in a ‘timely way’
The slowdown in colonoscopies may already be leading to more serious cases of colorectal cancer in Ontario, for instance,suggests a paper published in the Journal of the Canadian Association of Gastroenterology.
“Patients who were treated after the COVID-19 pandemic began were significantly more likely to present emergently to hospital. This means that they were more likely to present with bowel perforation, or severe bowel obstruction, requiring immediate life-saving surgery,” said the study’s lead author, Dr. Catherine Forse, in a call with CBC News.
“In addition, we found that patients were more likely to have large tumours.”
Dr. Lisa Salamon, an emergency room physician with the Scarborough Health Network, is pictured outside Birchmount Hospital, in Scarborough, Ont. (Evan Mitsui/CBC)
In some cases — like Labrador-Summers’s situation — Canadians learned alarming news about their health in hospital emergency departments after struggling to receive in-patient care through other avenues.
Shuttered family physician offices, a shift to telemedicine, and some patients’ fears surrounding COVID-19 may all have played a role.
“It became harder for patients to access care and to access it in a timely way,” Hanna said.
“At the same time, there were real risks — and there are real risks for leaving home to go anywhere, particularly to go to an outpatient clinic or a hospital in order to get checked out.”
Dr. Lisa Salamon, an emergency physician with the Scarborough Health Network in Toronto, said she’s now diagnosing more patients with serious cancers, including several just in the last few months.
“So previously, it may have been localized or something small, but now we’re actually seeing metastatic cancer that we’re diagnosing,” she explained.
Lessons for future pandemics
Health policy expert Laura Greer is dealing with Stage four, metastatic breast cancer herself after waiting more than five months for a routine mammogram she was initially due for in the spring of 2021 — a precautionary measure given that her mother had breast cancer as well.
Unlike an early-stage diagnosis, Greer’s cancer is only treatable, not curable.
“It was an example of what happens when you don’t have the regular screening, or those wellness visits,” said the Toronto resident and mother of two.
“I most likely would have had earlier-stage cancer if it had been sooner.”
Health policy expert Laura Greer is dealing with Stage 4, metastatic breast cancer after waiting more than five months for a routine mammogram she was due for in the spring of 2021. (Esteban Cuevas/CBC News)
Pausing access to care and screenings for other health conditions can have dire impacts on patients, according to Greer, offering lessons for how policy-makers tackle future pandemics.
“We need to make sure that we’ve got enough capacity in our health system to be able to flex, and that’s what we really didn’t have going into this,” she said.
For Labrador-Summers, it’s hard to forget the moment her life changed while she was alone in an emergency department, learning a terrifying diagnosis from a physician she’d just met. Her mind raced with questions about the future and concerns for her family.
Labrador-Summers’s husband and one of her sons kiss her on the dock near their lakeside home in Georgina, Ont. (Ousama Farag/CBC News)
“My older son had just told us they were expecting a child, and I just wanted to be there for them. And I didn’t know what next steps were. And we had lost my mom to cancer a few years back — to us, cancer was always terminal,” she recalled.
“So again, I’m alone, trying to process all of this.”
A screening following Labrador-Summers’ surgery and chemotherapy treatment wound up finding more cancer.
SANTA CLARA, Calif. (AP) — The San Francisco 49ers placed All-Pro running back Christian McCaffrey on injured reserve because of his lingering calf and Achilles tendon injuries.
The move made Saturday means McCaffrey will miss at least four more games after already sitting out the season opener. He is eligible to return for a Thursday night game in Seattle on Oct. 10.
McCaffrey got hurt early in training camp and missed four weeks of practice before returning to the field on a limited basis last week. He was a late scratch for the opener on Monday night against the Jets and now is sidelined again after experiencing pain following practice on Thursday.
McCaffrey led the NFL last season with 2,023 yards from scrimmage and was tied for the league lead with 21 touchdowns, winning AP Offensive Player of the Year.
The Niners made up for McCaffrey’s absence thanks to a strong performance from backup Jordan Mason, who had 28 carries for 147 yards and a touchdown in San Francisco’s 32-19 victory over the New York Jets. Mason is set to start again Sunday at Minnesota.
After missing 23 games because of injuries in his final two full seasons with Carolina, McCaffrey had been healthy the past two seasons.
He missed only one game combined in 2022-23 — a meaningless Week 18 game last season for San Francisco when he had a sore calf. His 798 combined touches from scrimmage in the regular season and playoffs were the third most for any player in a two-year span in the past 10 years.
Now San Francisco will likely rely heavily on Mason, a former undrafted free agent out of Georgia Tech who had 83 carries his first two seasons. He had at least 10 touches just twice before the season opener, when his 28 carries were the most by a 49ers player in a regular-season game since Frank Gore had 31 against Seattle on Oct. 30, 2011.
The Niners also have fourth-round rookie Isaac Guerendo and Patrick Taylor Jr. on the active roster. Guerendo played three offensive snaps with no touches in the opener. Taylor had 65 carries for Green Bay from 2021-23.
San Francisco also elevated safety Tracy Walker III from the practice squad for Sunday’s game against Minnesota.
BRUSSELS – Canada walked away with some hardware at the Diamond League track and field competition Saturday.
Alysha Newman finished third in women’s pole vault, while Marco Arop did the same in the men’s 800-metre race.
Newman won a bronze medal in her event at the recent Paris Olympics. Arop grabbed silver at the same distance in France last month.
Australia’s Nina Kennedy, who captured gold at the Summer Games, again finished atop the podium. Sandi Morris of the United States was second.
Newman set a national record when she secured Canada’s first-ever pole vault medal with a bronze at the Olympics with a height of 4.85 metres. The 30-year-old from London, Ont., cleared 4.80 metres in her second attempt Saturday, but was unable conquer 4.88 metres on three attempts.
Arop, a 25-year-old from Edmonton, finished the men’s 800 metres with a time of one minute 43.25 seconds. Olympic gold medallist Emmanuel Wanyonyi of Kenya was first with a time of 1:42.70.
Djamel Sedjati, edged out by Arop for silver in Paris last month, was second 1:42.87
This report by The Canadian Press was first published Sept. 14, 2024.
MILAN (AP) — Bologna’s preparations for its Champions League debut are not going well though it managed to spoil Como’s first Serie A home match in 21 years on Saturday.
Bologna came from two goals down to salvage a 2-2 draw to gather three points from its opening four matches.
Bologna hosts Shakhtar Donetsk on Wednesday. Its only other appearance in Europe’s top competition was in 1964 in the preliminary round of the old European Cup.
AC Milan is also winless as it prepares for a Tuesday Champions League match against Liverpool. The Rossoneri hosted promoted Venezia later. Juventus drew at Empoli 0-0.
Como made a great start in the fifth minute when Patrick Cutrone attempted to roll the ball across the six-yard box but it took a huge deflection off Bologna defender Nicolò Casale for an own goal.
Bologna thought it was gifted a way back into the match on the stroke of halftime when referee Marco Piccinini signalled for a penalty following an Alberto Moreno handball, but he revoked his decision and instead gave a free kick because the handball was just outside the area.
Bologna improved after the break but found itself further behind when Cutrone raced onto a through ball and cut inside past a defender and fired into the far bottom corner.
Tommaso Pobega hit the post for Bologna, which finally pulled one back in the 76th through substitute Santiago Castro.
Another substitute helped the visitors snatch a point when Samuel Iling-Junior curled a fine strike into the top left corner in stoppage time.
Unbeaten sides
Juventus, and more surprisingly Empoli, are among six unbeaten sides.
Empoli held Monza and Bologna to draws either side of a shock 2-1 win at Roma. Juventus’ perfect start to the season was ruined by Roma in a goalless draw before the international break.
On Saturday, there were few clearcut chances in Empoli although home goalkeeper Devis Vásquez made spectacular saves to fingertip out a Federico Gatti header and deny Dusan Vlahovic in a one on one with the Juventus forward.
Empoli had a good opportunity in the 73rd minute following an Alberto Grassi one-two with Pietro Pellegri but the finish was straight at Mattia Perin.
The host could have won it right at the death but Gatti flew in with a great sliding block to keep out Emanuel Gyasi’s close-range effort.
Juventus hosts PSV Eindhoven in the Champions League on Tuesday.
