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(Reuters Health) – An American study suggests that lung cancer patients whose radiotherapy treatments are interrupted by hurricanes or other natural disasters may not live as long as patients who complete their treatment without interruption .
Patients with cancer who undergo radiation therapy are particularly vulnerable in the event of a disaster, as they need reliable electricity for their daily treatments, noted researchers in JAMA. Previous research has linked even a brief interruption of daily radiation with a degradation of survival.
The present study focuses on patients with non-small cell lung cancer, the most common form. The researchers followed 1,734 patients whose radiotherapy had been disrupted by a hurricane between 2004 and 2014 and compared them to 1,734 similar patients undergoing uninterrupted treatment.
When hurricanes interrupted radiation, patients survived an average of 29 months after diagnosis, compared to 31 months for people without interruption.
"This is the first study to empirically badess the impact of natural disasters on cancer survival," said Leticia Nogueira, lead author of the study and researcher at the American Cancer Society in Atlanta.
The chances of survival were long for all participants in the study.
The researchers followed half of the patients for at least 15 months. During the study, 1,408 patients undergoing treatment interrupted by hurricanes died, as well as 1,331 patients unaffected by natural disasters.
The researchers estimated that the five-year survival rates were 14.5% for patients whose radiotherapy had been interrupted during hurricanes and 15.4% for other patients in the study.
Overall, patients were 19% more likely to die during the study when radiation was disrupted by hurricanes than when treatment continued uninterrupted.
Hurricane disaster reports during the course of the study lasted from 1 to 69 days. The risk of death during the study increased with the length of disaster claims, reaching 27% for 27-day disasters.
The study was not designed to prove whether or how hurricanes have a direct impact on survival after lung cancer. Another limitation is that researchers lacked data on factors that could independently influence survival outcomes, including patients' smoking history, side effects of treatment, and reasons for the exact dates of treatment breaks.
Nevertheless, differences in survival outcomes can and should be avoided, writes the study team.
"Hurricanes can be predicted and cancer patients should be included in disaster mitigation planning," Nogueira said via e-mail.
"Patients undergoing daily radiation treatment must be identified before a hurricane, treatment must be transferred to another facility, and off-grid insurance costs must be eliminated," Nogueira added.
When hurricane warnings arrive, patients who have not yet begun to emit radiation should, as far as possible, begin to provide care at an institution outside the pbadage of the hurricane. hurricane, said Dr. Richard Cbadidy, North Carolina's cancer-specialist radiation oncologist in Jacksonville. And patients already in treatment should get their care transferred.
"Doctors and other medical staff need to cope with crises and speed up radiation planning and other factors to minimize delays in care," Cbadidy, not involved in the study, told E-mail . "Working in a community-based cancer center in a hurricane-prone area, we are constantly fine-tuning and planning contingencies in the event of a disaster resulting in prolonged power loss or the ability of our radiation therapy clinics to function."
As extreme weather conditions become more prevalent, this type of planning takes on a new urgency, said Asal Johnson, a public health researcher at Stetson University in DeLand, Florida, who was not involved in the study.
"The impacts of climate change and badociated extreme weather events are extending to cancer patients with possible serious consequences," Johnson said via email. "It's important for cancer treatment facilities to have a system in place during the hurricane season and to communicate to patients what could be done if the facility were to be closed."
SOURCE: http://bit.ly/2kdYApN JAMA, online July 16, 2019.
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