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Are Unusual Cancer Patterns Linked to COVID-19? The Emerging Concerns


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In 2021, a year into the COVID-19 pandemic, oncologist Kashyap Patel began noticing an unsettling trend. During a routine Friday lunch with his team at Carolina Blood and Cancer Care Associates, he shared a case of a patient in his 40s diagnosed with cholangiocarcinoma, a rare and lethal cancer of the bile ducts usually seen in much older individuals. The revelation sparked a wave of similar stories from his colleagues, who had also encountered unusually aggressive and rare cancers. Within a year, Patel's office had recorded seven such cases.

 

"I've been in practice 23 years and have never seen anything like this," Patel later reflected. His colleague, Asutosh Gor, shared his concern: "We were all shaken."

 

These observations were not isolated. Across the country, doctors were noting a rise in aggressive, late-stage cancers since the pandemic began. Early national data and reports from major cancer institutions confirmed this trend. While many experts attribute this to disruptions in healthcare during the pandemic, others, like Patel, are exploring a more direct link between COVID-19 and cancer.

 

The idea that viruses can cause or accelerate cancer is not new. Since the 1960s, scientists have identified various infectious agents, such as HPV, Epstein-Barr, and hepatitis B, as contributing to 15 to 20 percent of all cancers worldwide. However, establishing a connection between COVID-19 and cancer will likely take years of research.

 

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"We are completely under-investigating this virus," stated Douglas C. Wallace, a geneticist and evolutionary biologist from the University of Pennsylvania. He warned that the long-term effects of repeated COVID-19 infections might be more significant than currently understood. Yet, skepticism remains. John T. Schiller, a researcher at the National Institutes of Health, pointed out that respiratory viruses like influenza and RSV, which include coronaviruses, typically do not linger in the body long enough to cause cancer.

 

David Tuveson, director of the Cancer Center at Cold Spring Harbor Laboratory, acknowledged that while there is no evidence of COVID-19 directly transforming cells into cancerous ones, the virus could act as an environmental stressor. He compared its potential impact to that of tobacco, alcohol, asbestos, or microplastics. "Covid wrecks the body, and that’s where cancers can start," Tuveson explained, noting that autopsy studies of COVID-19 victims showed signs of prematurely aged tissue.

 

As the pandemic unfolded, public health officials anticipated a surge in cancer cases due to delayed screenings and treatment interruptions. Studies, such as a paper in Lancet Oncology, confirmed increases in Stage 4 cancers across various types by late 2020. Institutions like Baptist Health Miami Cancer Institute and UC San Diego Health reported continued rises in late-stage cancers. Xuesong Han, a scientific director at the American Cancer Society, cited multiple reasons for this trend, including healthcare disruptions, economic factors, and societal barriers. However, Han also acknowledged the need to explore biological mechanisms of SARS-CoV-2 that could influence cancer development.

 

Afshin Beheshti, president of the COVID-19 International Research Team, shared similar concerns. His group of scientists, initially formed to tackle the virus, began investigating its potential links to cancer. Beheshti, with a background in cancer biology, found the widespread inflammation and vascular impacts of COVID-19 particularly troubling. "It kept nagging on my mind," he said.

 

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About a year ago, Beheshti contacted Patel, who had been documenting unusual cancer patterns. Together, they hosted a symposium with other scientists, concluding that there was compelling evidence to suggest links between the coronavirus and cancer. "Hopefully, we’re wrong," Beheshti remarked, "but everything is, unfortunately, pushing toward that being the case."

 

Various research efforts are now underway to investigate these potential links. Wallace is studying how COVID-19 affects cellular energy production, which might influence cancer susceptibility. Biodata experts are sequencing gene profiles from COVID-19 victims' organs, and a University of Colorado team is exploring whether COVID-19 can reawaken dormant cancer cells in mice. Their preliminary findings, published in April, indicated that SARS-CoV-2 could indeed trigger cancer cell proliferation in the lungs of cancer-surviving mice.

 

Ashani Weeraratna, a professor at Johns Hopkins Bloomberg School of Public Health, emphasized the importance of these findings, though she cautioned that mouse studies do not always translate to human experiences. She also noted that the research focused on acute infection or long COVID, not on the coronavirus vaccine, countering misinformation spread by some anti-vaccine groups.

 

"Mitigating risk of infection may be of particular importance for cancer patients," Weeraratna advised, underscoring the need for protective measures like masks, avoiding crowded places, and vaccination.

 

Further studies have hinted at potential mechanisms linking COVID-19 to cancer. Research from the University of Arkansas for Medical Sciences showed that SARS-CoV-2 proteins could fuel the replication of a herpesvirus linked to cancer. Other studies suggested that the coronavirus might disrupt the body's tumor suppression abilities, although direct evidence is still lacking.

 

Wallace argued that the lack of data on COVID-19 and cancer is more a result of policy decisions than scientific challenges. "Most governments don’t want to think about long COVID and much less long COVID and cancer," he said, criticizing the lack of funding for long-term effects of the virus. "I don’t think that’s a wise choice."

 

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Patel, driven by his firsthand observations, is conducting his own research into what he calls "an unusual pattern" of cancers. He is examining potential correlations between long-COVID markers and unusual cancers, collecting data from nearly 300 patients, and advocating for a national registry to analyze trends. His office has recorded numerous cases of patients with multiple cancers, rare cancers, and even couples diagnosed with new cancers since the pandemic began.

 

Patel theorizes that multiple COVID-19 infections could have cumulative effects, and that pandemic-related stress might exacerbate inflammation, increasing cancer risk. If a link is established, it could lead to earlier screenings and preventive measures for at-risk patients.

 

One of Patel’s patients, a 78-year-old diagnosed with three cancers within a year, exemplifies the urgency of this research. Another case involves Bob and Bonnie Krall, a couple who faced three types of cancer between them in just over a year. Despite lacking a family history of cancer, both had high levels of coronavirus antibodies, suggesting a possible connection.

 

"It’s like a cold. It seems like everyone has it," remarked Bob Krall, a 73-year-old flight instructor, reflecting on the prevalence of cancer among his acquaintances.

 

Even before Patel mentioned his research, Bonnie Krall had wondered if their cancers were related to COVID-19, as she was infected shortly before her diagnosis. "Maybe if we didn’t get covid…" she speculated, though her husband, Bob, remained uncertain about the possible outcomes.

 

The emerging evidence and ongoing research underscore the need for a deeper understanding of COVID-19’s long-term impacts. While definitive answers may take years, the potential link between the virus and cancer is a critical area of investigation that could shape public health strategies and patient care for years to come.

 

Credit: Washington Post 2024-06-10

 

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