Wildfires Pose Challenges to Cancer Care
Climate-related extreme weather is especially dangerous for people with medical conditions that make them more sensitive to environmental hazards (like air pollution) or who rely on essential medical services that may become inaccessible during disasters. An understudied group that may be at particular risk from climate change are cancer patients.
A new study in the Journal of the National Cancer Institute by our deputy director Amruta Nori-Sarma and researchers at the American Cancer Society found that patients recovering from lung cancer surgery in a facility near an active wildfire stayed in the hospital longer than similar patients in the same facility when there were no wildfires. Longer hospital stays may be explained by health care providers being reluctant to discharge patients due to potential health hazards, housing stability, safety issues, or normal post-op care not being available due to staff shortages or closed/inaccessible rehab centers.
This study is just the tip of the iceberg showing how extreme weather may be impacting patients with chronic illnesses. As the wildfire season gets longer and more intense, and wildfires start affecting broader swathes of the U.S. population, health care providers need to be ready with updated guidance that best protects their patients’ health.
Amruta Nori-Sarma
Patients recovering from lung cancer surgery may be especially vulnerable to environmental hazards and disruptions caused by wildfires. Wildfires can make reactive airway disease worse, not only due to smoke inhalation, but also from physical injury, mental health struggles, and exposure to contaminated water and soil. Despite these risks, there are currently no disaster preparedness guidelines to protect this vulnerable group from the hazards of wildfires.
Key findings
- Lung cancer patients who were treated during a wildfire stayed nearly 2 days longer in the hospital than similar patients treated in the same facility but not during a wildfire (9.4 days vs. 7.5 days)
- Length of stay at the hospital was longer for patients across all stages of lung cancer
Why does hospital length of stay matter?
Longer hospital stays can increase the risk of patient safety events, like adverse drug reactions or infections, and are estimated to cost $1,500 per day. Additionally, shorter hospital stays are used as a measure of higher quality of care. This quality-of-care metric may need to be re-evaluated in the context of providing care during a disaster. More research is needed to determine if extending hospital stays improves surgical care outcomes during disasters.
As climate change makes wildfire season longer and more intense, study authors recommend that health institutions adapt and improve their clinical and disaster preparedness guidelines for specific patient populations and incorporate environmental factors into how healthcare quality is measured.
Nogueira LM, Yabroff KR, Yates E, Shultz JM, Valdez RB, Nori-Sarma A. Facility exposure to wildfire disasters and hospital length of stay following lung cancer surgery. J Natl Cancer Inst. 2025 Mar 11:djaf040. doi: 10.1093/jnci/djaf040. Epub ahead of print. PMID: 40064312.
