Wildfires are complicating cancer care: Study

Wildfires and other climate-induced weather extremes are posing an increased threat to cancer patients by shifting their treatment trajectories and access to care, a new study has determined.

Patients recovering from lung cancer surgery within an active wildfire zone required longer hospital stays than those in areas that had no such blazes, scientists reported in the study, published on Wednesday in the Journal of the National Cancer Institute.

These lengthier stays could be due to the reluctance of health care providers to discharge patients to a hazardous environment, housing instability or safety issues — or due to the unavailability of routine post-op care, staff shortages or shuttered rehab centers, according to the study.

"There are currently no guidelines for protecting the health and safety of patients recovering from lung cancer surgery during wildfires in the United States,” lead author Leticia Nogueira, scientific director of health services research at the American Cancer Society, said in a statement.

“In the absence of guidelines, clinicians might resort to improvisational strategies," Nogueira added, noting that doing so serves to "better protect the health and safety of patients during wildfires.”

The complex nature of post-operative recovery from lung cancer procedures coupled with wildfire disasters pose considerable threats to patient health, beyond exposure to smoke, the authors stressed.

For example, they pointed to factors like water and soil contamination, evacuation orders while handling mobility and cognitive challenges, disruptions in pharmacy and grocery hours and changes in transportation accessibility.

Nogueira and her colleagues studied data available via the National Cancer Database for individuals 18 years or older who received a lobectomy or pneumonectomy for stages 1 to 3 lung cancer between 2004 and 2021.

They then evaluated differences between the length of stay for wildfire-exposed patients — those hospitalized in a Presidential Disaster Declaration area between the dates of surgery and discharge — and unexposed patients treated at the same facility during a non-disaster period.

The results revealed that patients exposed to a wildfire disaster had hospital stays that were on average two days longer: 9.4 days in comparison to 7.5 days.

That two-day difference, which applied to patients across all stages of cancer, could take a toll on U.S. health care systems, as hospital stays nationwide cost about $1,500 per day, according to the study.

As climate change continues to intensify and extend wildfire season, the researchers urged health care institutions to adapt and improve their clinical and disaster preparedness strategies for specific patient populations. These tactics, the authors continued, must also account for environmental influences.

"This study is just the tip of the iceberg showing how extreme weather may be impacting patients with chronic illnesses," senior author Amruta Nori-Sarma, deputy director of the Harvard T.H. Chan School of Public Health's Center for Climate Health and the Global Environment, said in a statement.

"As the wildfire season gets longer and more intense, and wildfires start affecting broader swathes of the U.S. population, health care providers need to be ready with updated guidance that best protects their patients’ health," Nori-Sarma added.

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