Features

“It’s in God’s hands now’

Cancer would not wait for Covid-delayed screening.

Shirley Love, 75, formerly of Morris, had rectal cancer in 2019. Love said COVID caused delays in her receiving a colonoscopy in 2021. Love finally had one in early 2022. She now has stage 4 rectal cancer.

In 2019, Shirley Love, 75, took 30 radiation treatments for rectal cancer.

In June 2021, Love, who was married to former Morris Police Chief Alan Love, was supposed to have a diagnostic colonoscopy.

But Shirley said her doctor couldn’t schedule one because COVID-19 cases were high and the colonoscopy was considered elective. Love bristles saying “colonoscopy” and “elective” together.

“Now you tell me, who gets a colonoscopy for fun?” Shirley said.

Shirley Love, 75, formerly of Morris, had rectal cancer in 2019. Love said COVID caused delays in her receiving a colonoscopy in 2021. Love finally had one in early 2022. She now has stage 4 rectal cancer.

Then Shirley had COVID-19 in August and couldn’t get a colonoscopy. She was still testing positive for COVID-19 in December, so no colonoscopy.

On Jan. 3, she went to the emergency department in severe pain. A CT scan showed a tumor pressing against her kidney.

“Then the Lord spoke to Alan and said for him to bring me to Florida, that I would get healed if I went down to Florida,” Shirley said. “Alan was in bad shape and I was in bad shape. How are we going to get to Florida? Neither one of us could probably make that trip.”

A family member helped transport the Loves to Florida, where they now live, Shirley said. Soon afterward, Shirley saw a doctor and had her colonoscopy. She had stage four rectal cancer.

Her dilemma has been repeated thousands of times in the nation. While the true long-term impact on cancer mortality remains unclear, the short-term impact of delayed screenings and treatment is predicted to be significant. Two studies in the United States and the United Kingdom, for example, predicted significant increases in cancer deaths.

National Cancer Institute Director Dr. Norman E. Sharpless projected in June 2020 that screenings missed as a result of the pandemic would lead to 10,000 additional deaths from breast and colorectal cancers alone.

“That’s the problem with this [COVID-19],” Shirley said. “They let things go too long.”

Shirley said she is receiving immunotherapy with the goal of getting back into remission.

“It’s in God’s hands now,” Shirley said.

Pandemic delayed routine health screenings

During the pandemic’s early days, the Illinois Department of Public Health recommended canceling all elective surgeries in order to “decompress the health care system during the COVID-19 response, and to prevent potential exposure to the virus,” according to a 2020 Herald-News story.

Statistics on the Illinois Health and Hospital Association website say 48 percent of the people surveyed said someone in their family had skipped or delayed medical care due to COVID-19, and 11 percent said a condition of a family member worsened due to missed care.

Screenings for breast, colorectal and prostate cancer sharply declined in the U.S. from March through May 2020, one study found.

For some people, delaying a routine cancer screening was merely an inconvenience. But for Wenora Johnson, 55, of Joliet, any delay is potentially deadly.

Wenora Johnson of Joliet holds a proclamation from the state of Illinois proclaiming March 2021 as Colorectal Awareness Month. Johnson is a colon cancer survivor and patient advocate.

Johnson was diagnosed with stage 3b colon cancer in 2011, which led to her diagnosis of Lynch syndrome, a genetic syndrome with a predisposition to certain cancers — endometrial and basal cell, in Johnson’s case.

Consequently, Johnson needs an annual colonoscopy. Her colonoscopy was delayed six months.

”I had three additional polyps,” Johnson, a three-time cancer survivor and Navy veteran, said in a 2021 Herald-News story. “And one was precancerous.”

What providers are seeing

Dr. Peter Roumeliotis, an internal medicine physician with Morris Hospital & Healthcare Centers, said a diabetic family member died from a heart attack. She had stopped taking her medicine because she didn’t want to go into the office for it, Roumeliotis said.

Another patient, with no family history of breast cancer, missed her annual mammograms. She now has breast cancer, he said.

A patient with a history of polyps missed a colonoscopy because of the coronavirus pandemic. He now has colon cancer and recently had a colectomy and a colostomy installed, he said.

Surgery centers are overwhelmed with people catching up with hip and knee replacements, he said.

“I know our office is booked three months out right now just trying to get everybody seen,” he said. “Lab work is extremely difficult to get performed right now.”

Dr. Peter Roumeliotis is an internal medicine physician with Morris Hospital & Healthcare Centers.

Hospitals used to call to remind patients to schedule their lab work. Now, some don’t have the staff to make such calls, Roumeliotis said.

But sometimes Roumeliotis’ patients tell him, ”I can’t afford to get the blood test. Can we wait six months and see if I can find a job?” And that creates more delays and strain on the health care system.

Moreover, outpatient surgery centers only take patients with health insurance. So now hospitals strain their own finances by seeing more public aid patients, he said. On top of that, many local specialists won’t see public aid patients.

Ditto for dentists.

“So we want them to get their teeth cleaned and have their broken teeth take care of,” Roumeliotis said. “But it’s almost impossible to find a dentist that accepts public aid and patients end up with worsening of health problems because of it.”

Patients with high blood pressure, diabetes and underlying but asymptomatic heart disease became sedentary and are now having chest pains when they walk, he said.

“A lot of those people are smokers who ended up smoking more because they were sitting around the house with nothing to do,” Roumeliotis said. “The people with heart disease had no activity because the cardiac rehab that we had at the hospital was closed for a year and half. And we’re seeing a lot of people who need heart stents. So that’s another issue.”

Diabetics who once had good blood sugar control are now poorly controlled. Maybe they didn’t get their fasting labs done for a year and a half or stopped logging their daily blood sugars, he said.

“They assume everything is hunky dory because their fasting blood sugar is good,” Roumeliotis said. “But their A1c is out of the roof.”

Video visits helped some patients, but telemedicine couldn’t monitor things such as heart murmurs, he said. A patient with a heart murmur wound up requiring surgery because no one was monitoring it.

Shortages of providers further complicated access to care. Staff left health care for multiple reasons: overburdened at work, ridiculous working hours, fear of getting COVID-19 or bringing it home to their families, he said.

“I had [COVID-19] in November 2020 before vaccines,” Roumeliotis said. “I was off work a month, but it took six months before my symptoms got better. And I wasn’t the only provider who got sick.”

Dr. Arpit Patel, a family medicine physician with Edward Medical Group in Plainfield, said he’s most commonly seen subpar control in his diabetic patients. Cancer diagnoses are up a little but not by much. But that still delayed treatment.

“Certain ones we could have picked up a couple years ago, we’re picking up now,” Patel said. “If we could have detected them earlier, we could have treated them earlier.”

People struggled to book appointments a year ago when so many patients were catching up, he said, though it’s better now.

“My schedule is pretty open and I can see patients the same week,” he said.

Dr. Chris Udocich, medical director at Silver Cross Hospital in New Lenox, said some of his private patients at Hedges Clinic in Frankfort are still delaying care because they’re afraid of catching COVID-19.

Telemedicine helped in some cases, Udovich said. But many patients need regular office visits to keep them on track with their medicine and daily management of chronic illnesses.

“Sometimes the first time I see them is actually in the hospital, when they’re critically ill,” Udovich said. “I ask, ‘What happened?’ And then say, ‘Well, I just didn’t want to come into the office.’ ”