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Joan H. Schiller, MD1; Steven D. Averbuch, MD2; and Christine D. Berg, MD3
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Why care about climate change? We all know about the effects climate change will have on our planet—heat waves, droughts, floods, wildfires, and other extreme weather-related disasters—but how will that impact us as clinicians?
As oncologists? And more importantly, how will it affect our patients?
It is well established that burning fossil fuels with the subsequent release of greenhouse gases causes climate change and air pollution, and that climate change causes global warming. Greenhouse gasses such as methane, carbon dioxide, and nitrous oxide trap infrared radiation and radiate it back to the surface, which warms the planet. Warmer air results in more heat-related illnesses that are aggravated by the humidity from the increased moisture
that a warmer atmosphere holds. These changes will also result in increases
in food-borne, water-borne, and vector-borne diseases; an increase in under-nutrition and food insecurity; an increase in incidence and severity of asthma and other respiratory diseases; and an increase in mental health problems.1,2 These are likely to result in mass migration of climate refugees who are displaced by rising sea levels or economic scarcity, with all of the associated health issues that will befall refugees, and violent conflict resulting from competition among nations for scarcer resources. All of these adverse health effects will be disproportionately worse in our patients with cancer. As a community, we need to advocate for mitigation of our climate change footprint, and we need to make adaptations for the more difficult future we and our patients are facing.
Climate Change and the Disproportionate Burden on Patients With Cancer
Climate change is expected to have a substantial effect on the burden of infectious diseases that are transmitted by insect vectors. Rising temperatures and changing rainfall patterns lead to an increase in the number and geographic range of disease-carrying mosquitoes, fleas, and ticks. As these insect carriers,
or vectors, move to new areas because of climate change and environmental degradation, diseases not normally found in those areas can spread and can jump from animals to humans, particularly with increased proximity between animals and humans. COVID-19, for example, is thought to have jumped from bats to humans, perhaps via another animal such as a pangolin, at a wet market in Wuhan, China.3 Thus, it is predicted that as the earth warms and rainfall patterns change, we will be seeing more and more pandemics in the coming decades.3 And they will have the most profound effects on our most vulnerable patients, including patients with cancer, by significantly increasing the risk of those patients contracting a contagion, as well as dying from it.
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