Earthquake disaster impact on health care of cancer patients: Single center experience

Abstract

Background: The earthquakes in February 2023 in Turkey had a major impact on Turkey's health system, causing damage to hospitals and health centres in the affected areas. Cancer patients are one of the groups that are highly influenced by the disaster. The aim of this study was to evaluate some of the demographic and clinical characteristics of cancer patients who are getting health care in earthquake-affected areas. Material and Methods: Fifty cancer patients who lived in 11 cities of Turkey affected by the earthquake and were admitted to Gazi University Department of Medical Oncology after the earthquake between 15 February 2023 and 15 March 2023 were included in the study. Data such as demographic characteristics, cancer diagnosis, time of cancer treatment, and earthquake history were taken retrospectively from nationally-linked electronic records (E-nabız). Results: Breast cancer was the most common diagnosis of these patients. Most of the patients were taking active treatment (60%). Chemotherapy and hormonotherapy were the most common treatment modalities (20% and 18%, respectively). The median delay in the active treatment of 14 cancer patients was 24 days (2-60). Conclusions: The earthquake disaster has led to important impacts on cancer patients' care in most affected areas. The human, financial and medical resources should be improved. Especially if detailed nationally-linked electronic records are provided, cancer patients will not have difficulty seeking health care. This disaster should be an important stimulus for hospitals and healthcare systems to improve the care of patients during disasters.

Keywords

• Cancer patients
• health care
• earthquake
• Turkey

References

1. Kahramanmaraş’ta meydana gelen depremler Hk. Basın Bülteni– 26. T.C. İçişleri Bakanlığı. Afet ve Acil Durum Yönetimi Başkanlığı. Available at: https://www.afad.gov.tr/kahramanmarasta-meydana-gelen-depremler-hk-basin-bulteni-26.
2. United Nations Population Fund (UNFPA). Turkiye Earthquake Situation Report #1. 10 Feb 2023. Available at: https://reliefweb.int/report/syrian-arab-republic/turkiye-earthquake-situation-report-1-10-february-2023.
3. Komuro R. A report of medical support for disaster victims in east Japan earthquake and tsunami. [Poster]. Wiley Online Library 2011:112-3.
4. Barton MB, Keane TJ, Gadalla T, Maki E. The effect of treatment time and treatment interruption on tumour control following radical radiotherapy of laryngeal cancer. Radiother Oncol. 1992 Mar;23(3):137-43. doi: 10.1016/0167-8140(92)90323-m.
5. Blumenthal DT, Won M, Mehta MP, Gilbert MR, Brown PD, Bokstein F, Brachman DG, Werner-Wasik M, Hunter GK, Valeinis E, Hopkins K, Souhami L, Howard SP, Lieberman FS, Shrieve DC, Wendland MM, Robinson CG, Zhang P, Corn BW. Short delay in initiation of radiotherapy for patients with glioblastoma-effect of concurrent chemotherapy: a secondary analysis from the NRG Oncology/Radiation Therapy Oncology Group database. Neuro Oncol. 2018 Jun 18;20(7):966-74. doi: 10.1093/neuonc/noy017.
6. Ohri N, Rapkin BD, Guha C, Kalnicki S, Garg M. Radiation therapy noncompliance and clinical outcomes in an urban academic cancer center. Int J Radiat Oncol Biol Phys. 2016 Jun 1;95(2):563-70. doi: 10.1016/j.ijrobp.2016.01.043.
7. Guetz GD, Nicolas P, Perret G-Y, Morere J-F, Uzzan B. Does delaying adjuvant chemotherapy after curative surgery for colorectal cancer impair survival? A meta-analysis. Eur J Cancer. 2010 Apr;46(6):1049-55. doi: 10.1016/j.ejca.2010.01.020.
8. D'Ambrosio DJ, Li T, Horwitz EM, Chen DYT, Pollack A, Buyyounouski MK. Does treatment duration affect outcome after radiotherapy for prostate cancer? Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1402-7. doi: 10.1016/j.ijrobp.2008.03.011.

9. Ozaki A, Leppold C, Tsubokura M, Tanimoto T, Saji S, Kato S, Kami M, Tsukada M, Ohira H. Social isolation and cancer management after the 2011 triple disaster in Fukushima, Japan: A case report of breast cancer with patient and provider delay. Medicine (Baltimore). 2016 Jun;95(26):e4027. doi: 10.1097/MD.0000000000004027.
10. Alcalde-Castro J, Hernandez-Gilsoul T, Dominguez-Rosado I, Chavarri-Guerra Y, Soto Perez-de-Celis E. Cancer care after the 2017 Central Mexico earthquake. J Glob Oncol. 2018 Jul:4:1-4. doi: 10.1200/JGO.18.00146.
11. Gorji HA, Jafari H, Heidari M, Seifi B. Cancer patients during and after natural and man-made disasters: A systematic review. Asian Pac J Cancer Prev. 2018 Oct 26;19(10):2695-2700. doi: 10.22034/APJCP.2018.19.10.2695.
12. Man RX, Lack DA, Wyatt CE, Murray V. The effect of natural disasters on cancer care: A systematic review. Lancet Oncol. 2018 Sep;19(9):e482-99. doi: 10.1016/S1470-2045(18)30412-1.
13. Tomio J, Sato H, Mizumura H. Interruption of medication among outpatients with chronic conditions after a flood. Prehosp Disaster Med. 2010 Jan-Feb;25(1):42-50. doi: 10.1017/s1049023x00007652.
14. Ochi S, Hodgson S, Landeg O, Mayner L, Murray V. Disaster-driven evacuation and medication loss: a systematic literature review. PLoS Curr. 2014 Jul 18:6:ecurrents.dis.fa417630b566a0c7dfdbf945910edd96. doi: 10.1371/currents.dis.fa417630b566a0c7dfdbf945910edd96.
15. David-West G, Musa F, Frey MK, Boyd L, Pothuri B, Curtin JP, Blank SV. Cross-sectional study of the impact of a natural disaster on the delivery of gynecologic oncology care. Disaster Med Public Health Prep. 2015 Dec;9(6):605-8. doi: 10.1017/dmp.2015.83.
16. Susman E. Unforeseen challenges after hurricane devastation. Lancet Oncol. 2005 Oct;6(10):744-6. doi: 10.1016/S1470-2045(05)70379-X.
17. Porzio G, Aielli F, Verna L, Aloisi P, Guadalupi F, Cannita K, Ricevuto E, Ficorella C. Home care for cancer patients after an earthquake: the experience of the "L'Aquila per la Vita" Home Care Unit. J Pain Symptom Manage. 2011 Sep;42(3):e1-4. doi: 10.1016/j.jpainsymman.2011.06.004.