When Disaster Strikes: Developing Emergency Preparedness in Oncology With Manali Patel, MD

An Overlooked Threat to Cancer Care

“Extreme weather events and climate-related disruptions are not just environmental issues—they are also cancer care issues,” explained Dr. Patel. “When there’s a power outage or a wildfire, patients can’t get to their treatments. It impacts everything from chemotherapy to palliative care.”

In 2024 alone, the US experienced 24 major weather-related disasters, each with the potential to disrupt the entire cancer care continuum. Patients may miss chemotherapy, radiation, or essential surveillance and prevention scans. For those in home hospice, displacement or lack of access to medications can cause profound suffering. The ripple effects of these disruptions extend from prevention to end-of-life care, underscoring the need for robust contingency planning.

Mapping the Risk

To better understand the scope of the problem, Dr. Patel’s team leveraged the US Climate Vulnerability Index and Medicare data to map where oncologists practice relative to high-risk disaster zones. “We found that over 65% of oncologists are practicing in proximity to a high-risk county,” she explains. “This was striking and really shows why this should be an important aspect that we focus on to prepare.” The resulting map offers a visual tool for cancer centers and clinicians to assess their vulnerability and plan accordingly.

Gaps in Preparedness

Despite the clear risks, preparedness remains inadequate. “Less than 25% of National Cancer Institute (NCI)–designated centers have any sort of preparedness plan for an extreme weather-related event,” Dr. Patel pointed out. This is particularly concerning given the increasing frequency and severity of disasters. She cited research showing that there was a 15% increase in mortality among breast cancer patients affected by Hurricane Katrina, emphasizing that “any disruption, especially along the continuum, can lead to worse clinical outcomes.” Dr. Patel also highlighted the often-overlooked mental health toll on clinicians, noting, “The severe distress and toll it takes is often an under-researched and under-discussed area.”

Building Resilience and Resources

While resources for these events are still being developed every day, Dr. Patel encourages collaboration and knowledge-sharing. “The Centers for Medicare & Medicaid Services (CMS) has emergency preparedness plans, and working together with NCI centers that have experienced these events is key,” she said. Her team is focused on building community resilience and integrating environmental risk into cancer screening and care guidelines.

“If there’s anything we can do together to try to prevent the disruption for patients prior to having an event, we should,” Dr. Patel concluded. “It’s going to take a village approach to get everyone working together on this issue and thinking about how to prioritize preparedness. That’s one aspect I would love to share with the audience, and I hope that we can find additional partners interested in working on this. The more we can get this awareness out, the more pertinent it will feel for people to take some of these steps to create and implement solutions.”

Key Takeaways

• Natural disasters disrupt every stage of cancer care, from prevention to end of life.
• Over 65% of oncologists practice near high-risk disaster zones, yet less than 25% of NCI centers have preparedness plans.
• Disaster-related care disruptions can lead to increased mortality and significant mental health burdens for clinicians.
• Collaboration, data-driven planning, and community resilience are essential for future preparedness.

About Dr. Patel

Manali Patel, MD, is an Associate Professor of Medicine in the Division of Oncology at Stanford University. She is also a Staff Oncologist at the Veterans Affair (VA) Palo Alto Health Care System. Dr. Patel specializes in the treatment of lung cancer, and she is passionate about improving equitable delivery of value-based cancer care.