As oncologists, we’ve witnessed how extreme weather events have disrupted treatment for our patients. Delays caused by storms or flooding or wildfires can disrupt the timing of chemotherapy and radiation therapy, eroding precious weeks from life-saving treatment schedules. These weather occurrences, which are growing more frequent and severe due to climate change, highlight an urgent need to prepare healthcare facilities, communities, and medical professionals for the impacts of climate change on cancer treatment.
Research shows weather disruptions may reduce patients’ survival
We conducted a study that revealed a distressing picture: wildfires and other climate-induced disasters are causing clinic closures, staff shortages, and disruptions in patient care. These disturbances not only create considerable stress for patients and their families but also impose physical, mental, and financial strains, especially on those in remote, rural areas. Moreover, these disruptions may even reduce patients’ survival duration.
There are many examples of impacts of climate-related disasters on patients. In Northern California, for instance, the challenging terrain becomes perilous following wildfires. Mudslides often render roads impassable, exacerbating the struggles of cancer patients who need to travel for treatment. While local communities strive to support those in need, they frequently face challenges in meeting the travel, accommodation, and logistical needs that cancer patients face specifically. Overcrowded evacuation shelters, unsuitable for immunocompromised patients, and the lack of targeted mental health support during these compounded crises are further issues.
Alarmingly, our study found that many oncology centers lack emergency or climate resilience plans. This highlights the urgent need to consider the physical, psychological, and financial needs of vulnerable populations, such as cancer patients, in local emergency preparedness plans. Healthcare leaders, policymakers, and local government each play a key role in crafting responses that cater to these specific patient and community needs.
Climate disasters exacerbate health inequities
Moreover, we also need to integrate health equity and community engagement into healthcare’s response. Climate disasters can result in delayed preventative healthcare, including cancer screenings and evaluations. Such delays can lead to late diagnoses and subsequently, treatments that are less effective. To mitigate these risks, it’s imperative to identify populations at risk both in clinical settings and through proactive community outreach. This approach is crucial for ensuring these communities have access to necessary resources and support, particularly in the periods leading up to and following climate events. Forming partnerships with organizations such Americares, along with utilization of resources like The Climate Resilience for Frontline Clinics Toolkit can improve preparedness aimed at reducing health risks among vulnerable groups.
Hospitals, health systems, and cancer centers must develop climate resilience plans that prepare both for the immediate impacts of climate events and the long-term healthcare infrastructure and community vulnerabilities. Frameworks such as the World Health Organization’s Operational Framework for Building Climate Resilient Health Systems and the HHS’s Sustainable and Climate Resilient Healthcare Facilities Toolkit provide valuable guidance.
Building climate resilience
The U.S. Department of Health and Human Services (HHS)’s Office of Climate Change and Health Equity (OCCHE) and the American Society of Radiation Oncology (ASTRO) are working to enhance health and cancer care resilience. However, we believe more can be done to safeguard the health of patients and communities.
Our recommendations for healthcare organizations include:
- Enhance Patient Outreach: Initiate regular communication and education programs for patients, especially those at high risk, about managing health during climate-related events.
- Strengthen Community Partnerships: Build strong relationships with local community organizations and emergency services.
- Implement Climate Resilience Plans: Develop and update plans, guided by frameworks from WHO and HHS.
- Advocate for Policy Change: Support urgent action to reduce greenhouse gas emissions, enhance climate resilience, and promote health equity through healthcare policies. This includes advocating for a transition away from reliance on fossil fuels.
- Ensure Professional Training: Provide development for healthcare workers in climate resilience and emergency response.
As we confront the realities of our changing climate, ensuring that every patient receives the best and most timely care possible, regardless of location or condition, is more crucial than ever.
About the authors
Katie Lichter MD, MPH is a resident physician within the Department of Radiation Oncology at UC San Francisco and is a Fellow at the Health and Human Services Office of Climate Change and Health Equity (OCCHE). Dr. Lichter advances research on the intersection of climate change and healthcare through UC San Francisco’s GreenHealth Lab, supported by the EaRTH Center.
Catherine Park, MD is a Chair in Radiation Oncology with a clinical focus on lymphoma and breast cancer at UC San Francisco. Dr. Park is committed to advocacy regarding the impacts of climate change on cancer care and to improving resilience and preparedness in healthcare settings.
Anna Paulsson, MD is a UCSF alumni, a practicing radiation oncologist in Sonoma County with Providence Medical Group, and Vice Chair of the ASTRO Early Career Committee.
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