I’ve had the privilege of meeting many people affected by melanoma in my role as Head of Medical Affairs at Novartis and during my clinical experience. Over the past year, these interactions have been particularly humbling. Whilst most people would agree that the pandemic has affected their lives in one way or another, people living with cancer have had a particularly unique and difficult experience. They have faced delayed access to treatment and care, a decline in their mental wellbeing, and a reduction in their overall quality of life as a direct and indirect result of national COVID-19 restrictions, and related pressures on healthcare systems.^1,2

• Melanoma is the most severe and life-threatening form of skin cancer.³
• One in every three cancers diagnosed is skin cancer.⁴
• Advanced melanoma is the fastest growing cancer in men and the second-fastest growing cancer in women.⁵
• Melanoma is among the most common cancers found in adolescent and young adult populations.⁶
• It is well-known that skin damage increases a person’s chances of developing melanoma and other forms of skin cancer in later life.

I recently came across The Global Coalition for Melanoma Patient Advocacy Survey results, which revealed an estimated 26,754 melanomas went undiagnosed in Europe in 2020 during the COVID-19 pandemic. The survey reported that approximately one-third of skin check appointments were missed, and an estimated 60,000 melanomas went undiagnosed worldwide during this period. The Global Coalition conducted the survey in November and December 2020, receiving a total of 734 responses from professional dermatologists across 36 countries.⁷

Marije Kruis, founder of international non-governmental organisation, Spot the Dot, and member of the Global Coalition for Melanoma Patient Advocacy, commented: “COVID-19-related lockdowns, coupled with the significant strain on healthcare systems under the pandemic, have led to a worryingly high proportion of skin checks being missed. With this trend set to continue into 2021, it’s critical people take action and personally check their own skin regularly for melanoma to be able to access any relevant treatment as soon as possible.”

It is concerning that news outlets from EU countries have reported that patients living with diseases like cancer are experiencing delayed access to hospital appointments due to fear of COVID-19 infection or simply due to extended appointment waiting times. Continued, regular access to care is essential for all cancer patients. After all, an individual who has identified a suspicious mole during a self-check at home still needs to visit a medical professional in clinic before melanoma can be diagnosed.

Many people affected by cancer have felt ‘lost’ and ‘disconnected’ from their healthcare professionals and wider support networks during the past year. With limited opportunities for social interaction, many cancer patients have experienced a negative impact on their mental wellbeing.²

Novartis is fostering a #EUnite movement to bring together all stakeholders with the aim to transform the European healthcare sector into a healthcare ecosystem of collaboration and cooperation.

We count on all stakeholders and equally on the melanoma community to partake in a collaborative ecosystem to revolutionise care through partnership, thus boosting sustainability and efficiency in EU healthcare.

COVID-19 taught us three things:

• It is possible to reorganise healthcare services and optimise systems to make them more robust and sustainable.
• Together, Policymakers, Regulators and Industry can accelerate the Medicine development process, so far apparently without compromising on safety and efficacy.
• ‘Dived we lose, United we win’ seems to be a universal truth in any crisis, including the current COVID-19 pandemic.

The COVID-19 pandemic has shown that an efficient healthcare infrastructure is necessary to support a stable economy and society at large. We need to apply the learnings out of the crisis and make this collaborative way of working a proxy towards sustainability so that EU patients continue to have timely access to the treatments they need.

For people living with melanoma, diagnosed or as of yet only suspected, we must acknowledge the significant impact COVID-19 has had on access to care, mental wellbeing, overall quality of their life and potentially even the length of their lives. This is essential if we are to ensure these effects are not experienced again and again in the future.

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1. The BMJ, ‘Counting the invisible costs of covid-19: the cancer pandemic’, available at: https://blogs.bmj.com/bmj/2020/11/05/counting-the-invisible-costs-of-covid-19-the-cancer-pandemic/ [Accessed April 2021]
2. Moraliyage, H., De Silva, D., Ranasinghe, W., Adikari, A., Alahakoon, D., Prasad, R., Lawrentschuk, N. and Bolton, D. (2021), Cancer in Lockdown: Impact of the COVID‐19 Pandemic on Patients with Cancer. The Oncol, 26: e342-e344. 
3. Mayo Clinic, ‘Melanoma’, available at: https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884 [Accessed April 2021]
4. World health organisation, ‘Skin Cancers’, available at: https://www.who.int/uv/faq/skincancer/en/index1.html [Accessed August 2019].
5. National Comprehensive Cancer Network (2010), NCCN clinical practice guidelines in oncology(TM) - melanoma. V.2.2010.
6. Matthews NH, al. Cutaneous Melanoma: Etiology and Therapy (2017) Available from: https://www.ncbi.nlm.nih.gov/books/NBK481862/ doi: 10.15586/codon.cutaneousmelanoma.2017.ch1
7. Data taken from the survey was conducted by The Global Coalition for Melanoma Patient Advocacy in November and December 2020, receiving a total of 734 responses from professional dermatologists across 36 countries. Dermatologists were asked to estimate the proportion of skin check appointments missed due to the pandemic and estimate the proportion of undiagnosed melanomas compared to a normal year. Available at https://5dd5d585-c6b9-4907-8029-01a1ae07ac16.filesusr.com/ugd/3c3532_98d024621ee04bfd89c2ebfe5b5dd909.pdf