Discussion
We reported a case of advanced breast cancer patient whose initial
diagnosis was delayed by 2 years in Fukushima, Japan, mainly due to the
combined effects of Typhoon Hagibis and the COVID-19 pandemic. If she
had been consulted earlier, she might have been able to receive
treatment for her breast cancer before she developed bone metastasis.
This case shows that undiagnosed breast cancer patients tend to postpone
their first medical consultation in the event of a disaster, and this
effect may be strengthened especially for patients who tend to delay
seeking help. A notable finding of this case is that living with other
family members partly prevented her from making initial medical
consultation. Although social support from family or friends is
extremely important for the treatment and recovery process of breast
cancer patients,16 it may also have a negative impact
as shown in this case. Therefore, it is important to understand the
characteristics of each patients and treat them individually.
At the same time, it is important to recognize that delays in medical
consultation may occur before healthcare professionals and others have
contact with those patients, which may limit the actual measures taken.
In order to deal with this problem, it is essential to cooperate with
media such as newspapers and television to further raise people’s
awareness of breast cancer symptoms and encourage patients to accurately
recognize the severity of their symptoms so that they can seek initial
advice from their family or friends. Also, especially in this case, it
would have been necessary to intervene to her work place or home to
ensure that the patient could receive appropriate medical care, for
example, by establishing an environment where the patient could easily
take time off work, or by sending someone who could take care of her
mother instead of her.
In addition, in the event of a disasters during the COVID-19 pandemic,
it is necessary to handle the situation with precautions to prevent the
spread of infection. Generally, those affected by disasters are
vulnerable to infectious diseases due to overcrowded shelters,
environmental changes and poor personal hygiene.17Furthermore, since many people have refrained from social interactions
for fear of infection, various support activities that have been carried
out in the past disasters, such as child care, transportation of
supplies, and soup kitchens,18 may be reduced. In
order to ensure access to medical services even in such a situation, it
is also important to share information on hospitals and evacuation
centers where medical treatment is available, and to expand telemedicine
services.
In conclusion, we experienced a breast cancer patient whose medical
consultation was delayed for a long time due to the combined effects of
the COVID-19 pandemic and the typhoon. Especially in the current
situation of the COVID-19 pandemic, it is important to communicate the
risks of breast cancer and the benefits of screening by effectively
utilizing the media to encourage patients to seek timely medical care.
In addition, it is important to approach patients individually by
providing consultation services for patients and their families, or
reminding patients to visit the hospital.
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