Clinicians at the UC Davis Comprehensive Cancer Center and other facilities within UC Davis Health are on a mission to get patients the care they need in spite of COVID-19. It is critical that patients keep on schedule with annual checkups and cancer screenings such as mammograms, Pap smears and colonoscopies. Appointments with their health care providers should not be delayed if there are concerns about such tests or a change in the patient's health. And, if any treatment is required, it is imperative for treatment to begin without delay. The cancer center is fully staffed, just as it was pre-pandemic, and precautions are being taken to ensure patient safety.

“We’re working to prevent post-pandemic deaths that could have been avoided — people with cancer, heart disease or other serious conditions who were afraid to come in for treatment due to COVID- 19,” said Richard Bold, physician-in-chief of the UC Davis Comprehensive Cancer Center. “Cancer doesn’t wait, and we’re worried that people with otherwise treatable disease will delay care as the pandemic persists."

UC Davis Health restricts the number of visitors, screens patients and employees for infection daily, mandates masks, maintains social distancing, and provides ample sanitizer and hand washing facilities, and most staff have been vaccinated. Going to a UC Davis medical facility for care is probably safer than a trip to the grocery store.

“Outside your home, it’s one of the safest places you can be, and delaying medically necessary care can have life-threatening consequences,” said Bold.

Fear isn’t the only concern that keeps some patients from getting the care they need. Because of the economic downturn associated with COVID-19, many people have lost their jobs and, as a result, their employer-sponsored health insurance. They may be faced with high premiums or out-of-pocket costs. UC Davis Health wants to make sure that financial challenges don’t prevent people from getting the care they need.

“We have developed programs to help people access affordable insurance if they are uninsured or assist them with changing insurance to get more appropriate coverage,” said Bold. “We don’t want cost to be a barrier to getting care.”

Embracing telemedicine

Even before COVID-19, patients sometimes faced difficulty that prevented them from seeking care, such as living in remote areas without transportation. UC Davis Health was already on track to solve that problem through telemedicine, or virtual doctor visits, and the coronavirus crisis has accelerated technology advancements.

“Some of the lessons we’re learning from COVID are changing how we deliver health care now and into the future,” said Bold. “Telemedicine is a really good example.”

While some procedures still need to be performed in person, telemedicine offers patients a way to connect with their physicians, review X-rays or lab results, discuss treatment options or conduct follow-up visits from the comfort of home. As many as 20% of cancer center visits are now conducted via telemedicine, which can be convenient for parents caring for children at home or people who cannot take time off work.

Reaching vulnerable populations during COVID-19

What impact is COVID-19 having on cancer prevention, control and survival? The UC Davis Comprehensive Cancer Center is collaborating with 17 other cancer centers to study the situation, thanks to funding from the National Cancer Institute.

The UC Davis cancer center’s grant is focused on diverse communities.

“We are the only center being funded to study six sets of vulnerable populations, a total of 1,000 people: African Americans, Chinese, Hmong, Latinos, Native Americans, Vietnamese and rural residents to determine the impact COVID-19 is having on cancer-related behaviors,” said co-director of the study, Moon S. Chen Jr., associate director for Community Outreach and Engagement.

Farm worker

The study is the first of its kind and will allow the outreach and engagement team and clinicians to better tailor how they communicate and partner with these vulnerable populations to enhance trust and better serve them.

The research team’s premise is that one size does not fit all. In some instances, the researchers are making contact by phone or virtual conversations. For others, online surveys and even in-person contact is helpful. For instance, Native Americans living in rural communities often come to community health centers to pick up their medications, providing an opportunity for direct outreach.

To improve outreach and engagement of African Americans, the study team is conducting focus groups to better understand how to enhance video visits for cancer care.

“We recognize that, in terms of our approach to each of these vulnerable groups, what may work in one population may not work in others,” said Associate Professor David Cooke, who heads General Thoracic Surgery and is co-directing the study. “We’re attempting to meet people where they live. If they’re comfortable with telemedicine, we will use telemedicine. If they prefer in-person contact, we will do that.”

Not deterred by COVID-19

When Grace Parker’s breast cancer returned, and she needed surgery, she refused to be deterred by COVID-19.

It was my fourth cancer recurrence,” said Parker. “I knew I couldn’t wait because cancer doesn’t take a break during a pandemic. I said, ‘Heck, yeah!’ when my doctor scheduled me for surgery in April.”

Marlene Blake and Dr. Richard Bold
Marlene Blake and Richard Bold.

Parker was reassured by the COVID-19 safety precautions in place, and was relieved when she learned that her tumor was removed successfully. Subsequent scans showed that the cancer had not spread, and she continues to come in for follow-up care.

Marlene Blake has a similar story.  With several masses discovered in both breasts, she could not wait and her surgery was scheduled for March, just as the first wave of the pandemic was underway.

“Whether there’s coronavirus or not, I wanted to fight cancer with the best possible approach,” Blake said. “Was  I fearful of having surgery during a pandemic? Of course, but there was  no reason to panic. It was a reasonable decision to move forward.”

Like Parker, Marlene Blake was reassured by the precautions she witnessed. The staff members, who answered all of her questions and explained everything they were doing to keep her safe, particularly impressed her. Her successful surgery and follow-up care mean she can move on with her life without worrying about cancer.