Cancer centres are uniquely positioned to protect communities and their most vulnerable residents – cancer patients – from climate-driven disasters by bolstering emergency preparedness, noted researchers with the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, the American Cancer Society (ACS), and collaborating organisations.
Writing in a commentary in the Journal of the National Cancer Institute (NCI), the researchers noted that all 71* of the country’s NCI-designated cancer centres have been impacted by one or more climate-related disasters during the past decade.
Wildfires. Floods. Hurricanes and tropical storms. Severe winter storms. Extreme heat events. Cancer centres have gained experience dealing with all types of climate hazards, according to the researchers.
Additionally, the centres already have emergency preparedness plans in place as required by the Centers for Medicare and Medicaid Services (CMS), the agency overseeing these federal health programs.
“During the COVID-19 pandemic, it became clear that cancer centres can adapt quickly to challenging circumstances and develop best practices to prioritise patient and public safety,” said Leticia Nogueira, PhD, the paper’s corresponding author. “The same type of prioritisation and collaboration between institutions and professionals from different backgrounds is urgently needed to better prepare and respond to climate-driven disasters.”
However, while cancer centres adapted quickly to the challenges posed by the pandemic, the researchers identified some significant shortcomings in emergency preparedness among the cancer centres when it came to climate-related disasters, especially when it came to protecting the health and safety of cancer patients.
For the analysis, the researchers conducted an extensive audit of the centres’ websites to identify and categorise current preparedness information, guidance, and practices. Their review revealed some glaring information gaps and deficiencies, including:
- Only half of the centres posted preparedness information specifically for cancer patients.
- Less than 25% contained emergency information for climate disasters, despite their increasing frequency and severity.
- Less than 10% of centres provided cancer-specific emergency-preparedness material related to climate-driven disasters.
- Only one centre’s website included information on maintaining psychological health and well-being during climate disasters.
Although some websites outlined steps that individuals can take to boost personal preparedness, including making disaster kits and evacuation plans and ensuring pet safety, very few – about 5% – included cancer-specific recommendations such as: pre-registering for special-needs shelters, requesting additional medical supplies before disasters, creating portable medical cards containing vital personal health information, and stocking medical items in disaster kits.
“As a psychiatrist, I know firsthand that the diagnosis and treatment of cancer brings about a multitude of stressors related to the physical, psychological, and socioeconomic consequences of the disease,” explained Zelde Espinel, MD, a Sylvester clinician and researcher and lead author of the paper. “Patients living with cancer – and their caregivers and care providers – have distinctive needs and vulnerabilities that are further amplified when faced with the risks posed by climate-driven extreme weather events.”
“NCI-designated cancer centres are well-positioned to advance knowledge and expertise about “climate-proofing” healthcare operations for cancer patients and others,” said Tracy Crane, PhD, co-lead of Cancer Control and director of Lifestyle Medicine, Prevention, and Digital Health at Sylvester, and one of the paper’s authors. “They have greater access to resources through accreditation, established relationships with other healthcare organisations, and are trusted entities within their communities.”
Additionally, the centres already have CMS-compliant emergency-preparedness plans that should be evaluated and revised, as needed, to better protect medically vulnerable populations during climate disasters.
Moreover, the centres can build on existing resources for centralised information sharing, such as the NCI’s “Emergency Resources for the Cancer Community,” the ACS’ “Guide to Getting Ready for a Natural Disaster,” and the Department of Health and Human Services’ website with hazard-specific content for actions before, during, and after disasters. Other federal and local resources are readily available and should be utilised as appropriate.
The researchers also recommended structured information sharing among cancer centres to share lessons learned from previous climate disasters and coordinated research efforts that promote collaboration in evidence-gathering, data analysis, implementation strategies, and communication methods that can result in best practices.
“Our research takes on even greater significance during the expansive heatwaves and climate disasters of 2023 as we encourage national cancer centres to pursue innovative strategies for enhancing emergency preparedness for their patients, providers, other staff, and care systems in this current era of compounding disasters,” said co-author James M. Shultz, PhD, an associate professor of public health at UM Miller School of Medicine. His Protect and Promote Population Health in Complex Crises research program focuses on safeguarding medically high-risk patients, particularly cancer patients, from disaster threats.
“Climate-related disasters are only expected to increase in the coming decade,” added Crane. “Cancer centres have a responsibility and an opportunity to partner with their communities and ensure they are prepared to protect medically vulnerable populations, especially cancer patients.”
*With the recent addition of the University of Florida (UF), there are now 72 NCI-designated cancer centres in the US. When the cancer centres were reviewed, UF had not yet received designation.
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