In this challenging time of the pandemic, timely cancer diagnosis and therapy is as important as it was without the pandemic. It is now realized that the COVID-19 pandemic is here to stay and we need to learn to live with it. Cancer on the other hand is best treated early. The pandemic won’t slow or stop cancer cells to grow. So, it is a must to treat cancer patients while taking all the needed precautions during the pandemic.
For the best results in any Cancer, the most important thing is early diagnosis and timely treatment. Earlier the stage at diagnosis, more are the chances of cure. However, in the current pandemic, it has been very difficult for many patients to get the diagnosis on time and early treatment because of various reasons like:
- Travel restrictions and lockdown
- Limited Transport access
- And most important is the dilemma for the patients that when, how, and where to get the treatment done for their cancer amidst the fear of the pandemic. But now with ease in travel and fewer restrictions, a patient needs to shun fear of the pandemic and understand the need for timely cancer treatment. In routine OPDs, we are seeing an increase in the advanced stage of cancers, relapses due to inadequate treatment, mortality due to no treatment, etc. This is avoidable by timely consult with Oncologists. Oncologists are aware of the complexity of cancer treatment which depends on many factors like the type of cancer, stage of cancer, fitness of the patient, co-morbidities of the patient, etc. We as Oncologists have imbibed the pandemic as a factor in this complex decision tree for the safety of the patients from both Cancer and COVID-19.
In general, the treatment options for any cancer include any one or more of the following modalities:
1. Surgery
2. Chemotherapy/Targeted therapy/Immunotherapy
3. Radiation
It has been found that the excess fear of acquiring infection in the pandemic is one of the most important factors in delaying access to healthcare for the diagnosis and treatment of cancer patients. However, staying indoors except the treatment days, using proper precautions with properly used face mask, hand hygiene, and social distancing especially when going out of homes for treatment can prevent most of the infections in cancer patients. Cancer patients requiring chemotherapy during the pandemic.
Some cancer patients are at increased risk of infection or increased severity of infection during the pandemic like patients with blood cancers, patients on chemotherapy causing immunosuppression, patients on immunotherapy, or patients undergoing bone marrow transplant. However, delaying cancer treatment can pose the risk of the progression of cancer in many patients to an advanced stage. Those patients with progressive cancer are more prone to infection in the pandemic. Most patients on hormonal therapy/targeted therapy can safely continue their treatment after discussing with their treating Oncologists. So, it is really important to discuss your individual case with your treating Oncologist before making any change or delaying the chemotherapy/treatment sessions.
Cancer patients requiring surgery during the pandemic:
Cancer surgery per se doesn’t significantly increase the risk of infection to the patients, but cancer surgery conducted in COVID-19 positive patients might increase the complications during or after surgery. However, delaying surgery in a potentially curative cancer patient can be a missed opportunity window for a cure. It has been found that delaying curative cancer surgery by even 2 to 3 months can be detrimental for the patient and can change the disease outcome for the
patient.
Cancer patients requiring radiation during the pandemic:
Radiation is required for the treatment of more than 50 percent of cancer patients. Radiation can be safely delivered even during the pandemic if delivered with proper precautions and planning. Also, most of the radiation can be delivered on an OPD basis without much hampering the sources required for pandemic management. However, the delay in radiation treatment can always worsen the cancer cure rate.
To conclude, there is no need to panic unnecessarily for the epidemic and delay your important cancer therapy. Rather, it is important to take necessary precautions against the pandemic and plan your cancer treatment timely, after discussing it with your Oncologist.
So, let us fight together against cancer and the pandemic. Because cancer is going to stay if not treated timely, but this pandemic shall pass soon.
Dr. Rushabh Kothari | Consultant – Medical Oncology | Narayana Multispeciality Hospital, Ahmedabad