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Researchers Explore Opportunities for Cancer Centers to Protect Medically High-Risk Patients from Climate-Driven Disasters

Researchers at the Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, and the American Cancer Society (ACS), examined current disaster preparedness resources available on the websites of National Cancer Institute (NCI)-designated cancer centers nationwide. They found sparse coverage and limited guidance related to preparing patients living with cancer for heatwaves, hurricanes, and other climate-related disasters.

Compounding disasters and climate change-fueled emergencies present challenges for cancer prevention and control efforts across the cancer care continuum, according to the researchers. The article, published in the Journal of the National Cancer Institute, underscores the importance of cancer centers taking a lead as knowledge hubs for disaster preparedness for medically vulnerable patients living with cancer, as one component of national climate adaptation strategies. 

Dr. James Shultz
Dr. James Shultz

“There is a critical need for integrated research and information sharing to improve emergency preparedness for medically high-risk patient populations, including patients living with cancer, in the context of compounding and climate-driven disasters,” said co-author James M. Shultz, Ph.D., Sylvester researcher and associate professor of public health in the Department of Public Health Sciences.

Researchers examined information available on the websites of 71 NCI-designated cancer centers. None had a comprehensive, dedicated, multi-hazard, and cancer patient-focused disaster preparedness portal. While 56 of the centers provided some elements of general emergency preparedness information, only 36 presented information specifically tailored for individuals with cancer. 

NCI-designated cancer centers were early to respond to the COVID-19 pandemic, releasing information on its possible impact on patients with cancer. As of September 2022, the majority of centers supplied some COVID-19 preparedness information on their websites. “This quick response demonstrates the healthcare system's ability to allocate resources and respond to urgent risks,” said Dr. Shultz. 

Yet only 17 centers provided varying elements of emergency preparedness guidance for climate-related disasters, with only 7 presenting cancer-specific information.

Researchers identified the lack of resource mobilization in response to climate change, and in this context, they highlighted the opportunity for cancer centers to take a lead role in advancing knowledge about disaster preparedness for patients with cancer. “Climate change is the greatest threat to human health of our time,” according to the paper’s senior author, Leticia Nogueira, Ph.D., ACS’s scientific director for Health Services Research. 

Researchers note that challenges posed by climate change to the healthcare system are becoming more complicated and unpredictable. Cancer patients, caregivers, and healthcare professionals face more than physical health threats. Trauma, loss, and life changes experienced during and after disasters can result in psychological distress and possible progression to new-onset psychiatric disorders. “Prioritizing mental health and psychosocial support is critical for maintaining the well-being and resilience of both patients and the frontline health professionals who care for them throughout all phases of a disaster,” according to lead author, Zelde Espinel M.D., Sylvester psychiatrist. “Patients must deal with a combination of cancer stressors and disaster stressors.” 

NCI-designated cancer centers play a critical role in cancer control and have greater access to resources and emergency preparedness experiences. Study authors indicated that the NCI-designated cancer centers are exceptionally well-equipped to secure the necessary resources and have extensive expertise in effective emergency response strategies.

Dr. Shultz spearheaded the creation of a comprehensive responder resilience toolkit for the Florida Department of Health (FDOH) as one output of his Protect & Promote Population Health in Complex Crises (P3H) program. The P3H program focuses on addressing the unique challenges medically high-risk individuals face during disasters and extreme events.

Given the accelerating frequency and impact of climate-driven weather events – including this year’s widespread and prolonged exposure to extreme heat – cancer centers nationwide must prepare with innovation and urgency, and share best practices and lessons learned following encounters with disasters in their respective regions. Researchers concurred that in order to advance cancer control efforts in the face of climate change, a nationwide, systematic, and timely disaster preparedness information-sharing system, as well as a coordinated cancer-specific emergency preparedness research endeavor, are advisable. 

“Confronting an increasingly complex risk landscape, with climate change acting as a threat multiplier, is critical for safeguarding patients living with cancer, their caregivers, and the healthcare professionals who are on the frontlines when disasters strike,” concluded Dr. Shultz.

Written by Deycha Torres Hernández
Published on August 10, 2023